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PubMed1989

Job strains and job satisfaction of dialysis nurses.

Results are reported from an investigation on job strains in dialysis nurses and needs for psychosocial staff training. 174 dialysis nurses in the Federal Republic of Germany answered the clinical questionnaire, which was distributed in cooperation with the German section of the EDTNA. Although the majority emphasized positive aspects of the job (particularly responsible work, contact to patients, and teamwork), more than one-fourth of the nurses reported marked psychosocial strains. Main sources of stress were doubts about the principle of maximum therapy, the consumerism of some patients, and intrateam tensions. Almost two-thirds confirmed the necessity of psychosocial staff training, favoring training units of 1-2 h once a month. In the staff's opinion psychosocial staff training should mainly include casework and cognitive as well as behavioral training for a better handling of patients and conflicts. Main topics suggested by the nurses for discussion were depression, coping with illness as well as handling of aggressive and pretentious patients. Finally, implications of the findings with respect to the goals and performance of psychosocial staff training are discussed.

Adult↗
PubMed2004

The Revised Kingston Standardized Cognitive Assessment.

The original Kingston Standardized Cognitive Assessment (KSCA) was designed to assess cognitive functioning in the elderly with suspected organic brain damage (i.e. dementia). It was specifically designed to be a relatively quickly administered assessment tool available to mental health professionals who were not trained in specialized cognitive assessment techniques. It was introduced over a decade ago to bridge a gap between brief, narrowly focused rating scales, and intensive, expensive, full neuropsychological assessments. Recently, a revision of the KSCA was completed. This revision includes the addition of a word-list memory task with immediate recall, delayed recall and recognition formats, as well as new norms for patients with Alzheimer's disease (AD). The updated norms reflect the abilities of higher-functioning (community-dwelling) patients. In order to facilitate the Revised KSCAs use we have developed a new scoring and analysis form as well as a more comprehensive scoring and administration manual. These changes have resulted in better detection of earlier Alzheimer's disease and use of comparison groups that reflect the changing referral base. The structure of the revised scale and updated normative data are described. An illustrative clinical case example is also provided.

Aged↗
PubMed2005

A teacher-consultation approach to social skills training for pre-kindergarten children: treatment model and short-term outcome effects.

This study evaluated the post-treatment outcome effects of a classroom-based social skills program for pre-kindergarten children, using a teacher-consultation model. The pre-K RECAP (Reaching Educators, Children, and Parents) program is a semi-structured, cognitive-behavioral skills training program that provides teachers with in-classroom consultation on program implementation and classroom-wide behavior management. Data on children's social skills and behavior problems were collected from parents and teachers at pre- and post-treatment, for 149 children aged 4-5 years (of whom 56% were girls). Significant treatment effects were found for teacher but not parent reports, with treatment group children improving significantly more than comparison group children in their teacher-rated social skills and internalizing and externalizing problems. These results provide some preliminary support for the efficacy of the program on children's social skills and behavior problems, and for a teacher-consultation model for training teachers to implement school-based mental health programs.

Child Behavior Disorders↗
PubMed2002

Gait performance in dementia: the effects of a 6-week resistance training program in an adult day-care setting.

BACKGROUND: Age-related declines in balance and muscle power are largely responsible for the changes in the various components of gait performance among elderly people. But these can often be remedied with strength training. People with cognitive impairment frequently demonstrate impaired gait, putting them at increased risks for falls and serious injury. OBJECTIVES: This paper reports on the effects of a six-week pilot study of moderate intensity strength training on the gait of elderly individuals with dementia who attend a day-care center. METHODS: Twenty-six adults (23 female, three male), age = 79.2 +/- 6.6 years, completed the study. Each subject completed a baseline assessment of lower extremity strength and gait. Gait was evaluated using free- and fast-gait speed over a 6-meter course, the Tinetti-Gait Assessment scale, the 'Timed-Up-and-Go', and the Gait Assessment Rating Scale (GARS). The intervention consisted of moderate-intensity progressive resistance lower extremity exercise using Theraband, for two to three sessions per week over the six weeks. Post-intervention assessment of strength and gait was repeated at the completion of the sixth week. Multiple paired t-tests were calculated for each outcome measure. RESULTS: The baseline assessment of gait suggests a high degree of frailty and risk for falls in the sample. Although post-intervention scores reflected improvement on all gait measures, the only statistically significant change observed was in fast-gait time. CONCLUSION: A six-week resistance training program proved to be of insufficient duration, intensity or specificity to produce significant change in gait outcome measures, with the exception of fast speed gait.

Activities of Daily Living↗
PubMed2006

Computer-assisted cognitive remediation in schizophrenia: what is the active ingredient?

An emerging body of research has shown that computer-assisted cognitive remediation, consisting of training in attention, memory, language and/or problem-solving, produces improvement in neurocognitive function that generalizes to untrained neurocognitive tests and may also impact symptoms and work functioning in patients with schizophrenia. The active ingredient of these interventions, however, remains unknown as control groups in these studies have typically included few, if any, of the elements of these complex behavioral treatments. This study compared the effects of an extended (12-month), standardized, computer-assisted cognitive remediation intervention with those of a computer-skills training control condition that consisted of many of the elements of the experimental intervention, including hours spent on a computer, interaction with a clinician and non-specific cognitive stimulation. Forty-two patients with schizophrenia were randomly assigned to one of two conditions and were assessed with a comprehensive neuropsychological test battery before and after treatment. Results revealed that cognitive-remediation training produced a significant improvement in working memory, relative to the computers-skills training control condition, but that there was overall improvement in both groups on measures of working memory, reasoning/executive-function, verbal and spatial episodic memory, and processing speed. Taken together, these findings suggest that specific practice in neurocognitive exercises targeted at attention, memory and language, produce improvements in neurocognitive function that are not solely attributable to non-specific stimulation associated with working with a computer, interacting with a clinician or cognitive challenge, but that non-specific stimulation has a salutary effect on neurocognition as well.

Adult↗
PubMed1982

The septo-hippocampal system and cognitive mapping.

Rats were trained on a rewarded alternation task, run as a spatial working memory task on an elevated T-maze. Experiment 1 tested the effects of fornix-fimbria (FOFI) lesions on the acquisition, and of medial septal (MS) lesions on the acquisition and retention of this task, when the rats had to use information provided by being forced to run to a selected goal arm. The FOFI lesion produced an enduring impairment; the MS rats showed a severe impairment initially, but subsequently showed some behavioural recovery, when tested in acquisition or in retention. Experiment 2 similarly tested the effects of lateral septal (LS) lesions on acquisition of the task, and found an impairment which again showed signs of recovery with further testing. Experiment 3 was a transfer test conducted on the rats which had shown recovery in Experiments 1 and 2. The rats were now forced to use information provided by simply being placed on a selected goal arm. Both control animals and lesion animals showed identical choice accuracy, lower than that seen in Experiments 1 and 2. Experiment 4 tested acquisition of the task used in Experiment 3, and acquisition of a task in which the rat had to use information provided by running to the goal arm via a different route. Control rats again performed poorly, and scarcely differed from MS rats. It was concluded that rats have difficulty in using information about 'places', and that controls and lesion rats learn the tasks in the same way. The implications for 'cognitive mapping' hypotheses are discussed.

Animals↗
PubMed2004

Indicated prevention of problem gambling among college students.

This research provides a brief qualitative description of the development of an indicated prevention intervention for college student gamblers. The proposed intervention integrates alcohol prevention strategies with elements of gambling treatment. The intervention combines cognitive-behavioral skills-training and motivational interviewing and includes personalized normative feedback, cognitive correction, discussion of gambling consequences, and relapse prevention techniques. Examples detailing all phases of the intervention are provided from interviews conducted in a pilot of the intervention. Preliminary pilot data suggests the intervention shows promise in reducing high risk gambling among college students.

Adult↗
PubMed1994

Experimental visual agnosia in the pigeon.

Recent research on animal cognitive ability has clarified that cognitive ability spreads to several species besides humans. Such studies make it possible to compare brain mechanisms of animal cognition and human cognition. Experimental lesions of the ectostriatum in pigeons caused deficits in the artificial pattern recognition, arbitrary classification of natural objects, conspecific individual recognition and discrimination of two different avian species. The lesions did not result in deficits in natural concept, such as food or conspecific. These results suggest that the ectostriatal lesions selectively disrupt visual cognition acquired through discriminative training.

Agnosia↗
PubMed1999

Equilibrium and limb coordination in mild cognitive impairment and mild Alzheimer's disease.

OBJECTIVE: To examine changes in equilibrium and limb coordination in normal aging, mild cognitive impairment, and moderate cognitive impairment associated with early probable Alzheimer's disease (AD), by means of parametric clinical measures. DESIGN: Case series SETTING: Out-patient clinic. PARTICIPANTS: A consecutive sample of 365 community-residing ambulatory volunteers (137 men, 228 women; mean age 70.4 +/- 9.4 years; mean educational attainment 14.6 +/- 3.1 years), who were followed in an ongoing longitudinal study of aging and AD, comprising cognitively intact individuals, persons with mild cognitive impairment, and patients with mild AD. MEASUREMENTS: For general magnitude of cognitive function, the Global Deterioration Scale (GDS). For cognition, the Mini-Mental State Examination (MMSE). Equilibrium was assessed with parametric measurements of single leg stance (SLS) and tandem walking (TW). Limb coordination was assessed with parametric measurements of foot tapping (FT), alternating pronation and supination (PS), and sequential finger to thumb tapping (FTH). MAIN RESULTS: After adjustment for age, persons with mild cognitive impairment or mild AD had significantly poorer performance on parametric clinical tests of equilibrium and limb coordination compared with cognitively intact individuals (P < .05). CONCLUSIONS: Changes in equilibrium and limb coordination are clinically demonstrable in persons with mild cognitive impairment and mild AD using simple parametric tests. Such tests could potentially identify individuals with increased risk of falling. Early diagnosis and treatment of conditions that can jeopardize equilibrium and limb coordination, as well as balance and coordination training, might help cognitively impaired older people to maintain optimal function and may decrease the risk of falls and injuries.

Accidental Falls↗
PubMed1985

Functional interactions between inferotemporal and prefrontal cortex in a cognitive task.

Monkeys were trained to perform a visual short-term memory task (delayed matching to sample). In some of the animals, cooling probes were implanted over dorsolateral prefrontal cortex, covering sulcus principalis and adjacent areas; microelectrode pedestals were implanted over inferotemporal cortex. Other animals were fitted with converse implants: cooling probes over a portion of the inferotemporal cortical convexity and microelectrode pedestals over prefrontal cortex. In the awake and behaving monkeys, bilateral cooling of either the prefrontal or the inferotemporal region (to 20 degrees C) induced, in the other region, reversible changes of spontaneous and task-related cell discharge. In the two cortices remote cooling induced augmentations and diminutions of cell reaction to the color samples which the animal had to retain for correct performance of the task. The same was true for cell discharge during the delay, the retention period which followed each sample. However, a net effect of remote cooling was, in both cortices, a diminution of color-dependent differences in the reactions and delay-discharge of some cells. Concomitantly, errors of task-performance increased. Cells that as a result of remote cortical cooling showed changes of reaction to the color samples were found more commonly in supragranular than infragranular layers. The results are interpreted as evidence of mutual influences between inferotemporal and prefrontal areas, probably mediated by corticocortical connections. The single-cell data, together with the behavioral data, suggest that those influences are functionally important for visual discrimination and short-term memory.

Action Potentials↗
PubMed2006

Surgical Multimedia Academic, Research and Training (S.M.A.R.T.) tool: a comparative analysis of cognitive efficiency for two multimedia learning interfaces that teach the pre-procedural processes for carpal tunnel release.

This study proposes a series of guidelines for designing multimedia educational interfaces that combine educational strategies with cognitive load theory. There is a large body of research that confirms multimedia education is at least as effective as the traditional approach, but there is no discussion regarding the effectiveness of the interface design. This trial compares two interfaces to determine which design techniques are most cognitively efficient for the learner.

Carpal Tunnel Syndrome↗
PubMed2000

Adult ADHD: evaluation and treatment in family medicine.

Attention-deficit/hyperactivity disorder (ADHD) affects 30 to 50 percent of adults who had ADHD in childhood. Accurate diagnosis of ADHD in adults is challenging and requires attention to early development and symptoms of inattention, distractibility, impulsivity and emotional lability. Diagnosis is further complicated by the overlap between the symptoms of adult ADHD and the symptoms of other common psychiatric conditions such as depression and substance abuse. While stimulants are a common treatment for adult patients with ADHD, antidepressants may also be effective. Cognitive-behavioral skills training and psychotherapy are useful adjuncts to pharmacotherapy.

Adult↗
PubMed2005

Cognitive-behavioral treatment for childhood sleep disorders.

Sleep problems are very prevalent during childhood and may have adverse developmental impact. The efficacy of a number of cognitive-behavioral interventions for the most prevalent problems such as difficulty falling asleep and night-wakings has been repeatedly demonstrated with relatively rapid outcomes and high success rates. Preventive interventions in infancy have shown some promise in lowering the rates of sleep problems in infants of trained parents. Cognitive-behavioral interventions have also been proposed for childhood parasomnias (sleepwalking, night terrors, nightmares, and rhythmic behaviors), however, very limited research has been conducted to assess the efficacy of these interventions. Specific methodological issues, limitations and needs have been identified in the clinical literatures. These issues include: (a) integrating objective sleep assessment methods in clinical research; (b) identifying the specific curative factors of various effective interventions; (c) the absence of long-term follow-up studies for assessing relapse problems; (d) assessing the role of mode of delivery (i.e., professional consultation versus written information) in treatment efficacy; and (e) the need to expand the research on clinical interventions for the parasomnias.

Biomedical Research↗
PubMed1998

Cognitive-behavioral intervention effects on mood and cortisol during exercise training.

The purpose of the present study was to assess the effect of a time limited cognitive-behavioral stress management program (CBSM) on mood state and serum cortisol among men and women rowers (N = 34) undergoing a period of heavy exercise training. After controlling for life-event stress (LES), CBSM was hypothesized to reduce negative mood state and cortisol among rowers during a period of heavy training; mood and cortisol changes over the intervention period were hypothesized to be positively correlated. LES was positively associated with negative affect at study entry. After covariance for LES, rowing athletes randomly assigned to the CBSM group experienced significant reductions in depressed mood, fatigue, and cortisol when compared to those randomized to a control group. Decreases in negative affect and fatigue were also significantly associated with cortisol decrease. These results suggest that CBSM may exert a positive effect on athletes' adaptation to heavy exercise training.

Adolescent↗
PubMed1997

Lack of positive outcomes from a cognitive-behavioral HIV and AIDS prevention intervention for inner-city men: lessons from a controlled pilot study.

African American men are at increasingly high risk for HIV infection, but there have been few studies of HIV risk reduction interventions for heterosexual ethnic minority men. The present study randomly assigned 81 African American men to one of two HIV prevention interventions: a four-session cognitive-behavioral skills training HIV risk reduction intervention that has been successful with other populations or a four-session HIV risk education and sensitization control condition. Men were assessed at baseline, at immediate postintervention, and at a 3-month follow-up. Forty-five percent of participants dropped out of the intervention; dropouts were younger, more likely to have used condoms, and less likely to have been tested for HIV antibodies than men who completed the study. Outcome analyses showed that both interventions significantly increased AIDS-related knowledge, initial intentions to change HIV risk behaviors, and reduced unprotected vaginal intercourse. However, there were no significant differences between groups on any of the measures at postintervention or follow-up assessments. Recognizing the limitations of our small sample size, the results of this initial study caution against generalizing skills training HIV prevention interventions that have been successful with other populations to African American heterosexual men.

Adult↗
PubMed2003

[Qualification via training courses].

Patient education includes cognitive parts as well as coping aspects and learning new skills. Therefore it is necessary to prepare the interdisciplinary training team for their tasks. The German Society of Rheumatology offers special training courses for these tasks. The training courses are divided into a basic seminar and a seminar for special education programs. The basic seminar will mediate knowledge and increase skills used in patient education. Conceptions, effectiveness and advantages are shown. Information and experiences specially mixed with exercises in the areas of communication, group dynamics and adult education take place. In the seminar for special education programs information about this program and its specific problems is given. In addition participants have the possibility to discuss their experiences.

Certification↗