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PubMed1979

Algorithm-derived, computer-generated interpretive comments in the reporting of laboratory tests.

The volume of laboratory and other data that physicians encounter daily is more than most can mentally process without oversight or error. Routine use of computer-generated reminders is one solution to this problem that is now widely suggested. We report our experience with the daily use of a user-written program of algorithm-derived, computer-generated comments in the reporting of chemical profiles and routine thyroid function tests in a busy medium-sized privately owned independent clinical laboratory.

Blood Chemical Analysis↗
PubMed2001

The nature of semantic memory deficits in Alzheimer's disease: new insights from hyperpriming effects.

While semantic memory deficits are a common landmark of Alzheimer's disease, the nature of these impairments remains to be clarified. Implicit tasks which assess semantic priming effects are often used to understand semantic deficits in Alzheimer's disease, but they have led to unclear conclusions because of methodological problems such as intervention of attentional mechanisms. To explore the effects of semantic priming in Alzheimer's disease and their relationship with semantic memory deficits, we used two tasks, one implicit and the other explicit. The implicit task was a lexical decision task to assess semantic priming, and in which pairs of words had coordinate (tiger-lion) or attribute relationships (zebra-stripe). The explicit task was a semantic knowledge task composed of namings and questions involving superordinate categories and attribute knowledge of concepts. The two tasks systematically assessed the integrity of the same concepts. This protocol was given to 53 Alzheimer's disease patients with mild to moderate dementia and to 20 controls. The Alzheimer's disease group as a whole obtained significantly greater priming effects (hyperpriming) than controls in the coordinate condition, and equivalent priming in the attribute condition. In the coordinate condition, a subgroup of 26 patients, with attribute knowledge deficits, had larger priming effects than both a subgroup without semantic deficits and the control group. These results show that in Alzheimer's disease the semantic priming effects vary according to the degree of attribute loss, and the presence of hyperpriming would reflect semantic memory deficits. This study unravels the fine-grained structure of semantic memory disturbances in Alzheimer's disease with mild to moderate dementia, affecting initially the attributes of concepts within a hierarchical network in which superordinate concepts remain preserved.

Aged↗
PubMed2000

Correlates of disability among elderly retirees with "subclinical" cognitive impairment.

BACKGROUND: We assessed the effects of impaired Executive Control Function (ECF) on Instrumental Activities of Daily Living (IADL) and level of care among noninstitutionalized elderly retirees with "subclinical" cognitive impairment. METHODS: Subjects (N = 561; age 78.2 +/- 5.0 years) were residents of a single, 1,500 bed, continuing care retirement community. Subjects were examined for cognitive impairment using the Executive Interview (EXIT25), Mini-Mental State Examination (MMSE), and an executive clock-drawing task (CLOX). The CLOX is divided into executively sensitive (CLOX 1) and simple constructional (CLOX2) subtests. RESULTS: Residents in congregate high-rises (n = 301) differed significantly from those in independent-living apartments (n = 260) with respect to age, gender, percent living alone, EXIT25, CLOX1, MMSE, and CLOX2 scores (all p < .03). Only differences in ECF measures persisted after adjusting for age and living alone (p < .004). The EXIT25 (p < .006) and CLOX2 (p = .02) were associated with the use of prostheses. The differences in EXIT25 scores persisted after adjusting for level and living alone (p = .01). All instruments distinguished residents with impairment in IADLs. However, only CLOX2 (p < .001), EXIT25 (p < .001), and age (p < .001) made significant independent contributions. CONCLUSIONS: ECF has statistically significant effects on level of care and IADL impairment, even among noninstitutionalized retirees. This emergent disability is not well detected by traditional global cognitive measures. Evaluation and treatment may be delayed unless ECF measures are employed.

Activities of Daily Living↗
PubMed1996

General and specific speed mediation of adult age differences in memory.

The proposal that age-related differences in some measures of speed of performance may not be independent of the age-related differences in other measures of speed of performance has been associated with considerable controversy. Because converging evidence can often resolve this type of controversy, correlation-based procedures are proposed to distinguish general (or common) and specific (or unique) age-related influences on measures of speeded performance. Results from three earlier studies and from a new study suggest that a large proportion of the age-related variance in a wide range of speed measures is shared and is not distinct. Furthermore, the common or general speed factor appears to play an important role in the mediation of age-related differences in memory.

Adolescent↗
PubMed2005

Intrusions in episodic recall: age differences in editing of overt responses.

Two experiments compared episodic word-list recall of young and older adults. In Experiment 1, using standard free-recall procedures, older adults recalled significantly fewer correct items and made significantly more intrusions (recall of items that had not appeared on the target list) than younger adults. In Experiment 2, we introduced a new method, called externalized free recall, in which participants were asked to recall any items that came to mind during the recall period but to indicate with an immediate key press those items they could identify as intrusions. Both age groups generated a large number of intrusions, but older adults were significantly less likely than young adults to identify these as nonlist items. Results suggest that an editing deficit may be a contributor to age differences in episodic recall and that externalized free recall may be a useful tool for testing computationally explicit models of episodic recall.

Adult↗
PubMed1985

Verbatim and inferential memory in young and elderly adults.

Young and elderly adults were tested for inferential and verbatim recall from a list of unrelated sentences. All participants performed an encoding task (pleasantness rating or comprehension task) during input and, at test, attempted to answer a series of who questions. Half of the questions required verbatim recall; the other half could only be answered on the basis of an inference from an input sentence. For both types of question, young adults recalled more than elderly adults. Age differences were larger after pleasantness rating than after the comprehension task for both kinds of recall, suggesting that any benefits of comprehension encoding are not the result of specific attention to inferences but, more generally, result from the meaning integration or unique representation created for each sentence. Analyses of conditionalized recall (i.e., recall given a particular level of similarity between comprehension encoding and experimenter's subsequent inferential cues) showed that old adults were less likely than young adults to use inferential recall cues highly similar to their own comprehension responses.

Adult↗
PubMed1987

Diagnostic errors using the Short Portable Mental Status Questionnaire with a mixed clinical population.

The validity of the Short Portable Mental Status Questionnaire (SPMSQ) was evaluated using two criteria: clinical diagnosis and neuropsychological diagnosis. The 40 study participants represented a mixed clinical sample of neurologic and psychiatric patients, all of whom were or had been inpatients. Laboratory data (CT, EEG, etc.) were available for 45% of the patients. Neuropsychological diagnosis of organic impairment was based on an extensive test battery. The SPMSQ did not significantly relate to either clinical or neuropsychological diagnosis. It is recommended that a "normal" score on the SPMSQ be regarded as nonspecific regarding organic cognitive impairment rather than suggestive of normal brain functioning.

Aged↗
PubMed1989

Are there age differences in chunking?

We examined the ability of younger and older adults to organize letter sequences in memory when no external inducement of chunking was used. In order to do so, subjects were tested on a paired-associate, serial recall task. From these data the number of completely recalled sequences was computed, as well as global and stop transitional error probabilities (TEPs). Older adults recalled fewer correct letter sequences than did the young adults, but the global and stop TEP data indicated that both age groups were chunking the four-letter sequences into two sets of two letters. Thus, the present study indicates that there are no age differences in primary organization, but that older adults exhibit an age deficit in serial recall.

Adult↗
PubMed1990

Adult age group differences in story recall style.

The story recall style of younger (mean age = 18.67 years) and older adults (mean age = 65.96) was examined in this study. Following presentation of a narrative in either fable or non-fable form, participants produced written responses under one of four recall conditions: total recall, summary, gist, or gist plus moral. Analysis of the response protocols revealed quantitative and qualitative differences associated with age in the non-fable but not the fable condition. In response to the non-fable, older adults exhibited a style that was more integrative or interpretive than that of the younger adults, whose protocols were highly text-based and literal. Overall, the fable condition produced more text-based responses than did the non-fable condition. In addition, instructions at recall influenced responding. Response patterns could be shifted toward a more text-based style under total recall instructions, while more interpretive responses were obtained under the gist plus moral condition.

Adolescent↗
PubMed1993

Improvements in cognitive performance for schoolchildren in Zaire, Africa, following an iron supplement and treatment for intestinal parasites.

Tested 47 first-year primary school children at a mission school in rural Zaire for cognitive ability with the Kaufman Assessment Battery for Children (K-ABC) adopted to the language of Kituba. Within a day of this test, each child was evaluated for blood hemoglobin (Hgb) level and the presence of intestinal parasites. Half of the children received an iron supplement (20 mg Fe) for 30 days and those children positive for the intestinal parasites of ankylostome or ascaris were randomly selected to receive either a vermifuge treatment or placebo. All of the children were again evaluated medically and cognitively 4 weeks after the initiation of treatment. Using discriminant analysis, performance on the Mental Processing Composite of the K-ABC 1 month after treatment in combination with increases in blood Hgb resulted in the successful classification of 74% in terms whether a child had received both iron supplement and vermifuge treatment (p = .007). With respect to our home evaluation for each child, factors related to the nutritional and economic well-being of the home environment proved a reliable marker for Simultaneous Processing ability. However, the present findings also suggest that over the short-term, changes in blood Hgb that accompany both vermifuge and iron supplement treatment together can improve certain aspects of cognitive ability, perhaps by means of heightened attentional capacity.

Anemia, Hypochromic↗
PubMed1996

Behavioral sleep states in very low birth weight preterm neonates: relation to neonatal health and vagal maturation.

Assessed the relation of behavioral codes of quiet versus active sleep state to neonatal health status in 62 very low birth weight preterm neonates. Sleep sessions (12 min) were coded for percentage time in active versus quiet sleep at 33, 34, and 35 weeks conceptional age. ECG was monitored during each sleep session to derive measures of heart rate, heart rate variability, and an index of cardiac vagal tone derived from respiratory sinus arrhythmia. Higher risk neonates spent more sleep session time in active sleep than healthier preterm neonates. Cardiac vagal tone showed a maturational change during the study weeks, whereas percentage of sampled sleep time in active sleep did not. Vagal maturation measured by age-related increases in the amplitude of respiratory sinus arrhythmia was associated with less active sleep overall, although weekly measures of respiratory sinus arrhythmia and sleep state were not related. Follow-up data on 30 of the neonates indicated that heart rate variability and cardiac vagal tone, but not sleep state measures, were related to better outcomes in mental processing, social skills, and motor skills, and to fewer behavior problems. Results are discussed in terms of the lack of coupling between behavioral and physiological components of preterm sleep states at this age as compared with that seen in full-term sleep states.

Female↗
PubMed2001

Different brain areas activated during imagery of painful and non-painful 'finger movements' in a subject with an amputated arm.

The purpose of the present study was to investigate differences in brain activation with functional magnetic resonance imaging (fMRI) during imagery of painful and non-painful 'finger movements' and 'hand positioning' in a subject with an amputated arm. The subject was a right-handed man in his mid-thirties who lost his right arm just above the elbow in a car-train accident. MRI was performed with a 1.5 T Siemens Vision Plus scanner. The basic design involved four conditions: imagining 'painful finger movements', 'non-painful finger movements', 'painful hand positioning', 'non-painful hand positioning'. Imagery of finger movements uniquely activated the contralateral primary motor cortex which contains the classic 'hand area'. The lateral part of the anterior cerebellar lobe was also activated during imagery of finger movements. Imagery of pain uniquely activated the somatosensory area, and areas in the left insula and bilaterally in the ventral posterior lateral nucleus of the thalamus. It is suggested that the insula and thalamus may involve neuronal pathways that are critical for mental processing of pain-related experiences, which may relate to a better understanding of the neurobiology of phantom limb pain.

Adult↗
PubMed1981

Time course of mental and psychomotor effects of 30 per cent nitrous oxide during inhalation and recovery.

Two experiments were conducted testing the duration of action of nitrous oxide on human performance. In the first experiment, 11 subjects inhaled 30 per cent nitrous oxide for two periods of 40 min each, 45 min apart. Their mental and psychomotor skills were measured using free recall, tapping board, arithmetic and flicker fusion tests before and 2, 12, 22 and 32 min after establishing and end-tidal concentration of N2O of 30 per cent. Recovery was tested using the same tests 2, 12, 22 and 32 min after discontinuation of N2O. Eleven additional subjects inhaled oxygen only and served as a control group. In the second experiment, 8 subjects received both 30 per cent N2O and oxygen in cross-over fashion, and their flicker fusion threshold was measured. When compared to baseline or oxygen administration, N2O significantly impaired tapping rate, number of words recalled, and performance in arithmetic tests. The effects of N2O were maximal at 2 min and remained similar throughout the entire administration. In flicker fusion tests, the effects of N2O were similar to those of stimulant drugs; N2O improved the subjects' ability to discriminate the fusion of flickering light. Recovery was complete in 22 min. The effects of, and recovery from the second administration of N2O were similar to those of the first experiment. There was no evidence of development of tolerance to mental and psychomotor effects of the drug.

Adult↗
PubMed1991

Correlational analysis of speech audiometric scores, hearing loss, age, and cognitive abilities in the elderly.

A battery of speech audiometric measures and a battery of neuropsychological measures were administered to 200 elderly individuals with varying degrees of pure-tone sensitivity loss. Results were analyzed from the standpoint of the extent to which variation in speech audiometric scores could be predicted by knowledge of pure-tone hearing level, age, and cognitive status. For the four monotic test procedures (PB, SPIN-Low, SPIN-High, and SSI) degree of hearing loss bore the strongest relation to speech recognition score. Cognitive status accounted for little of the variance in any of these four speech audiometric scores. In the case of the single dichotic test procedure (DSI), both degree of hearing loss and speed of mental processing, as measured by the Digit Symbol subtest of the WAIS-R, accounted for significant variance. Finally, age accounted for significant unique variance only in the SSI score.

Aged↗
PubMed1984

Dyslexia.

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Adolescent↗
PubMed1996

Catecholamines in attention-deficit hyperactivity disorder: current perspectives.

OBJECTIVE: To provide an update on the "catecholamine hypothesis" of attention-deficit hyperactivity disorder (ADHD). METHOD: Recent work examining the measurement of the norepinephrine, epinephrine, and dopamine systems in ADHD and normal subjects is reviewed and discussed in the context of recent neuroimaging and animal studies. RESULTS: While data clearly indicate a role for all three of the above neurotransmitters in ADHD, a hypothesis suggesting "too much" or "too little" of a single neurotransmitter will no longer suffice. The central norepinephrine system may be dysregulated in ADHD, such that this system does not efficiently "prime" the cortical posterior attention system to external stimuli. Effective mental processing of information involves an anterior "executive" attention system which may depend on dopaminergic input. The peripheral epinephrine system may be a critical factor in the response of individuals with ADHD to stimulant medication. CONCLUSION: A multistage hypothesis is presented which emphasizes the interaction of norepinephrine, epinephrine, and dopamine in modulation of attention and impulse control.

Attention Deficit Disorder with Hyperactivity↗
PubMed1996

Dreams: their function in health and illness.

Despite centuries of published theory and research, general agreement on the nature and function of dreaming continues to elude the scientific community. As theory and evidence accumulate and collide, the recounting and analysis of dreams continue as powerful clinical tools for healing self and patients. The article reviews major theories of dreaming, including a description of the basic structure of dreams and mental processes in dream formation; explores the usefulness of dreams in promoting health and dealing with illness through the analyses of three dreams; and identifies basic principles of dream exploration for use in clinical nursing practice.

Adaptation, Psychological↗