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Dizziness and balance difficulties are not uncommon in children, with prevalence estimates in the general population ranging from 5%-18%, although the precise prevalence of those caused by vestibular dysfunction is not known. Whilst healthcare professionals are aware that vestibular dysfunction may lead to poor balance and delayed gross motor development in young children, little is known generally about the longer-term consequences of vestibular dysfunction in this group. This thesis sought to identify the existing evidence in the literature regarding the impact of vestibular dysfunction in children and young people (CYP), to identify the evidence gaps, and to add to the existing knowledge base by reporting on the author's own original research study regarding chronic symptoms and health-related quality of life in this group. The thesis includes a scoping review of the literature performed to identify and summarize evidence from studies investigating the impact of vestibular dysfunction in CYP (e.g. ongoing symptoms, balance function, motor development and health-related quality of life). Databases and other sources were searched methodically and 33 studies met the criteria for inclusion in the review. The review confirmed that there is some evidence about the physical effects of vestibular dysfunction in children, but that this evidence is limited by methodological and design quality issues and the heterogeneous nature of the studies. There is a paucity of evidence about the interaction between vestibular and cognitive function, and the impact on psychological wellbeing and quality of life in CYP with vestibular dysfunction, The empirical research paper, presented in a journal paper format, reports on the author's own observational cohort study of CYP with vestibular dysfunction. For this study, 49 CYP with vestibular dysfunction and 44 of their parents/carers completed a survey which included the Paediatric Vestibular Symptom Questionnaire (pVSQ), the Paediatric Quality of Life Inventory (PedsQL) and an open question asking for comments about vestibular dysfunction affects their/their child's life. The findings indicate that chronic vestibular symptoms are ongoing in many CYP with vestibular dysfunction even years after the onset of vestibular dysfunction: the majority of CYP (76%) in this study and most of the parents and carers (81%) reported the presence of significant levels of vestibular symptoms (the mean duration since onset of was 7.9 years), with females reporting more severe symptoms than males. Vestibular dysfunction was associated with impaired health-related quality of life (HRQoL): 61% of the children and young people in this study, and 57% of their parent/carers reported significantly impaired HRQoL in all domains compared to healthy norms. Linear regression modelling confirmed that high levels of vestibular symptoms are the main predictor of poor HRQoL with congenital vestibular dysfunction, and bilateral or central vestibular dysfunction also being additional risk factors for reduced HRQoL. Thematic analysis of the qualitative data collected explored study participants' perceptions of the consequences of vestibular dysfunction. Overarching themes identified were ongoing 'Symptoms' and 'Falls & Imbalance', which affected activities such as 'School', 'Exercise', 'Everyday activity', and had an impact on 'Emotions'. The final chapter of the thesis provides a critical review of the process and findings of the scoping review and research study, and the implications of the findings for clinical practice and future research. There is also a reflective account of the author's experience conducting the research as part of the Higher Specialist Scientist Training programme (HSST), and how this has contributed to personal and professional development.

The current thesis has been prepared in journal format and it reports a systematic literature review, an empirical research study, and a paper on relevant critical reflections. Based on a hybrid cognitive and metacognitive model for social anxiety disorder and on a metacognitive approach to emotional difficulties, the main aim of the thesis was to investigate the potential contributions of metacognitive beliefs to social anxiety over and above that of cognitive beliefs. To this effect, the systematic literature review investigated the nature and strength of the associations between social anxiety and two types of beliefs: cognitive beliefs, referred to as social beliefs, (i.e., conditional and unconditional self-beliefs, and high standards) and metacognitive beliefs (i.e., beliefs about thoughts and thinking processes). Cross-sectional, longitudinal and experimental studies were included, and correlation and regression coefficients, as well as results from group comparisons were extracted. Twenty three papers were reviewed using narrative synthesis. The results showed a robust positive association between social beliefs and social anxiety and suggested a possible mediation effect of cognitive processes. Metacognitive beliefs were also positively associated with social anxiety both directly and indirectly, through cognitive processes. The empirical study expanded on these results by investigating the potential prospective associations between metacognitive beliefs and social anxiety. A sample of 156 university students and staff completed a battery of questionnaires twice, two months apart. Regression analyses showed that irrespective of social beliefs, metacognitive beliefs about the uncontrollability and dangerousness of thoughts were individual positive predictors of and explained additional variance in social anxiety two months later. This effect was partly mediated by self-focused attention. Social beliefs did not show a prospective individual contribution to social anxiety. Following the above, the critical reflections paper focused on the process of conducting these studies. The adopted epistemological stance is discussed and the process of decision making during the various stages of research is expounded. The strengths and limitations, the findings in the context of wider research, and the implications for clinical practice and future research are discussed.

Obesity is one of the most serious public health challenges of the 21st century, associated with a range of adverse physical, psychological, social and economic consequences. The aetiology of obesity is complex; however, the psychological factors associated with overweight and obesity remain poorly understood. The first paper critically appraises evidence for three of the most developed psychological theories of obesity. Based on these findings, literature from the fields of emotion regulation and attachment are reviewed, and a novel developmental theory of obesity based on an integration of these theoretical constructs is proposed. Recommendations for future research based on a theoretical framework of emotion regulation are made, and implications for clinical practice including a focus on enhancing caregiver sensitivity are highlighted. The second paper explores the applicability of an established cognitive model of Bulimia Nervosa (BN) and binge eating to an overweight and obese sample. Findings support the relevance of cognitive aspects of the model in an overweight and obese sample, and highlight the potential role of early attachment relationships in the formation of cognitions that make an individual vulnerable to overweight and obesity in later life. Theoretical and clinical implications based on the established cognitive model are considered. Limitations include reliance on self-report and the correlational nature of analyses used. Recommendations for future research with larger, more representative samples to address these limitations are made. Overall, this dissertation makes a unique contribution to the psychological understanding of overweight and obesity, which has the potential to enhance treatment outcomes and suggests useful avenues for further research.

Music and religion exist ubiquitously across time and space, hold profound phylogenetic importance to the human condition, and provide fruitful avenues for culture research. Existing norms, values, schemas, language, and mythological frameworks interact with auditory harmony, melody, and rhythm, within naturalistic settings, to condition profound psychological mechanisms with deep implications to the study of social psychology and culture. Music has been and continues to be a normative tool in the use of religious ritualistic practice. Music has both the ability to facilitate changes in cognition and emotion on an individual level, while also strengthening group bonds and unifying a community at the social level. Religion represents a powerful cultural framework that one is typically conditioned to at an extremely early age and exerts massive pressure on the norms and values of the environment it exists in. This dissertation seeks to explore differences and similarities of music and religious practice across cultures and offers implications for the field of cross-cultural psychology. The first essay is a quantitative paper that examines how one’s religion and how one practices their religion shapes their psychological mechanisms associated with the emotional construal of terror, within the naturalistic setting of the covid-19 pandemic. During the pandemic many people have turned to their religious faiths for comfort and meaning in these existentially threatening times, however, many people have also found their ability to practice their religion effected by Covid-19, as well. The second essay will utilize a qualitative methodology to probe the use of music in ritualistic settings to understand cultural similarities and differences and what implications that may have for further understanding human cognitive and emotional capabilities and potentials. The final paper will be an interdisciplinary theory paper that borrows from social psychology, organizational psychology, musical psychology, and theology to propose mechanisms for how live musical practice in a communal setting interact to induce transformations in an individual’s sense of self. Often referred to as the “human obsession”, music is a unique communicative agent capable of arousing powerful cognitive and emotional responses in both the listener and performer across cultures.

Thesis Abstract An Investigation of Cognitive Deficits Related to Surgery for Glioblastoma using a Computerised Assessment Tool - Rohitashwa Sinha Glioblastoma, the most aggressive type of primary brain cancer, causes abysmal survival rates and high risks of cognitive deficit to its sufferers. These deficits are due to both its being diffusely infiltrative and its radical treatments such as brain surgery and radiotherapy. Currently the course of cognitive deficits from before to after surgery has not been reliably researched. Studies report high rates of drop-out due to burdensome 'pen-and-paper' based assessments conducted by neuropsychologists, a lack of these resources entirely or the data collection being focused on the period around radiotherapy or less aggressive tumours instead. As a result, patients still undergo resection surgery for glioblastoma without a reliable evidence base for making their treatment decisions, without any assessment for their cognitive deficit burden and without any targeted interventions to protect their cognitive function. In this doctoral research, I have set up a prospective study to assess cognitive function before and after resection surgery, but before radiotherapy and with particular focus on participants with glioblastoma who have been underserved by current infrastructure and research focus. The methodology involves using a computerised testing battery called 'OCS-Bridge', which has broadened the access to such cognitive assessments. Participant retention has been higher than in the literature. This may be due in part to the efficiency of the format as well as the study design for data collection, where assessment timepoints were advised by patients and carers rather than clinicians. Using a variety of analysis techniques, this thesis progresses through a systematic review confirming the lack of reliable consensus in this area and a format comparison study to support the use of OCS-Bridge by comparison to conventional testing. Next, machine learning and Kaplan-Meier analyses are used to show cognitive deficits as predictors of clinical outcomes including overall survival. The longitudinal analyses of the high peri-operative odds of cognitive deficits until radiotherapy follows. Finally, a tract based spatial statistics study using diffusion tensor MRI brain scans demonstrates that a common anatomical mechanism exists, affecting the same right hemisphere white matter tracts underlying social cognition deficits in participants with glioblastoma as is seen in traumatic brain injury and neurodegenerative disease contexts. 3 By contributing new knowledge, research methodology, immediately translational implications for clinical practice and by linking the mechanisms of cognitive deficits between glioblastoma and other neurological diseases, the results herein have already secured further research funding. This future work will build on the understanding of cognitive deficits presented here and to trial a targeted rehabilitation intervention to help people with glioblastoma and their families.

Armed conflict and its aftermath cause undeniable harm to the mental health and education of children, posing multiple ongoing threats to their survival and rights. The average length of displacement for a refugee today is over 25 years, meaning that millions of children will carry a “dual burden” of war traumas as well as daily displacement stressors through childhood and beyond. Yet the exact mechanisms through which refugee children’s experiences of different conflict-related adversities influence their mental health and education outcomes remain unclear. This three-paper dissertation draws from methods of psychology, neuroscience, and education and uses a risk and resilience theoretical framework to illuminate these mechanisms. Using both quantitative and qualitative methods and primary and secondary data, I examine layers of refugee children’s socioecological contexts during sensitive periods of early childhood and adolescence (a) to describe how distinct dimensions of war trauma and displacement stress shape their developmental outcomes and (b) to discern how factors such as caregivers, peers, schools, legal status, and others contribute to their risk and/or resilience. Paper 1 studies Syrian adolescent refugees (n=240) displaced to and living in Jordan in 2015. Using an innovative neuropsychology tablet assessment to gauge executive functioning, this quantitative research found that adolescents’ greater feelings of insecurity significantly predicted poor inhibitory control, that PTSD significantly predicted poorer working memory, but cumulative trauma exposures did not predict poorer cognition. Paper 2 studies Syrian, Afghan, Palestinian, and Iraqi primary caregivers (n=50) of refugee infants and toddlers displaced to Lebanon and Greece in 2016-2018. Through interviews, this qualitative study formed a typology of war and displacement adversities and identified four pathways through which caregivers reported connections between such adversities and their compromised mental health and negative parenting behaviors. Paper 3 examines 19 existing studies featuring multinational adolescent unaccompanied refugee minors (URMs) displaced to the United States, Canada, and Europe from 1990-2019. Through integrative metasynthesis, this qualitative study found that the literature describes URMs’ educational resilience primarily as derived from their individual strengths, whereas risk factors were largely identified in their microsystem, exosystem, and macrosystem. The literature shows systemic barriers such as denied legal asylum status, withdrawn mental health services, and discriminatory school bureaucracies to have cascading negative consequences for URMs’ educational pursuit, persistence, and success. Together, my results indicate that risk and resilience are not mutually exclusive for refugee children, that displacement stressors matter in addition to war traumas in shaping developmental outcomes, and that ultimately, prolonged resilience in a context of protracted displacement may hold future risks for children. Findings suggest the need to address risk factors at multiple levels of children’s socioecological environments to improve outcomes for refugee child mental health and education.

Cognitive abilities vary widely across the animal kingdom, and multiple hypotheses have been formulated to explain why. The Relationship Intelligence Hypothesis (RIH) posits that maintaining and managing high quality pair-bonds is a key driver of cognitive evolution. The RIH was first proposed more than a decade ago, and while its introductory paper has been widely cited, little work has been done to interrogate the RIH's central predictions. In this thesis, I critically evaluate the RIH. First, in Chapters 2 - 4, I test central predictions of the RIH within one wild study system, the jackdaw (Corvus monedula). Specifically, I test whether (i) pairs have fully aligned fitness interests (Chapter 2); (ii) pairs use consolation as a mechanism through which to manage and maintain their bond (Chapter 3); (iii) pair-bond strength (1) varies between pairs, (2) is consistent within pairs, (3) positively correlates with socio-cognitive performance, and (4) positively correlates with reproductive success (Chapter 4). Finally, I test whether a commonly used method in the study of cognitive evolution - the comparative study of brain size - is methodologically robust (Chapter 5). I find that jackdaw partners do not always have fully aligned fitness interests, and that they do not use consolation to manage and maintain their pair-bond. However, pair-bond strength does vary between pairs, is consistent within pairs and is positively correlated with a measure of socio-cognitive performance, partner responsiveness. While I did not find a link between pair-bond strength and reproductive success, partners with stronger bonds were better able to adjust hatching synchrony to environmental conditions. Finally, I demonstrate that comparative studies of brain size are not methodologically robust. In Chapter 6, I integrate my findings with contemporary empirical and theoretical evidence in order to critically evaluate the RIH. I end by proposing future directions for the study of cognitive evolution.

Most of the research on treatment approaches for acute ischemic stroke have focused on the effect of thrombolysis (IVT) and thrombectomy (EVT) on survival and functional outcomes. Little is known about the cognitive outcomes after IVT and EVT following acute ischemic stroke. The objective of this systematic review was to determine the differential cognitive and functional outcomes following thrombolysis or thrombectomy after mild to severe ischemic stroke in adults. Data was sourced using seven online databases. The SITS Registry was also searched as well as the grey literature in the form of Open Grey and Google Scholar. Initially, 1,040 articles were identified from 2000-2020. After screening full text papers, a total of 7 articles were eligible for data synthesis. Cognitive impairment on the Montreal Cognitive Assessment (MoCA) at 90 days post stroke was evident in patients who received either IVT or EVT. On tasks of executive function in particular the Trail Making Test, impaired performance was observed for EVT at 90 days and 365 days post stroke and IVT at 180 days post-stroke. A higher percentage of patients treated with EVT achieved functional independence on activities of daily living on the Barthel Index (BI) at 90 days and 2190 days post stroke, compared to those treated with IVT.  The current empirical study examined predictors of post-acute memory impairment and the relative contributions of alcohol (intoxication at time of injury and history of problematic alcohol use) on memory during the post- acute recovery stage after Traumatic Brain Injury (TBI). Case files from 303 individuals admitted to inpatient neuro-rehabilitation after single incident TBI were reviewed. Approximately 40% had a documented history of problematic alcohol use and around one third were intoxicated at time of injury. Using hierarchical regression analyses, older age and history of problematic alcohol use significantly predicted poorer performance on measures of immediate memory and global memory. Having a high skilled occupation significantly predicted better performance on the immediate and delayed memory index on the RBANS. Both history of problematic alcohol use and intoxication at time injury provided a significant and unique contribution to the prediction of global memory performance on the RBMT in the post-acute recovery stage after TBI (F (9,167) = 6.24, p < .001), albeit accounting for a small variance. Being intoxicated at time of injury resulted in more intact global memory in this mild to severe TBI sample. Clinical implications and limitations are discussed.

Simple neural systems are increasingly powerful tools in our exploration of cognitive mechanisms and their evolution. From mapping the entirety of the fly neuronal network to the utility of the honeybee genome, the pool of knowledge surrounding invertebrate brains and behaviors is growing. With that said, simple neural systems are often associated with simple behaviors, mechanistically useful but not comparable to the larger, more complex abilities of vertebrates. Polistes fuscatus paper wasps offer an opportunity to shift this perception in a new direction. Polistes fuscatus are cognitively specialized for faces, in that they learn faces more adeptly and efficiently relative to all other stimuli. Until recently, cognitive specialization has been unique to vertebrates, and even still there are only a few known examples. In vertebrates, cognitive specialization is linked to specialized neural mechanisms. Thus far, the link between cognitive specialization and specialized neural mechanisms has not been explored in invertebrates. In this dissertation, I explore not only the complex behaviors of P. fuscatus wasps, but also connect these behaviors to their neural mechanisms. I experimentally utilize the natural geographic variation in P. fuscatus’ ability to learn faces, to explore the phenotypic and genotypic origins of this complex skill. In Chapter II, I explore the development of the behavioral mechanism behind individual recognition – individual face specialization. By rearing wasps from populations with and without face specialization in a common garden, I find that the specialized ability to learn faces is plastic, and can rapidly change based on social environment. Based on the plasticity of their behavioral development, I next explore the potentially paired neurological mechanisms and plasticity of face learning. In Chapter III, I utilize the Immediate Early Gene c-fos, a highly conserved marker of neural activity, to evaluate neural activity during conspecific face learning. I use a negatively reinforced operant conditioning protocol, with a positive (learned) stimulus and a negative (not learned) stimulus to examine neurological reactions to faces in the wasp brain. I found that wasps from a population with individual recognition had distinct neurological activity to faces, as compared to the control stimuli and wasps from populations without individual recognition. This reaction takes place primarily in the central brain, a region suspected, but not confirmed, to play a crucial role in face learning. Chapter III marks the first instance of potential neurological specialization for faces in an invertebrate. However, this approach was targeted, using only one gene. Therefore, in Chapter IV I use RNAseq to generate high-level analyses of brain gene expression during face learning in the brains of P. fuscatus. I find distinctive transcriptomic responses to faces, and differences in gene expression between populations with and without individual recognition, and across sensory and processing regions of the brain. My results show that processing regions of the P. fuscatus brain analogous to the neocortex in vertebrates have the most distinct neurogenomic reaction to faces. The combined results of Chapters III and IV link several processing regions of the insect brain to a specialized learning task, and point to gene expression as a critical tool in exploring convergent mechanisms of cognition. Overall, the results of my dissertation provide the first evidence of a link between cognitive specialization and specialized neural mechanisms in invertebrates, and provide important evidence for the utility of simple neural systems in exploring complex behaviors.

Background: Self-care is an important part of the comprehensive treatment plan for people living with heart disease, specifically, coronary heart disease and heart failure. Physical activity is a key self-care healthy behavior. Older adults face barriers to self-care including symptom burden, comorbidities, depression, and age as well as cognitive in the heart failure populationObjectives: To study factors related to self-care on an individual’s mental health, perceived health, and quality of life of older adults living with heart disease. To examine the direct association of physical activity as a primary predictor on these important outcomes. To evaluate the role of depression as a mediator of physical activity and quality of lifeMethods: A systematic review was used to evaluate reported cognitive impairment in the older adult living with heart failure. Additionally, survey of 20-year surviving cohort of people living with chronic coronary disease was used to conduct a cross-sectional survey to evaluate the relationship of quality of life and physical activity as well as the mediation effect of depression on the relationship of physical activity and quality of life.Results: The systematic review found that cognitive impairment was either diagnosed or measured using a validated tool in 8-66% of people living with heart failure over the age of 80 years. However, the population living with heart failure over 80 years old had poorer cognition by either measurement or physician diagnosis when compared to the population living with the heart failure less than 80 years old. Three studies did find the population living with heart failure had poorer measured cognition or a higher amount of diagnosed cognitive impairment when compared to the general population of the same age.Important findings from the cross-sectional study revealed that regular physical activity is associated with better perceived health and quality of life when adjusted for age, socioeconomic factors, and comorbidities. Heart failure was significantly associated with lower quality of life. It is known from evidence that having heart failure is associated with lower quality of life. Other significant findings included the effect of physical activity on quality of life being mediated by depressive symptoms in the population living with chronic CHD.Conclusions: Self-care is part of any medical treatment. Physical activity is an essential self-care behavior in CHD, but the benefits reach beyond the heart. Associated with hypertension and diabetes control, physical activity is also known to have primary prevention properties related to the brain including cognition and depression. Importantly, these papers found physical activity is associated with quality of life and better perceived health. Public investment and promotion of physical activity could have lasting benefits towards a healthy aging population. It is our responsibility since any self-care not done, is care not given.

ABSTRACT Written Corrective Feedback (WCF) in writing classes is fundamental to interactions between teachers and students about students’ writing and to help students further improve their writing. As one of the main feedback sources, teachers’ cognition (e.g., teachers’ thoughts, knowledge, and beliefs) needs to be probed to properly understand teachers and their teaching (Borg, 2006). Currently, there is little research regarding teachers’ cognition and their practice of offering WCF in mainland China. The purpose of this study was to explore ESL teachers’ knowledge of, experience with and practice of WCF, and to investigate the connection among these aspects. The participants were teachers of English from a major normal university. The phenomenological methodology was used to explore teachers’ cognition and practice of WCF when teaching writing to undergraduate and graduate students. The study employed a triangulated approach that included a questionnaire administered to 55 teachers, interviews with two teachers and a study of the two teachers’ feedback responses to 68 students’ papers/journal entries, which were collected to further explore the interviewees’ practice of WCF. Questionnaire data was statistically aggregated and tabulated. The interview data was analyzed using Hycner’s 15 steps. The teachers’ responses on students’ papers were analyzed according to WCF types (direct CF, indirect CF, metalinguistic, focus of feedback, electronic CF, and reformulation) and error types (organizational errors, stylistic errors, and linguistic errors) and the results were tabulated. Findings indicated that ESL teachers possessed different levels of knowledge concerning WCF and used a varying number of WCF types to target error types. Most teachers were not well trained or provided with opportunities to be equipped with the necessary skills, to further improve their cognition and practice of providing feedback. Differences existed between teachers’ perceptions of the employment of WCF and their actual practice of it. The findings are an indication that administrators should consider employing multiple strategies to better equip teachers of writing to teach and provide feedback more effectively and efficiently. The future of providing WCF on writing in mainland China is dependent upon a workforce that excels in feedback cognition and practice.

Search is a fundamental aspect of decision-making, strategy and innovation. Despite a strong focus on search at the organizational level, the individual level has been under-explored – despite the fact that search is ultimately a human endeavour. To overcome this gap, the main research question guiding my dissertation is: How do selected individual abilities influence search behaviour, and ultimately performance? In each of the included papers, I highlight the role of a specific cognitive capability as a driver of search behaviour and ultimately performance. I interact individual abilities with environmental factors to better understand organizational-level outcomes. Paper 1 examines temporal focus. Temporal focus can be described as the degree of attention devoted to the dimensions of past, present and future, respectively. Our results reaffirm past findings: that temporal attention does indeed impact strategic performance, controlling for the environment. We also find that temporal focus has a different impact on strategic performance depending on the dimension of temporal focus under investigation. Paper 2 focuses on how emotions and work-life concerns affect the likelihood of becoming an entrepreneur. Paper 3 looks at working memory. While controlling for the setting, we find that heterogeneous strategies emerge, and show that differences in working memory affect people’s propensity to explore, which in turn explains performance. Finally, in paper 4, we examine persistence. Our results support the findings that individual search is indeed adaptive and driven by performance feedback. Our findings show that persistent individuals perform more exploitative search, and that persistence is an important moderator in the relationship between performance feedback and search behaviour. Overall, this dissertation serves to enrich the literature on the microfoundations of search and strategy. I rely on multiple methods, including experiments, interviews and linguistic analysis, and show that temporal focus, working memory and persistence are important drivers of search behaviour, strategy and ultimately performance. Through this dissertation, I open up the “black box” of search behaviour to reveal the capabilities of entrepreneurs, managers and decision-makers in general that contribute to organizational-level performance.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic, disabling condition with debilitating fatigue and neuroimmune symptoms. Consensus about diagnosis, pathogenesis and efficacious treatments for ME/CFS are yet to be elucidated. Advances in the understanding of microbiota-gut-brain interactions in healthy and disease states, combined with evidence of gastrointestinal symptoms and gut dysbiosis in individuals with ME/CFS has directed investigation towards the role of enteric microbiota in this condition. The body of work presented in this thesis includes five publications based on reviews and empirical research conducted over the past 3.5 years. The first review paper (Paper 1) found preliminary evidence to support the proposal that microbiota-gut-brain interactions may contribute to sleep, mood and cognitive symptoms but revealed gaps in knowledge with few empirical studies that have investigated commensal microbiota in patients with ME/CFS. Papers 2 and 3 describe the results of a correlational analyses between microbiota and ME/CFS symptoms in a cross-sectional, retrospective study of 274 ME/CFS patients. A notable finding from this study included sex-specific interactions between gut microbiota and symptom expression in ME/CFS, signaling possible sex differences in microbial function. The systematic review examining symptom and etiological overlap between D-lactic acidosis and ME/CFS in Paper 4, revealed preliminary support for the hypothesis that subclinical concentrations of D-lactate from bacterial dysbiosis may be a mechanism contributing to several ME/CFS symptoms (including fatigue, neurocognitive impairments, pain, sleep disturbances, motor disturbances, gastrointestinal abnormalities, cardiovascular, respiratory, thermostatic, and comorbid mood and behavioural disturbances). The review highlighted the gaps in knowledge without measurement of D-lactate concentrations in ME/CFS samples. Paper 5 presents the results of an open-label, repeated-measures trial examining the efficacy of a 4-week treatment (alternate weeks of Erythromycin and D-lactate free probiotic) for an overgrowth of commensal Streptococcus species in 44 adult patients with ME/CFS. Large time effects were shown including a reduction in Streptococcus count and improvement on several clinical outcomes (sleep, cognition and total symptoms) for the total sample at post intervention. Ancillary results highlighted individual variability in microbial changes and the importance of other genera with changes in Bacteroides, Bifidobacteria and Clostridium and associated with clinical changes in males. In combination, the analysis of literature and results from both cross-sectional and experimental studies substantiate the theoretical premise that microbiota and gut dysbiosis contribute to specific neuropsychological symptoms in some ME/CFS patients. Our mechanistic understanding of gut dysbiosis will be advanced by multidisciplinary investigations that include assessment of clinical symptoms, the microbiome (combined sequencing and culture techniques), metabolites, oxidative and inflammatory markers, and immune profiles that help identify possible factors contributing to, precipitating or perpetuating imbalances in microbial composition. These advances may help clarify diagnostic discrepancies and inform efficacious treatment alternatives that are responsive to individual variability.

The number of older adults will rapidly increase within the next generation (Brookmeyer, Johnson, Ziegler-Graham, & Arrighi, 2007). Alzheimer’s disease risk increases with age, especially after age 60 (NIA, n.d.). Aging leads to a decrease in functional independence, and this side effect is exacerbated by cognitive decline (Johnson, Lui, & Yaffe, 2007). Executive function is a predictor of Alzheimer’s disease onset and progression (Zhang, Han, Verhaeghen, & Nilsson, 2007). The Geriatric ImPACTTM test is a potential new and more convenient testing methods than traditional methods used. The purpose of this research is to validate the Geriatric ImPACTTM test by comparing the scores to those of traditionally used paper and pencil tests. The paper and pencil tests showed correlation with the Geriatric ImPACTTM, indicating that the Geriatric ImPACTTM tests the same cognitive domains of the traditional testing battery. This test is validated and is more convenient to use than the paper and pencil tests. Future research is needed to confirm this and should use a larger sample size, including participants with diagnosed cognitive decline.

Sensemaking of large textual information is a cognitively intensive task. Prior work has shown the value of large 2D high-resolution-display spaces in supporting the sensemaking process, by providing a "Space to Think" in which analysts can organize information and externalize their thought process. In this paper, we investigate how analysts use 3D immersive spaces for the same task. To this end, we conducted a user study where participants were asked to solve an intelligence analysis task using an Immersive Space to Think (IST) in a 3D virtual environment using an HMD. The study results show that the concepts of Space to Think extend naturally to 3D immersive space and that the 3D space offers some additional opportunities. With immersive space, analysts i) organized in a surrounding virtual sphere, ii) exploited the depth dimension for encoding relevance, and iii) traded-off between physical navigation and occlusion.

The aim of this paper is to bridge the process of scientific reasoning with the field of cognitive science, and more specifically, the cognitive mechanisms involved during reasoning. This intent of bridging scientific reasoning with cognitive mechanisms gave birth to a new model: the “Z” model of scientific reasoning. This model integrates the traditional scientific reasoning steps while depicting the cognitive mechanisms and mental flexibilities at use during reasoning. The goal of this experiment was to test the “Z” model and thus investigate the role of divergent and convergent thinking during scientific reasoning. In addition, the “Z” model highlights the importance of Contextual Focus during scientific reasoning. Contextual Focus is defined as the cognitive shift between modes of thoughts. Contextual Focus was tested to investigate its predictive power on our specific measure of scientific reasoning (Bouncing Ball Reasoning Task; BBRT) and a broader measure of scientific reasoning (Lawson Test of Scientific Reasoning; LTSR). In addition, the predictive power over scientific reasoning performances of Intellect and Openness, the personality traits of interest, was also tested. First, we hypothesized that participants experimentally primed to think divergently should perform better during the exploration of the problem space during a scientific reasoning task (Phase 1 of BBRT). As predicted, participants in the divergent thinking group generated on average more hypotheses than the participants in the convergent thinking and the control groups. Secondly, we hypothesized that participants experimentally primed to think convergently should perform better during the exploitation of the evaluative space during a scientific reasoning task (Phase 2 of BBRT). As predicted, participants in the convergent thinking group displayed on average fewer categorical errors than the participants in the divergent thinking or the control groups. In addition, Contextual Focus was found to be a significant predictor of the overall performance in exploring the problem space of our specific scientific reasoning problem. Intellect score over broader scientific reasoning (LTSR) performance, Contextual Focus and Intellect were found to be significant predictors of broader scientific reasoning (LTSR) performance. Those findings can also be interpreted with broader cognitive science lenses. Given that complex mental tasks such as problem solving and critical thinking also require divergent and convergent thinking, future research should test whether the priming used during our experimental protocol also leads to an advantage on more general reasoning tasks.

Speculation about artificial intelligence and big data has become commonplace. Foremost among these discussions is the potential for these technologies to displace the value of human labor. However, these discussions have become untethered from the history and development of the technologies in question. This paper analyzes paradigms of artificial intelligence to reveal that they are closely tied to different types of logical inference. The properties of computing machinery provide them with an advantage at deductive and inductive tasks when compared with human cognition. But, the understudied method of Peircean abduction poses several problems for computing machinery. Moreover, Peircean abduction, also called “creative abduction,” bears resemblance to important themes in the history of humanism. Human cognition handles the issues of Peircean abduction with remarkable ease, suggesting that humans will maintain a comparative advantage at this type of logical inference for the foreseeable future.

In Books with Bodies: Experientiality in post-1980s Multimodal Print Literature , I examine contemporary British and North American authors’ use of books as platforms for multimodal narration. “Multimodality” refers to the concurrent use of several semiotic systems (such as writing, maps, charts) for communication. The pointed juxtaposition of different semiotic systems in a literary text requires a combination of perception processes on the reader’s part. My dissertation charts the ways in which multimodal literary books published in response to the proliferation of electronic reading and writing interfaces from the 1980s onward prompt metacognitive awareness about "reading" as an experience that is grounded in bodily interactions and sensory contact with the modes and the platforms that mediate literature. I term this metacognitive awareness about the readers’ embodied engagement with the text’s material form "presence," by revising Hans Ulrich Gumbrecht’s notion of "presence-effect." The theoretical framework for this dissertation comes from three fields: I combine approaches to multimodality that originated in the study of social semiotics, insights from the cognitive sciences--the “second-generation” models of cognition--and twentieth century philosophies of experience, particularly those of Maurice Merleau-Ponty, Michel Serres, and Gumbrecht. By analyzing multimodal fictions, poetry, and lyrical essays such as Mark Haddon’s The Curious Incident of the Dog in the Night-Time (2003), Salvador Plascencia’s The People of Paper (2005), Anne Carson’s Nox (2010), Jonathan Safran Foer’s Tree of Codes (2010), and Doug Dorst and J.J. Abrams’s S. (2013), among other texts, Books with Bodies subverts the distinction between higher-order mental abilities (such as language processing) and lower-order perceptions (like touch) which underlies prior scholarship on the cognitive impact of literature. Indeed, I argue that the tendency to unpack the literary experience primarily in terms of how the mind processes language persists due to the equation of cognition with computation in first-generation artificial intelligence (AI) researches that influenced cognitive literary studies. Drawing on insights from queer and disability studies, I show that when we take cognition as analogous to information processing, we pathologize behavioral or cognitive differences. Thus, at a time when AI researches are finally moving beyond language processing to consider embodiment, my dissertation demonstrates the manner in which contemporary literature can contribute to the understanding of embodied, enactive intelligence.

Huntington’s disease (HD) is a devastating, autosomal-dominantly inherited and progressive motor system disease that currently is estimated to affect more than 30,000 people in the United States (National Institute of Neurological Disorders and Stroke [NINDS], 2017). Unfortunately, there is no cure for this disease and prognosis is generally poor, with death occurring at around 15-20 years post-diagnosis (NINDS, 2017). Given HD’s distinct effect on motor function, most of the literature has centered around pharmacological treatment for movement. As a result of the disease’s progressive nature, cognition, and swallowing are likely to become impaired over the course of the disease; however, the effects of the disease on these systems have been studied to a lesser extent. Consequently, evidence to support the efficacy of rehabilitative therapies for management of HD symptoms is lacking. Not only is this gap in the literature concerning, as HD carriers could potentially be missing out on therapies that may prove to be beneficial, but it also hinders therapists’ use of evidence-based practice for management of the disease. This paper examines available research regarding the management of HD from a communication sciences and disorders (CSD) perspective for use by clinical speech-language pathologists (SLPs). Specifically, this literature review examines evidence-based research regarding the diagnosis, assessment, and management of disorders of speech, language, cognition, and swallowing, with the goal of providing insight into the SLP’s role in the management of HD.

Occupational prolonged sitting associated with modern sedentary behaviours has been shown to be correlated with obesity and all-cause mortality. The negative impacts of prolonged sitting are not limited to physiological issues and may extend to cognitive function including attentional processes. Attention is an important cognitive domain that is involved in the majority of cognitive performance. The use of standing desks in the workplace offers a potential solution to prolonged sitting; however, the effects of standing workstations on the attention domain of cognitive function have not been thoroughly evaluated in the current literature. The aim of this paper was to identify the effects of working from a standing desk on attention during a simulated working day compared to a seated desk by using a counterbalanced cross-over study design. Thirty healthy volunteers (14 females and 16 males) aged between 20 and 49 years old were randomised into two groups (sitting or standing on the first testing day) that were matched by strata of age and gender. Each participant performed two full days of testing, one in sitting condition and another in a standing condition with a seven-day washout period. Each testing day consisted of three testing sessions and included morning, midday and afternoon times. The effects of each Condition (sitting and standing) and Time of Day (morning, midday and afternoon) on attention were evaluated. The cognitive tasks that measured attention domain included Continuous Performance Task (A-X and Inhibition), Paced Auditory Serial Addition Test and Figural Intersection Task. The results of this study showed a significant increase in performance in the Figural Intersection Task, whereby performance whilst standing was better. A significant interaction between Condition and Time of Day in the Continuous Performance Task – Inhibition showed faster reaction times in the afternoon whilst standing. There were no main effects of Condition for any of the other attentional tasks. With regard to Time of the Day, the findings revealed that, overall, participants performed more efficiently at Midday and Afternoon in comparison to Morning. The findings of this study reject popular concerns of standing workstations affecting attention by showing that the use of standing desks, not only can help reduce sedentary-ness, but can also improve attentional capacity. The physiological and attentional advantages associated with standing desks should be made aware to all corporate parties, companies and offices.

In his account of the intellectual cognition of singulars, Aquinas claims that the intellect cognizes singulars by way of mental images. Some recent commentators have claimed that Aquinas' appeal to mental images is inadequate to account for the intellectual cognition of singulars because mental images considered in terms of their qualitative character alone have content that is general and are, therefore, insufficient to determine reference to a singular. That is, if Aquinas takes mental images to refer to singulars because those singulars perfectly resemble the mental images, then his account is deficient. In my paper, I argue that the critical interpretation above is predicated on a misunderstanding of Aquinas regarding the intentionality of images. I investigate Aquinas' account of the intentionality of images in order to show that Aquinas understands the reference of mental images to be determined not by their qualitative character alone but also by the causal relation that obtains between the cognizer and a singular.