Sarai R. Boelema

The Odor Awareness Scale: A New Scale for Measuring Positive and Negative Odor Awareness

The Odor Awareness Scale (OAS) is a questionnaire designed to assess individual differences in awareness of odors in the environment. The theory that odor awareness can be distinguished in awareness of negative (to be avoided) odors and positive (to be approached) odors was tested using confirmatory factor analysis (CFA) on the 34-item questionnaire after completion by 525 respondents. CFA (after deletion of 2 items) showed good fit of the 2-factor theory, resulting in a positive awareness subscale (11 items, Cronbachs alpha = .77) and a negative awareness subscale (21 items, Cronbachs alpha = .80). Furthermore, reports of sickness from environmental odors were correlated with the negative odor awareness factor, not the positive odor awareness factor. Respondents scoring high on the overall sum score of the OAS showed significantly better olfactory performance on an odor perception test battery than respondents with a low score. These results suggest a causal relation between awareness of potentially negative odors, olfactory performance and experiencing health effects from environmental odor exposure, that warrants further investigation.

On the Development of Implicit and Control Processes in Relation to Substance Use in Adolescence.

Adolescence is a period in which brain structures involved in motivation and cognitive control continue to develop and also a period in which many youth begin substance use. Dual-process models propose that, among substance users, implicit or automatically activated neurocognitive processes gain in relative influence on substance use behavior, while the influence of cognitive control or reflective processes weakens. There is evidence that a variety of implicit cognitive processes, such as attentional bias, biased action tendencies (approach bias), memory bias and at a neural level, cue reactivity, are associated with adolescent substance use. The impact of these implicit processes on the further development of addictive behaviors appears to depend on moderating factors, such as (premorbid) executive control functions. Clear negative effects of adolescent substance use on executive control functions generally have not been found using behavioral tasks, although some studies have identified subtle and specific effects on cognitive functioning.

Development of sucking patterns in pre-term infants with bronchopulmonary dysplasia

Background: Pre-term infants with bronchopulmonary dysplasia (BPD) are at risk of acquiring brain abnormalities. Combined with ongoing breathing difficulties, this may influence the development of their sucking patterns. Objective: To determine the longitudinal development of sucking patterns from birth until 10 weeks’ post-term age in pre-term infants with and without BPD. Methods: The sucking patterns of 16 pre-term infants with BPD and 15 pre-term infants without BPD were prospectively assessed with the Neonatal Oral-Motor Assessment Scale. The infants were matched for gestational age (<30 weeks). We recorded approximately 12 feeding episodes per infant, from 34 until 50 weeks’ post-menstrual age. We diagnosed the infants’ sucking patterns as normal, dysfunctional, or disorganized. Then, we examined the development of the sucking patterns in relation to relevant clinical characteristics. Results: Thirty (21%) of 142 feeding episodes of the pre-term infants with BPD and 36 (23%) of 156 of those without BPD were diagnosed as normal (non-significant). Of the abnormal patterns, 3 were diagnosed as dysfunctional and 229 as disorganized. Before term-equivalent age, definitely abnormal sucking patterns were more prevalent in the pre-term infants with BPD than in those without BPD: 69 (49%) and 47 (30%) episodes, respectively (χ2 = 10.7, p < 0.01). In particular, the abnormal patterns including the item ‘incoordination’, defined as the inability to coordinate sucking and swallowing with breathing, were more prevalent: 36 and 15%, respectively (χ2 = 6.37, p < 0.05). There was no difference between the two groups regarding the age at which they acquired normal sucking patterns. Relevant clinical characteristics did not influence the development of the sucking patterns. Conclusions: The developmental characteristicof sucking patterns in infants with BPD was that these infants were unable to coordinate swallowing with breathing. This was the case especially prior to term-equivalent age; after term-equivalent age, the development of sucking closely resembled that of pre-term infants without BPD.

Adolescent Heavy Drinking Does Not Affect Maturation of Basic Executive Functioning: Longitudinal Findings from the TRAILS Study

Background and Aims Excessive alcohol use is assumed to affect maturation of cognitive functioning in adolescence. However, most existing studies that have tested this hypothesis are seriously flawed due to the use of selective groups and/or cross-sectional designs, which limits the ability to draw firm conclusions. This longitudinal study investigated whether patterns of alcohol use predicted differences in maturation of executive functioning in adolescence. Additionally, gender was tested as a possible moderator. Methods We used data from the Tracking Adolescents’ Individual Lives Survey (TRAILS), which comprises a cohort of 2,230 Dutch adolescents. Maturation of executive functioning was measured by assessing the standardized improvement on each of four basic executive functions (i.e., inhibition, working memory, and shift- and sustained attention) between ages 11 and 19. Participants were assigned to one of six (heavy) drinking groups (i.e., non-drinkers, light drinkers, infrequent heavy drinkers, increased heavy drinkers, decreased heavy drinkers, and chronic heavy drinkers). We conducted linear regression analyses, and adjusted for relevant confounders. Results The six drinking groups did not reveal significant differences in maturation between drinking groups. E.g., maturation executive functioning of chronic heavy drinkers in comparison to non-drinkers; inhibition: B = -0.14, 95% CI [-0.41 to 0.14], working memory: B = -0.03, 95% CI [-0.26 to 0.21], shift attention: B = 0.13, 95% CI [-0.17 to 0.41], sustained attention: B = 0.12, 95% CI [-0.60 to 0.36]. Furthermore, gender was not found to be a significant moderator. Conclusions Four years of weekly heavy drinking (i.e., chronic heavy drinkers) did not result in measurable impairments in four basic executive functions. Thus, regular heavy drinking in adolescence does not seem to affect these basic behavioural measures of executive functioning.

The Montreal Cognitive Assessment–Basic (MoCA-B) is not a reliable screening tool for cognitive decline in HIV patients receiving combination antiretroviral therapy in rural South Africa

BACKGROUND HIV-associated neurocognitive disorders (HAND) are frequently occurring comorbidities in HIV-positive patients, diagnosed by means of a neuropsychological assessment (NPA). Due to the magnitude of the HIV-positive population in Sub-Saharan Africa, easy-to-use cognitive screening tools are essential. METHODS This was a cross-sectional clinical trial involving 44 HIV-positive patients (on stable cART) and 73 HIV-negative controls completing an NPA, the International HIV Dementia Scale (IHDS), and a culturally appropriate cognitive screening tool, the Montreal Cognitive Assessment-Basic (MoCA-B). HAND were diagnosed by calculating Z-scores using internationally published normative data on NPA, as well as by using data from the HIV-negative group to validate the MoCA-B. RESULTS One hundred and seventeen patients were included (25% male, median age 35 years, median 11 years of education). A moderate correlation was found between the MoCA-B and NPA total Z-score (Pearsons r=0.36, p=0.02). Area under the curve (AUC) values for MoCA-B and IHDS were 0.59 and 0.70, respectively. The prevalence of HAND in HIV-positive patients was 66% when calculating Z-scores using published normative data versus 48% when using the data from the present HIV-negative cohort. CONCLUSION The MoCA-B appeared not to be a valid screening tool for HAND in this setting. The prevalence of HAND in this setting is high, but appeared overestimated when using published norms.