BACKGROUND\nEmotional impairments constitute a crucial and widely described dimension of alcoholism, but several affective abilities are still to be thoroughly explored among alcohol-dependent patients. This is particularly true for empathy, which constitutes an essential emotional competence for interpersonal relations and has been shown to be highly impaired in various psychiatric states. The present study aimed at exploring empathic abilities in alcoholism, and notably the hypothesis of a differential deficit between emotional and cognitive empathy.\n\n\nMETHODS\nEmpathy abilities were evaluated among 30 recently detoxified inpatients diagnosed with alcohol dependence and 30 paired healthy controls, using highly validated questionnaires (Interpersonal Reactivity Index [J Pers Soc Psychol44:113] and Empathy Quotient [J Autism Dev Disord34:163]). Correlational analyses were performed to evaluate the links between empathy scores and psychopathological measures (i.e., depression, anxiety, interpersonal problems, and alexithymia).\n\n\nRESULTS\nWhen psychiatric comorbities are controlled for, alcoholism is not associated with a general empathy deficit, but rather with a dissociated pattern combining impaired emotional empathy and preserved cognitive one. Moreover, this emotional empathy deficit is not associated with depression or anxiety scores, but is negatively correlated with alexithymia and the severity of interpersonal problems.\n\n\nCONCLUSIONS\nAt the theoretical level, this first observation of a specific deficit for emotional empathy in alcoholism, combined with the exact inverse pattern observed in other psychiatric populations, leads to a double-dissociation, which supports the notion that emotional and cognitive empathy are 2 distinct abilities. At the clinical level, this deficit calls for considering emotional empathy rehabilitation as a crucial concern in psychotherapy.

Dissociation between affective and cognitive empathy in alcoholism: A specific deficit for the emotional dimension.

In India, increasing lifespan and decreasing fertility rates have resulted in a growing number of older persons. By 2050, people over 60 years of age are predicted to constitute 19.1% of the total population. This ageing of the population is expected to be accompanied by a dramatic increase in the prevalence of dementia. The aetiopathogenesis of dementia has been the subject of a number of prospective longitudinal studies in North America and Europe; however, the findings from these studies cannot simply be translated to the Indian population. The population of India is extremely diverse in terms of socio-economic, cultural, linguistic, geographical, lifestyle-related and genetic factors. Indeed, preliminary data from recently initiated longitudinal studies in India indicate that the prevalence of vascular and metabolic risk factors, as well as white matter hyperintensities, differs between urban and rural cohorts. More information on the complex role of vascular risk factors, gender and genetic influences on dementia prevalence and progression in Indian populations is urgently needed. Low-cost, culturally appropriate and scalable interventions need to be developed expeditiously and implemented through public health measures to reduce the growing burden of dementia. Here, we review the literature concerning dementia epidemiology and risk factors in the Indian population and discuss the future work that needs to be performed to put in place public health interventions to mitigate the burden of dementia.

/pdf/changing-demography-and-the-challenge-of-dementia-in-india-3lq4ajiw0q.pdf

Changing demography and the challenge of dementia in India.

Background Globally, nearly two-thirds of people with dementia reside in low- and middle-income countries (LMICs), yet research on how to support people with dementia in LMIC settings is sparse, particularly regarding the management of behavioural and psychological symptoms of dementia. Understanding how best to manage these symptoms of dementia with non-specialist approaches in LMICs is critical. One such approach is a non-pharmacological intervention based on the Montessori method. Aims To evaluate the feasibility and acceptability of a culturally adapted, group-based Montessori intervention for care home residents with dementia and their study partners, who were paid care workers in Pakistan. Method This was a two-stage study: a cultural adaptation of the Montessori intervention and a single-arm, open-label, feasibility and acceptability study of 12 participant dyads. Feasibility and tolerability of the intervention and study procedures were determined through the recruitment rate, adherence to the protocol and acceptance of the intervention. Qualitative interviews were undertaken with the study partners. A pre-post exploratory analysis of ratings of behavioural and psychological symptoms of dementia, functional ability and quality of life were also conducted. Results The recruitment and retention rates of people with dementia were acceptable, and the intervention was well tolerated by participant dyads. Findings show a reduction in agitation levels and improvement in mood and interest for the activities. Conclusions Feasibility studies of low-cost, easy-to-deliver and culturally adapted interventions are essential in laying the groundwork for subsequent definitive effectiveness and/or implementation trials for dementia in LMICs, where awareness and resources for dementia are limited.

Montessori intervention for individuals with dementia: feasibility study of a culturally adapted psychosocial intervention in Pakistan (MIRACLE).

Background: Patient and public involvement (PPI) is an active partnership between the public and researchers in the research process. In dementia research, PPI ensures that the perspectives of the person with "lived experience" of dementia are considered. To date, in many lower- and middle-income countries (LMIC), where dementia research is still developing, PPI is not well-known nor regularly undertaken. Thus, here, we describe PPI activities undertaken in seven research sites across South Asia as exemplars of introducing PPI into dementia research for the first time. Objective: Through a range of PPI exemplar activities, our objectives were to: (1) inform the feasibility of a dementia-related study; and (2) develop capacity and capability for PPI for dementia research in South Asia. Methods: Our approach had two parts. Part 1 involved co-developing new PPI groups at seven clinical research sites in India, Pakistan and Bangladesh to undertake different PPI activities. Mapping onto different "rings" of the Wellcome Trust's "Public Engagement Onion" model. The PPI activities included planning for public engagement events, consultation on the study protocol and conduct, the adaptation of a study screening checklist, development and delivery of dementia training for professionals, and a dementia training programme for public contributors. Part 2 involved an online survey with local researchers to gain insight on their experience of applying PPI in dementia research. Results: Overall, capacity and capability to include PPI in dementia research was significantly enhanced across the sites. Researchers reported that engaging in PPI activities had enhanced their understanding of dementia research and increased the meaningfulness of the work. Moreover, each site reported their own PPI activity-related outcomes, including: (1) changes in attitudes and behavior to dementia and research involvement; (2) best methods to inform participants about the dementia study; (3) increased opportunities to share knowledge and study outcomes; and (4) adaptations to the study protocol through co-production. Conclusions: Introducing PPI for dementia research in LMIC settings, using a range of activity types is important for meaningful and impactful dementia research. To our knowledge, this is the first example of PPI for dementia research in South Asia.

/pdf/patient-and-public-involvement-for-dementia-research-in-low-2j8of9968r.pdf

Patient and Public Involvement for Dementia Research in Low- and Middle-Income Countries: Developing Capacity and Capability in South Asia.

Research priority setting aims to collate stakeholder opinion to determine the most pressing research questions. Priority setting exercises influence decisions around research funding, development and policy. We compared published dementia research priority setting exercises from international healthcare systems.

/pdf/comparing-international-dementia-research-priorities-jamn5z0e.pdf

Comparing international dementia research priorities—Systematic review

A roadmap to develop dementia research capacity and capability in Pakistan: A model for low- and middle-income countries

PurposeParents' health literacy is an important element to ensure the sound health of children. One of the major purposes of this study was to systematically collect and review the literature that identified the relationship between two variables: parents' health literacy and their child's health.Design/methodology/approachTo meet the purpose, the authors searched four well-reputed research databases such as Web of Science, Scopus, Google Scholar and LISTA (Library, Information Science and Technology Abstracts) comprehensively to collect the relevant research on the topic. Except for books, various types of content from different years were used for this review. The investigators used Preferred Items for Systematic Reviews and Meta-analysis guidelines to select eligible studies for this review. The authors also assessed the quality of the reviewed research in the light of well-reputed quality guidelines shared by Boynton and Greenhalgh (2004).FindingsThe majority of the reviewed studies found a statistically significant relationship between parents' health literacy and the health of their children. Findings also identified that the majority of the reviewed literature scored from 9 to 12 on the quality assessment criteria. Results also highlighted that the majority of the reviewed research on parents' health literacy and child health has been conducted in the USA and utilized quantitative methods to conduct research on the topic under this study.Research limitations/implicationsThis systematic review has multiple theoretical and practical implications for parents, policymakers and researchers.Originality/valueThis is the first systematically collected and reviewed paper on the relationship between parents' health literacy and child health.

Relationship between parents' health literacy and child health: systematic review

Previous research has linked anti-social behavior (ASB) to subtypes of empathy and also to sensation seeking, but there is limited research on the relative roles of empathy subtypes and sensation seeking traits in predicting ASB subtypes. The current study therefore investigated the relationship between sensation seeking, the three subtypes of empathy (emotional reactivity, cognitive empathy and social skills) and the two subtypes of ASB (physically aggressive and non-aggressive). An online survey consisting of Demographic Variables Questionnaire, Brief Sensation Seeking Scale, Empathy Quotient and the Antisocial Behavior Measure was sent to student volunteers, leading to a total of 537 respondents. Empathy alone accounted for a relatively modest proportion of the total variance in the ASBs, with emotional reactivity being the only significant predictor. Adding sensation seeking to the regression led to a marked improvement in prediction for non-aggressive ASB and a slight but significant improvement for physically aggressive ASB. Sensation seeking, emotional reactivity and social skills (but not cognitive empathy) contributed unique variance for both ASB subtypes. The greatest variance for physically aggressive and non-aggressive ASB were accounted for by emotional reactivity and sensation seeking, respectively. The results indicate that both sensation seeking and sub-types of empathy are important in predicting ASBs. This has theoretical implications for different personality models and has practical implications for the development of preventive measures to avoid such behaviors.

/pdf/sensation-seeking-or-empathy-physically-aggressive-and-non-lv9jromgm7.pdf

Sensation Seeking or Empathy? Physically Aggressive and Non-Aggressive Antisocial Behaviors (ASBs) Amongst University Students

Abstract Health Information Literacy (HIL) influences the decision making of individuals towards the understanding of health-related matters. Married women are the major contributors to family members’ health decisions in a country like Pakistan, where the role of women in family life is very significant. In most families, women are responsible for food selection, cooking, management of the home, including cleanliness etc. Married working women have an integral role both at home and workplace. The current study explores the everyday health information literacy (EHIL) of 213 married working women using a survey research design with a convenient sampling technique from two prominent universities of Lahore, Pakistan. The study’s findings reveal that most of the married working women (3.57 mean value) are well-aware of the sources from where the health-related information can be obtained. Sixty-two percent of the respondents prefer using allopathic healthcare methods for medical treatment. Moreover, 38 percent of women do not understand health-related terminologies. It has been noted that age, education, nature of the job, birthplace, nuclear family system, and educational environment are the significant demographic factors that contribute towards the levels of EHIL.

Measuring Everyday Health Information Literacy: A Survey of Pakistani Married Working Women

/pdf/classifying-and-defining-heterogeneity-within-antisocial-405t63s6ds.pdf

Saima Eman

Papers

A roadmap to develop dementia research capacity and capability in Pakistan: A model for low- and middle-income countries

Relationship between parents' health literacy and child health: systematic review

Sensation Seeking or Empathy? Physically Aggressive and Non-Aggressive Antisocial Behaviors (ASBs) Amongst University Students

Measuring Everyday Health Information Literacy: A Survey of Pakistani Married Working Women

Classifying and Defining Heterogeneity within Antisocial Behaviour