SEARCH · PubMed Health

Results for “Cognitive Reflection”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,297 records · Page 72Linked to original sources

PubMed2006

Indices of low-grade chronic inflammation correlate with early cognitive deterioration in an elderly Greek population.

Elevated serum levels of adhesion molecules (AM) reflect low-grade chronic inflammation and have been associated with several conditions of neuronal damage. The aim of the present study was the investigation of possible correlation between early cognitive decline and inflammatory processes in the elderly as indicated by plasma C-reactive protein (CRP) and AM levels. Thirty-seven subjects with dementia were selected from a community-dwelling, genetically isolated, geriatric population (above 60 years of age) based on the Mini Mental State Examination scale (MMSE) and the Diagnostic and Statistical Manual (DSM-IV) criteria. In parallel, a group of 33 age-matched healthy controls were selected from the same population. The levels of CRP (mg/l), sICAM-1 (ng/ml) and sVCAM-1 (ng/ml) were measured in the serum samples of both groups. Serum concentrations of all three molecules sICAM-1, sVCAM-1 and CRP were significantly higher in the dementia group when compared to controls (656.78 +/- 161.51 versus 467.05 +/- 231.26, p < 0.01; 631.64 +/- 149.76 versus 449.04 +/- 285.27, p < 0.01; 1.53 +/- 0.97 versus 0.7221 +/- 0.61, p < 0.01, respectively). Furthermore, a positive correlation was observed between the three molecules studied and the degree of severity of cognitive impairment. The findings of this study enhance the hypothesis of the presence of an underlying inflammatory process leading to cognitive deterioration and predisposing dementia in the elderly. The present work supports the evaluation of inflammatory molecules as early indicators of cognitive decline in elderly individuals.

Adult↗

PubMed1992

An examination of the implications of adopting a process approach to curriculum planning, implementation and evaluation.

A process may be seen as that which has purpose, organization and structure, facilitating an act of moving forward. Thus, a process reflects Bruner's view of education as facilitating cognitive growth and as a way in which individuals explore and gain mastery over a complex world. A process approach is not without its problems, namely in that some nursing skills require a precise, predetermined outcome best achieved by the use of behavioural objectives. A curriculum promoting growth and continued learning calls for increased funding, which may cause problems in today's financial climate. Exploration of concepts calls for careful planning of practical experience and may be difficult where supernumerary status is not fully implemented. However, a process approach may reduce the theory practice gap and lead to a reflective and proactive practitioner. On-going education of clinical staff is required and increased communication between educational and clinical staff. This approach may lead to a more holistic view of nursing education and achievement measured in not only quantitative but also qualitative terms. Solving the problems that a process approach may present may cause nursing education to be enhanced.

Attitude↗

PubMed2005

Neuropsychologic assessment of frontal lobe dysfunction.

Given the pervasive nature of executive deficit, assessment of executive functions is of crucial importance in neuropsychiatry, child and adolescent psychiatry, geriatric psychiatry, and other related areas. A number of neuropsychologic tests of executive function commonly are used in assessing several clinical disorders, including but not limited to traumatic brain injury, schizophrenia, depression, attention deficit disorder/attention deficit hyperactivity disorder, and dementia. Because the concept of executive control in its current form constitutes an over arching construct, a construct that is based on the cognitive symptoms of the frontal lobe disorder caused by many disparate underlying conditions, no single measure of executive function can adequately tap the construct in its entirety.Therefore, it is necessary to administer several tests of executive function,each assessing a particular aspect of the executive function. An appropriate combination of such neuropsychologic tests and batteries, including the Wisconsin Card Sorting Test, Tower test, Stroop test, the D-KEFS, and the ECB, provides an adequate but relatively crude mechanism for assessing executive systems dysfunction. Neuroscientists continue to refine their understanding of the nature of executive control, and additional innovative procedures that reflect state-of-the-art insights of cognitive neuroscience have been introduced recently. Among a few first steps in that direction are nonveridical, actor-centered procedures such as the CBT and the Iowa Gambling Test.

Cognition Disorders↗

PubMed2002

Cognitive effects of precentral cortical stimulation for pain control: an ERP study.

Electrical stimulation of the motor cortex (MCS) is a promising and increasingly used neurosurgical technique for the control of refractory neuropathic pain. Although its mechanisms of action remain unknown, recent functional imaging data suggest involvement of the thalamus, brainstem and anterior cingulate/orbitofrontal cortex. Since some of these areas are also implicated in higher cognitive functions, notably attentional processes, we analysed cognitive ERPs and behavioural performance during an "oddball" auditory detection task in patients submitted to this procedure. Eleven consecutive patients undergoing MCS because of neuropathic refractory pain, ranging in age from 25 to 71 years, were included in the study. ERPs were obtained in all cases both during the application ("MCS-on") and within the 10 min that followed discontinuation of the procedure ("MCS-off"). In five patients, ERPs could also be obtained just before the start of MCS. When the patients' sample was taken as a whole, there were no consistent effects of MCS on the ERPs. There was, however, a significant interaction of MCS action with the patients' age, reflecting a significant delay during MCS of the cognitive responses N2 and P3 (N200 and P300) in the group of patients older than 50 years exclusively. This effect was rapidly reversible after MCS discontinuation. No MCS-related changes were observed in the N1 component. At the individual level, the effect of MCS on the endogenous ERPs was highly variable, ranging from a total stability of ERPs (mostly in younger subjects) to latency differences of tens of milliseconds in the older group. These results, together with recent experiments showing P300 alteration during repetitive transcranial stimulation, suggest that motor cortex stimulation may interfere with relatively simple cognitive processes such as those underlying target detection, and that the risk of abnormal cognitive effects related to cortical stimulation may increase with age. Although the procedure appears on the whole remarkably safe, complementary neuropsychological studies in this category of patients are advised, as well as caution to possible adverse cognitive effects when using MCS in the elderly, notably in the presence of pre-existent cerebral lesions.

Adult↗

PubMed1990

Cognitive dysfunction in spinal cord injury patients: sensitivity of the Functional Independence Measure subscales vs neuropsychologic assessment.

The Functional Independence Measure (FIM) has been developed to provide an objective measure of functional gains during acute and chronic rehabilitation of disabled individuals, including those with spinal cord injury (SCI). A unique characteristic of the FIM, as compared with other functional scales, is that it reflects abilities in the areas of communication and social cognition. In order to examine the external validity of these subscales, 41 acute SCI patients were evaluated with the FIM just before discharge from acute rehabilitation. The subscale scores were compared to the results of a comprehensive, predominantly motor-free, neuropsychologic battery administered 74.8 +/- 5.3 days postinjury. Evaluation of scatter plots indicated that there were no relationships between any neuropsychologic test results and the discharge FIM social cognition or communication subscale scores. This was attributed to a ceiling effect in the FIM ratings. The results of this study suggest that the FIM cannot be a substitute for comprehensive neuropsychologic assessment in SCI patients.

Adult↗

PubMed2006

Mild memory impairment in healthy older adults is distinct from normal aging.

Mild memory impairment was detected in 28% of a sample of healthy community-dwelling older adults using the delayed recall trial of a word list learning task. Statistical analysis revealed that individuals with memory impairment also demonstrated relative deficits on other measures of memory, and tests of executive function, processing speed and global cognition, as measured by the CERAD and CogState batteries and CANTAB paired associate learning task. These relative deficits cannot be explained by age-related changes, education, intelligence, mood, health-related factors, or the individuals' ApoEepsilon4 status. Memory-impaired individuals (n = 30) did not recognize the extent of their memory and cognitive difficulties beyond the general complaints expressed by normal elderly (n = 77) within the study and their apparent difficulties did not appear to impact on their participation in life activities. These findings suggest it is unlikely that the memory and cognitive difficulties demonstrated by individuals with mild memory impairment reflect normal aging. Rather it is possible that such impairment may signal early neurodegenerative processes worthy of further investigation.

Aged↗

PubMed1995

Reflection-on-practice: enhancing student learning.

The writing of a reflective diary is viewed as an effective tool for promoting reflection and learning in students, and for self-assessment and evaluation of a clinical learning experience. This work is a study of 30 undergraduate nurses and their use of reflective diaries during a period of community health care practice. The theoretical basis of the study is based on Schön's work on reflection-in-action. The research tool, developed for the study of nursing practice by Powell, is based on Mezirow's levels of reflectivity. The findings are that, in the sample used, students do reflect on their practice according to Mezirow's levels of reflectivity, but that the highest number of reflections occur at the lower levels of reflectivity (94% of the total number of scores). However, although only 6% of the total number of scores were found at the higher levels of reflectivity, some 22 of the samples of 30 students did attain conceptual and theoretical reflectivity, the highest levels of reflectivity.

Cognition↗

PubMed2004

The mind-brain relationship: the emergent self.

This paper explores the mind-brain relationship, using insights from contemporary neuroscience. It seeks to investigate how our brains become who we are, how subjective experience arises. In order to do this some explanation is given of the basic concepts of how the brain produces our subjective mental life. Current neuropsychological and neurobiological understanding of early brain development, memory, emotion and consciousness are explored. There is also an attempt at mapping the mind-brain-self relationship from a uniquely Jungian perspective. Clinical material is included in order to show the relevance of these insights to our work in the consulting room, arguing the value of the affect-regulating, relational aspects of the analytic dyad that forge new neural pathways through emotional connection. Such experience forms the emotional scaffolding necessary for the emergence of reflective function.

Brain↗

PubMed1995

Behavioral disturbance in dementia.

Fifty-seven subjects with moderate to severe dementia (49 with Alzheimer's disease) were rated twice, 8 weeks apart, using the Mini-Mental State Examination (MMSE), the Blessed Information-Memory-Concentration Test (BIMC), and the Stockton Geriatric Rating Scale (SGRC). Only three subjects lived at home; the rest were in long-stay hospital beds or nursing homes. For 29 subjects, the first rating coincided with their referral to a comprehensive geriatric psychiatry service. The main hypothesis, that the level of behavioral disturbance would correlate positively with the level of cognitive impairment, was strongly confirmed. This finding may reflect the severity of dementia in the study sample. The correlations between MMSE and BIMC scores were .87 at entry and .92 at exit, suggesting that the two measures were broadly equivalent, although both had marked floor effects. Test-retest reliability was high for all three measures. Overall, medication was of limited effectiveness in managing severe behavioral disturbance, highlighting the need for introducing effective behavioral programs.

Aged↗

PubMed1998

The use of clinical logs to improve nursing students' metacognition: a pilot study.

The purpose of this study was to examine the effectiveness of the use of a reflective clinical log to improve students' thinking strategies and metacognition (cognitive awareness). Rather than prepare a written nursing care plan prior to entering the clinical setting, students instead were asked to write in a clinical log at the completion of their clinical day, reflecting upon client problems that they had identified, the data that were used to identify these problems, the nursing interventions that were used, and the results of these interventions. The students reported that they preferred the use of a reflective log over writing nursing care plans and they felt that the logs improved their ability to think about their thinking (i.e. their metacognition). The results of this pilot study indicate that reflection in clinical logs assists students to become more active learners, to manage their own thinking, and to improve their metacognition. Additional research in this area is needed to confirm study findings and to provide further understanding regarding the effectiveness of clinical logs as a teaching strategy to improve students' metacognition.

Cognition↗

PubMed1994

Detection of stimulus deviance within primate primary auditory cortex: intracortical mechanisms of mismatch negativity (MMN) generation.

Mismatch negativity (MMN) is a cognitive, auditory event-related potential (AEP) that reflects preattentive detection of stimulus deviance and indexes the operation of the auditory sensory ('echoic') memory system. MMN is elicited most commonly in an auditory oddball paradigm in which a sequence of repetitive standard stimuli is interrupted infrequently and unexpectedly by a physically deviant 'oddball' stimulus. Electro- and magnetoencephalographic dipole mapping studies have localized the generators of MMN to supratemporal auditory cortex in the vicinity of Heschl's gyrus, but have not determined the degree to which MMN reflects activation within primary auditory cortex (AI) itself. The present study, using moveable multichannel electrodes inserted acutely into superior temporal plane, demonstrates a significant contribution of AI to scalp-recorded MMN in the monkey, as reflected by greater response of AI to loud or soft clicks presented as deviants than to the same stimuli presented as repetitive standards. The MMN-like activity was localized primarily to supragranular laminae within AI. Thus, standard and deviant stimuli elicited similar degrees of initial, thalamocortical excitation. In contrast, responses within supragranular cortex were significantly larger to deviant stimuli than to standards. No MMN-like activity was detected in a limited number to passes that penetrated anterior and medial to AI. AI plays a well established role in the decoding of the acoustic properties of individual stimuli. The present study demonstrates that primary auditory cortex also plays an important role in processing the relationships between stimuli, and thus participates in cognitive, as well as purely sensory, processing of auditory information.

Acoustic Stimulation↗

PubMed1998

Neuroanatomical aspects of cognitive-behavioural therapy response in obsessive-compulsive disorder. An evolving perspective on brain and behaviour.

BACKGROUND: Recent research has demonstrated that cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) can systematically modify cerebral metabolic activity in a manner which is significantly related to clinical outcome. METHOD: A substantial body of research is reviewed which supports an involvement of neural circuitry connecting the orbitofrontal cortex, cingulate gyrus and basal ganglia in the expression of the symptoms of OCD. RESULTS: Data are presented which expand upon previous work demonstrating effects of CBT on functional interactions between limbic cortex and the basal ganglia. CONCLUSIONS: The relevance of these effects of CBT on brain function is discussed in the context of recent advances in our knowledge of cortical-basal ganglia physiology. The clinical importance of these data is best appreciated when they are seen to reflect the interactive nature of the relationships between cognitive choice, behavioural output and brain activity.

Behavior Therapy↗

PubMed2004

Increased frontal white matter diffusion is associated with glial metabolites and psychomotor slowing in HIV.

Diffusion-weighted imaging (DWI) measures brain water diffusion that is sensitive to microscopic brain injury. A total of 11 HIV seropositive patients were compared to 14 seronegative subjects using DWI, proton magnetic resonance spectroscopy (1H MRS), and neuropsychological tests. The apparent diffusion coefficient (ADC) was significantly increased in the HIV patients, primarily in the frontal white matter (FWM; +5%, p=0.01). Diffusivity correlated positively with the glial marker myo-inositol (r=0.5, p=0.008) and negatively with cognitive performance (NPZ-8 composite score; r=-0.43, p=0.05). These findings suggest increased brain water diffusion may reflect increased glial activation or inflammation, which in turn, may contribute to the cognitive deficits in HIV patients.

Adolescent↗

PubMed1994

Cardiovascular disease and distribution of cognitive function in elderly people: the Rotterdam Study.

OBJECTIVE: To investigate the distribution of cognitive function in elderly people and to assess the impact of clinical manifestations of atherosclerotic disease on this distribution. DESIGN: Single centre population based cross sectional door to door study. SETTING: Ommoord, a suburb of Rotterdam, the Netherlands. SUBJECTS: 4971 subjects aged 55 to 94 years. MAIN OUTCOME MEASURE: Cognitive function as measured by the mini mental state examination. RESULTS: The overall participation rate in the study was 80%. Cognitive test data were available for 90% of the participants. Increasing age and lower educational level were associated with poorer cognitive function. Previous vascular events, presence of plaques in the carotid arteries, and presence of peripheral arterial atherosclerotic disease were associated with worse cognitive performance independent of the effects of age and education. On average the differences were moderate; however, they reflected the net result of a shift of the total population distribution of cognitive function towards lower values. Thereby, they resulted in a considerable increase in the proportion of subjects with scores indicative of dementia. CONCLUSIONS: These findings are compatible with the view that atherosclerotic disease accounts for considerable cognitive impairment in the general population.

Age Distribution↗

PubMed1998

Dissociation of frontal and cerebellar activity in a cognitive task: evidence for a distinction between selection and search.

Human brain imaging studies have found that increases in functional activation in left-frontal cortex during cognitive tasks are often accompanied by similar increases in right-cerebellar regions. The present study used functional magnetic resonance imaging (fMRI) to investigate the distinctive contributions of these regions using a word stem completion task. Stems with many possible completions (MANY condition) were alternately presented with stems that had few possible completions (FEW condition), and subjects were asked to covertly complete each stem with a word and press a response switch for each successful completion. Prominent increases in activation in the MANY, relative to the FEW, condition were observed in the left middle frontal gyrus (Brodmann areas 9/10) and left caudate nucleus. In contrast, portions of the right-cerebellar hemisphere (posterior quadrangular lobule and superior semilunar lobule) and cerebellar vermis exhibited increases in the FEW, relative to the MANY, condition. This double dissociation suggests that the frontal and cerebellar regions make distinctive contributions to cognitive performance, with left-frontal (and striatal) activations reflecting response selection, which increases in difficulty when there are many appropriate responses, and right-cerebellar activation reflecting the search for responses, which increases in difficulty when even a single appropriate response is hard to retrieve.

Adult↗

PubMedDate not supplied

[Naive objectivism in the assessment of behavioral disorders].

Naive objectivism is a widespread attitude in human and social science research, although it disregards important principles of the theory of cognition. In the history of philosophy two naive approaches to the understanding of the world were continually disputed; 1. rationalism which purports unlimited cognitive power of the human mind, 2. a kind of empiricism which denies subjective elements in the process of cognition. Today the overestimation of human understanding is reflected in a dogmatic adherence to specific professional or idealogically biased doctrines and in the dubious ideal of a purely empirical science with its limited applicability to mankind. The exaggerated expectations regarding the inherent lawfulness of the empirical research field is demonstrated by excessive data collection and by the useless attempt to define behavioral disorders as deviation from the statistical norm. However, behavior disorders can only be understood, if the totality of being human is considered. They are to be seen as failing attempts to give and to maintain a meaning to life.

Child Behavior Disorders↗

PubMed1999

Balancing bilinguals: lexical-semantic production and cognitive processing in children learning Spanish and English.

The present study investigated developmental changes in lexical production skills in early sequential bilinguals, in both Spanish (L1) and English (L2), exploring the effects of age, years of experience, and basic-level cognitive processing (specifically the ability to resist interference) within a timed picture-naming task. To assess resistance to interference, naming was compared in low competition (blocked-single language) vs. high competition (mixed-alternating language) conditions. Participants were 100 individuals, 20 at each of 5 different age levels (5-7, 8-10, 11-13, 14-16, & young adults). All had learned Spanish as a first language in the home, with formal English experience beginning at 5 years. Gains were made in both languages across age. However, there was a developmental crossover from Spanish dominance in the youngest children, through a period of relatively balanced Spanish and English skills in middle childhood, culminating in a clear pattern of English dominance among adolescents and young adults. Although all groups experienced a greater slowing of response times in the mixed-language condition relative to the blocked-language condition, developmental changes in the pattern of speed-accuracy trade-offs in the mixed condition can be interpreted to reflect a change in the ability to resist cognitive interference during word production.

Adolescent↗

PubMed1995

The relationship between the mini-mental state examination and cognitive functioning in normal elderly adults: a componential analysis.

The relationship between the Mini-Mental State Examination (MMSE) and selected cognitive performance indices was examined in a sample of 251 non-demented adults over 75 years of age. MMSE items were divided into I 1 binomial content domains and an examination of these revealed that only seven had sufficient variability to predict cognitive performance. A factor analysis with these items yielded three factors, reflecting memory, spatial skill, and the ability to follow commands. After controlling for age and education, these factor scores were included as predictors of specific cognitive tasks including two measures of free recall, and two measures of visuospatial skill. The memory factor score was a strong predictor of the two free recall tasks and block design. The spatial factor score contributed to the prediction of the two visuospatial measures, as well as free recall of organizable words. The results suggest that, in normal ageing, the predictive value of the MMSE is due to subset of cognitively demanding items that are heavily influenced by both memory and visuospatial skills.

Aged↗