Daily Life Tasks Research Articles

Patient and caregiver perspectives on a tool to increase recognition of undiagnosed dementia: a qualitative study

BackgroundEarly detection of dementia may improve patient care and quality of life, yet up to half of people with dementia are undiagnosed. Electronic health record (EHR) data could be used to help identify individuals at risk of having undiagnosed dementia for outreach and assessment, but acceptability to people with dementia and caregivers is unknown.MethodsWe conducted five focus groups at Kaiser Permanente Washington (KPWA), an integrated healthcare system in Washington State, to explore people’s feelings about timing of dementia diagnosis, use of EHR-based tools to predict risk of undiagnosed dementia, and communication about risk. We recruited people enrolled in KPWA who had dementia or mild cognitive impairment, people enrolled in KPWA who had neither diagnosis, and caregivers (i.e., loved ones of people with dementia who assist with various tasks of daily life). People who were non-white or Hispanic were oversampled. Two team members analyzed transcripts using thematic coding.ResultsForty people (63% women; 59% non-white or Hispanic) participated in the focus groups. Themes that arose included: perceived pros and cons of early dementia diagnosis; questions and concerns about a potential tool to assess risk of undiagnosed dementia; and preferences related to patient-provider conversations disclosing that a person was at high risk to have undiagnosed dementia. Participants supported early diagnosis, describing benefits such as time to adjust to the disease, plan, involve caregivers, and identify resources. They also acknowledged the possible psychosocial toll of receiving the diagnosis. Participants supported use of an EHR-based tool, but some people worried about accuracy and privacy. Participants emphasized that information about risk of undiagnosed dementia should be communicated thoughtfully by a trusted provider and that the conversation should include advice about prognosis, treatment options and other resources when a new dementia diagnosis was made.ConclusionPeople with dementia or mild cognitive impairment, people with neither diagnosis, and caregivers of people with dementia supported using EHR-based tools to help identify individuals at risk of having undiagnosed dementia. Such tools must be implemented carefully to address concerns and ensure that people living with dementia and their caregivers are adequately supported.

The neural correlates of intermanual transfer

Intermanual transfer of motor learning is a form of learning generalization that leads to behavioral advantages in various tasks of daily life. It might also be useful for rehabilitation of patients with unilateral motor deficits. Little is known about neural structures and cognitive processes that mediate intermanual transfer. Previous studies have suggested a role for primary motor cortex (M1) and the supplementary motor area (SMA). Here, we investigated the functional neuroanatomy of intermanual transfer with a special emphasis on functional connectivity within the motor network and between motor regions and attentional networks, including the fronto-parietal executive control network and visual attention networks. We designed a finger tapping task, in which young, heathy subjects trained the non-dominant left hand in the MRI scanner. Behaviorally, transfer of sequence learning was observed in most cases, independently of the trained hand's performance. Pre- and post-training functional connectivity patterns of cortical motor seeds were investigated using generalized psychophysiological interaction analyses. Transfer was correlated with the strength of connectivity between the left premotor cortex and structures within the dorsal attention network (superior parietal cortex, left middle temporal gyrus) and executive control network (right prefrontal regions) during pre-training, relative to post-training. Changes in connectivity within the motor network, and more particularly between trained and untrained M1, as well as between the SMA and untrained M1, correlated with transfer after training. Together, these results suggest that the interplay between attentional, executive and motor networks may support processes leading to transfer, whereas, following training, transfer translates into increased connectivity within the motor network.

The Accuracy of Tidal Volume Measured With a Smart Shirt During Tasks of Daily Living in Healthy Subjects: Cross-sectional Study.

BackgroundThe Hexoskin is a smart shirt that can take continuous and objective measurements and could be part of a potential telemonitoring system.ObjectiveThe aim of this study was to determine the accuracy of the calibrated Hexoskin in measuring tidal volumes (TVs) in comparison to spirometry during various tasks.MethodsIn a cross-sectional study, the TV of 15 healthy subjects was measured while performing seven tasks using spirometry and the Hexoskin. These tasks were performed during two sessions; between sessions, all equipment was removed. A one-time spirometer-based calibration per task was determined in session 1 and applied to the corresponding task in both sessions. Bland-Altman analysis was used to determine the agreement between TV that was measured with the Hexoskin and that measured with spirometry. A priori, we determined that the bias had to be less than ±5%, with limits of agreement (LOA) of less than ±15%. Lung volumes were measured and had to have LOA of less than ±0.150 L.ResultsIn the first session, all tasks had a median bias within the criteria (±0.6%). In the second session, biases were ±8.9%; only two tasks met the criteria. In both sessions, LOA were within the criteria in six out of seven tasks (±14.7%). LOA of lung volumes were greater than 0.150 L.ConclusionsThe Hexoskin was able to correctly measure TV in healthy subjects during various tasks. However, after reapplication of the equipment, calibration factors were not able to be reused to obtain results within the determined boundaries.Trial RegistrationNetherlands Trial Register NL6934; https://www.trialregister.nl/trial/6934

Metacognition Mediates the Effect of Social Communication and Internalizing Behaviors on Self-management of Daily Life Tasks for Diploma-Track Autistic Youth

Social communication and executive functioning challenges as well as co-occurring anxiety/depression may make acquiring the skills needed to manage daily life tasks difficult for diploma-track autistic youth, thus limiting their participation in adult roles. This study describes the associations between executive function, social communication skills, and internalizing behaviors on task management in academically capable autistic adolescents (n = 46) using multiple regression with mediator analysis. The three predictors and youth age explained a moderate amount of variance in task management. Metacognition mediated the effect of social communication skills and internalizing behaviors on task management. Relations between underlying factors that influence self-management of daily life tasks are complex, supporting the need for multifaceted assessment and intervention approaches for academically capable autistic youth.

A-61 Predictors of Subjective and Objective Everyday Functioning in Middle-Aged and Older Adults with HIV

Abstract Objective Older adults with HIV are at increased risk for difficulties with instrumental activities of daily living (IADLs). Awareness of their functional capacity has emerged as an important area for research, but it is not well studied in PWH. The purpose of this study is: (1) to identify factors associated with subjective and objective IADL difficulty in PWH and (2) to identify factors associated with under- or over-reporting of IADL difficulties. Methods This cross-sectional study included 261 adults with HIV. Participants completed a neuropsychological battery, self-report and performance-based measures of IADLs. Self-report measures included the Patient’s Assessment of Own Functioning Inventory (PAOFI) and the Lawton and Brody IADL Questionnaire. The Timed Instrumental Activities of Daily Living (TIADL) task was used as an objective measure. Hierarchical multiple regressions were performed to identify factors associated with subjective and objective assessment of everyday functioning as well as factors associated with discrepancy between self-report and actual performance of IADLS. Results On the PAOFI, higher depression (p = 0.001), lower conscientiousness (p > 0.001), and better processing speed (p = 0.017) predicted worse functioning. On the Lawton and Brody, higher depression (p = 0.049) predicted of worse functioning. On the TIADL, older age (p = 0.1), lower WRAT-4 score (p > 0.001), worse processing speed (p > 0.001), and worse motor function (p = 0.1) were associated with worse performance. Processing speed predicted discrepancy between subjective and objective performance of IADLs (p = 0.1). Conclusions Several demographic, cognitive, and personality variables are associated with worse subjective and objective everyday functioning, as well as an individual’s ability to accurately self-appraise their functional capacity.

The Internet-Based Conversational Engagement Clinical Trial (I-CONECT) in Socially Isolated Adults 75+ Years Old: Randomized Controlled Trial Protocol and COVID-19 Related Study Modifications.

Background: Increasing social interactions through communication technologies could offer a cost-effective prevention approach that slows cognitive decline and delays the onset of Alzheimer's disease. This paper describes the protocol of an active project named “Internet-based conversational engagement clinical trial (I-CONECT)” (ClinicalTrials.gov: NCT02871921). The COVID-19 pandemic related protocol modifications are also addressed in the current paper.Methods: I-CONECT is a multi-site, assessor-blind, randomized controlled behavioral intervention trial (RCT). We aim to randomize 320 socially isolated adults 75+ years old [160 Caucasian and 160 African American participants, 50:50 split between those with normal cognition and mild cognitive impairment (MCI)] recruited from the community to either the video chat intervention group or the control group (1:1 allocation). Those in the video chat group receive a computer and Internet service for the duration of the study, which they use to video chat with study staff for 30 min/day 4×/week for 6 months (high dose), and then 2×/week for an additional 6 months (maintenance dose). Both video chat and control groups have a brief (about 10 min) telephone check-in with study staff once per week. The primary outcome is the change in global cognitive function measured by Montreal Cognitive Assessment (MoCA) from baseline to 6 months. Secondary outcomes include changes in cognition in memory and executive function domains, emotional well-being measured by NIH Toolbox emotional battery, and daily functional abilities assessed with the Revised Observed Tasks of Daily Living (OTDL-R). Eligible participants have MRIs at baseline and 6 months. Participants contribute saliva for genetic testing (optional consent), and all video chats, weekly check-in calls and neuropsychological assessment sessions are recorded for speech and language analysis. The pandemic halted research activities and resulted in protocol modifications, including replacing in-person assessment with remote assessment, remote deployment of study equipment, and revised targeted sample size.Discussion: This trial provides user-friendly hardware for the conversational-based intervention that can be easily provided at participants' homes. The trial aspires to use age and culture-specific conversational materials and a related platform developed in this trial for enhancing cognitive reserve and improving cognitive function.

Self-Management of Daily Life Tasks for Adolescents With Autism Spectrum Disorder Without Intellectual Disability

Abstract Date Presented 04/13/21 The Pediatric Evaluation of Disability Inventory–Computer Adaptive Test-ASD (PEDI): Responsibility Scale targets limitations in managing daily life tasks. Adolescents (ages 14–22) with autism spectrum disorder without intellectual disability (N = 125) performed below expectations based on their intellectual level on the PEDI. Eighty-six percent of youth demonstrated borderline or significant delays in management of life tasks. If unaddressed, this challenge may create significant barriers to success in work and independent living. Primary Author and Speaker: Elizabeth Munsell Additional Authors and Speakers: Joshua Wenig, Hannah Cooper Contributing Authors: Alexandra Gunther, Julie Russell, Jordan McNamee, and Samantha Martel

Between Limb Muscle Co-activation Patterns in the Paretic Arm During Non-paretic Arm Tasks in Hemiparetic Cerebral Palsy.

Tasks of daily life require the independent use of the arms and hands. Individuals with hemiparetic cerebral palsy (HCP) often experience difficulty with fine motor tasks demonstrating mirrored movements between the arms. In this study, bilateral muscle activations were quantified during single arm isometric maximum efforts and submaximal reaching tasks. The magnitude and direction of mirrored activation was examined in 14 individuals with HCP and 9 age-matched controls. Participants generated maximum voluntary torques (MVTs) in five different directions and completed ballistic reaches while producing up to 80% of shoulder abduction MVT. Electromyography (EMG) signals were recorded from six upper extremity muscles bilaterally. Participants with HCP demonstrated more mirrored activation when volitionally contracting the non-paretic (NP) arm than the paretic arm (F = 83.543, p < 0.001) in isometric efforts. Increased EMG activation during reach acceleration resulted in a larger increase in rest arm co-activation when reaching with the NP arm compared to the paretic arm in the HCP group (t = 8.425, p < 0.001). Mirrored activation is more pronounced when driving the NP arm and scales with effort level. This directionality of mirroring is indicative of the use of ipsilaterally terminating projections of the corticospinal tract (CST) originating in the non-lesioned hemisphere. Peripheral measures of muscle activation provide insight into the descending pathways available for control of the upper extremity after early unilateral brain injury.

Translation and cultural adaptation of the Persian version of Vestibular Disorders Activities of Daily Living scale (VADL): a validity and reliability study

Background Vestibular disorders can lead to functional limitations and deficits in performing routine daily life tasks. The Vestibular Disorders Activities of Daily Living scale (VADL) is a useful tool for impact assessment level of functional limitations in patients with vestibular disorders. Objective Translation, cultural adaptation and evaluation of the reliability and validity of VADL to Persian. Methods In this analytical–descriptive study, VADL was translated based on the native protocol of the International Quality of Life questionnaire and adapted to the conditions found in Iranian culture. Upon confirmation of face validity, this scale was performed on 90 Persian patients with vestibular disorders (aged between 25 and 85 years). After one week, 53 participants were asked to complete the questionnaire again. Finally, reliability was evaluated with both methods of internal consistency and test-retest reproducibility. Results Five items out of 28 were modified to adapt the scale to the culture of Iranians, and they were approved by the original designer of the questionnaire. Internal consistency was confirmed by Cronbach’s alpha coefficient of 0.94, and repeatability was confirmed by the Interclass Correlation Coefficient of 0.97. Conclusion The Persian version of VADL was relatively equivalent to the original content and it was in compliance with the terms of Persian culture with high validity and reliability. Therefore, it may be a useful tool for the assessment of functional limitation in some patients with vestibular disorders.

Impaired Performance on a Cognitively-Based Instrumental Activities of Daily Living Task, the 10-Item Weekly Calendar Planning Activity, in Individuals With Stroke Undergoing Acute Inpatient Rehabilitation.

Performance-based, functionally relevant, and standardized measures of cognitive-instrumental activities of daily living (C-IADL) can complement neuropsychological tests of cognitive impairment and provide valuable clinical information to inform rehabilitation planning. Existing measures have been validated in the outpatient setting. Here, we sought to evaluate a 10-item, short-form of a C-IADL measure, Weekly Calendar Planning Activity (WCPA-10), in inpatients with stroke undergoing acute rehabilitation. The specific goal was to determine if the WCPA-10 could differentiate between stroke patients undergoing acute inpatient rehabilitation and healthy control individuals. We also explored whether the WCPA-10 would identify C-IADL limitations in stroke patients screened as having intact cognition. Seventy-seven stroke inpatients undergoing rehabilitation and 77 healthy control participants completed the WCPA-10, which involves entering a list of simulated, fictional appointments into a weekly schedule while keeping track of and adhering to multiple task rules and ignoring built-in obstacles and distractions. Compared to the control group, stroke patients had significantly worse accuracy, made more errors, used fewer cognitive strategies, followed fewer rules, took more time to complete the task, and were less efficient. 83% of stroke patients were less accurate than predicted by their age, and 64% used less strategies than their age prediction. Among 28 participants who screened as having “normal” cognitive function on the Montreal Cognitive Assessment, the majority had deficits on the WCPA-10. Our results provide initial support for use of a brief C-IADL assessment, WCPA-10, for individuals with stroke undergoing inpatient rehabilitation. They indicate that stroke patients have deficits in C-IADL accuracy, efficiency, and strategy use at this stage of stroke recovery. Results highlight the need to use performance based, functional cognitive assessments, even for those who perform well on cognitive screening tools.

Betalogger: Smartphone Sensor-based Side-channel Attack Detection and Text Inference Using Language Modeling and Dense MultiLayer Neural Network

With the recent advancement of smartphone technology in the past few years, smartphone usage has increased on a tremendous scale due to its portability and ability to perform many daily life tasks. As a result, smartphones have become one of the most valuable targets for hackers to perform cyberattacks, since the smartphone can contain individuals’ sensitive data. Smartphones are embedded with highly accurate sensors. This article proposes BetaLogger , an Android-based application that highlights the issue of leaking smartphone users’ privacy using smartphone hardware sensors (accelerometer, magnetometer, and gyroscope). BetaLogger efficiently infers the typed text (long or short) on a smartphone keyboard using Language Modeling and a Dense Multi-layer Neural Network (DMNN). BetaLogger is composed of two major phases: In the first phase, Text Inference Vector is given as input to the DMNN model to predict the target labels comprising the alphabet, and in the second phase, sequence generator module generate the output sequence in the shape of a continuous sentence. The outcomes demonstrate that BetaLogger generates highly accurate short and long sentences, and it effectively enhances the inference rate in comparison with conventional machine learning algorithms and state-of-the-art studies.

A Descriptive Correlational Study to Evaluate Three Measures of Assessing Upper Extremity Function in Individuals with Multiple Sclerosis.

Background Activities of daily living and quality of life (QOL) are hindered by upper extremity (UE) impairments experienced by individuals with multiple sclerosis (iMS). The Nine-Hole Peg Test (9-HPT) is most frequently used to measure UE function. However, it does not measure peoples' ability to perform routine tasks in daily life and may not be useful in iMS who cannot pick up the pegs utilized in the 9-HPT. Therefore, we evaluated three measures to explore a more comprehensive assessment of UE function: Upper Extremity Function Scale (UEFS), Action Research Arm Test (ARAT), and the 9-HPT. The objectives were to quantitatively assess the relationship between these measures of UE function, understand if the measures correlate with QOL as calculated by the MS Quality of Life-54 (MSQOL-54), and to determine differences in the measures based on employment status. Methods 112 (79 female) iMS were prospectively recruited for this descriptive correlational study. Inclusion criteria were as follows: confirmed diagnosis of MS or clinically isolated syndrome, age ≥ 18 years, and ability to self-consent. All statistical analyses including Spearman's correlation coefficient (rs) and Kruskal-Wallis tests were performed using SPSS. Results A moderate correlation (rs = −0.51; p < 0.001) was found between the ARAT and 9-HPT scores for the more impaired hand. Likewise, a moderate correlation was found between UEFS and the physical health composite scores (PHCSs) of MSQOL-54 (rs = −0.59; p < 0.001). Finally, performances on ARAT, 9-HPT, and UEFS differed between the employed individuals and those on long-term disability (p = 0.007, p < 0.001, and p = 0.001). Conclusion The UEFS moderately correlated with the QOL measure, and considering the UESF is a patient-reported outcome, it could be used to complement routinely captured measures of assessing UE function. Further study is warranted to determine which measure, or combination of measures, is more sensitive to changes in UE function over time.

Robotics Dexterous Grasping: The Methods Based on Point Cloud and Deep Learning.

Dexterous manipulation, especially dexterous grasping, is a primitive and crucial ability of robots that allows the implementation of performing human-like behaviors. Deploying the ability on robots enables them to assist and substitute human to accomplish more complex tasks in daily life and industrial production. A comprehensive review of the methods based on point cloud and deep learning for robotics dexterous grasping from three perspectives is given in this paper. As a new category schemes of the mainstream methods, the proposed generation-evaluation framework is the core concept of the classification. The other two classifications based on learning modes and applications are also briefly described afterwards. This review aims to afford a guideline for robotics dexterous grasping researchers and developers.

The chimera of the competency-based approach to teaching mathematics: a study of carpentry purchases for home projects

The competency-based approach conceives mathematics as a necessary tool for dealing with daily-life tasks. Many studies have focused on examining the low math competency people show when solving problems in real-life contexts, but rarely characterize the type of mathematics needed in these contexts and how people use this mathematics. The current study was designed to analyze the mathematics utilized by 312 customers when purchasing carpentry products in a store specialized in home projects. Aspects of the Anthropological Theory of the Didactic, especially the extended praxeological model, were employed to undertake the analysis. While the approach is primarily qualitative, quantitative aspects were also considered to elucidate the nature of the identified mathematics tasks, the techniques that customers employed to solve them, and the difficulties associated with the use of these techniques. The study reveals that having solid mathematical knowledge is insufficient when it comes to solving everyday tasks, because related contextual knowledge is also required. The nature of the tasks identified in this study and the didactic way in which the clerk guided the customers through the projects suggested that there are no only complex relationships between school mathematics and outside-school mathematics, but there exist also different didactics specific to the contexts. For elaborating the home carpentry projects, the customers needed to handle a set of carpentry knowledge and techniques as well as carpentry-related mathematics that are not necessarily taught at school.

The Working Memory Network and Its Association with Working Memory Performance in Survivors of non-CNS Childhood Cancer

ABSTRACT Childhood cancer and its treatment puts survivors at risk of low working memory capacity. Working memory represents a core cognitive function, which is crucial in daily life and academic tasks. The aim of this functional MRI (fMRI) study was to examine the working memory network of survivors of childhood cancer without central nervous system (CNS) involvement and its relation to cognitive performance. Thirty survivors (aged 7–16 years, ≥ 1 year after cancer treatment) and 30 healthy controls performed a visuospatial working memory task during MRI, including a low- and a high-demand condition. Working memory performance was assessed using standardized tests outside the scanner. When cognitive demands increased, survivors performed worse than controls and showed evidence for slightly atypical working memory-related activation. The survivor group exhibited hyperactivation in the right-hemispheric superior parietal lobe (SPL) in the high- compared to the low-demand working memory condition, while maintaining their performance levels. Hyperactivation in the right SPL coincided with poorer working memory performance outside the scanner in survivors. Even in survivors of childhood cancer without CNS involvement, we find neural markers pointing toward late effects in the cerebral working memory network. Abbreviations fMRI: Functional magnetic resonance imaging; CNS: Central nervous system; MNI: Montreal Neurological Institute; SES: Socioeconomic status; SPL: Superior parietal lobe

Foraging behavior in visual search: A review of theoretical and mathematical models in humans and animals.

Visual search (VS) is a fundamental task in daily life widely studied for over half a century. A variant of the classic paradigm-searching one target among distractors-requires the observer to look for several (undetermined) instances of a target (so-called foraging) or several targets that may appear an undefined number of times (recently named as hybrid foraging). In these searches, besides looking for targets, the observer must decide how much time is needed to exploit the area, and when to quit the search to eventually explore new search options. In fact, visual foraging is a very common search task in the real world, probably involving additional cognitive functions than typical VS. It has been widely studied in natural animal environments, for which several mathematical models have been proposed, and just recently applied to humans: Lévy processes, composite and area-restricted search models, marginal value theorem, and Bayesian learning (among others). We conducted a systematic search in the literature to understand those mathematical models and study its applicability in human visual foraging. The review suggests that these models might be the first step, but they seem to be limited to fully comprehend foraging in visual search. There are essential variables involving human visual foraging still to be established and understood. Indeed, a jointly theoretical interpretation based on the different models reviewed could better account for its understanding. In addition, some other relevant variables, such as certain individual differences or time perception might be crucial to understanding visual foraging in humans.

Assessing Activity of Daily Living Task Performance Among Autistic Adults.

Why is this topic important?: Activity of daily living (ADL) assessments are used to determine what Autistics can and cannot do in their day-to-day life, what services they may be eligible for, and to monitor gains. However, we struggled to find an assessment that was useful and relevant from an Autistic point-of-view.What is the purpose of this article?: The purpose of this article was to review and evaluate current ADL assessments usefulness for Autistics and provide recommendations for improving the ADL assessment process.What is the perspective of the authors?: The first author is an Autistic social worker and the second author is an occupational therapist and postdoctoral fellow. The authors' perspective is based in the neurodiversity paradigm and social model of disability, which centers on respecting and acknowledging differences in the brain and their effects on Autistics' lives. We believe in strengths-based approaches versus deficit-based models.What did you find about this topic?: We found 17 measurement tools, some that compared Autistic ADL performance with neurotypical performance, a few that were observation-based meaning the researcher or clinician watched the Autistic person complete the ADLs, and many forms or guides that asked questions about ADL performance. Only six measures allowed Autistic people to respond to the questions themselves, whereas the rest of the measures had someone else respond for them. These measures did not include questions about how sensory differences (e.g., feeling upset by the feeling of jeans or the taste of minty toothpaste) or feeling sad or nervous may also impact ADL performance.What do the authors recommend?: We recommend that researchers partner with Autistic adults to make new ADL assessments. If researchers or clinicians are using previously made ADL assessments, we recommend that they use self-report and adapt the materials to make it easier to understand (e.g., using pictures). We also recommend that researchers and clinicians ask Autistics what they need or want to make the assessment easier and more comfortable for them. Finally, researchers and clinicians should ask follow-up questions about sensory differences and whether someone is feeling sad or nervous to know how this impacts their ability to do their ADL tasks.How will these recommendations help autistic adults now or in the future?: These recommendations will help Autistic adults be more involved in the evaluation process, which will make the assessments more trustworthy and relevant to Autistics. This also could help more Autistic people get services and supports that are useful to them. Finally, this may help researchers when monitoring if these supports or services actually work.

Branching Condition of the Color-Word Interference Test Enhances Prediction of Meta-Tasking in Community-Dwelling Older Adults.

Meta-tasking (MT) is an aspect of executive functioning (EF) that involves the ability to branch (i.e., to apply "if-then" rules) and to effectively interleave sub-goals of one task with sub-goals of another task. As such, MT is crucial for successful planning, coordination, and execution of multiple complex tasks in daily life. Traditional tests of EF fail to adequately measure MT. This study examined whether Condition 4 of the Color-Word Interference Test (CWIT-4; the inhibition/switching condition that requires branching) predicted MT beyond Condition 3 (CWIT-3; inhibition-only condition) and beyond other subtests from the Delis-Kaplan Executive Function System (D-KEFS) that have a switching condition. Ninety-eight non-Hispanic white community-dwelling older adults completed the first four subtests of the D-KEFS and an ecologically valid measure of MT. Time to completion and total errors on CWIT-4 accounted for variance in MT above and beyond CWIT-3 and beyond the switching conditions of other D-KEFS subtests. Results remained virtually unchanged when controlling for demographics and general cognitive status. Among older adults, CWIT-4 is more strongly associated with MT than other D-KFES tasks. Future research should examine whether CWIT-4 relates to lapses in instrumental activities of daily living among older adults above and beyond other EF tests.

Preparation for Adulthood: Shifting Responsibility for Management of Daily Tasks From Parents to Their Children.

Importance: Limited research has described the timing of acquisition of the broad range of skills required for the transition to adulthood.Objective: To describe the timing of the shift of responsibility for daily tasks from parent to child.Design: This study used an existing data set of parent responses to 49 items in the Responsibility domain of the Pediatric Evaluation of Disability Inventory Computer Adaptive Tests.Participants: A U.S. nationally representative sample of 2,205 typically developing children and youth ages 0 to 20 yr.Outcomes and Measures: Descriptive analyses focused on two ages: (1) starting age (when >50% of parents reported their child was taking at least some responsibility for a task) and (2) full responsibility age (when >50% of parents reported their child was taking full responsibility for the task).Results: The process of shifting responsibility for daily life tasks from parent to child typically occurred over a long period. Many task items had an interval of 5 yr from starting age to full responsibility age; the longest interval was 15 yr. Youth began assuming responsibility for more complex tasks and tasks that involved more risk at ages 10 to 15.Conclusions and Relevance: Results can serve as a reference for the timing of the transition to greater self-management of daily life tasks across childhood and adolescence. Timing of responsibility shifts may reflect a combination of development of underlying capacities and social transitions. Executive functioning may be especially relevant for management of the more complex tasks required in daily life in adulthood.What This Article Adds: The transfer of responsibility for managing tasks of daily life from parents to children often extends over a period of many years. Clinicians may find the results helpful when discussing the future with parents of young people with disabilities and other chronic conditions and the tasks that their children must learn to manage for independent living as an adult.

Serum long chain omega-3 fatty acids and depression among adults in the United States: An analysis of NHANES 2011–2012

• Adults with higher omega-3 fatty acid levels had less severe depressive symptoms. • Adults with higher EPA reported less impact of depressive symptoms on daily life. • Our results are one of the few in a population representative of adults in the US. Few studies have examined biomarkers of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) with depression, that are less prone to error than self-reported intake. We aimed to determine associations between serum EPA, DHA and the sum of long chain (LC) omega-3 fatty acids with depression in the National Health and Nutrition Examination Survey (NHANES) 2011–2012 cycle. Fatty acids were expressed as a % of total fatty acids. Depression was assessed by the Patient Health Questionnaire (PHQ)-9 and categorized as minimal (score 0–4, reference), mild (5–9), moderate (10–14), and moderately severe to severe depression (15–27). The impact of depressive symptoms was also assessed. Associations were estimated by regression with adjustment for sociodemographic covariates. Among 1186 adults, 77.9% reported minimal depressive symptoms, while 14.3%, 5.06% and 2.75% of participants had mild, moderate and moderately severe to severe depression. Higher serum EPA, DHA and LC omega-3 fatty acids were associated with lower relative risk (RR) of moderately severe to severe depression. For example, EPA: RR=0.30, SE 0.11, p = 0.005. Participants with higher serum EPA, were less likely to report very or extreme difficulty with daily life tasks due to depressive symptoms (RR=0.39, SE 0.17, p = 0.05). The temporal nature of relationships cannot be determined due to the cross-sectional design. Higher serum omega-3 fatty acids were associated with lower risk of moderately severe to severe depression while serum EPA was positively associated with ability to perform daily life tasks. Collectively, this shows the importance of EPA and DHA for treating depression.