Neurocognition and functional outcome in early-onset schizophrenia and attention-deficit/hyperactivity disorder: A 13-year follow-up.

Objective: The relation between neurocognitive impairments and functional outcome has been documented in both early onset schizophrenia (EOS) and attention-deficit/hyperactivity disorder (ADHD), but less is known about the long-term relation between these factors. The present study investigates how neurocognition at baseline is related to measures of functional outcome at 13-year follow-up in subjects with EOS and ADHD. Method: Subjects with EOS (n = 15), ADHD (n = 19), and healthy controls (n = 30) were followed up 13 years after initial assessment. All subjects were between 12 and 18 years of age at baseline and between 24 and 30 at follow-up. They were retested at T2 with the same comprehensive neurocognitive test battery as used at T1, and reassessed with various symptom and behavior ratings and functional outcome measures. Results: Both groups were characterized by reduced functional outcome at follow-up, although of different magnitude and type, compared with healthy controls. In the EOS group, neurocognitive baseline measures were associated with social functioning at follow-up (η2 between .26 and .41), while for the ADHD group, no significant predictions were found. Conclusions: Adolescents with EOS and ADHD are characterized by poor functional outcome compared with healthy controls when reassessed as young adults. Executive function, memory and attention were related to social and community functioning in EOS. For ADHD no significant predictions were found although functional outcome was poor. For both groups treatment should focus on training of social skills and activities of daily living to enhance the long-term functional outcome. For EOS cognitive remediation should also be considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Network Governance in Contested Urban Landscapes

Urban planning is one of the policy fields where new forms of governance are developing. The article focuses on governance networks as one emergent form of governance in urban planning. In governance literature, discourse networks are seen as a threat to representative democracy. This article argues that the consequences for democracy depend on the type of network that develops and its performance in relation to democratic norms. Governance networks are discussed through the lens of democratic network governance, the utility of which is explored as an analytical tool in a case study of urban planning in Norway. In this context a governance network was constructed as a response to market-orientated planning practice in order to enhance citizen participation and public debate. The aim of this article is to discuss the relevance of the theory of network governance relating it to new forms of participation in public planning processes. The study shows that governance networks could strengthen democracy, though important questions about meta-governance, however, remain unsolved. The article also shows that networks operating in an institutional vacuum tend to fail in institutional capacity building.     

Metabolic Profiles of Brain Metastases

Metastasis to the brain is a feared complication of systemic cancer, associated with significant morbidity and poor prognosis. A better understanding of the tumor metabolism might help us meet the challenges in controlling brain metastases. The study aims to characterize the metabolic profile of brain metastases of different origin using high resolution magic angle spinning (HR-MAS) magnetic resonance spectroscopy (MRS) to correlate the metabolic profiles to clinical and pathological information. Biopsy samples of human brain metastases (n = 49) were investigated. A significant correlation between lipid signals and necrosis in brain metastases was observed (p < 0.01), irrespective of their primary origin. The principal component analysis (PCA) showed that brain metastases from malignant melanomas cluster together, while lung carcinomas were metabolically heterogeneous and overlap with other subtypes. Metastatic melanomas have higher amounts of glycerophosphocholine than other brain metastases. A significant correlation between microscopically visible lipid droplets estimated by Nile Red staining and MR visible lipid signals was observed in metastatic lung carcinomas (p = 0.01), indicating that the proton MR visible lipid signals arise from cytoplasmic lipid droplets. MRS-based metabolomic profiling is a useful tool for exploring the metabolic profiles of metastatic brain tumors.