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PubMedDate not supplied

The differential effects of two systematic reading comprehension approaches with students with learning disabilities.

This study compared two highly dissimilar approaches for teaching students to determine character motive when reading three types of narrative text. The three text types used were textually explicit, textually implicit, and scriptually implicit. The two approaches were an explicit rule-based instruction approach and a basal-reader activity-based approach. Forty students with learning disabilities were randomly assigned to either the explicit rule-based or the basal-reader activity-based instructional group. Daily instructional sessions lasted 45 minutes and were conducted for 2 weeks. The groups were evaluated on four comprehension measures: (a) daily retells of stories, (b) unit tests, (c) a transfer measure, and (d) a maintenance measure. The results suggest that rule-based instruction is superior to an activity-based approach when teaching students with learning disabilities to determine character motives irrespective of text type on short-term measures. However, there were no significant differences between the two instructional groups on the maintenance and transfer tests.

Child↗
PubMed1987

Minor head trauma in children: an intervention to decrease functional morbidity.

Minor head trauma is common among children and evokes strong parental reaction. Parents often rush the child to an emergency department or consult their pediatrician by telephone despite the minor nature of the injury. In a previous report we showed that children with minor head trauma appear to have limitations in their usual daily activities and a high rate of school absenteeism. This study was a prospective, randomized trial of an intervention designed to reduce this functional morbidity after head trauma. Parents in the control group (n = 168) received routine discharge instructions. Parents in the intervention group (n = 153) received a discharge interview during which the nurse gave more explicit and behaviorally oriented instructions. The nurse also called intervention parents the next day to reassure them and to urge that the children return to their usual routine. One month after the injury a questionnaire was administered by telephone to assess physical health status, social or functional limitations, and behavior problems. The majority of parents (85%) were anxious, and this was not alleviated by previous experience with head trauma. Triage nurses incorrectly rated one third of the parents as not anxious. Physical health status, role activity indices, and behavior problems, were similar for the intervention and control groups 1 month after the head injury. Subsequent morbidity was highly correlated with parental anxiety. In managing children with minor head trauma, pediatricians and emergency department physicians must focus their discharge instructions on the parent's anxiety, emphasize the minor severity of the injury, and urge that the children return to their usual routine.

Adolescent↗
PubMedDate not supplied

Effectiveness of Spanish intervention for first-grade English language learners at risk for reading difficulties.

The effectiveness of an explicit, systematic reading intervention for first-grade students whose home language was Spanish and who were at risk for reading difficulties was examined. Participants were 69 students in 20 classrooms in 7 schools from 3 districts who initially did not pass the screening in Spanish and were randomly assigned within schools to a treatment or comparison group; after 7 months, 64 students remained in the study. The intervention matched the language of instruction of their core reading program (Spanish). Treatment groups of 3 to 5 students met daily for 50 min and were provided systematic and explicit instruction in oral language and reading by trained bilingual intervention teachers. Comparison students received the school's standard intervention for struggling readers. Observations during core reading instruction provided information about the reading instruction and language use of the teachers. There were no differences between the treatment and comparison groups in either Spanish or English on any measures at pretest, but there were significant posttest differences in favor of the treatment group for the following outcomes in Spanish: Letter-Sound Identification (d = 0.72), Phonological Awareness composite (d = 0.73), Woodcock Language Proficiency Battery-Revised Oral Language composite (d = 0.35), Word Attack (d = 0.85), Passage Comprehension (d = 0.55), and two measures of reading fluency (d = 0.58-0.75).

Child↗
PubMedDate not supplied

[The effect of pre-test verbal instruction on spatial organization of cortical electrical activity].

Analysis of coherence of cortical electric activity performed in 30 healthy subjects revealed changes in the spatial organization of cortical electric activity after listening the instruction, i.e., loading the explicit working memory with a sequence of operations of the cognitive task to be solved in the course of the experiment. Comparison of instructions presenting several cognitive tasks showed that greater load of the working memory is associated with higher coherence of cortical activity, especially, in the parietotemporal and occipital areas.

Brain Mapping↗
PubMed2004

Limiting the playing field: does restricting the number of possible diagnoses reduce errors due to diagnosis-specific feature identification?

INTRODUCTION: Diagnostic hypotheses influence the identification of clinical features by medical trainees. This influence is strong enough to lead students to interpret features incorrectly if the initial diagnostic suggestion is incorrect. In the present study, we investigated whether reducing the pool of possible diagnoses at the time of test to a few highly plausible alternatives would focus the search for and interpretation of clinical features on a few alternative diagnoses and, as a result, reduce the influence of an initial diagnostic hypothesis on feature identification. METHODS: Naive students were taught 10 electrocardiographic (ECG) diagnoses. At test, they were asked to report all features visible on new ECGs. The test ECGs were presented with the suggestion of a tentative diagnosis (either the correct diagnosis or a plausible alternative) under 2 conditions: students were either instructed that the ECG represented one of 3 possible diagnoses (which were explicitly mentioned), or they were instructed that the ECG might represent any of the 10 diagnoses learned. RESULTS: Students' identification of the ECG features was strongly influenced by the diagnostic suggestion. Reducing the number of alternatives available at the time of test did not reduce the impact of a diagnostic suggestion on feature interpretation. DISCUSSION: Increasing the salience of alternative hypotheses does not reduce the impact of a diagnostic suggestion on the interpretation of clinical features.

Bias↗
PubMed1979

Digit span estimation and the effects of explicit strategy training on recall of EMR individuals.

Accuracy of digit span estimation by EMR subjects at two different MA levels, 8 and 11, was assessed. The effects of explicit strategy training, generalized instruction, and no training on recall performance and apportionment of study time were compared. The older group was more realistic in their digit span estimation than was the younger group. Explicit strategy training facilitated digit recall and evoked longer study times than did the other conditions.

Age Factors↗
PubMed1978

A comparison of the mechanisms and some properties of instructed sudomotor and cardiac control.

Instructed control defined as differential compliance with verbal instructions to increase and decrease a response was assessed when a change in sudomotor activation or heart rate was specified as the behavioral goal. Instructed control of heart rate was evident prior to explicit feedback training for this response, but instructed control of sudomotor activation defined as finger sweating and measured as skin conductance was not. Feedback training subsequently established instructed control of sudomotor responding, but such training did not lead to a significant improvement in control of heart rate. Explicit strategy suggestions emphasizing emotional responding and intended or actual movement appeared to interfere with the performance of instructed control under both target conditions. Instructed changes in heart rate were attended by correlated changes in somatomotor and respiratory function. Somatomotor and respiratory responses were also observed when subjects were instructed to change sudomotor activation, but these correlated activities were of small magnitude and were not augmented by feedback training as was target responding. Several accounts of the basis for differences that were evident between the target conditions with respect to feedback effects and response patterns are discussed.

Adult↗
PubMed1993

Perceptual and conceptual cueing in implicit and explicit retrieval.

Subjects saw or heard words in a list (e.g. limerick) and then took two successive tests. The first was a yes/no recognition test in which auditory/visual modality of test words was manipulated orthogonally to the study modality. The second test varied with experimental conditions: subjects produced words to either perceptual (fragment) cues (l- -e-ick) or conceptual cues (What name is given to a lighthearted five-line poem?), under either explicit or implicit retrieval instructions. The major findings were: (a) that regardless of the type of retrieval cue (perceptual or conceptual) the degree of dependency between recognition and cued recall was greater than that between recognition and implicit retrieval; and (b) that modality shifts adversely affected perceptually cued explicit and implicit retrieval, whereas they had no effect either on conceptually cued retrieval or on recognition. These results suggest that the memory system subserving, and the processes involved in, conceptual priming differ from those underlying recognition and perceptual priming.

Analysis of Variance↗
PubMed2005

Stroke Specific Quality of Life Scale: Danish adaptation and a pilot study for testing psychometric properties.

BACKGROUND AND PURPOSE: Stroke has an effect on many aspects of quality of life (QoL) and therefore it is important to measure the magnitude of the impact. Items in the American version of the Stroke Specific Quality of Life (SS-QoL) Scale are developed with help from patients with stroke and include even language impairments. AIMS: To translate and culturally adapt the American SS-QoL Scale, version 2.0, a stroke-specific instrument measuring health-related QoL, into a Danish version, and to perform a pilot testing of the psychometric properties of the instrument. METHODS: The guidelines recommended by Guillemin et al. (J Clin Epidemiol, 46, 1993, 1417) were followed including two independent forward and one back translation, inclusion of laymen, here patients with stroke and their spouses, pretest, and examining selected items with a probing technique. Four couples were included in the pretest, 14 in the pilot study. The patients for pretest and pilot study were selected strategically with regard to interest for participation, experience as stroke survivors, sufficient capacity of language perception and cohabitant status. RESULTS: In the Danish version instructions were made more distinct and formal than in the original American version. Explanatory examples within the items were excluded. One new item adjusted for Danish conditions replaced one in the original version, and the response categories concerning personality were adjusted for cultural differences. The pilot study resulted in a more explicit formulation of the instructions to mark each item only once and on the same line as the item. CONCLUSIONS: A Danish version of SS-QoL version 2.0 has been developed and content as well as format has proved relevant and acceptable to patients with stroke including those with impaired language production. The next step is testing the psychometric properties of the instrument.

Activities of Daily Living↗
PubMedDate not supplied

Formulating secondary-level reading interventions.

Recent advances concerning emerging/beginning reading skills, positive behavioral support (PBS), and three-tiered schoolwide prevention models combined with federal mandates (i.e., IDEA and No Child Left Behind) have stimulated interest in providing early and intensive instructional intervention services to children at risk for reading and behavior problems. New measures for identifying students as early as kindergarten who are not acquiring early basic literacy skills make this possible. However, questions regarding exactly how to formulate, deliver, sustain, and manage secondary-level interventions remain to be addressed. This paper describes first-year, first-grade findings for students participating in secondary-level interventions (i.e., small-group reading instruction) in a randomized trial of the efficacy of secondary and tertiary reading and behavior interventions under way at the Center for Early Intervention in Reading and Behavior, University of Kansas. The formulation of the experimental secondary-level intervention was guided by evidence supporting the efficacy of (a) small groups of 3 to 6 participating students and low student-teacher ratio combined with (b) explicit, phonics-based instruction. Selected curricula were Reading Mastery, Proactive Reading, Programmed Reading, and Read Well, use of which varied by choice across experimental-group schools. PBS was an additional intervention context in experimental schools. Comparison schools and first-grade teachers did not employ the three-tiered model, early screening, or PBS; most students were taught using conventional whole-group instruction, little or no individualization, and curricula with weak scientific evidence. Initial results indicate significantly larger growth for experimental secondary-level at-risk students than for comparisons. Experimental-group first graders not showing growth were those identified with disabilities or behavioral risks and English language learners. Implications are discussed.

Child↗
PubMed2004

Patient expectations of treatment for back pain: a systematic review of qualitative and quantitative studies.

STUDY DESIGN: A systematic review of qualitative and quantitative studies. OBJECTIVES: To summarize evidence from studies among patients with low back pain on their expectations and satisfaction with treatment as part of practice guideline development. SUMMARY OF BACKGROUND DATA: Patients are often dissatisfied with treatment for acute or chronic back pain. METHODS: We searched the literature for studies on patient expectations and satisfaction with treatment for low back pain. Treatment aspects related to expectations or satisfaction were identified in qualitative studies. Percentages of dissatisfied patients were calculated from quantitative studies. RESULTS: Twelve qualitative and eight quantitative studies were found. Qualitative studies revealed the following aspects that patient expectation from treatment for back pain or with which they are dissatisfied. Patients want a clear diagnosis of the cause of their pain, information and instructions, pain relief, and a physical examination. Next, expectations are that there are more diagnostic tests, other therapy or referrals to specialists, and sickness certification. They expect confirmation from the healthcare provider that their pain is real. Like other patients, they want a confidence-based association that includes understanding, listening, respect, and being included in decision-making. The results from qualitative studies are confirmed by quantitative studies. CONCLUSIONS: Patients have explicit expectations on diagnosis, instructions, and interpersonal management. New strategies need to be developed in order to meet patients' expectations better. Practice guidelines should pay more attention to the best way of discussing the causes and diagnosis with the patient and should involve them in the decision-making process.

Attitude to Health↗
PubMed1996

Adherence to single daily dose of aspirin in a chemoprevention trial. An evaluation of self-report and microelectronic monitoring.

A consecutive sample of 64 healthy adults (33 female and 31 male) were recruited at the University of Michigan Medical Center, Ann Arbor. Data were available for analysis on 57 subjects. The participants were asked to take a single daily dose of aspirin ranging from 0 to 640 mg. Adherence to the daily aspirin ingestion was measured by self-report and the Medication Event Monitoring System (MEMS, Aprex Corp, Fremont, Calif); adherence rate for the study population was 35%. The adherence rates for all dosing errors between self-report and Medication Event Monitoring System were significantly different (P = .002). There was no significant gender difference in adherence rates. Adherence to regular aspirin ingestion was poor in healthy, paid subjects despite explicit, written and verbal instructions. Patient self-report alone is not a reliable measure of adherence.

Adult↗
PubMed1978

Verbal reinforcement combinations in schizophrenics.

Investigated the effects of verbal reinforcement paradigms on hospitalized schizophrenics and staff. Positive reinforcement that involved good was found to be relatively ineffective for all groups; furthermore, associating good with the termination of a white noise did not increase its effectiveness for schizophrenics. Verbal punishment was more effective than verbal positive reinforcement for staff, but for schizophrenics only when explicit problem-solving instructions were given. The results suggest that the reduction of deficit is not more likely via verbal punishment; if anything, deficit is increased because of increased staff performance under verbal punishment.

Behavior Therapy↗
PubMed1988

The Munich Personality Test (MPT)--a short questionnaire for self-rating and relatives' rating of personality traits: formal properties and clinical potential.

The Munich Personality Test (MPT) is a brief questionnaire for the assessment of six personality dimensions proper (Extraversion, Neuroticism, Frustration Tolerance, Rigidity, Isolation Tendency, Esoteric Tendencies), one additional scale (Schizoidia, composed of the two shortest scales, Isolation Tendency and Esoteric Tendencies); an Orientation towards Social Norms, which might bias the rating, and the Motivation to perform the rating adequately can be ascertained by means of two control scales. There are two test versions, one for self-rating, the other one for a rating by a key person from the subject's social surroundings ("relatives' rating"). The instruction of both scales explicitly relates to times of mental and physical health in order to reduce the influence of symptoms of a disease on the values of the scales. The data presented indicate a highly consistent factorial structure of self-ratings and relatives' ratings, a significant concordance of both kind of ratings, a sufficient to marked degree of internal consistency of the test scales depending on the number of items in the scales, a fair degree of retest reliability after approximately 1 year and also, though less markedly, after around 7 years in psychiatric patients, and significant differences between groups of psychiatric patients and healthy subjects in all personality scales proper, partially depending on the type of the mental disorder. Judging from relatives' ratings and from other authors' data obtained in recovered patients, these differences cannot be fully explained by the influence of symptoms on the ratings. On the other hand, secondary changes of personality after brain damage have been demonstrated by other authors using a modified testing procedure. On the whole, the MPT offers a fairly differentiated picture of the personality structure in mental patients and healthy subjects.

Adult↗
PubMed2006

The nature of memory related activity in early visual areas.

Memory for visual items can evoke activity in visual processing regions, which is typically assumed to reflect conscious remembering. However, based on previous findings, we hypothesized that such activity in early visual areas (BA17, BA18) may reflect priming, a form of nonconscious memory. We tested this hypothesis in two fMRI experiments with similar stimulus protocols, but explicit or implicit task instructions. During initial runs, abstract shapes were presented to either side of fixation, filled with parallel lines of random orientation and color. In subsequent runs, old and new shapes (plus related shapes in Experiment 2) were presented at fixation. In Experiment 1, participants were instructed to remember each shape and its spatial location during initial runs; during subsequent runs they classified each shape as old and on the "left", old and on the "right", or "new". A right fusiform gyrus region (BA18) and a left lingual gyrus region (BA18) were preferentially associated with shapes previously presented on the left and right, respectively. In support of our hypothesis, this early visual area activity was independent of response accuracy for spatial location. In Experiment 2, for each shape, participants identified parallel line orientation relative to horizontal. Consistent with our hypothesis, specific neural activity was observed in early visual regions (BA17, BA18, extending into BA19), with old activity greater than related and new activity (likely reflecting priming). The results of these experiments provide convergent evidence that memory related early visual area activity (BA17, BA18) can reflect nonconscious processing.

Adult↗
PubMed2005

Is anterior cingulate cortex necessary for cognitive control?

Functional neuroimaging studies in normal humans suggest that dorsal anterior cingulate cortex (dACC) plays an important role in cognitive control. This brain area is reliably activated when tasks require the ongoing adjustment of the allocation of attention. The dACC has come to occupy a central role in theories of attention and cognitive control, which hold that dACC either monitors response conflict, signalling the need for adjustments in cognitive processes, or directly mediates such adjustments. However, functional imaging results cannot establish that a brain area is necessary for a particular cognitive process. This requires evidence from loss-of-function studies. Here we assessed cognitive control in four human subjects with damage to dACC and 12 age- and education-matched control subjects using several measures drawn from the functional imaging literature. All four subjects with dACC damage showed normal adjustments in performance following manipulation of response conflict in both Stroop and go-no go tasks. Furthermore, damage to the dACC did not impair the phenomenon of post-error slowing, nor alter the ability to adjust performance in response to explicit speed or accuracy instructions. Thus, cognitive control, as assessed by four different measures in two different tasks, appears to be intact in these subjects, arguing against a necessary role for dACC in this process.

Adult↗
PubMed2002

Attentional mechanisms linking rejection to hostile reactivity: the role of "hot" versus "cool" focus.

Drawing on the hot-cool systems analysis of self-regulation, we examined whether attentionalfocus mediates the negativity of cognitive-affective reactions to interpersonal rejection. The hypothesis was that whereas a hot, arousing focus to representing rejection experiences should increase anger-hostility, accessing the cool system through distraction and distancing should attenuate such responses. Participants imagined an autobiographical rejection experience, focusing either on their physiological and emotional reactions (hot focus) or on the physical setting of the experience (cool focus). Participants in a third condition received no specific attentional instructions. Both implicit and explicit measures showed that hostile thoughts and feelings were attenuated in the cool-focus compared with the hot-focus condition. The findings support the adaptive value of activating a cooling strategy under hot, arousing conditions that otherwise elicit automatic, hot-system responses.

Adult↗
PubMed2004

Participatory research and evaluation: from best practices for all states to achievable practices within each state in the context of the Master Settlement Agreement.

Because the Centers for Disease Control and Prevention (CDC) already assisted state tobacco control initiatives, many state health departments turned to CDC for guidance on how to use Master Settlement Agreement monies. This article describes how CDC funded participatory research to establish local evidence and provided technical assistance for participatory program evaluation. The article (a) presents a telephone interview study of principal investigators (PIs) to determine how CDC could best facilitate participatory research and (b) identifies factors CDC considered to devise evaluation technical assistance that reflected local context. The interview study identified 8 areas where PIs needed CDC's support to undertake participatory research: continuity, timeliness, flexibility, clear and explicit expectations, appropriate and instructive accountability, creation of a vision for participatory research, tailored technical assistance, and enhancement of partner collaboration and support. These findings are being used to inform CDC's research funding. Meanwhile, user-driven technical assistance for participatory evaluation is being accessed by many states.

Benchmarking↗