[Effects of curriculum changes on cognitive acquisition and attitude towards basic sciences].
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Attitude↗
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Mild cognitive impairment in Hispanic Americans: an overview of the state of the science.
The identification of persons with mild cognitive impairment (MCI) is becoming a priority in healthcare as persons with this disorder are generally believed to progress to a diagnosis of dementia or Alzheimer's disease (AD) at a higher rate than those persons without it in the general population. Despite the knowledge that minority groups, particularly Hispanics, have been shown to have an increased risk for the development of AD, there is paucity of research in the identification and progression of MCI in ethnic minority groups. This article will review MCI definitions, diagnostic criteria, and gaps that exist in the literature pertaining to MCI in Hispanic Americans. Central questions to be addressed by nurse scientists are given.
Adolescent↗
A neuropsychological approach to intelligence.
This paper proposes that current psychometric intelligence tests are limited in evaluating cognitive activity. From a neuropsychological perspective, they fail to measure some fundamental cognitive abilities such as executive functions, memory, and visuospatial abilities. The analysis of the Wechsler Intelligence Scale presented shows that the original rationale for selecting the specific subtests included in the WAIS was unclear. The concept of a g factor in cognition is also analyzed, with the conclusion that the g factor continues to be controversial. The value of intelligence tests in predicting school performance is also criticized. It is proposed that the psychometric concept of general intelligence should be deleted from cognitive and neurological sciences. Finally, it is proposed that, in the future, neuropsychological instruments sensitive to more specific cognitive abilities replace current psychometric intelligence tests.
Cognition↗
Vinpocetine for cognitive impairment and dementia.
BACKGROUND: Vinpocetine is a synthetic ethyl ester of apovincamine, a vinca alkaloid obtained from the leaves of the Lesser Periwinkle (Vinca minor) and discovered in the late 1960s. Although used in human treatment for over twenty years, it has not been approved by any regulatory body for the treatment of cognitive impairment. Basic sciences studies have been used to claim a variety of potentially important effects in the brain. However, despite these many proposed mechanisms and targets, the relevance of this basic science to clinical studies is unclear. OBJECTIVES: To assess the efficacy and safety of vinpocetine in the treatment of patients with cognitive impairment due to vascular disease, Alzheimer's disease, mixed (vascular and Alzheimer's disease) and other dementias. SEARCH STRATEGY: The Cochrane Dementia & Cognitive Improvement Group's Specialized Register was searched using the terms vinpocetin*, cavinton, kavinton, Rgh-4405, Tcv-3B, "ethyl apovincaminate", vinRx, periwinkle, "myrtle vincapervinc" and cezayirmeneksesi. The manufacturers of vinpocetine were asked for information on trials of vinpocetine for dementia. In addition we tried to collect articles not listed in MEDLINE or other sources on the Internet (e.g. articles in Hungarian and Romanian). SELECTION CRITERIA: All human, unconfounded, double-blind, randomized trials in which treatment with vinpocetine was administered for more than a day and compared to control in patients with vascular dementia, Alzheimer's dementia or mixed Alzheimer's and vascular dementia and other dementias. Non-randomized trials were excluded. DATA COLLECTION AND ANALYSIS: Data were independently extracted by the two reviewers (SzSz and PW) and cross-checked. Data from "washout" periods were not used for the analysis. For continuous or ordinal variables, such as cognitive test results, the main outcomes of interest were the change in score from baseline. The categorical outcome of global impression was transformed to binary data (improved or not improved) as was the occurrence of adverse effects; here the endpoint itself was of interest the Peto method of the "typical odds ratio" was used. A test for heterogeneity of treatment effects between the trials was made if appropriate. Data synthesis and analysis were performed using the Cochrane Review Manager software (RevMan version 4.1). MAIN RESULTS: All identified studies were performed before the 1990s and used various terms and criteria for cognitive decline and dementia. The three studies included in the review involved a total of 583 people with dementia treated with vinpocetine or placebo. The reports of these studies did not make possible any differentiation of effects for degenerative or vascular dementia. The results show benefit associated with treatment with vinpocetine 30mg/day and 60 mg/day compared with placebo, but the number of patients treated for 6 months or more was small. Only one study extended treatment to one year. Adverse effects were inconsistently reported and without regard for relationship to dose. The available data do not demonstrate many problems of adverse effects but intention-to-treat data were not available for any of the trials. REVIEWER'S CONCLUSIONS: Although the basic science is interesting, the evidence for beneficial effect of vinpocetine on patients with dementia is inconclusive and does not support clinical use. The drug seems to have few adverse effects at the doses used in the studies. Large studies evaluating the use of vinpocetine for people suffering from well defined types of cognitive impairment are needed to explore possible efficacy of this treatment.
Alzheimer Disease↗
The cognition-sensitive approach to dementia. Parallels with the science of unitary human beings.
1. Theory can provide practical guidelines for nursing interventions and research. 2. The Science of Unitary Human Beings, a grand theory, provides input into clarifying the Cognition-Sensitive Approach, a mid-range theory. 3. Cognition in the Alzheimer's disease process can be categorized hierarchically. 4. The Cognition-Sensitive Approach provides a theoretical base for holistic nursing interventions for people with Alzheimer's disease.
Aged↗
Integrating conventional science and aboriginal perspectives on diabetes using fuzzy cognitive maps.
There is concern among Aboriginal communities in Canada that conventional approaches to the treatment of diabetes are ineffective in part because they fail to recognize the local Aboriginal perspective on the causal determinants of diabetes. While this shortcoming has been recognized, there have been no explicit attempts to practically define these perspectives and prescribe how conventional health management might be altered to incorporate them. In part, this may be due to difficulties in communicating Aboriginal perspectives in a manner which permits incorporation into conventional science-based frameworks. Here we use fuzzy cognitive mapping (FCM) as a technique to represent and compare Canadian Aboriginal and conventional science perspectives on the determinants of diabetes as contained in published articles drawn from a search of Medline and PubMed (1966-2005). The FCM allows for a detailed description of the complex system of culture, spirituality and balance at the root of the Aboriginal view. It also highlights how, for these less tangible factors, it is possible to identify more concrete stressors and outcomes which are amenable to management and monitoring. This preliminary comparison of conventional and Aboriginal views also demonstrates the potential for FCM as a technique to extract, compare and integrate perspectives of different knowledge systems into health management and policy development.
Attitude to Health↗
Assessing pain in cognitively impaired nursing home residents: the state of the science and the state we're in.
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Cognition Disorders↗
Public bioethics and publics: consensus, boundaries, and participation in biomedical science policy.
Public bioethics bodies are used internationally as institutions with the declared aims of facilitating societal debate and providing policy advice in certain areas of scientific inquiry raising questions of values and legitimate science. In the United States, bioethical experts in these institutions use the language of consensus building to justify and define the outcome of the enterprise. However, the implications of public bioethics at science-policy boundaries are underexamined. Political interest in such bodies continues while their influence on societal consensus, public debate, and science policy remains ambiguous. This article presents a theoretical discussion of public bioethics bodies as boundary organizations and examines them in terms of relationship to the moral and cognitive authority of science and other forms of expertise, mechanisms for public participation in controversial science policy, and the deployment of consensus models. The theoretical discussion is examined in the case of the U.S. Human Embryo Research Panel.
Advisory Committees↗
Unconscious inhibition and facilitation at the objective detection threshold: replicable and qualitatively different unconscious perceptual effects.
Although the veridicality of unconscious perception is increasingly accepted, core issues remain unresolved [Jack, A., & Shallice, T. (2001). Introspective physicalism as an approach to the science of consciousness. Cognition, 79, 161-196], and sharp disagreement persists regarding fundamental methodological and theoretical issues. The most critical problem is simple but tenacious-namely, how to definitively rule out weak conscious perception as an alternative explanation for putatively unconscious effects. Using a direct task and objectively undetectable stimuli, the current experiments demonstrate clearly reliable unconscious perceptual effects, which differ qualitatively from weakly conscious effects in fundamental ways. Most importantly, the current effects correlate negatively with stimulus detectability, directly rebutting the exhaustiveness, null sensitivity, and exclusiveness problems [Reingold, E., & Merikle, P. (1988). Using direct and indirect measures to study perception without awareness. Perception & Psychophysics, 44, 563-575; Reingold, E., & Merikle, P. (1990). On the inter-relatedness of theory and measurement in the study of unconscious processes. Mind and Language, 5, 9-28)], which all predict positive correlations. Moreover, the current effects are entirely bidirectional [Katz, (2001). Bidirectional experimental effects. Psychological Methods, 6, 270-281)] and radically uncontrollable, including below-chance performance despite intentions to facilitate. In contrast, weakly conscious effects on direct measures are unidirectional, facilitative, and potentially controllable. Moreover, these qualitative differences also suggest that objective and subjective threshold phenomena are fundamentally distinct, rather than the former simply being a weaker version of the latter [Merikle, P., Smilek, D., Eastwood, J. (2001). Perception without awareness: Perspectives from cognitive psychology. Cognition, 79, 115-134]. Accordingly, it is important to distinguish between rather than conflate these methods. Further, the current effects reinforce recent work [e.g. Naccache, L., Blandin, E., & Dehaene, S. (2002). Unconscious masked priming depends on temporal attention. Psychological Science, 13, 416-424] demonstrating that unconscious effects, although not selectively controllable, are nonetheless mediated by strategic and individual difference factors, rather than being immune to such influences as long thought.
Adult↗
Early science instruction: addressing fundamental issues.
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Child↗
Science, truth, and the unknown.
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Cognition↗
Interpreting the notion that technology is value-neutral.
Value-freedom or value-neutrality is a well-known topic in the philosophy of science. But what about the value-neutrality of technology, medical or other? Is it too far-fetched to imagine technology as in some sense value-neutral--in view of its intimate connection with purposeful human action? No; unexpected perhaps, but less far-fetched than expected. If we try to conceive of technology as a cognitive possibility abstracted from each and every specific social context, we shall find (at least) three senses in which it may be regarded as value-neutral: (1) neutral vis-à-vis different possible uses and ends; (2) neutral before action; (3) neutral qua cognitive object, analogous to the cognitive core of science. The further meanings and implications of these three senses of value-neutrality are discussed. What is this exercise good for? The nature of technology is indeed worth pondering in its own right, not least from this rather unusual angle. But beyond that: as the possible meanings of value-neutrality are tried out, the radical nature of human responsibility for the social implementation of technology will be highlighted.
Diffusion of Innovation↗
Help clients develop hopes for the future.
The purposes of this article are (a) to examine cognitive, emotional, and spiritual aspects of hope as reflected in the literature; (b) to describe three clinical approaches that have been used in occupational therapy to engage clients in development of hopes for the future; and (c) to consider practical issues that have been raised by therapists seeking to incorporate development of hopes in their practice. Literature from health care and the social sciences indicates that cognitive, emotional, and spiritual aspects of hope are interwoven in a complex process that evolves over time after major loss. Three alternative clinical strategies for collaborating with clients in developing hopes are reviewed, including a goal-setting and goal-attainment approach, an occupational change approach, and a life history approach. These clinical strategies are illustrated by the stories of an elderly mental health client, an adult rehabilitation client, and an adolescent orthopedic client, which are drawn from research in which the authors have been involved. Discussion of issues involved in incorporating hope work into daily practice is based on the experiences of practicing therapists who participated in a workshop. These include pragmatic issues of documentation and reimbursement of this aspect of practice as well as clinical issues of how to develop hopes among clients who appear hopeless.
Adolescent↗
A conceptual framework for achieving performance enhancing drug compliance in sport.
There has been, and continues to be, widespread international concern about athletes' use of banned performance enhancing drugs (PEDs). This concern culminated in the formation of the World Anti-Doping Agency (WADA) in November 1999. To date, the main focus on controlling the use of PEDs has been on testing athletes and the development of tests to detect usage. Although athletes' beliefs and values are known to influence whether or not an athlete will use drugs, little is known about athletes' beliefs and attitudes, and the limited empirical literature shows little use of behavioural science frameworks to guide research methodology, results interpretation, and intervention implications. Mindful of this in preparing its anti-doping strategy for the 2000 Olympics, the Australian Sports Drug Agency (ASDA) in 1997 commissioned a study to assess the extent to which models of attitude-behaviour change in the public health/injury prevention literature had useful implications for compliance campaigns in the sport drug area. A preliminary compliance model was developed from three behavioural science frameworks: social cognition models; threat (or fear) appeals; and instrumental and normative approaches. A subsequent review of the performance enhancing drug literature confirmed that the overall framework was consistent with known empirical data, and therefore had at least face validity if not construct validity. The overall model showed six major inputs to an athlete's attitudes and intentions with respect to performance enhancing drug usage: personality factors, threat appraisal, benefit appraisal, reference group influences, personal morality and legitimacy. The model demonstrated that a comprehensive, fully integrated programme is necessary for maximal effect, and provides anti-doping agencies with a structured framework for strategic planning and implementing interventions. Programmes can be developed in each of the six major areas, with allocation of resources to each area based on needs-assessment research with athletes and other relevant groups.
Australia↗
Preliminary investigation of voice onset time production in persons with dysphagia.
The purpose of this study was to determine whether voice onset time (VOT) values of persons with dysphagia differed from those of a person with normal swallow function. Five male subjects with dysphagia (average age = 80.6 years) and a control subject (age = 79 years) read 18 consonant-vowel-consonant words in quasi-random order. These syllables began with the voiced and voiceless cognates from the three stop places of articulation (i.e., bilabial, alveolar, and velar). These consonants were followed by the vowels /i/, /a/, and /u/. Digital audio tape recordings were performed and speech was digitized onto disk. Measurements were completed using BLISS software (Mertus J: BLISS User's Manual. Providence: Department of Cognitive and Linguistic Sciences, Brown University, 1989) implemented on a 486 microcomputer. Averages and standard deviations of the VOT measures for the six stop consonants were compared between the two experimental groups. For the dysphagic speakers, average VOT values for voiceless stops were shorter, and there were larger negative VOT values for voiced stops. Standard deviations for the VOT productions pf the dysphagic subjects were smaller. Statistical comparisons showed significant differences between individual dysphagic speakers and the normal control for three of the five subjects. These preliminary data suggest that dysphagia affects the fine motor control required for accurate VOT production in speech.
Aged↗
Demonstrating translational research for mental health services: an example from stigma research.
In seeking to understand how the goal of providing efficient and effective mental health services can best be attained, services researchers have developed principles and methods that distinguish it from other research approaches. In 2000, the National Institute of Mental Health called for translational research paradigms that seek to expand the conceptual and methodological base of mental health services with knowledge gained from basic behavioral sciences such as cognitive, developmental, and social psychology. The goal of this paper is to enter the discussion of what is translational research by illustrating a services research program of the Chicago Consortium for Stigma Research on mental illness stigma. Our research strives to explain the prejudice and discrimination that some landlords and employers show toward people with mental illness in terms of basic research from social psychology and contextual sociology. We end the paper with a discussion of the implications of this research approach for the very practical issues of trying to change mental illness stigma.
Attitude to Health↗
Social psychological contributions to the decade of the brain. Doctrine of multilevel analysis.
The 1990s were declared by Congress to be the "decade of the brain." This declaration is important to all psychologists, not only neuroscientists, because with this declaration come expectations of the cognitive and behavioral sciences generally and because the brain does not exist in isolation but rather is a fundamental component of developing and aging individuals who themselves are mere actors in the larger theater of life. This article examines the importance of a multilevel, integrative approach to the study of mental and behavioral phenomena in the decade of the brain, reviews how this approach highlights the synergistic relationship between theoretical and clinically relevant research, and illustrates how this approach can foster the transition from microtheories to general psychological theories.
Behavior↗
Commentary on Meehl and Waller's (2002) path analysis and verisimilitude.
P. E. Meehl and N. G. Waller's (2002) proposed method may not yield unique solutions for model parameters nor unique solutions for model lack of fit. The author argues from a naturalistic-cognitive philosophy of science that science seeks objective knowledge and that hypothesis testing is central to achieving that goal. It is also argued that P. E. Meehl and N. G. Waller's proposal blurs the distinction between hypothesis testing and explorations of the data seeking an optimal model to serve as a prospective inductive generalization. But it is noted that inductive generalizations are never unique and must be tested to eliminate those that reflect subjective aspects of the researcher's methods and points of view.
Humans↗