It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Wednesday, January 29, 2025
People with schizophrenia have an altered ability to visually perceive contrast
Researchers of the University of Barcelona have identified a deficit in contrast perception
Schizophrenia is a serious mental disorder that affects around 1% of the world’s population. Researchers of the University of Barcelona have identified a deficit in contrast perception in people with schizophrenia. According to a review of more than 600 studies, these patients have an impaired ability to see differences in light intensity between adjacent areas, which allows us to identify shapes, textures and details in the environment.
These results could help to decipher dysfunctions in the neural and computational mechanisms of schizophrenia. Furthermore, this perceptual alteration could also be explored as a potential non-invasive biomarker for the diagnosis or monitoring of this disorder. However, the authors stress the need for further studies to confirm this relationship and to clarify the role of other factors such as medication in this visual disturbance.
The article, published in the journal Schizophrenia Bulletin, is signed by researchers Daniel Linares and Cristina de la Malla, together with master’s student Aster Joostens, from the Vision and Control of Action Group of the Faculty of Psychology and the UB Institute of Neurosciences (UBneuro).
A key indicator of visual function
The symptoms of schizophrenia are characterized by alterations in thinking and behaviour, such as loss of contact with reality, delusions or hallucinations, but there are also abnormalities in the perception of visual stimuli, such as deficits in the perception of colour or contrast. Understanding these abnormalities may provide clues as to how information processing disturbances contribute to the characteristic symptoms of schizophrenia. “Contrast perception is one of the most fundamental abilities of vision, as without it, we cannot adequately perceive the environment and the objects in it, which can compromise everyday tasks such as moving through space, recognizing faces or reading”, explains the research team, part of the Department of Cognition, Development and Educational Psychology.
The neural mechanisms involved in this alteration could be related to the levels of glutamate, a neurotransmitter thought to play a central role in the pathogenesis of the disease. “A decrease in this neurotransmitter can lead to reduced neural activity in the brain areas responsible for processing contrast. Consequently, a decrease in contrast sensitivity, although not of great magnitude, may reflect an underlying impairment in the glutamatergic system of affected individuals”, note the experts.
Contrast sensitivity testing could therefore be “a valuable tool for identifying individuals with schizophrenia who show a more pronounced dysfunction in this neurotransmitter pathway. For example, these patients could be ideal candidates for clinical trials evaluating drugs that specifically target glutamatergic signalling”, they state.
According to a review of more than 600 studies, these patients would have difficulty in detecting differences in light intensity between adjacent areas, without which they cannot adequately see their surroundings and objects.
Unravelling the impact of medication and care
The results of the study show a large-scale impairment in contrast perception in people with schizophrenia, but also that this dysfunction may be influenced by other factors. “In the study, we have identified a relationship with the dose of antipsychotic medication administered, suggesting that the impairment may be at least partially due to the effects of the medication”, they note.
Moreover, it would be crucial to know in more detail what the role of attention, as none of the studies reviewed have considered that patients may perform the test less focused — although, according to the experts, these people are known to be more prone to attentional lapses. “A deficit in performing a perceptual or cognitive task may derive from a specific impairment in the processes that the task is designed to assess, but it could also reflect a more generalized cognitive impairment, such as attention lapses, which could be estimated by the proportion of errors in easy tests”, they explain. The fact that the studies have not taken this factor into account “opens up the possibility that these lapses contribute to the deficit that has been observed”, they add. Thus, to determine whether the impairment is directly caused by the illness and to use this indicator as a biomarker of psychosis, the researchers stress the need for further studies with experimental designs that allow the uncoupling of perceptual attention deficits and that include populations with psychotic symptoms, with little or no medication. “In this line, we are currently measuring contrast sensitivity in patients with anti-NMDAR encephalitis, a disease in which there is also psychotic symptomatology, using a paradigm that includes control tests to monitor their attention”, they conclude.
A new study has taken a closer look at how healthcare quality is measured in three major countries—Israel, the United States, and the United Kingdom—uncovering striking similarities and critical gaps. The research delved into Israel’s Quality Indicators in Community Healthcare (QICH), the US’s Healthcare Effectiveness Data and Information Set (HEDIS), and the UK’s Quality and Outcomes Framework (QOF). While all three systems prioritize family medicine and process-focused metrics, the study highlights a lack of attention to structural and outcome-based indicators. The findings underscore the need to rethink how we assess healthcare quality, urging a more balanced approach that includes all aspects of medical care, from infrastructure to patient outcomes. This analysis sheds light on how countries can learn from each other to provide better, more equitable care for their populations.
[Hebrew University of Jerusalem]– A new comparative study led by Prof. Adam J. Rose from the Hebrew University's Braun School of Public Health and Community Medicine, alongside Reut Israeli from the Hebrew University’s Braun School of Public Health and Community Medicine and Dr. Gil A. Geva from Tel Hashomer, sheds light on how healthcare quality is measured in Israel, the United States, and the United Kingdom. The study evaluated three major sets of quality indicators: Israel's Quality Indicators for Community Healthcare (QICH), the US's Healthcare Effectiveness Data and Information Set (HEDIS), and the UK's Quality and Outcomes Framework (QOF).
The findings, published in Journal of General Internal Medicine highlight key differences and similarities in how healthcare systems prioritize quality measures, providing critical insights for future policy development.
The key findings of the study highlight several important aspects. First, all three measure sets heavily focus on family medicine and primary care, which account for the majority of their indicators. This emphasis may inadvertently overlook the contributions of other medical disciplines such as mental health, surgery, and internal medicine.
Second, the study revealed an overwhelming reliance on process measures across the three systems, with limited emphasis on structural and definitive outcome measures. For instance, while QICH emphasized intermediate outcomes, it lacked indicators for structural measures and completely omitted definitive patient outcomes.
Third, the domains of "effective clinical care," "community/population health," and "communication and care coordination" received the most attention across all three systems. However, certain domains, such as "efficiency and cost reduction" and "patient safety," were underrepresented, particularly in QICH and QOF.
Finally, the study attributes differences in indicator selection to systemic and procedural disparities. While QICH operates through a voluntary, collaborative framework with Israel’s HMOs, both HEDIS and QOF are guided by external agencies that rely on financial incentives to drive compliance.
Implications for Policy and Practice:
Dr. Rose emphasized the need for greater balance in quality measurement systems, particularly in addressing underrepresented medical disciplines and quality domains. “Reassessing these indicators regularly could help ensure they better reflect the comprehensive needs of healthcare systems and the populations they serve,” said Dr. Rose.
The study serves as a foundation for future research to refine and expand quality measurement frameworks, enabling healthcare systems to promote more equitable and effective care.
Just over half of U.S. adults (52%) support their state requiring vaccination as a condition of school attendance in an effort to protect children who cannot be vaccinated for medical reasons, according to a January 2025 survey from the Annenberg Public Policy Center.
PHILADELPHIA – With President Donald Trump having threatened school vaccine mandates for children during his campaign, a new survey finds that nearly three-quarters of U.S. adults support requiring that children be vaccinated against preventable diseases such as measles, mumps, and rubella. To protect children who cannot be vaccinated for medical reasons, over half of Americans also support states prohibiting other unvaccinated children from attending school, either private or public. However, support for this prohibition has dropped significantly since the spring of 2019, prior to the Covid-19 pandemic.
Comparing responses from a new January 2025 Annenberg Public Policy Center (APPC) nationally representative survey with an APPC national survey conducted in April and May 2019, less than a year before the World Health Organization declared Covid-19 a global pandemic, we find a significant drop in support for states prohibiting unvaccinated children (for non-medical reasons) from attending public or private schools. Further, the new survey finds increased support for state policies allowing parents to opt out of vaccinating their children for medical, religious, and personal or philosophical reasons. The public, however, continues to support state policies that set aside funding to provide free or discounted access to the measles, mumps, and rubella (MMR) vaccine.
The survey finds that these changes are driven in part by changing views from 2019 to 2025 among self-described Republicans – notably, a decline in support for the mandatory vaccination of children for preventable diseases such as measles, mumps, and rubella, and large increases in support for parents to opt out of having their children vaccinated for medical, religious, and personal or philosophical reasons. The growing support for parental opt-outs is universal across political party for medical exemptions, while religious and personal exemptions are seen to lesser degrees among self-described Democrats or political independents (identifying as independent or with a party other than the Republican or Democratic ones).
APPC’s latest survey asked about state policies because school-related vaccine requirements are set at the state level, not the federal level. Nonetheless, federal actions can influence state-level policy. At a June 22, 2024, campaign event, then-presidential candidate Donald Trump said he would not provide federal funding to any school that has a vaccine requirement:
And on Day One, I will sign a new executive order to cut federal funding for any school pushing Critical Race Theory, and I will not give one penny to any school that has a vaccine mandate or a mask mandate.
To date, Trump has not signed such an order on vaccine mandates.
His nominee for Secretary of Health and Human Services, Robert F. Kennedy, Jr., who lately has been seeking to distance himself from his long-promoted anti-vaccine views, led the vaccination-focused organization Children’s Health Defense before he stepped aside in April 2023 to run for president. As stated currently on its website, that organization takes the position “it should be the parent’s choice, and not the government’s, to decide what goes into the bodies of their children. Statewide policy is becoming more and more oppressive while, at the same time, more inadequately-tested vaccines are added to the childhood schedule. Parents in many states are now fighting to keep their personal beliefs and religious exemptions in place and prevent mandates.”
In July 2023, Kennedy told podcaster Lex Fridman that “There’s no vaccine that is, you know, safe and effective.” However, in a Nov. 6, 2024, statement to NBC News, Kennedy said, “If vaccines are working for somebody, I’m not going to take them away. People ought to have choice, and that choice ought to be informed by the best information … So, I’m going to make sure scientific safety studies and efficacy are out there, and people can make individual assessments about whether that product is going to be good for them.”
Infectious disease expert Paul A. Offit, of Children’s Hospital of Philadelphia, says parents have every right to be skeptical, but that Kennedy has misrepresented the findings of vaccine safety studies and “is a vaccine cynic, failing to accept studies that refute his beliefs.” The Centers for Disease Control and Prevention (CDC) says that the “Food and Drug Administration regulates vaccines to make sure they are safe and effective,” and the CDC publishes an immunization schedule for childhood vaccinations.
While policies around school-related vaccine requirements are set at the state level, most states follow the guidelines and recommendations of the CDC’s Advisory Committee on Immunization Practices (ACIP), part of the U.S. Department of Health and Human Services, which, if confirmed by the U.S. Senate, Kennedy would oversee. Because the HHS secretary has the authority to approve those appointed to ACIP, Kennedy would have the power to refashion that committee’s membership.
The APPC survey findings are based on a nationally representative panel survey of 538 U.S. adults fielded from Jan. 3-5, 2025, with a margin of sampling error of ± 5.2 percentage points. It is compared here with a nationally representative panel survey of 2,344 U.S. adults conducted from April 18-May 13, 2019, with a margin of error of ± 2.8 percentage points, and, where noted, APPC’s nationally representative Annenberg Science and Public Health (ASAPH) knowledge panel waves conducted in January 2023 (n=1,641, MOE ±3.2 pp), June 2023 (n=1,586, MOE ±3.3 pp) and August 2023 (n=1,482, MOE ±3.5 pp). For more on the surveys, see the end of this news release or the topline.
Support for vaccine requirements for MMR for children remains high
Over 7 in 10 U.S. adults (73%) support a policy making it mandatory for parents to vaccinate their children against preventable diseases such as measles, mumps, and rubella. This is not significantly different than the 2019 findings which indicated that 77% supported this type of vaccine requirement.
An analysis of the current findings by party reveals a sharp partisan split, with 86% of Democrats saying it should be mandatory for parents to vaccinate their children against preventable diseases such as measles, while just 62% of Republicans and 72% of independents feel this way.
Most favor states requiring vaccination to attend school, though support has fallen
Certain vaccinations are required for students to attend school in all 50 states and Washington D.C. A majority of U.S. adults (52%) support their state requiring vaccination as a condition of school attendance, whether public or private, in an effort to protect children who cannot be vaccinated for medical reasons. However, this represents a nearly 20-point drop from our survey in spring 2019, when 71% supported requiring vaccination as a condition of public or private school attendance. Support for this requirement declined across all political groups.
In addition, the percentage of those who “strongly support” school-related vaccination requirements has fallen sharply, from nearly half (47%) of U.S. adults in 2019 to barely a quarter (24%) in January 2025.
Nevertheless, when asked to indicate which view is closer to their own when it comes to childhood vaccines for MMR and public-school attendance, 66% say they are closer to the view that healthy children should be required to be vaccinated because of the potential risk when children are not vaccinated. Only a fifth of adults (21%) say they are closer to the view that parents should be able to decide whether to vaccinate their children who attend public schools, even if their decision not to vaccinate creates health risks for other children and adults. These views are little changed from 2023, when we asked ASAPH survey panelists their views in January, June, and August 2023.
Post-pandemic support grows for opt-out choice on vaccinating children
According to the National Council of State Legislatures (NCSL), all states have exemptions from school vaccination requirements for medical reasons. Thirty states and Washington, D.C., allow exemptions from school vaccination requirements for religious reasons, and 13 states allow exemptions for personal or philosophical reasons.
Our survey shows a large and significant increase in support among U.S. adults for states giving parents the choice to opt out of school-associated vaccination of their children for medical, religious, or personal/philosophical reasons. Nearly two-thirds of U.S. adults (63%) somewhat or strongly support a law allowing parents in their state to choose not to vaccinate their children for medical reasons, while a little more than a fifth (22%) oppose such a policy. In 2019, 36% said they would support such a policy and 46% would oppose it.
Nearly 4 in 10 (39%) say they would support a state policy that would allow parents to choose not to vaccinate their children for religious reasons, almost double from 2019, when 20% said they would support this policy. In 2019, 63% said they would oppose states allowing parents to choose not to vaccinate their children on religious grounds, while 41% said they would do so in our 2025 survey.
Support has doubled for state-sanctioned parental choice around vaccines for philosophical reasons. In our January survey, 35% said they would support a policy in their state that would allow parents to choose not to vaccinate their children for personal or philosophical reasons, double the proportion expressing such support in the spring of 2019 (17%). Opposition to this policy dropped from 69% in spring 2019 to 49% in January 2025.
Growing support for parental opt-outs by party
When our 2019 and 2025 respondents were questioned about support for different reasons parents might choose not to vaccinate their children, or to opt out, there was a disproportionate growth over time in Republican and independents’ support, compared with Democrats’, for religious opt-outs, and among Republicans compared with independents and Democrats for personal/philosophical opt-outs. Over time, all three groups saw similar growth in support for medical opt-outs.
Medical opt-outs for childhood vaccines: From 2019 to 2025, support for states offering medical opt-outs for childhood vaccinations increased to 63% from 36%. Over this period, support for medical opt-outs grew by a stunning 31 percentage points among Republicans (to 69% from 38%), 28 percentage points among independents (to 66% from 38%), and 22 points among Democrats (to 53% from 31%). Over this period, the number of those who opposed these opt-outs shrank dramatically, to 20% from 47% among Republicans, 32% from 51% among Democrats, and 17% from 41% among independents. (See the topline for details.)
Religious opt-outs for childhood vaccines: From 2019 to 2025, support for states offering religious opt-outs for childhood vaccinations nearly doubled, to 39% from 20%. Among Republicans support for religious opt-outs grew to 52% from 24% and among independents to 42% from 22% (the change for Democrats was not significant). Again, opposition to these opt-outs sharply dropped, to 29% from 62% among Republicans and 34% from 58% among independents (the change for Democrats was not significant).
Personal or philosophical opt-outs for childhood vaccines: From 2019 to 2025, support for states offering personal or philosophical opt-outs for childhood vaccines more than doubled, to 35% from 17%. Again, Republicans led in supporting these opt-outs, with support growing to 44% from 16% in 2019. Support among Democrats grew to 22% from 12%, and among independents to 38% from 22%. The numbers opposing these opt-outs collapsed most sharply among Republicans, to 41% from 71%, and independents, to 42% from 61% (the change among Democrats was not significant).
Most support state funding of free or discounted MMR vaccines
More than 8 in ten U.S. adults (84%) say they would support their state setting aside public funds to provide free or discounted access to MMR vaccines. This has not significantly changed from 2019, when 81% expressed support for such a policy.
Survey methodology
The data come from survey questions the Annenberg Public Policy Center (APPC) placed on SSRS’s nationally representative opinion panel of 1,077 U.S. adults conducted from Jan. 3-5, 2025. SSRS is an independent market research company. A randomly assigned half-sample of 538 respondents were asked these questions in the same manner as the 2019 survey. The margin of sampling error (MOE) is ± 5.2 percentage points at the 95% confidence level for the n=538 half-sample. The results are compared with a nationally representative panel survey of 2,344 U.S. adults conducted from April 18-May 13, 2019, with a margin of error of ± 2.8 percentage points, and where noted, APPC’s nationally representative ASAPH panel waves conducted in January 2023 (n=1,641 MOE ±3.2 pp), May 2023 (n=1,586, MOE ±3.3 pp) and August 2023 (n=1,482, MOE ±3.5 pp). The margin of sampling error for demographic subgroups is higher. All figures are rounded to the nearest whole number and may not add to 100%. Combined subcategories may not add to totals in the topline and text due to rounding.
Ken Winneg, APPC’s managing director of survey research, managed the data collection and conducted the analysis with APPC research analyst Laura A. Gibson. APPC research analyst Shawn Patterson Jr. contributed to this study. Kathleen Hall Jamieson is the director of APPC.
The Annenberg Public Policy Centerwas established in 1993 to educate the public and policy makers about communication’s role in advancing public understanding of political, science, and health issues at the local, state, and federal levels.
Method of Research
Survey
Caption
APPC's January 2025 survey finds a large and significant increase in support among U.S. adults for states giving parents the choice to opt out of social-associated vaccination of their children for medical, religious, or personal/philosophical reasons. Source: Annenberg Public Policy Center.
There is a partisan split on whether it should be mandatory for parents to vaccinate their children against preventable diseases like measles, mumps, and rubella, with Democrats more supportive (86%) than Republicans (62%).
From 2019 to 2025, support for states offering medical opt-outs for childhood vaccination grew to 63% from 36%. Over this period, support for medical opt-outs grew by 31 percentage points among Republicans, 28 points among independents, and 22 points among Democrats. Source: Annenberg Public Policy Center surveys.
From 2019 to 2025, support for states offering religious opt-outs for childhood vaccinations nearly doubled, to 39% from 20%. Source: Annenberg Public Policy Center surveys
From 2019 to 2025, support for states offering personal or philosophical opt-outs for childhood vaccines more than doubled, to 35% from 17%. Republicans led in supporting these opt-outs, with support growing to 44% from 16% in 2019. Source: Annenberg Public Policy Center
Credit
Annenberg Public Policy Center
Innovative one-minute video game boasts 80% success rate in diagnosing autism
An international partnership results in technology pinpointing autism-specific traits
Credit: Kennedy Krieger Institute and Nottingham Trent University
BALTIMORE, January 28, 2025— A new one-minute video game is able to accurately and efficiently identify children with autism from those who have ADHD or are neurotypical.
Developed by researchers at Kennedy Krieger Institute and Nottingham Trent University, the tool, called the Computerized Assessment of Motor Imitation (CAMI), uses motion-tracking technology to detect differences in motor imitation skills.
In the study, 183 children, ages 7–13, were asked to copy the dance-like movements of a video avatar for one minute, while their imitation performance was measured using CAMI. The video game tool was able to correctly distinguish children with autism vs. neurotypical children with a 80% success rate. CAMI also differentiated autism from ADHD with 70% accuracy. Researchers say that this is a particular challenge because ADHD and autism often co-occur, and it can be hard to identify the diagnoses, even by expert clinicians.
Dr. Stewart Mostofsky, a pediatric neurologist and director of the Center for Neurodevelopmental and Imaging Research at Kennedy Krieger Institute and co-author of the study, says this tool is a step forward in how we diagnose autism.
“Diagnosing autism can be challenging, especially when children have overlapping traits with other conditions like ADHD. If the condition is misdiagnosed, it can impact support and resources for the child.” said Dr. Mostofsky.
It is often time-consuming to diagnose autism, requiring highly trained clinicians and costing families an estimated $1,500 to $3,000 annually, according to the U.S. National Library of Medicine.
Dr. Bahar Tunçgenç, senior author and social development expert at Nottingham Trent University, said: “Autism is traditionally seen as a social-communication disorder, but we now know sensory-motor difficulties, like motor imitation, play a key role in shaping social and communication skills. CAMI identifies autism by tapping into these challenges, which are distinct from ADHD.” She added, “What makes CAMI exciting is its simplicity. Video games are fun for kids, fast for clinicians, and provide clear results.”
With further development, CAMI could be adapted for younger children and those with more severe developmental challenges, broadening its impact. Researchers hope CAMI’s success inspires new ways to simplify and improve diagnostic tools for other conditions.
“This tool could transform autism diagnoses worldwide,” said. Dr. Mostofsky. “By identifying autism as precisely as possible, we can connect children to interventions that improve their quality of life and long-term outcomes. We want to see CAMI used widely in clinics to support diagnosis as an alternative that is quick, low-cost, and requires minimal set-up.”
About Kennedy Krieger Institute Kennedy Krieger Institute, an internationally known, non-profit organization located in the greater Baltimore/Washington, D.C. region, transforms the lives of more than 27,000 individuals a year through inpatient and outpatient medical, behavioral health and wellness therapies, home and community services, school-based programs, training and education for professionals and advocacy. Kennedy Krieger provides a wide range of services for children, adolescents and adults with diseases, disorders or injuries that impact the nervous system, ranging from mild to severe. The Institute is home to a team of investigators who contribute to the understanding of how disorders develop, while at the same time pioneer new interventions and methods of early diagnosis, prevention and treatment. Visit www.kennedykrieger.org/ for more information about Kennedy Krieger.
About Nottingham Trent University
Nottingham Trent University (NTU) has been named UK ‘University of the Year’ five times in six years, (Times Higher Education Awards 2017, The Guardian University Awards 2019, The Times and Sunday Times 2018 and 2023, Whatuni Student Choice Awards 2023) and is consistently one of the top performing modern universities in the UK.
It is the 3rd best modern university in the UK (The Times and Sunday Times Good University Guide 2023). Students have voted NTU 1st in the UK for student employability (Uni Compare 2025)
NTU is the 5th largest UK institution by student numbers, with over 40,000 students and more than 4,400 staff located across six campuses. It has an international student population of almost 7,000 and an NTU community representing over 160 countries.
NTU owns two Queen’s Anniversary Prizes for outstanding achievements in research (2015, 2021). The first recognises NTU’s research on the safety and security of global citizens. The second was awarded for research in science, engineering, arts and humanities to investigate and restore cultural objects, buildings and heritage. The Research Excellence Framework (2021) classed 83% of NTU’s research activity as either world-leading or internationally excellent.
NTU was awarded GOLD in the national 2023 Teaching Excellence Framework (TEF) assessment, as it was in 2019.
NTU is a top 10 for sport (British Universities and Colleges Sport league table 2023). NTU is the most environmentally sustainable university in the UK and second in the world (UI Green Metric University World Rankings, 2023).
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Journal
The British Journal of Psychiatry
Article Title
Evaluating Computerised Assessment of Motor Imitation (CAMI) for identifying autism-specific difficulties not observed for attention-deficit hyperactivity disorder or neurotypical development
