Putting Brain Training to the Test in the Workplace: A Randomized,Blinded, Multisite,Active-Controlled Trial

Background

Cognitive training (CT) is effective at improving cognitive outcomes in children with and without clinical impairment as well as older individuals. Yet whether CT is of any preventative health benefit to working age adults is controversial. Our objective was therefore to investigate the real-world efficacy of CT in the workplace, involving employees from across the working-age spectrum and addressing many of the design issues that have limited trials to date.

Methods and Findings

135 white collar employees of a large Australian public sector organization were randomised to either 16 weeks (20 minutes three times per week) of online CT or an active control (AC) program of equal length and structure. Cognitive, wellbeing and productivity outcome measures were analysed across three timepoints: baseline, immediately after training and 6 months post-training. CT effects on cognitive outcomes were limited, even after planned subgroup analyses of cognitive capacity and age. Unexpectedly, we found that our AC condition, which comprised viewing short documentaries about the natural world, had more impact. Compared to the CT group, 6 months after the end of training, those in the AC group experienced a significant increase in their self-reported Quality of Life (Effect Size g = .34 vs −.15; TIME×GROUP p = .003), decrease in stress levels (g = .22 vs −.19; TIME x GROUP p = .03), and overall improvement in Psychological Wellbeing (g = .32 vs −.06; TIME×GROUP p = .02).

Conclusions

CT does not appear to positively impact cognition or wellbeing amongst white collar office workers; however, short time-out respite activities may have value in the promotion of psychological wellbeing. Given looming challenges to workplace productivity, further work-based interventional research targeting employee mental health is recommended.

Trial Registration

This trial was registered with the Australian New Zealand Clinical Trials Registry: ACTRN12610000604000 (http://www.anzctr.org.au/TrialSearch.aspx).     

Managing Potato Biodiversity to Cope with Frost Risk in the High Andes: A Modeling Perspective

Austral summer frosts in the Andean highlands are ubiquitous throughout the crop cycle, causing yield losses. In spite of the existing warming trend, climate change models forecast high variability, including freezing temperatures. As the potato center of origin, the region has a rich biodiversity which includes a set of frost resistant genotypes. Four contrasting potato genotypes –representing genetic variability- were considered in the present study: two species of frost resistant native potatoes (the bitter Solanum juzepczukii, var. Luki, and the non-bitter Solanum ajanhuiri, var. Ajanhuiri) and two commercial frost susceptible genotypes (Solanum tuberosum ssp. tuberosum var. Alpha and Solanum tuberosum ssp. andigenum var. Gendarme). The objective of the study was to conduct a comparative growth analysis of four genotypes and modeling their agronomic response under frost events. It included assessing their performance under Andean contrasting agroecological conditions. Independent subsets of data from four field experiments were used to parameterize, calibrate and validate a potato growth model. The validated model was used to ascertain the importance of biodiversity, represented by the four genotypes tested, as constituents of germplasm mixtures in single plots used by local farmers, a coping strategy in the face of climate variability. Also scenarios with a frost routine incorporated in the model were constructed. Luki and Ajanhuiri were the most frost resistant varieties whereas Alpha was the most susceptible. Luki and Ajanhuiri, as monoculture, outperformed the yield obtained with the mixtures under severe frosts. These results highlight the role played by local frost tolerant varieties, and featured the management importance –e.g. clean seed, strategic watering- to attain the yields reported in our experiments. The mixtures of local and introduced potatoes can thus not only provide the products demanded by the markets but also reduce the impact of frosts and thus the vulnerability of the system to abiotic stressors.     

Changing Mortality Profile among HIV-Infected Patients in Rio de Janeiro,Brazil: Shifting from AIDS to Non-AIDS Related Conditions in the HAART Era

Introduction

We describe temporal trends in the mortality rates and factors associated with AIDS and non-AIDS related mortality at the Evandro Chagas Clinical Research Institute (IPEC), Oswaldo Cruz Foundation (FIOCRUZ).

Methods

Adult patients enrolling from 1986 through 2009 with a minimum follow up of 60 days were included. Vital status was exhaustively checked using patients’ medical charts, through active contact with individuals and family members and by linkage with the Rio de Janeiro Mortality database using a previously validated algorithm. The CoDe protocol was used to establish the cause of death. Extended Cox proportional hazards models were used for multivariate modeling.

Results

A total of 3530 individuals met the inclusion criteria, out of which 868 (24.6%) deceased; median follow up per patient was 3.9 years (interquartile range 1.7–9.2 years). The dramatic decrease in the overall mortality rates was driven by AIDS-related causes that decreased from 9.19 deaths/100PYs n 1986–1991 to 1.35/100PYs in 2007–2009. Non-AIDS related mortality rates remained stable overtime, at around 1 death/100PYs. Immunodeficiency significantly increased the hazard of both AIDS-related and non-AIDS-related causes of death, while HAART use was strongly associated with a lower hazard of death from either cause.

Conclusions

Our results confirm the remarkable decrease in AIDS-related mortality as the HIV epidemic evolved and alerts to the conditions not traditionally related to HIV/AIDS which are now becoming more frequent, needing careful monitoring.     

Disease in the History of Modern Latin America: From Malaria to AIDS and From Popular Medicine to Medical Populism: Doctors, Healers, and the Public Power in Costa Rica 1800–1940

Disease in the History of Modern Latin America: From Malaria to AIDS . Diego Armus, ed. Durham, NC: Duke University Press, 2003. 326 pp.
From Popular Medicine to Medical Populism: Doctors, Healers, and the Public Power in Costa Rica 1800–1940 . Steven Palmer. Durham, NC: Duke University Press, 2003. 329 pp.     

Preventing and Controlling Cancer in North America: A Cross-Cultural Perspective; Evaluating Alternative Cancer Therapies: A Guide to the Science and Politics of an Emerging Medical Field

Preventing and Controlling Cancer in North America:. Cross-Cultural Perspective. Diane Weiner. ed. Westport, CT: Praeger Publishers, 1999. xvii. 245 pp.
Evaluating Alternative Cancer Therapies:. Guide to the Science and Politics of an Emerging Medical Field. David J. Hess. New Brunswick, NJ: Rutgers University Press, 1999. xxi. 260 pp.     

Flexible Bodies: The Role of Immunity in American Culture from the Days of Polio to the Age of AIDS/Crafting Science: A Sociohistory of the Quest for the Genetics of Cancer

Flexible Bodies: The Role of Immunity in American Culture from the Days of Polio to the Age of AIDS. Emily Martin. Boston: Beacon Press, 1994 (cloth and paper), xxiii. 320 pp.
Crafting Science:. Sociohistory of the Quest for the Genetics of Cancer. Joan Fujimura. Cambridge: Harvard University Press, 1996. xii. 322 pp.     

Racial Differences in the Sums of Skinfolds and Percentage of Body Fat Estimated from Impedance in Black and White Girls, 9 to 19 Years of Age: The National Heart,Lung, and Blood Institute Growth and Health Study

Objectives: This National Heart, Lung, and Blood Institute Growth and Health Study report assesses racial differences in fat patterning in black and white girls ages 9 to 19 years, comparing the sum of triceps and subscapular skinfolds (SSFs) and percentage of body fat (%BF) from impedance as two indices of adiposity. It is hypothesized that racial differences in fat patterning manifest during puberty. Research Methods and Procedures: SSF and %BF were measured annually. Racial differences in SSF and %BF were evaluated by age. Associations between %BF and SSF were evaluated using the Pearson's correlations coefficient. Classification agreement was evaluated using the kappa‐statistic. Effects of pubertal stage and race on classification agreement were examined using multivariate models. Results: White girls had a greater mean %BF at 9 to 12 years of age; black girls had a greater %BF thereafter. Black girls had a greater mean SSF at every age. The correlation coefficient between SSF and %BF was 0.79, and there was good agreement between %BF and SSF in separating high (>85th percentile) from not high (kappa = 0.60 for whites and 0.66 for blacks). SSF associated more with %BF in prepuberty and early puberty than in late puberty. Discussion: Despite good correlations between %BF and SSF, the two methods indicate different fat patterns in black and white girls.     

Feasibility and Acceptability of Global Positioning System (GPS) Methods to Study the Spatial Contexts of Substance Use and Sexual Risk Behaviors among Young Men Who Have Sex with Men in New York City: A P18 Cohort Sub-Study

Background

No global positioning system (GPS) technology study has been conducted among a sample of young gay, bisexual, and other men who have sex with men (YMSM). As such, the purpose of this study was to evaluate the feasibility and acceptability of using GPS methods to understand the spatial context of substance use and sexual risk behaviors among a sample of YMSM in New York City, a high-risk population.

Methods

Data came from a subsample of the ongoing P18 Cohort Study (n = 75). GPS feasibility and acceptability among participants was measured with: 1) a pre- and post-survey and 2) adherence to the GPS protocol which included returning the GPS device, self-report of charging and carrying the GPS device as well as objective data analyzed from the GPS devices. Analyses of the feasibility surveys were treated as repeated measures as each participant had a pre- and post-feasibility survey. When comparing the similar GPS survey items asked at baseline and at follow-up, we present percentages and associated p-values based on chi-square statistics.

Results

Participants reported high ratings of pre-GPS acceptability, ease of use, and low levels of wear-related concerns in addition to few concerns related to safety, loss, or appearance, which were maintained after baseline GPS feasibility data collection. The GPS return rate was 100%. Most participants charged and carried the GPS device on most days. Of the total of 75 participants with GPS data, 75 (100%) have at least one hour of GPS data for one day and 63 (84%) had at least one hour on all 7 days.

Conclusions

Results from this pilot study demonstrate that utilizing GPS methods among YMSM is feasible and acceptable. GPS devices may be used in spatial epidemiology research in YMSM populations to understand place-based determinants of health such as substance use and sexual risk behaviors.     

A community mobilisation intervention to prevent violence against women and reduce HIV/AIDS risk in Kampala, Uganda (the SASA! Study): study protocol for a cluster randomised controlled trial

ABSTRACT: BACKGROUND: Gender based violence, including violence by an intimate partner, is a major global human rights and public health problem, with important connections with HIV risk. Indeed, the elimination of sexual and gender based violence is a core pillar of HIV prevention for UNAIDS. Integrated strategies to address the gender norms, relations and inequities that underlie both violence against women and HIV/AIDS are needed. However there is limited evidence about the potential impact of different intervention models. This protocol describes the SASA! Study: an evaluation of a community mobilisation intervention to prevent violence against women and reduce HIV/AIDS risk in Kampala, Uganda. METHODS: The SASA! Study is a pair-matched cluster randomised controlled trial being conducted in eight communities in Kampala. It is designed to assess the community-level impact of the SASA! intervention on the following six primary outcomes: attitudes towards the acceptability of violence against women and the acceptability of a woman refusing sex (among male and female community members); past year experience of physical intimate partner violence and sexual intimate partner violence (among females); community responses to women experiencing violence (among women reporting past year physical/sexual partner violence); and past year concurrency of sexual partners (among males). 1583 women and men (aged 18-49 years) were surveyed in intervention and control communities prior to intervention implementation in 2007/8. A follow-up cross-sectional survey of community members will take place in 2012. The primary analysis will be an adjusted cluster-level intention to treat analysis, comparing outcomes in intervention and control communities at follow-up. Complementary monitoring and evaluation and qualitative research will be used to explore and describe the process of intervention implementation and the pathways through which change is achieved. DISCUSSION: This is one of few cluster randomised trials globally to assess the impact of a gender-focused community mobilisation intervention. The multi-disciplinary research approach will enable us to address questions of intervention impact and mechanisms of action, as well as its feasibility, acceptability and transferability to other contexts. The results will be of importance to researchers, policy makers and those working on the front line to prevent violence against women and HIV.