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Voice prosody measures have been linked with Alzheimer's disease (AD), but it is unclear whether they are associated with normal cognitive aging. We assessed relationships between voice measures and 10-year cognitive changes in the MIDUS national sample of middle-aged and older adults ages 42-92, with a mean age of 64.09 (standard deviation = 11.23) at the second wave. Seven cognitive tests were assessed in 2003-2004 (Wave 2) and 2013-2014 (Wave 3). Voice measures were collected at Wave 3 (N = 2585) from audio recordings of the cognitive interviews. Analyses controlled for age, education, depressive symptoms, and health. As predicted, higher jitter was associated with greater declines in episodic memory, verbal fluency, and attention switching. Lower pulse was related to greater decline in episodic memory, and fewer voice breaks were related to greater declines in episodic memory and verbal fluency, although the direction of these effects was contrary to hypotheses. Findings suggest that voice biomarkers may offer a promising approach for early detection of risk factors for cognitive impairment or AD.

Preclinical indicators of disease such as inflammation, cortisol and glucose dysregulation, and multisystem dysregulation (allostatic load) are related to individual differences in the level of cognitive functioning across adulthood. This study examined whether individual biological systems and allostatic load are related to differential patterns of change in cognitive functioning over 9 years. Data are from the Midlife in the United States (MIDUS) study second (biomarker and cognitive) and third waves (cognitive). The sample includes 863 men and women who ranged in age from 35 to 85 when the data were first collected. MIDUS biomarkers include a comprehensive range of biological and anthropometric measurements reflecting cardiovascular functioning, glucose metabolism, lipid metabolism, inflammation, HPA axis function, as well as sympathetic and parasympathetic nervous system function. Summary indices of dysregulation in each of these major systems as well as an overall index of multi-system dysregulation, or allostatic load were examined in relation to 9-year changes in episodic memory and executive functioning from the Brief Test of Adult Cognition by Telephone. Regression analyses, controlling for preexisting diseases and medications, showed that higher allostatic load was associated with decreased executive functioning over time for those who started out with higher cognitive performance at baseline, after adjusting for age, gender, race, English language, education, neurological conditions, medication use and smoking. Identifying biomarkers as antecedents of cognitive changes in midlife and old age, can potentially aid in the early detection of cognitive impairments and increase the possibilities for preventive interventions.

Introduction Despite the availability of age- and education-adjusted standardized scores for most neuropsychological tests, there is a lack of objective rules in how to interpret multiple concurrent neuropsychological test scores that characterize the heterogeneity of Alzheimer's disease. Methods Using neuropsychological test scores of 2091 participants from the Framingham Heart Study, we devised an automated algorithm that follows general diagnostic criteria and explores the heterogeneity of Alzheimer's disease. Results We developed a series of stepwise diagnosis rules that evaluate information from multiple neuropsychological tests to produce an intuitive and objective Alzheimer's disease dementia diagnosis with more than 80% accuracy. Discussion A data-driven stepwise diagnosis system is useful for diagnosis of Alzheimer's disease from neuropsychological tests. It demonstrated better performance than the traditional dichotomization of individuals' performance into satisfactory and unsatisfactory outcomes, making it more reflective of dementia as a spectrum disorder. This algorithm can be applied to both within clinic and outside-of-clinic settings., Highlights • Stepwise diagnosis rules for Alzheimer's disease (AD) dementia diagnosis. • Heterogeneous AD profiles based on specific AD risk factors identified. • Selection of important neuropsychological tests aid differential diagnoses. • Grading system more reflective of dementia as a spectrum disorder. • Automated diagnosis rules applicable to both within clinic and outside-of-clinic settings.

Using a cross-case analysis of online, on-campus and online university teacher preparation courses, this study critically examines the constraints and affordances of online teacher education in preparing teachers for culturally and linguistically diverse (CLD) urban schools. The results of the study indicate that while there was no significant difference between online and on-campus courses in terms of teacher acquisition of knowledge related to CLD instruction and assessment, questions remain about whether online teacher preparation can promote critical self-reflection, culturally responsive teaching practices, and collaboration within schools, when teacher learning is not supported and situated in schools and communities in an ongoing and structured way.

It is recommended that soccer players consume a high carbohydrate diet to augment performance. However, growing evidence suggests that there is a link between high free-sugar (FS) intake (>5% total energy intake; TEI) and metabolic diseases. Furthermore, foods that are often high in sugar, such as processed foods, are typically lacking in nutrient quality. We therefore analysed total-sugar, FS, dietary fibre, and micronutrient intake of players from an English Premier League academy under (U) 18 (n = 13), U15/16 (n = 25), and U13/14 (n = 21) using a 7-day food diary. Data were compared with current United Kingdom (UK) dietary reference value (DRV) for FS via a t test. The U13/14s (10% ± 18%) and U15/16s (11% ± 30%) both consumed higher amounts of FS in comparison with the UK DRV of 5% TEI (P < 0.01); conversely, the U18s did not exceed the DRV (5% ± 13%). Furthermore, FS intake of the U18s was significantly lower than the U13/14s and U15/16s (P < 0.01). Dietary fibre was below the DRV (25 g/day for U13/14 and U15/16s; 30 g/day for U18s) for all squads (19.0 ± 4.7, 19.6 ± 8.3, 17.1 ± 4.2 g/day, respectively), but not different between squads. Additionally, micronutrient reference intakes were generally met. In conclusion, we provide novel data on dietary sugar, fibre, and micronutrient intake within elite youth soccer players. We report an apparent “nutritional transition” from schoolboy to fulltime soccer player, with U18s showing a significantly lower intake of sugar in comparison with younger squads, and a similar intake of FS to the UK DRVs. Practitioners should target improving player education around sugar and fibre consumption.

Background Promoting the link between human and ecosystem health is crucial for building resilient communities. Hillwalking provides health benefits arising from physical activity and exposure to nature. Furthermore, it is likely to influence environmental knowledge and pro-environmental behaviour through connectedness to nature. This project aimed to explore 1) hillwalking and walk leading motivations and perceived benefits, and 2) the role of the environment and nature connectedness among walk leaders and walking holiday guests. Methods The first study was completed with seventeen volunteer walk leaders and used a mixed methods design: hillwalking interviews, physical activity measurements, location data and the Nature-relatedness scale. The second study involved five group interviews with the total of twenty-five guests on three different walking holidays. The qualitative data from both studies were analysed using a combined thematic and grounded theory approach and the results were merged with the quantitative data to explore the impacts of environmental factors. Results Primary motivations for hillwalking included pleasure, escape from everyday life pressures, to re-charge, being in nature, social inclusion and health. Emerging overarching themes such as balance and adaptation were reported as essential values for walking and were linked to nutritional, physical activity related and environmental aspects of health awareness. The perceived benefits positively impacted on engagement. Connectedness to nature was linked to environmental knowledge and attitudes which manifested in pro-environmental walking behaviour. Conclusions The pleasure arising from several aspects of hillwalking or walk leading was the drive for regular engagement, therefore a primary intrinsic motivation. The results imply that attending group walking holidays has the scope to increase environmental awareness and engagement in outdoor physical activity and could be considered as a promotion tool. Key messages The findings have the scope to inform future walking promotion programs and encourage long-term engagement by shifting the focus of promotion messages to intrinsic motivational factors. The results support that hillwalking can be used as a tool for combined health and environmental awareness promotion.

BACKGROUND Although some neuropsychological (NP) tests are considered more central for the diagnosis of Alzheimer disease (AD), there is a lack of understanding about the interaction between different cognitive tests. OBJECTIVE This study aimed to demonstrate a global view of hierarchical probabilistic dependencies between NP tests and the likelihood of cognitive impairment to assist physicians in recognizing AD precursors. METHODS Our study included 2091 participants from the Framingham Heart Study. These participants had undergone a variety of NP tests, including Wechsler Memory Scale, Wechsler Adult Intelligence Scale, and Boston Naming Test. Heterogeneous cognitive Bayesian networks were developed to understand the relationship between NP tests and the cognitive status. The performance of probabilistic inference was evaluated by the 10-fold cross validation. RESULTS A total of 4512 NP tests were used to build the Bayesian network for the dementia diagnosis. The network demonstrated conditional dependency between different cognitive functions that precede the development of dementia. The prediction model reached an accuracy of 82.24%, with sensitivity of 63.98% and specificity of 92.74%. This probabilistic diagnostic system can also be applied to participants that exhibit more heterogeneous profiles or with missing responses for some NP tests. CONCLUSIONS We developed a probabilistic dependency network for AD diagnosis from 11 NP tests. Our study revealed important psychological functional segregations and precursor evidence of AD development and heterogeneity.

Patient recruitment is widely recognized as a key determinant of success for clinical trials. Yet a substantial number of trials fail to reach recruitment goals-a situation that has important scientific, financial, ethical, and policy implications. Further, there are important effects on stakeholders who directly contribute to the trial including investigators, sponsors, and study participants. Despite efforts over multiple decades to identify and address barriers, recruitment challenges persist. To advance a more comprehensive approach to trial recruitment, the Clinical Trials Transformation Initiative (CTTI) convened a project team to examine the challenges and to issue actionable, evidence-based recommendations for improving recruitment planning that extend beyond common study-specific strategies. We describe our multi-stakeholder effort to develop a framework that delineates three areas essential to strategic recruitment planning efforts: (1) trial design and protocol development, (2) trial feasibility and site selection, and (3) communication. Our recommendations propose an upstream approach to recruitment planning that has the potential to produce greater impact and reduce downstream barriers. Additionally, we offer tools to help facilitate adoption of the recommendations. We hope that our framework and recommendations will serve as a guide for initial efforts in clinical trial recruitment planning irrespective of disease or intervention focus, provide a common basis for discussions in this area and generate targets for further analysis and continual improvement.

Purpose – The purpose of this paper is to outline an innovative method of delivering staff development in an higher education (HE) setting. The paper evaluates the processes behind the “Focus on Inspiring Teaching” week and outlines its initial impact on staff. Design/methodology/approach – This is a descriptive case study which highlights how an immersive staff development event can be used to enable HE teaching practitioners to utilise more inspiring approaches to teaching and learning. The paper draws on questionnaire evaluations (n = 43). Findings – The paper highlights how staff development events can be used to foster communities of practice for teaching staff. For this to be successful, staff needs to be committed to reflecting on their own practice and be sufficiently engaged to partake actively of staff development events. By establishing these communities, inspiring practice in teaching can be developed with successful outcomes. The paper outlines a model for staff development which could be established in other HE settings. Practical implications – Immersive staff development events are effective in achieving sustainable impact. To achieve success effective leadership and a team of committed teaching staff are needed. Success was also fostered by not making sessions compulsory whereby the staff could opt in for sessions to fit around teaching schedules. Originality/value – This paper will be of interest to those working in staff development and training and academic managers. It indicates how immersive staff development can have a positive impact on staff practice to bring about improvements to the student experience.

In this chapter, an approach to professional learning for content teachers of multilingual students is presented that is grounded in teachers collaboratively engaging in an online instructional cycle. It includes exploring new concepts, apply new teaching strategies to their classrooms and sharing their results. The approach is presented with specific examples of activities offered online for science teachers working with multilingual learners. This chapter also presents teachers responses to the online learning experiences and future directions of this kind of collaborative, online professional learning.

While traditional approaches to dietary analysis in athletes have focused on total daily energy and macronutrient intake, it is now thought that daily distribution of these parameters can also influence training adaptations. Using 7-day food diaries, we quantified the total daily macronutrient intake and distribution in elite youth soccer players from the English Premier League in U18 (n = 13), U15/16 (n = 25) and U13/14 squads (n = 21). Total energy (43.1 ± 10.3, 32.6 ± 7.9, 28.1 ± 6.8 kcal·kg-1·day-1), CHO (6 ± 1.2, 4.7 ± 1.4, 3.2 ± 1.3 g·kg- 1·day-1) and fat (1.3 ± 0.5, 0.9 ± 0.3, 0.9 ± 0.3 g·kg-1·day-1) intake exhibited hierarchical differences (p < .05) such that U13/14 > U15/16 > U18. In addition, CHO intake in U18s was lower (p < .05) at breakfast, dinner and snacks when compared with both squads but no differences were apparent at lunch. Furthermore, the U15/16s reported lower relative daily protein intake than the U13/14s and U18s (1.6 ± 0.3 vs. 2.2 ± 0.5, 2.0 ± 0.3 g·kg-1). A skewed distribution (p < .05) of daily protein intake was observed in all squads, with a hierarchical order of dinner (~0.6 g·kg-1) > lunch (~0.5 g·kg-1) > breakfast (~0.3 g·kg-1). We conclude elite youth soccer players do not meet current CHO guidelines. Although daily protein targets are achieved, we report a skewed daily distribution in all ages such that dinner > lunch > breakfast. Our data suggest that dietary advice for elite youth players should focus on both total daily macronutrient intake and optimal daily distribution patterns.

In Colorado, the Colorado Student Assessment Program (CSAP) has been created as the performance standard to determine progress that Colorado students are making toward meeting content standards. This study utilized results of the CSAP across 3 years (1999–2001) to determine the impact that standards-based education in Colorado is having on Latino students in general, and on Latino English language learners (ELLs) specifically. CSAP results in reading and writing in English and Spanish were compared for Latinos taking the CSAP in Spanish, Latinos taking the CSAP in English, and all Colorado third and fourth graders. This study also examined the extent to which school report card grades were affected in schools with large numbers of ELLs. Results indicate that the percentage of Latinos meeting state standards as measured by the Spanish CSAP is equivalent to, and in some cases higher, than the percentage of Latinos who are taking the CSAP in English. However, a gap exists between Latinos, no matter ...

The objective of these studies was to characterize the macrophage mannose receptor binding and pharmacological properties of carbohydrate remodeled human placental-derived and recombinant β-glucocerebrosidase (pGCR and rGCR, respectively). These are similar but not identical molecules that were developed as enzyme replacement therapies for Gaucher disease. Both undergo oligosaccharide remodeling during purification to expose terminal mannose sugar residues. Competitive binding data indicated carbohydrate remodeling improved targeting to mannose receptors over native enzyme by two orders of magnitude. Mannose receptor dissociation constants (Kd) for pGCR and rGCR were each 13 nmol/L. At 37°C, 95% of the total macrophage binding was mannose receptor specific. In vivo, pGCR and rGCR were cleared from circulation by a saturable pathway. The serum half-life (t1/2) was 3 minutes when less than saturable amounts were injected intravenously (IV) into mice. Twenty minutes postdose, β-glucocerebrosidase activity increased over endogenous levels in all tissues examined. Fifty percent of the injected activity was recovered. Ninety-five percent of recovered activity was in the liver. Parenchymal cells (PC), Kupffer cells (KC), and liver endothelium cells (LEC) were responsible for 75%, 22%, and 3%, respectively, of the hepatocellular uptake of rGCR and for 76%, 11%, and 12%, respectively, of the hepatocellular uptake of pGCR. Both molecules had poor stability in LEC and relatively long terminal half-lives in PC (t1/2 = 2 days) and KC (t1/2 = 3 days).

The CHANGE! Project(ChildrenOs Health, Activity, and Nutrition: Get Educated!), involving Year 6 children ( n = 290 total; n = 138 intervention; n = 152control) in Wigan, aimed to promote the consumption of FV as part of a healthy lifestyle. A teaching resource was adapted and Anglicisedfrom the Planet Health programme

These findings suggest that written guidelines are effective in helping athletes to meet dietary recommendations but more advice is needed to select appropriate food sources to reduce the weight penalty of carrying extra food. Research is needed to establish the reasons behind the athletes’ food choices; further promotion of the benefits of CHO-rich diets and sports products may be useful, or alternatively the development of new products that suit the needs of ultra-endurance athletes, who may limit current usage due to factors such as sweetness and flavour fatigue, may be necessary.

Participation in ultra-endurance events such as mountain marathons is increasing, yet analysis of the nutritional intake and requirements of this group of athletes have received relatively little attention. This field study examined athletes’ food intake prior to, and during a mountain marathon event to assess compliance with recommendations and to identify associations with performance. Nineteen male athletes competing in the Longmynd Hike (LH) completed a 7-day food diary in the week prior to the event and a weighed food inventory of all items consumed during the event. Despite reported intentions to increase carbohydrate (CHO) consumption in the week prior to the event, there was no significant change in consumption across the week. The mean daily CHO intake of 4.5 g/kg/d was below that recommended to effectively enhance glycogen stores. CHO and energy consumption prior to the event were positively associated with performance [energy (kJ/kg/d): r = .56, p = 0.03; CHO (g/kg/d): r = .54, p = 0.04]. Energy and CHO consumption during the event were also positively correlated with performance [energy (kJ/kg/h): r = .80, p < 0.001; CHO (g/kg/h): r = .75, p = 0.001)], despite most participants again failing to meet recommendations for intake. Further research is needed to determine reasons for non-compliance with nutritional guidelines and to investigate to what extent type and timing of macronutrient intake during such events impacts on performance.

The functional role of neutrophils during acute inflammatory responses is regulated by two high affinity interleukin-8 receptors (CXCR1 and CXCR2) that are rapidly desensitized and internalized upon binding their cognate chemokine ligands. The efficient re-expression of CXCR1 on the surface of neutrophils following agonist-induced internalization suggests that CXCR1 surface receptor turnover may involve regulatory pathways and intracellular factors similar to those regulating beta2-adrenergic receptor internalization and re-expression. To examine the internalization pathway utilized by ligand-activated CXCR1, a CXCR1-GFP construct was transiently expressed in two different cell lines, HEK 293 and RBL-2H3 cells. While interleukin-8 stimulation promoted CXCR1 sequestration in RBL-2H3 cells, receptor internalization in HEK 293 cells required co-expression of G protein-coupled receptor kinase 2 and beta-arrestin proteins. The importance of beta-arrestins in CXCR1 internalization was confirmed by the ability of a dominant negative beta-arrestin 1-V53D mutant to block internalization of CXCR1 in RBL-2H3 cells. A role for dynamin was also demonstrated by the lack of CXCR1 internalization in dynamin I-K44A dominant negative mutant-transfected RBL-2H3 cells. Agonist-promoted co-localization of transferrin and CXCR1-GFP in endosomes of RBL-2H3 cells confirmed that receptor internalization occurs via clathrin-coated vesicles. Our data provides a direct link between agonist-induced internalization of CXCR1 and a requirement for G protein-coupled receptor kinase 2, beta-arrestins, and dynamin during this process.

Following a three-year staff development initiative within one faculty in a UK university, the authors reflected on inspiring teaching and the role that staff development can play in enhancing individual practice. Teaching is a core component of Higher Education and is complex and multi-faceted both theoretically and in practice. Through individual reflections to a set of pre-determined questions, a group of Higher Education teachers (n = 5) with a responsibility for the development of learning, teaching and assessment, share their thoughts, feelings and beliefs on inspiring teaching. The interpretive analysis of the data shows from a staff perspective that the notion of inspiring teaching has three main components which are all interrelated, those being; the actual teaching and learning experience; the design of the curriculum and the teacher/student relationship. Staff development initiatives were found to help people explore and develop their own teaching philosophy, to develop new practices and to share and learn from others. However, individual’s mindset, beliefs and attitudes were found to be a challenge. Teachers can frame their development around the different aspects of inspiring teaching and with support from senior leadership as well as a positive culture, teaching communities can work together towards inspiring teaching.

Changes in hydration status have been shown to have deleterious effects on physiological functioning, physical performance, mental decision making, and subjective sensation of effort. This exploratory study assessed the hydration status of athletes taking part in mountain marathon events and the implications on performance, cognition and well-being markers. Twenty-nine male recreational athletes from the Original Mountain Marathon (OMM) and nineteen from the Longmynd Hike (LH) provided urine samples before, at mid-point (in the OMM) and after the events. Body mass; reaction time tests; and subjective ratings of well-being and effort were also collected/performed at these time points. Post-urine specific gravity (Usg) values [(OMM: 1.023 (range: 1.008 – 1.038) g/ml; LH: 1.024 (range: 1.014 – 1.035) g/ml] were significantly higher than pre-values [(OMM: 1.013 (range: 1.002 – 1.026) g/ml; LH: 1.013 (range: 1.002 – 1.026) g/ml] in both events (p < 0.01), but there was no significant change from mid- to post-event in the OMM (p > 0.05). There was no association between hydration status and overall performance in the LH, whilst change in Usg from pre- to mid-event was positively associated with performance in the OMM (r = .561, p = 0.004). Whilst no associations were observed between hydration status and reaction time, rate of perceived exertion and subjective ratings of nausea showed positive associations with Usg. These findings suggest that although changes in hydration status of this level may not significantly affect performance, they can impact on participant sensations of effort and well-being.