ORCID Profile
0000-0002-7632-5632
Current Organisations
UNSW Sydney
,
University of Birmingham
,
Loughborough University
,
University College London
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Publisher: Wiley
Date: 08-2020
DOI: 10.14814/PHY2.14539
Publisher: Frontiers Media SA
Date: 12-04-2021
DOI: 10.3389/FPHYS.2021.656746
Abstract: Cerebrovascular reactivity (CVR) is used as an outcome measure of brain health. Traditionally, lower CVR is associated with ageing, poor fitness and brain-related conditions (e.g. stroke, dementia). Indeed, CVR is suggested as a biomarker for disease risk. However, recent findings report conflicting associations between ageing or fitness and CVR measures. Inconsistent findings may relate to different neuroimaging modalities used, which include transcranial Doppler (TCD) and blood-oxygen-level-dependant (BOLD) contrast magnetic resonance imaging (MRI). We assessed the relationship between CVR metrics derived from two common imaging modalities, TCD and BOLD MRI, within the same in iduals and with expected significant differences (i.e., younger vs. older) to maximise the expected spread in measures. We conducted two serial studies using TCD- and MRI-derived measures of CVR (via inspired 5% CO 2 in air). Study 1 compared 20 younger (24 ± 7 years) with 15 older (66 ± 7 years) participants, Study 2 compared 10 younger (22 ± 2 years) with 10 older (72 ± 4 years) participants. Combining the main measures across studies, no significant correlation ( r = 0.15, p = 0.36) was observed between in idual participant TCD- and BOLD-CVR measures. Further, these measures showed differential effects between age groups with TCD-CVR higher in the older compared to younger group (4 ± 1 vs. 3 ± 1 %MCAv/mmHg P ET CO 2 p & 0.05, Hedges’ g = 0.75), whereas BOLD-CVR showed no difference ( p = 0.104, Hedges’ g = 0.38). In Study 2 additional measures were obtained to understand the origin of the discrepancy: phase contrast angiography (PCA) MRI of the middle cerebral artery, showed a significantly lower blood flow (but not velocity) CVR response in older compared with younger participants ( p & 0.05, Hedges’ g = 1.08). The PCA CVR metrics did not significantly correlate with the BOLD- or TCD-CVR measures. The differing CVR observations between imaging modalities were despite expected, correlated ( r = 0.62–0.82), age-related differences in resting CBF measures across modalities. Taken together, findings across both studies show no clear relationship between TCD- and BOLD-CVR measures. We hypothesize that CVR differences between imaging modalities are in part due to the aspects of the vascular tree that are assessed (TCD:arteries BOLD:venules/veins). Further work is needed to understand the between-modality CVR response differences, but caution is needed when comparing CVR metrics derived from different imaging modalities.
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.BIOPSYCHO.2009.12.011
Abstract: The ability to monitor one's sleepiness has obvious implications for safety critical procedures. Laboratory findings indicate that we may be poor at doing this compared with objective measurements (e.g. reaction times (RT)). However, the respective testing situations usually differ, to favour objective measures. These typically entail longer test durations with less distractions both factors facilitate sleepiness. Using the Karolinska Sleepiness Scale (KSS) we compared subjective responses with RTs, in 2 min epochs, over 10 min periods in identical quiet settings, early afternoon, in 21 healthy volunteers with 5h prior night's sleep restriction. Whereas the initial KSS score was unrelated to 10 min RT, the KSS subsequently showed a similar, significant increase, comparable with RT. Changes in both scores were very significantly correlated. KSS scores indicated that 5 min was an effective 'settling down' period. Participants were good at estimating their sleepiness if presented with a procedure equivalent to that of the objective measure.
Publisher: Frontiers Media SA
Date: 16-08-2021
DOI: 10.3389/FPSYT.2021.710703
Abstract: Background: Behavioral and psychological symptoms of dementia (BPSD, also known as neuropsychiatric symptoms (NPS), changed behaviors and responsive behaviors), occur in up to 90 percent of people living with dementia (PLWD). These symptoms and behaviors strongly correlate with functional and cognitive impairment and contribute to ~30% of overall dementia costs. As decisions regarding care and strategies for BPSD are generally based on professional frames of reference, this study investigates whether the perspectives of PLWD and families/care partner on BPSD terminology can inform a more nuanced conceptualization of BPSD. Methods: PLWD and families/care partners participated in one-on-one semi-structured interviews. A thematic iterative approach was used to code the data and identify common themes until theoretical saturation was reached. Themes were compared between groups. Data were analyzed deductively in relation to pre-existing terminology regarding BPSD, and inductively to discover new ideas on use of such terminology as perceived by PLWD and others. Results: Forty-one volunteers were interviewed: 21 PLWD, mean age 71 yrs, mean Mini-Mental State Examination score 25, and 20 family members/care partners. Three main themes emerged from the data: (1) descriptions of BPSD from people with lived experience compared to clinical terms, (2) viewpoints on interpreting causes, and (3) experiences of concurrent BPSD. The experiences described and terms used by PLWD and families/care partners differed from terms used in existing professional frameworks (e.g., “disinhibition” described as ‘loss of filter') and there were differences between PLWD and family members' interpretations of BPSD causes. Discussion/Conclusion: Reports from PLWD and families/carers describing their experiences of BPSD suggest a reconceptualization of BPSD terminology is needed to understand and de-stigmatize these symptoms and behaviors. For ex le, the term “agitated/hard to handle” would benefit by clearer, contextualized description, such as “frustrated with cognitive decline, discriminatory behavior and inadequate support systems.” In better understanding in idual expressions of BPSD, families, professionals and societies will be able to respond in ways that are helpful for PLWD. An informed, integrated understanding of BPSD and improved terminology use will have the potential to improve the quality of care and support for PLWD.
Publisher: Elsevier
Date: 2021
Publisher: Cambridge University Press (CUP)
Date: 02-10-2023
Publisher: Springer Science and Business Media LLC
Date: 18-09-2023
Publisher: Elsevier BV
Date: 08-2019
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.ARR.2022.101669
Abstract: Depression is a common psychological symptom associated with dementia. Pharmacological approaches are often used despite two large negative trials of efficacy. This meta-analysis examines nonpharmacological (i.e., psychosocial) approaches for symptoms of depression in people living with dementia and reports statistical and clinical significance. Relevant studies published between 2012 and 2020 were sourced by searching electronic databases: MEDLINE, EMBASE, PsychINFO, Social Work Abstracts and the Cochrane Central Register of Controlled Trials. Studies were assessed for methodological quality. Random-effects meta-analysis was performed to calculate a pooled effect size (ES) and 95% confidence intervals (CI). Overall, 37 nonpharmacological studies were identified including 2,636 participants. The mean quality rating was high (12/14, SD=1.4). Meta-analysis revealed that nonpharmacological approaches were significantly associated with reduced symptoms of depression with a medium effect size (ES=-0.53, 95%CI [-0.72, -0.33], p < 0.0001). There was considerable heterogeneity between studies. Meta-regression revealed this was not driven by intervention type or setting (residential versus community). Nonpharmacological approaches such as reminiscence, cognitive stimulation/ rehabilitation, therapeutic, music-based approaches and education/ training, have the potential to reduce symptoms of depression in dementia.
Publisher: Cambridge University Press (CUP)
Date: 04-11-2022
DOI: 10.1017/S1041610222000849
Abstract: This study investigated the views of people living with dementia and their families/care partners on (i) what they find helpful or unhelpful regarding behavioral changes, i.e. which coping strategies they used for themselves and/or which responses from others, and (ii) what they consider to be appropriate terminology to describe behavioral changes. One-on-one semi-structured interviews were conducted with people living with dementia and families/care partners face to face, online, or over the telephone. Data from open-ended questions were analyzed inductively. Common themes were derived from the data using an iterative approach. Twenty-one people living with dementia and 20 family members/care partners were interviewed. Four main themes were derived for helpful responses, and three main themes for unhelpful responses. Helpful responses included providing clear professional support pathways and supportive environments where people living with dementia can engage in physical, cognitive, social, and spiritual activities. Unhelpful responses included discriminatory treatment from others and use of medicalized terminology. Views toward terminology varied people with lived experience most favored using “changed behaviors” over other terminology. Areas for improvement included targeting dementia stigma, societal education on dementia, and building confidence in people living with dementia by focusing on living well with dementia. Knowledge of the views of people living with dementia may assist healthcare professionals to provide more appropriate care for people living with dementia.
Publisher: Springer Science and Business Media LLC
Date: 24-11-2020
DOI: 10.1038/S41598-020-76160-9
Abstract: Cocoa flavanols protect humans against vascular disease, as evidenced by improvements in peripheral endothelial function, likely through nitric oxide signalling. Emerging evidence also suggests that flavanol-rich diets protect against cognitive aging, but mechanisms remain elusive. In a randomized double-blind within-subject acute study in healthy young adults, we link these two lines of research by showing, for the first time, that flavanol intake leads to faster and greater brain oxygenation responses to hypercapnia, as well as higher performance only when cognitive demand is high. In idual difference analyses further show that participants who benefit from flavanols intake during hypercapnia are also those who do so in the cognitive challenge. These data support the hypothesis that similar vascular mechanisms underlie both the peripheral and cerebral effects of flavanols. They further show the importance of studies combining physiological and graded cognitive challenges in young adults to investigate the actions of dietary flavanols on brain function.
Publisher: Springer Science and Business Media LLC
Date: 30-04-2018
DOI: 10.1038/S41598-018-24972-1
Abstract: Healthy ageing is associated with decline in cognitive abilities such as language. Aerobic fitness has been shown to ameliorate decline in some cognitive domains, but the potential benefits for language have not been examined. In a cross-sectional s le, we investigated the relationship between aerobic fitness and tip-of-the-tongue states. These are among the most frequent cognitive failures in healthy older adults and occur when a speaker knows a word but is unable to produce it. We found that healthy older adults indeed experience more tip-of-the-tongue states than young adults. Importantly, higher aerobic fitness levels decrease the probability of experiencing tip-of-the-tongue states in healthy older adults. Fitness-related differences in word finding abilities are observed over and above effects of age. This is the first demonstration of a link between aerobic fitness and language functioning in healthy older adults.
Publisher: JMIR Publications Inc.
Date: 27-04-2022
Abstract: hysical inactivity is a preventable risk factor for several chronic diseases and one of the driving forces behind the growing global burden of disease. Recent evidence has shown that interventions using mobile smartphone applications (apps) can promote a significant increase in physical activity (PA) levels. However, the accuracy and reliability of using apps is unknown. he aim of our review is to determine the accuracy and reliability of using mobile apps to measure PA levels in young people. We conducted a systematic review guided by PRISMA. tudies published from 2007 to 2020 were sourced from eight databases (Ovid MEDLINE, Embase (Elsevier), Cochrane Library (Wiley), PsychINFO (EBSCOhost), CINAHL (EBSCOHost), Web of Science (Clarivate), SPORTDiscus (EBSCOhost), and IEEE Xplore Digital Library database). Studies conducted in young people, aged 10-24 years without chronic illness that evaluated a mobile app’s ability to measure PA. Primary outcomes include validity, reliability and/or responsiveness of the measurement approach. Duplicate screening was conducted for eligibility, data extraction and assessing the risk of bias. Results are reported as a systematic review. The main outcome measures assessed were: total PA time (mins/day or mins/week), total moderate-vigorous PA per week, daily step count, intensity measure (heart rate), and frequency measure (days per week). f the 149 identified studies, five met inclusion criteria (n=322 participants, 58% female mean age 14±3 years). Three studies measured criterion validity and compared PA measured via apps against an Actigraph accelerometer. The two studies that reported on construct validity reported a significant difference between self-reported PA and the objective measure. Only one of the five apps examined is available to the public, and though this app was highly accepted by young people, the app recorded PA to be significantly different to participants’ self-reported PA. verall, few studies assess the reliability, validity and responsiveness of mobile apps to measure PA in healthy young people, with studies typically only reporting on one measurement property. Of the three studies that measured validity, all concluded mobile phones to be an acceptable and valid tool. More research is needed into the validity and reliability of smart-phone apps to measure PA levels in this population, as well as populations with other characteristics, including age groups and those with chronic disease. ystematic review registration: PROSPERO CRD42019122242.
Publisher: Cambridge University Press (CUP)
Date: 31-03-2020
Publisher: Wiley
Date: 25-05-2021
DOI: 10.1002/BRB3.2126
Abstract: Resting cerebral blood flow (CBF) and perfusion measures have been used to determine brain health. Studies showing variation in resting CBF with age and fitness level using different imaging approaches have produced mixed findings. We assess the degree to which resting CBF measures through transcranial Doppler (TCD) and arterial spin labeling (ASL) MRI provide complementary information in older and younger, fit and unfit cohorts. Thirty‐five healthy volunteers (20 younger: 24 ± 7y 15 older: 66 ± 7y) completed two experimental sessions (TCD/MRI). Aging and fitness effects within and between imaging modalities were assessed. Middle cerebral artery blood velocity (MCAv, TCD) was lower and transit time (MRI) slower in older compared with younger participants ( p .05). The younger group had higher gray matter cerebral perfusion (MRI) than the older group, albeit not significantly ( p = .13). Surprisingly, fitness effects in the younger group (decrease/increase in MCAv/transit time with fitness, respectively) opposed the older group (increase/decrease in MCAv/transit time). Whole cohort transit times correlated with MCAv (r=−0.63 p .05), whereas tissue perfusion did not correlate with TCD measures. TCD and MRI modalities provide complementary resting CBF measures, with similar effects across the whole cohort and between subgroups (age/fitness) if metrics are comparable (e.g., velocity [TCD] versus transit time [MRI]).
Publisher: Cambridge University Press (CUP)
Date: 25-03-2022
DOI: 10.1017/S1041610222000151
Abstract: Disinhibited behaviors in dementia are associated with multiple negative outcomes. However, effective interventions are under-researched. This systematic review aims to provide an overview of intervention studies that report outcome measures of disinhibited behaviors in dementia. Systematic searches of the databases MEDLINE, EMBASE, and PsychINFO, Social Work Abstracts and Cochrane Central Register of Controlled Trial databases were conducted for publications published between 2002 and March 2020. We included hand-searched reviews, original articles, case reports, cohort studies, and randomized controlled trials (RCTs). All studies were rated for research quality. Statistical and clinical significance were considered for in idual studies. Effect sizes were included where provided or calculated where possible. Mean effect sizes were calculated for RCTs only. The systematic review included studies involving people living with dementia. The Neuropsychiatric Inventory disinhibition subscale was used most often. Nine pharmacological and 21 nonpharmacological intervention studies utilized different theoretical/clinical approaches. These included pain management, antidepressants, models of care, education and/or training, music-based approaches, and physical activity. The quality of research in RCTs was strong with a greater effect size in nonpharmacological compared to pharmacological approaches (mean Cohen’s d = 0.49 and 0.27, respectively). Disinhibition was a secondary outcome in all studies. Pharmacological (including pain management and antidepressants) and, more so, nonpharmacological (models of care, education/training, physical activity, and music) approaches were effective in reducing disinhibition.
Publisher: Wiley
Date: 19-03-2020
DOI: 10.1113/EP087883
Publisher: Wiley
Date: 31-08-2016
DOI: 10.1113/EP085672
Publisher: JMIR Publications Inc.
Date: 26-04-2022
DOI: 10.2196/39085
Abstract: Physical inactivity is a preventable risk factor for several chronic diseases and one of the driving forces behind the growing global burden of disease. Recent evidence has shown that interventions using mobile smartphone apps can promote a significant increase in physical activity (PA) levels. However, the accuracy and reliability of using apps is unknown. The aim of our review was to determine the accuracy and reliability of using mobile apps to measure PA levels in young people. We conducted a systematic review guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Studies published from 2007 to 2020 were sourced from 8 databases—Ovid MEDLINE, Embase (Elsevier), Cochrane Library (Wiley), PsychINFO (EBSCOhost), CINAHL (EBSCOhost), Web of Science (Clarivate), SPORTDiscus (EBSCOhost), and IEEE Xplore Digital Library database. Studies were conducted in young people aged 10-24 years and without chronic illnesses, who evaluated a mobile app’s ability to measure PA. Primary outcomes included validity, reliability, and responsiveness of the measurement approach. Duplicate screening was conducted for eligibility, data extraction, and assessing the risk of bias. Results were reported as a systematic review. The main physical activity measures evaluated for each study were the following: total PA time (min/day or min/week), total moderate to vigorous PA per week, daily step count, intensity measure (heart rate), and frequency measure (days per week). Of the 149 identified studies, 5 met the inclusion criteria (322 participants, 176 female mean age 14, SD 3 years). A total of 3 studies measured criterion validity and compared PA measured via apps against PA measured via an Actigraph accelerometer. The 2 studies that reported on construct validity identified a significant difference between self-reported PA and the objective measure. Only 1 of the 5 apps examined was available to the public, and although this app was highly accepted by young people, the app recorded PA to be significantly different to participants’ self-reported PA. Overall, few studies assess the reliability, validity, and responsiveness of mobile apps to measure PA in healthy young people, with studies typically only reporting on one measurement property. Of the 3 studies that measured validity, all concluded that mobile phones were acceptable and valid tools. More research is needed into the validity and reliability of smartphone apps to measure PA levels in this population as well as in populations with other characteristics, including other age groups and those with chronic diseases. PROSPERO CRD42019122242 www.crd.york.ac.uk rospero/display_record.php?RecordID=122242
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Claire Burley.