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Objectives\ud \ud To investigate the effectiveness of an 8‐session cognitive analytic therapy (CAT) protocol for patients with anxiety and depression in the context of relational problems, personality disorder traits, or histories of adverse childhood experiences and then to compare outcomes with cognitive behavioural therapy (CBT).\ud \ud \ud Methods\ud \ud The study was conducted in a single Improving Access to Psychological Therapies (IAPT) service and used sessional outcome monitoring. Propensity score matching was used to derive equivalent CAT (N = 76) and CBT (N = 73) samples through matching intake characteristics. Longitudinal multilevel modelling (LMLM) compared patterns of symptomatic change over time between the two therapies.\ud \ud \ud Results\ud \ud LMLM found no significant differences between CAT and CBT in depression, anxiety, and functional impairment outcomes and showed similar symptom change trajectories. Small between‐therapy post‐treatment effects and medium‐to‐large within‐therapy effects were found. CAT patients attended significantly more sessions, and the CAT dropout rate was significantly lower.\ud \ud \ud Conclusions\ud \ud Brief CAT appears acceptable and effective for patients with anxiety and depression in the context of complex relational problems when delivered within the high intensity tier of an IAPT service. The potential added value of CAT in IAPT services is discussed.\ud \ud \ud Practitioner points\ud \ud Practitioners (under appropriate supervision) could use 8‐session CAT when treating patients with anxiety and depression in the context of clinical complexity.\ud \ud The 8‐session CAT model holds organizational promise in IAPT services.\ud \ud Brief CAT interventions should retain theoretical integrity.

This paper explores how one neighbourhood revitalization initiative addresses – or fails to address – intersecting systems of oppression as it seeks to facilitate resident-led change. Unlike many similar initiatives, the Neighbourhood Action Strategy in Hamilton, Ontario, Canada has an explicit focus on grassroots community development and resident leadership, and actors within the strategy have paid significant attention to issues of inclusion. We draw on in-depth interviews with City staff, local service providers, and neighbourhood residents, as well as on observation of neighbourhood meetings and media analysis, to explore how diversity, inclusion, and equity are understood and managed by different actors within the Strategy. We demonstrate that despite a stated mandate of inclusion, the initiative often struggles to engage significant participation from working-class and racialized people. We argue that this is in part due to complex interpersonal and institutional dynamics informed by race and class, which create significant tensions that ultimately limit the initiative's ability to create meaningful transformation. We conclude with some lessons learned about how to disrupt the racist, classist, and other oppressive discourses that can operate even within the most progressive initiatives.

This review explores the evidence base for Acceptance and Commitment Therapy (ACT) for people experiencing psychosis, the quality of the evidence, and potential benefits of this intervention. A systematic search of the literature was conducted on the electronic academic databases MEDLINE, Google Scholar, PsycArticles and PsycINFO up to October 2016. A systematic search identified 427 articles and thirteen studies were selected as eligible for review. The current research base indicates that ACT has the potential to be considered an effective treatment in psychosis even in briefer forms, such as 4 sessions for inpatients, and in individuals experiencing severe symptoms or complex co-morbidities. There is emerging evidence that ACT is a useful intervention for individuals that may present with psychosis whether at inpatient settings or in community teams. ACT can be utilised in group settings as this indicates time and cost-effectiveness (reaching a larger range of individuals). The studies suggest ACT can help reduce rehospitalisation rates, have an impact on the psychological inflexibility of people experiencing psychosis and is beneficial for people with either first episode or enduring psychosis. Nevertheless, there is a need to take the current findings with caution due to methodological criticism and potential for bias within some studies, which is discussed in the review. Despite this, advances to our understanding of ACT for those experiencing psychosis is improving. To continue this, larger randomised controlled trials are required to give this research area a more robust evidence base. Studies should also aim to include follow up data to assess the impact of the brief interventions on a much longer scale. Other recommendations for future research studies are noted.

ObjectivesPatients with functional memory disorder (FMD) report significant memory failures in everyday life. Differentiating these patients from those with memory difficulties due to early stage neurodegenerative conditions is clinically challenging. The current study explored whether distinctive neuropsychological profiles could be established, suitable to differentiate patients with FMD from healthy individuals and those experiencing amnestic mild cognitive impairment (a-MCI).MethodsPatients with a clinical diagnosis of FMD were compared with patients with a-MCI, and healthy matched controls on several tests assessing different cognitive functions. Patients with clinically established mood disorders were excluded. Patients with FMD and a-MCI were broadly comparable on the level of their subjective memory complaints as assessed by clinical interview.ResultsThe neuropsychological profile of the FMD patients, although they expressed subjective memory and attention concerns during their clinical interview was distinct from patients with a-MCI on tests of memory [semantic fluency, age of acquisition (AoA) analysis of semantic fluency, verbal and non-verbal memory]. FMD patients did not differ significantly from healthy controls, but their scores on the letter fluency and digit cancellation tasks were not significantly different from those of the a-MCI patients indicating a possible sub-threshold deficit on these tasks.ConclusionWhilst subjective complaints are common within the FMD population, no objective impairment could be detected, even on a sensitive battery of tasks designed to detect subtle deficits caused by an early neurodegenerative brain disease. This study indicates that FMD patients can be successfully differentiated from patients with neurodegenerative memory decline by characterising their neuropsychological profile.

Action Research (AR), and Collaborative Action Research (CAR) in particular, has made a significant contribution to the development of inclusive policies and practices in education, which has been a feature of Continued Professional Development (CPD) in some schools in the UK. This chapter describes and evaluates the process of a CAR project I participated in as Head of an English department in an inner-city secondary school in England. It takes a reflexive approach to critique the benefits and explore the challenges of working through a project of this kind within a tightly controlled and data-driven context. The chapter draws on a Social Constructivist theoretical framework and explores the values and practices of the inclusive pedagogies that underpinned the project and helped to facilitate and drive forward the research process.

Canadian policies on research ethics and institutional constructions of research ethics reify colonial relations, erase Indigenous presences from research and education, and are analogous to historical projects of settler colonial erasure that establish settler rights to land. Indigenous peoples are always placed “somewhere else,” and that extends to research practice. These research relationships are institutionalized as “ethical” at the beginning, but rarely followed up with at the end. A re-working of research ethics conventions is important to account for Indigenous presence throughout the academy, as well as to reflect the different form and functions that research can and will take in a decolonial future.

This chapter examines the engagement of health geographers with food issues, tracing the historical and intellectual trajectory of the topic within health geography but also in the broader related disciplines of public health and food studies. Perhaps the most obvious application of health geographers' skills in the study of food is the issue of food environments. The food-desert literature has been beset with measurement controversies and methodological challenges. Research has suggested that food deserts are not observable across all urban areas or in all high-income countries. Indeed, a systematic review by Beaulac, Kristjansson and Cummins found little evidence of food deserts outside of the United States. The modern era has created new challenges, such as the widespread concerns about overnutrition and obesity and food contamination. Health geographers have increasingly engaged with food issues through the lens of obesity and obesity prevention.

Activists and academics have increasingly drawn on the concept of "food justice" in recent years. While this trend is encouraging, we argue that a focus on "inclusion" by these actors may actually work to reproduce inequitable relationships. Food justice research and practice should thus move beyond inclusion to connect food system inequities to interlocking structures of oppression, such as capitalism, patriarchy, white supremacy, and colonialism. In Canada, placing food justice in the context of ongoing processes of colonialism—and recognizing that no justice can happen on stolen land—is particularly important. While we make these suggestions, we do not claim to have all the answers; we struggle through the same tensions we raise here in our own work. Nonetheless, we feel that encouraging those interested in food activism to consider intersecting systems of domination, to challenge such structures and their complicity in them, and to build solidarity with other activists, perhaps using land as the basis for new conversations and alliances, may be key steps toward cultivating an anti-colonial food justice praxis.

There is a renewed interest in the potential of municipal governments working collaboratively with local communities to address health inequities. A growing body of literature has also highlighted the benefits and limitations of participatory approaches in neighbourhood interventions initiated by municipal governments. However, few studies have investigated how neighbourhood interventions tackling health inequities work in real-time and in context, from the perspectives of Community Developers (CDs) who promote community participation. This study uses a process evaluation approach and semi-structured interviews with CDs to explore the challenges they face in implementing a community development, participatory process in the City of Hamilton's strategy to reduce health inequities – Neighbourhood Action . Findings demonstrate that municipal government can facilitate and suppress community participation in complex ways. CDs serve as significant but conflicted intermediaries as they negotiate and navigate power differentials between city and community actors, while also facing structural challenges. We conclude that community participation is important to bottom-up, resident-led social change, and that CDs are central to this work.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Objective: Specialist services for dementia are seeing an increasing number of patients. We investigated whether interactional and linguistic features in the communication behaviour of patients with memory problems could help distinguish between those with problems secondary to neurological disorders (ND) and those with Functional Memory Disorder (FMD). Methods: In Part 1 of this study, a Diagnostic Scoring Aid (DSA) was developed encouraging linguists to provide quantitative ratings for 14 interactional features. An optimal cut-off differentiating ND and FMD was established by applying the DSA to 30 initial patient–doctor memory clinic encounters. In Part 2, the DSA was tested prospectively in ten additional cases analysed independently by two Conversation Analysts blinded to medical information. Results: In part one, the median score of the DSA was +5 in ND and -5 in FMD (p

In recent years, food crises have heightened awareness of food security vulnerabilities even in rich nations. However, the extent to which various issues related to food security (such as consistent access to nutritious food in conditions which maintain human dignity) have been incorporated into Canadian policy and practice is not well documented. This article draws on a number of sources—including policy documents and media reports—to explore how food security is being conceptualized in Canada, particularly at the national level. The article chronicles changes in food security discourse over time, suggesting that recognition of food security as a “Canadian” problem has been partial and contested, and reflects persistent geographic imaginaries of Canada (e.g., as a land of agricultural abundance) and unrelenting social and cultural exclusions (e.g., of Canada's Aboriginal people). La securite alimentaire et la sante au Canada : les imaginaires, les exclusions et les possibilites Resume Au cours des dernieres annees, les crises alimentaires ont accelere la prise de conscience des vulnerabilites en matiere de securite alimentaire et ce, meme dans les pays riches. Toutefois, l'ampleur de l'integration des divers enjeux lies a la securite alimentaire (comme l'acces en tout temps a des aliments nutritifs dans des conditions conformes au respect de la dignite humaine) dans les politiques et les pratiques canadiennes n'a pas ete bien documente. Cet article utilise de nombreuses sources, y compris des documents de politique et des reportages mediatiques, afin d'explorer la facon dont la securite alimentaire est conceptualisee au Canada, notamment au niveau national. L'article rend compte des changements apportes au discours sur la securite alimentaire au fil du temps, ce qui donne a penser que la reconnaissance de la securite alimentaire comme un probleme « canadien » demeure fragmentaire et contestee, et temoigne d'imaginaires geographiques tenaces propres au Canada (par exemple, un pays ou la production agricole est abondante) et de situations permanentes d'exclusion sociale et culturelle (par exemple, des peuples des Premieres nations).

Memory problems are a very common reason for presenting to primary care. There is a need for better treatments for dementia. Increased government and media interest may result in greater number seeking help for memory problems, which may not reduce the dementia gap but rather increase numbers seen who do not have dementia. This review highlights the issues around the diagnostic criteria and terminology used for people with memory complaints.A comprehensive literature search using PubMed using keywords for articles on subjective memory decline (SMD)/impairment/complaints, subjective cognitive decline (SCD), mild cognitive impairment (MCI) and functional memory disorder (FMD).There is a need for early accurate detection of dementia syndromes so that trials of new treatments can begin earlier on the disease process.Diagnostic criteria and terminology used for disorders of memory including SCD, MCI and FMD.This article reviews SCD and whether this can be used to predict Alzheimer's disease. The review also discusses the terminology used for non-progressive memory problems and the long-term outcomes for this patient group.The accurate distinction of premorbid dementia syndromes from benign non-progressive memory problems. Studies of treatment options for people with benign non-progressive memory problems and longer-term follow-up to determine which patients develop chronic problems.

The proliferation of community gardening, and the increasing recognition of its benefits, has led many municipalities to develop community garden policies. Using the process of drafting a community garden policy in the city of Hamilton, Canada, as a case study, this paper illustrates how an environmental justice framework could inform the creation of an effective, inclusive community gardening policy. At the same time, barriers within the policy process could mitigate against the meaningful incorporation of environmental justice concerns. The paper concludes with a discussion of how greater inter-departmental and community collaboration in policy development, as well as the more routine application of an environmental justice lens, could mitigate the ill effects of the inequitable distribution of environmental and other resources.

Emerging forms of social mobilisation are explored, using food initiatives in Canada as an example. Food networks are particularly interesting as a case study: they have holistic goals that include both environmental and social concerns, the number and scope of food initiatives have rapidly increased, and there has recently been a high level of public engagement around food issues. Networks among alternative food initiatives (AFIs) are investigated using a survey and in-depth interviews. Food movement networks exhibit some elements of collective identity, but network members have diverse goals, projects, and tactics that do not always align into a coherent political program. Social network theory and the analytic of complex assemblages are employed to help understand these results. Understanding how these food networks function provides insight not just into food networks, but also more generally into the study and practice of social mobilisation around environmental issues.

PurposeThe purpose of this article was to provide multiple examples of how (central) auditory processing disorder ([C]APD) is being evaluated and treated at various audiology clinics throughout the United States.MethodThe authors present 5 cases highlighting the diagnosis and treatment of (C)APD in children and adults. Similarities and differences between these cases have been showcased through detailed histories, evaluation protocol, and treatment options. When possible, the rationale for evaluation procedures and intervention processes were described and compared with guidelines and findings within the literature.Results and ConclusionsThese cases illustrate the varied processes and clinical protocols by which children and adults are evaluated, diagnosed, counseled, and treated for (C)APD. In addition, similarities and differences between the referral source, evaluation team, developmental history, comorbidities, test battery, recommendations, and remediations were described. The multiple clinic sites, diversity of clinical philosophies, variety of test measures, and diversity of patient populations make these cases ideal for showcasing the assortment of methodologies used with patients who present with histories and characteristics consistent with (C)APD.

Recently, the planning profession in North America has begun to recognize the importance of integrating food considerations into planning. However, the field of food system planning is still in its infancy, and its proponents seek a more thorough understanding of the applied role of planning practitioners in this emerging field. This exploratory investigation included interviews with a small sample of self-identified "food system planners" in Canada and the United States whose work is quietly nurturing this emerging subfield in the planning profession. Based on the views of this sample of planners, we offer several considerations on how the professional planning establishment can enhance the ability of planners to contribute to the development of holistic, sustainable, and equitable food systems. The lessons learned here may be applicable to other fields and disciplines where food system work is an emerging focus.

Objectives: In the UK dementia is under-diagnosed, there is limited access to specialist memory clinics, and many of the patients referred to such clinics are ultimately found to have functional (non-progressive) memory disorders (FMD), rather than a neurodegenerative disorder. Government initiatives on ‘timely diagnosis’ aim to improve the rate and quality of diagnosis for those with dementia. This study seeks to improve the screening and diagnostic process by analysing communication between clinicians and patients during initial specialist clinic visits. Establishing differential conversational profiles could help the timely differential diagnosis of memory complaints.\ud \ud Method: This study is based on video- and audio recordings of 25 initial consultations between neurologists and patients referred to a UK memory clinic. Conversation analysis was used to explore recurrent communicative practices associated with each diagnostic group.\ud \ud Results: Two discrete conversational profiles began to emerge, to help differentiate between patients with dementia and functional memory complaints, based on (1) whether the patient is able to answer questions about personal information; (2) whether they can display working memory in interaction; (3) whether they are able to respond to compound questions; (4) the time taken to respond to questions; and (5) the level of detail they offer when providing an account of their memory failure experiences.\ud \ud Conclusion: The distinctive conversational profiles observed in patients with functional memory complaints on the one hand and neurodegenerative memory conditions on the other suggest that conversational profiling can support the differential diagnosis of functional and neurodegenerative memory disorders.

In the last two decades, emergency food provision (e.g., food banks, meal programmes) has become an increasingly institutionalized form of hunger relief. Critiques of the emergency food system, as articulated by Poppendieck’s 1998 book Sweet Charity?, suggest that such programmes are unable to cope with growing hunger in a meaningful, stable, efficient, or culturally appropriate way, and that they may facilitate government retrenchment. Meanwhile, popular attention has increasingly focused on the environmental and social costs of our globalized industrial food system, and efforts to challenge it (e.g., urban fruit gleaning, chicken rearing) are becoming widespread. These efforts have drawn new kinds of organizations into the world of food (in)security. Drawing on organizational documents and key informant interviews, this paper examines how emergency food provision is changing because of the rise of ‘community food security’ discourse and practice in the period since Sweet Charity? Findings suggest that emergency food providers have responded to critiques in partial and incongruent ways. Organizations face structural constraints that curtail their ability to reorganize, while new kinds of organizations are engaging in community food security projects, both challenging and reinforcing the charity food model in ways that have relevance for progressive (food) organizing more generally.

Purpose – Sustainability initiatives typically operate for a limited time period, but it is often unclear whether they have lasting effects. The purpose of this paper is to examine a laboratory fume hood campaign, in order to identify factors that might contribute or detract from long‐term change persistence.Design/methodology/approach – The University of Toronto Sustainability Office ran a fume hood sash‐closing campaign in one building for a four‐month period. The campaign had two components: awareness‐raising, where the safety and energy benefits of sash‐closing were explained through posters, presentations, and a website; and a competition where participants received raffle tickets when their sashes were in compliance during unannounced inspections. Sash heights were recorded six and a half months before the campaign, throughout the campaign itself, and eight months after the campaign. Surveys and focus groups were used to assess participant attitudes and experiences.Findings – The campaign was effect...

The environmental justice movement has highlighted not only the unequal distribution of environmental hazards across lines of race and class, but also the white, middle-class nature of some environmentalisms, and broader patterns of marginalization underlying people's opportunities to participate or not. There is a significant body of work discussing Hispanic environmental justice activism in the US, but not in Canada. This paper draws on interviews with representatives of organizations working on environmental initiatives within the Hispanic population of Toronto, Canada to explore definitions of and approaches to environmentalism(s) and community engagement. Four interrelated “mechanisms of exclusion” are identified in this case study—economic marginalization; (in)accessibility of typical avenues of participation; narrow definitions of “environmentalism” among environmental organizations; and the perceived whiteness of the environmental movement. Taken together, these mechanisms were perceived as limiting factors to environmental activism in Toronto's Hispanic population. We conclude that the unique context of Toronto's Hispanic community, including contested definitions of “community” itself, presents both challenges and opportunities for a more inclusive environmentalism, and argue for the value of “recognition” and “environmental racialization” frameworks in understanding environmental injustice in Canada.

Neuregulin/ErbB signaling maintains high efficacy of synaptic transmission by stabilizing the postsynaptic apparatus via phosphorylation of α-dystrobrevin1., Neuregulin (NRG)/ErbB signaling is involved in numerous developmental processes in the nervous system, including synapse formation and function in the central nervous system. Although intensively investigated, its role at the neuromuscular synapse has remained elusive. Here, we demonstrate that loss of neuromuscular NRG/ErbB signaling destabilized anchoring of acetylcholine receptors (AChRs) in the postsynaptic muscle membrane and that this effect was caused by dephosphorylation of α-dystrobrevin1, a component of the postsynaptic scaffold. Specifically, in mice in which NRG signaling to muscle was genetically or pharmacologically abolished, postsynaptic AChRs moved rapidly from the synaptic to the perisynaptic membrane, and the subsynaptic scaffold that anchors the AChRs was impaired. These defects combined compromised synaptic transmission. We further show that blockade of NRG/ErbB signaling abolished tyrosine phosphorylation of α-dystrobrevin1, which reduced the stability of receptors in agrin-induced AChR clusters in cultured myotubes. Our data indicate that NRG/ErbB signaling maintains high efficacy of synaptic transmission by stabilizing the postsynaptic apparatus via phosphorylation of α-dystrobrevin1.

Alternative food initiatives have been challenged by critics to address the long-term, structural challenges confronting the food system in an integrated and comprehensive way. Confronting these challenges requires dynamic, multilevel and multisectoral strategies that integrate antipoverty efforts, ecological sustainability, food, wellness and community building throughout all aspects of the food system. Moving initiatives beyond the margins can begin by identifying and building on the successes of existing projects. In this pursuit, this paper articulates the case of The Stop Community Food Centre as it has evolved from a food bank offering emergency relief into a thriving neighborhood hub where people come together to grow, cook, and share food, and where people advocate for measures to establish a more just, sustainable, and healthy food system for all.

Food security is a fundamental element of community health. Informal house-lot food growing, by providing convenient access to diverse varieties of affordable and nutritious produce, can provide an important support for community food security. In this exploratory assessment of the contribution home food gardening makes to community food security, in-depth interviews were conducted with gardeners in two contrasting neighborhoods in Toronto, Canada. A typology of food gardeners was developed, and this qualitative understanding of residential food production was then assessed from a community food security perspective. It was found that growing food contributes to food security at all income levels by encouraging a more nutritious diet. The sustainability of household food sourcing and gardeners’ overall health and well-being also increased with food production. Secure access to suitable land to grow food and gardening skills were the most significant barriers found to residential food production.

This paper investigates coverage of cancer in three Canadian newspapers in order to explore how the print media presents issues related to cancer risk and prevention. Six months of newspaper coverage was coded and analysed quantitatively to identify trends in coverage. A small subset of these articles was then analysed qualitatively to identify latent and underlying messages. Results from the analysis suggest that coverage emphasised risk management through individual choice and lifestyle change, privileging a discourse of individual control. Conversely, social and environmental risks related to cancer were minimised, despite the emerging academic consensus around the central importance of social and environmental determinants of health. Lifestyle was the most frequently mentioned source of cancer risk. Social and environmental health links were mentioned sparingly, and when environmental links were presented they were contested in ways that lifestyle risks were not. The coverage reflects the prevalent di...

This article explores the relationships among environmental health, social capital and collective action in the industrial city of Hamilton, Ontario, Canada. Survey results from 512 households are used to document intra-urban variation in levels of social capital (defined as norms, networks and trust) and collective action in the context of environmental health issues, and specifically air quality. Despite real differences between areas in terms of socio-demographic characteristics, little variation in either social capital or collective action by area was observed. Further, while social networks and community involvement were significant predictors of collective action, indicators of norms and trust were not. Hence, the conception of social capital as a unitary construct that produces place-specific benefits is not reflected in the example explored here.

This paper examines waterfront revitalization in Hamilton, Ontario, Canada. Unlike many contemporary North American cities, heavy industry continues to dominate the local economy, and the physical manifestations of this industry (mills, smokestacks, and industrial air and water pollution) remain visible along Hamilton’s harbourfront. Within the last three decades, major investments in improving the city’s environment – and reputation – have been undertaken within the city, including the Hamilton Harbour Waterfront Trail, opened to the public in 2000. This paper uses newspapers and municipal documents to track the development of the Trail, from the initial planning of the Trail until the present day. These sources suggest that the proposal and subsequent development of the waterfront trail are linked to broader discourses of environmental and economic revitalization within and beyond the city. In addition, issues of access and inclusiveness are highlighted. These results draw attention to the ways that waterfront development is both locally situated and moulded by broader discourses and trends.

One of the key components of critical geography is praxis—defined here as the melding of theory/reflection and practice/action as part of a conscious struggle to transform the world. Put simply, praxis is giving life to ideas about the way the world is—and could be—by acting on one's convictions in daily (work and home) life. Praxis can thus take many forms, and can occur both within and outside the academy. This paper examines how research and practice can be co-constituted by examining the “food movement” (ie the mobilization of disparate social actors in resistance to various aspects of the dominant corporate–industrial food system) in Canada as a case study. Through this lens, different forms of praxis are interrogated, not to identify a uniform “best praxis”, but rather to highlight the benefits and drawbacks of particular approaches in this one specific context. In so doing, the paper explores how critical geographers might contribute, through praxis, to the recognition and restructuring of social relations as part of the broader emancipatory project that is central to critical theory.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Objective: This study explores whether the profile of patients’ interactional behaviour in memory clinic conversations with a doctor can contribute to the clinical differentiation between functional memory disorders (FMD) and memory problems related to neurodegenerative diseases. Methods: Conversation Analysis of video recordings of neurologists’ interactions with patients attending a specialist memory clinic. “Gold standard” diagnoses were made independently of CA findings by a multi-disciplinary team based on clinical assessment, neuropsychological testing and brain imaging. Results: Two discrete conversational profiles for patients with memory complaints emerged, including (i) who attends the clinic (i.e., whether or not patients are accompanied), and (ii) patients’ responses to neurologists’ questions about memory problems, such as difficulties with compound questions and providing specific and elaborated examples and frequent “I don’t know” responses. Conclusion: Specific communicative difficulties are characteristic of the interaction patterns of patients with a neurodegenerative pathology. Those difficulties are manifest in memory clinic interactions with neurologists, thereby helping to differentiate patients with dementia from those with FMD. Practical implications: Our findings demonstrate that conversational profiles based on patients’ contributions to memory clinic encounters have diagnostic potential to assist the screening and referral process from primary care, and the diagnostic service in secondary care.

The Drosophila homologue of the microtubule associated protein MAP1B is encoded by the futsch locus. The deduced protein Futsch is about twice the size of MAP1B and shows high homology in the N- and C-terminal domains. The central part of Futsch is characterized by a highly repetitive structure based on a 37 amino acid motif. Futsch, like MAP1B, colocalizes with microtubules and is necessary for the organization of the microtubule cytoskeleton during axonal growth and synaptogenesis. To further analyze the functional relevance of Futsch as a MAP1B-like protein, we performed a molecular analysis of the conserved protein domains. Using a number of antisera, we show that, unlike the MAP1B polyprotein, which is cleaved to generate a heavy and light chain, Futsch is expressed as a single protein. The function of MAP1B is in part regulated by phosphorylation mediated by kinases that include casein kinase 2 and glycogen synthase kinase 3beta (GSK3beta). We show here that at least one GSK3beta phosphorylation site of MAP1B is conserved in Futsch and that this site can be phosphorylated by GSK3beta and its Drosophila homologue, Shaggy/Zeste-white 3. To test the functional relevance of these findings we generated a number of minigenes and assayed their ability to rescue the phenotype of futsch mutants. Our data highlight some differences between MAP1B and Futsch but demonstrate that important structural and functional aspects are conserved between fly and vertebrate members of this protein family.

Ongoing interest in therapeutic landscapes has contributed noticeably to the development of a "post-medical geography of health" (Kearns, R.A., Professional Geographer 45 (1993) 139). Drawing on a variety of sources, including in-depth interviews and newspaper coverage from Hamilton, Canada, this paper explores the processes by which ordinary places are characterised as healthy or unhealthy, and investigates how health-affirming and health-denying places exist together in everyday life. We argue that it is possible for places to simultaneously hurt and heal, and that the therapeutic effect of place is largely contingent on individuals' physical and social locations. Further, we attempt to illustrate how these meanings are negotiated at a variety of different geographic scales.

This article explores individual and community action taken in response to perceived environmental risks by investigating the determinants of environmental action across a range of action types. A conceptual framework is first presented, which provides a foundation for investigating the role of local compositional (i.e., individual characteristics), contextual (i.e., neighborhood environment), and collective (i.e., social networks) factors in environmental action. To test the utility of the conceptual framework, a quantitative survey was administered to a random sample of households (n = 512) in Hamilton, Canada. The results suggest that the predictors of environmental action vary by action type (i.e., personal change, individual civic action, and cooperative civic action), and that factors related to perceived environmental exposure and social capital generally play a stronger, more consistent role in civic environmental action than sociodemographic or neighborhood factors. The results underscore the role of social connection in responses to perceived environmental risks.

Social capital has been the focus of considerable academic and policy interest in recent years. Despite this interest, the concept remains undertheorized: there is an urgent need for a critical engagement with this literature that goes beyond summary. This paper lays a foundation for a critical dialogue between social capital and health promotion, by examining problematics in the conceptualization and practice of social capital building and linking these to models of community development, a cornerstone health promotion strategy. In so doing, the paper contributes to the existing literature by providing a theoretical exposition and critique of various threads in social capital discourse, and linking these threads explicitly to community development practice. Distinctions between communitarian, institutional and critical approaches to social capital are elaborated, and the relationships between these three approaches and three models of community development-social planning, locality development, and social action-are discussed. The existing social capital literature is then critically examined in relation to three key themes common to both literatures: community integration, public participation, and power relations. This examination suggests that social capital cannot be conceived in isolation from economic and political structures, since social connections are contingent on, and structured by, access to material resources. This runs counter to many current policy discourses, which focus on the importance of connection and cohesion without addressing fundamental inequities in access to resources. This paper posits that approaches to community development and social capital should emphasise the importance of a conscious concern with social justice. A construction of social capital which explicitly endorses the importance of transformative social engagement, while at the same time recognising the potential negative consequences of social capital development, could help community organizers build communities in ways that truly promote health.

This article examines the degree to which relationships between social capital and health are embedded in local geographical contexts and influenced by demographic factors, socio-economic status, health behaviours and coping skills. Using data from a telephone survey of a random sample of adults (N=1504 respondents, response rate=60%), the article determines if relationships between involvement in voluntary associations and various measures of individual health are associated with neighbourhood of residence in the mid-sized city of Hamilton, Canada. Associational involvement and overweight status (assessed by body-mass score) were weakly but significantly related after controlling for the other variables; involvement had relationships with self-rated health and emotional distress before but not after controlling for socio-economic status, health behaviours and coping skills. Relationships between neighbourhood of residence and two health outcomes, self-rated health and overweight status, were statistically significant before and after controlling for the other characteristics of respondents; neighbourhood of residence was not a significant predictor of number of chronic conditions and emotional distress in multivariate models. The neighbourhood and associational involvement relationships with health were not dependent upon one another, suggesting that neighbourhood of residence did not help to explain the positive health effects of this particular measure of social capital.

This paper reports the results of a comparative analysis of the psychosocial impacts of municipal solid waste disposal facilities (both landfills and incinerators) in six communities in the provinces of Ontario and British Columbia, Canada. Telephone surveys were administered to random samples of residents living around each facility between 1990 and 1995 (total n=1203). The results of logistic regression analyses show that type of facility was the strongest predictor of residents' awareness, concern, and actions taken in response to site concerns. Essentially, residents living in close proximity to a landfill had a higher probability of reporting awareness, concern or actions than residents living around an incinerator site. There was little evidence of differences in reactions between Ontario and British Columbia (BC) residents, despite variations in provincial policies on waste disposal. The effects of other predictors, with the exception of involvement in the local community, were not consistent, supp...

Focus group sessions were held with rural freeway commuters who use Highway 403 from Brantford to Hamilton, Canada, to identify the characteristics of their trip that helped determine their view of the quality of service for the trip. The results from that analysis were then compared with two other types of freeway users who had previously been studied: urban freeway commuters who use Queen Elizabeth Way from Toronto to Hamilton and tractor-trailer drivers. The findings suggest that despite some commonality among the three groups, each group valued a trip characteristic that they did not experience or at least could not be sure of. That characteristic differs across the three groups. Urban commuters were concerned about travel time, rural commuters about maneuverability, and truck drivers about steady traffic flow and physical road conditions. Despite these differences, an argument can be made that density, the service measure for freeways, is a reasonable proxy for most of these concerns. The results also suggest that it is harder to defend by using the same breakpoints on density for different types of freeways or even for different types of drivers. Although operational issues were the primary concern, it may also be appropriate to consider a second rating that addresses the quality of the facility as well as the existing level-of-service method that addresses the quality of operations on it.

Effective risk communication is central to good environmental risk management. While studies have shown that newspapers are the primary source of information to the public regarding environmental issues, little is known about how environmental news is used as a risk-communication tool. This article explores the role of local information systems in risk communication, using newspaper content analysis as well as in-depth interviews with journalists and community residents to develop a case study of an environmental assessment process for a nonhazardous industrial-waste landfill. Results indicate that risk messages were chosen and shaped by journalists on the basis of their own exigencies. In addition, while newspapers were a major source of risk information, their impact was mitigated by resident distrust and access to other information sources, most notably their own personal information networks. These results have implications for environmental policy, as decision makers often use—either passive...

with a mean of 12.6 years of education (8-17). The mean number of professional fights was 45.2 and years of professional fighting, 14.3. Impairments on cognitive tests were frequent, with 43% failing a psychomotor speed test, 57% failing a processing speed test and 28.6% failing a memory test. The memory test was failed by a similar proportion of active fighters, while less active fighters failed the tests involving speed. . When corrected for age and other relevant variables, thalamic volume did not differ between active and retired fighters, but a greater fight exposure was associated with smaller volumes (p1⁄4.0.031). Conclusions: Cognitive dysfunction is common in retired fighters, and may be associated with specific changes in the brain. Timed tasks are particularly vulnerable, whereas impairment in memory is seen similarly in younger, active fighters. Analysis of larger groups of fighters will further elucidate this relationship.

Community activism is a common occurrence in situations where actual or perceived environmental health is threatened. How this activism is undertaken has changed over time, but remains an important issue in environmental health research and practice. Keywords: community; environment; health

Although the concept of level of service for freeways is usually defined in terms of users’ perceptions, very few studies have sought drivers’ or passengers’ views about what is important to them. Such information is particularly important for the evaluation of extended trips on freeways as opposed to trips on a single section or segment. Such information is valuable not only for improving the Highway Capacity Manual but also for establishing appropriate criteria for assessment of intelligent transportation system proposals. The results of focus group sessions are reported in which a group of commuters discussed their views about determinants of the freeway quality of service that they experienced. Total travel time is the most important determinant for them, but a number of other aspects of the trip also matter, including safety, traveler information, and maneuverability (density). The importance of travel time is a reminder that travel is a derived demand, not something that commuters do for the pleasure of the drive.