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Sarah Black

Publications and source records attributed to Sarah Black.

2 recordsLinked to original sources

How successful is errorless learning in supporting memory for high and low-level knowledge in dementia?

Errorless learning has been shown to be very successful in the rehabilitation of memory problems particularly in patients with severe forms of memory impairment. Much of this research has focused on testing knowledge of specific details studied, ignoring any additional, higher-level knowledge that patients may have acquired during the learning process. Hence, it is pertinent to ask whether errorless learning is equally successful in the acquisition of high and low-level knowledge. In this paper, we present results of several studies comparing the effectiveness of errorless and standard trial-and-error methods in acquisition of high and low-level knowledge in people diagnosed with dementia and non-impaired controls. In Study 1, participants were asked to learn novel face-name-occupation associations; and knowledge across a range of levels, from very general (i.e., high-level) to very specific (i.e., low-level), was examined. For patients with probable Alzheimer's disease and controls there was evidence of increased benefit from errorless training in general, but the technique was most beneficial for patients attempting to retrieve specific detail. Study 2 was conducted to address the problem raised by the failure in Study 1 to manipulate learning condition at our highest knowledge level. This novel manipulation was successful, but neither of the patients received the standard benefit from errorless training. Study 3, involving a small group of dementia patients with mixed diagnoses, was conducted to replicate findings from Study 1. Results from the group analysis confirmed that the benefit obtained from errorless learning increased as a function of knowledge specificity, but again several patients failed to show a consistent effect of learning condition. Implications for use of the errorless technique are discussed.

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Guideline for the management of late-life depression in primary care.

OBJECTIVE: To develop a guideline for the primary care management of depression in later life based on best practice. METHOD: Source material included relevant guidelines, literature reviews and consensus documents coupled with an updated literature review covering 1998-October, 2001. This material was summarised as a series of evidence-based statements and recommendations agreed by consensus. RESULTS: Good quality evidence exists for the pharmacological and psychological treatment of depressive episode (major depression), although not specifically in primary care. There is some evidence of efficacy of antidepressants in late-life dysthymia and minor depression associated with poor functional status. In depressive episode, current evidence suggests acute treatment for at least six weeks and a continuation period of at least 12 months. Both tricyclic antidepressants and Selective Serotonin Re-uptake Inhibitors are effective in longterm prevention. There is less data on how to manage patients who do not respond in the acute treatment phase. More data is needed on sub-groups of patients with specific co-morbid medical conditions and those who are frail. Collaborative care is effective in older depressed primary care patients. CONCLUSIONS: There are effective treatments for depression in primary care. More research is needed to address the optimum treatment of depression with medical co-morbidity and to elucidate the role of newer psychological interventions. Collaborative care between primary care and specialist services is a promising new avenue for management.

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