What do IPAQ questions mean to older adults? Lessons from cognitive interviews

Background Most questionnaires used for physical activity (PA) surveillance have been developed for adults aged ≤65 years. Given the health benefits of PA for older adults and the aging of the population, it is important to include adults aged 65+ years in PA surveillance. However, few studies have examined how well older adults understand PA surveillance questionnaires. This study aimed to document older adults’ understanding of questions from the International PA Questionnaire (IPAQ), which is used worldwide for PA surveillance. Methods Participants were 41 community-dwelling adults aged 65-89 years. They each completed IPAQ in a face-to-face semi-structured interview, using the “think-aloud” method, in which they expressed their thoughts out loud as they answered IPAQ questions. Interviews were transcribed and coded according to a three-stage model: understanding the intent of the question; performing the primary task (conducting the mental operations required to formulate a response); and response formatting (mapping the response into pre-specified response options). Results Most difficulties occurred during the understanding and performing the primary task stages. Errors included recalling PA in an “average” week, not in the previous 7 days; including PA lasting ≤10 minutes/session; reporting the same PA twice or thrice; and including the total time of an activity for which only a part of that time was at the intensity specified in the question. Participants were unclear what activities fitted within a question’s scope and used a variety of strategies for determining the frequency and duration of their activities. Participants experienced more difficulties with the moderate-intensity PA and walking questions than with the vigorous-intensity PA questions. The sitting time question, particularly difficult for many participants, required the use of an answer strategy different from that used to answer questions about PA. Conclusions These findings indicate a need for caution in administering IPAQ to adults aged ≥65 years. Most errors resulted in over-reporting, although errors resulting in under-reporting were also noted. Given the nature of the errors made by participants, it is possible that similar errors occur when IPAQ is used in younger populations and that the errors identified could be minimized with small modifications to IPAQ.

Loneliness and classroom participation in adolescents with learning disabilities : a social cognitive view

Students with learning disabilities (LD) often experience significant feelings of loneliness. There is some evidence to suggest that these feelings of loneliness may be related to social difficulties that are linked to their learning disability. Adolescents experience more loneliness than any other age group, primarily because this is a time of identity formation and self-evaluation. Therefore, adolescents with learning disabilities are highly likely to experience the negative feelings of loneliness. Many areas of educational research have highlighted the impact of negative feelings on learning. This begs the question, =are adolescents with learning disabilities doubly disadvantaged in regard to their learning?‘ That is, if their learning experience is already problematic, does loneliness exacerbate these learning difficulties? This thesis reveals the findings of a doctoral project which examined this complicated relationship between loneliness and classroom participation using a social cognitive framework. In this multiple case-study design, narratives were constructed using classroom observations and interviews which were conducted with 4 adolescent students (2 girls and 2 boys, from years 9-12) who were identified as likely to be experiencing learning disabilities. Discussion is provided on the method used to identify students with learning disabilities and the related controversy of using disability labels. A key aspect of the design was that it allowed the students to relate their school experiences and have their stories told. The design included an ethnographic element in its focus on the interactions of the students within the school as a culture and elements of narrative inquiry were used, particularly in reporting the results. The narratives revealed all participants experienced problematic social networks. Further, an alarmingly high level of bullying was discovered. Participants reported that when they were feeling rejected or were missing a valued other they had little cognitive energy for learning and did not want to be in school. Absenteeism amongst the group was high, but this was also true for the rest of the school population. A number of relationships emerged from the narratives using social cognitive theory. These relationships highlighted the impact of cognitive, behavioural and environmental factors in the school experience of lonely students with learning disabilities. This approach reflects the social model of disability that frames the research.

The effects of cognitive ageing on the use of complex interfaces

This paper discusses an experiment investigating the effects of cognitive ageing and prior-experience with technology on using complex interfaces intuitively. Overall 37 participants, between the ages of 18 to 83, participated in this study. All participants were assessed for their cognitive abilities and prior-experience with technology. It was anticipated that the Central Executive function (a component of Working Memory) would emerge as one of the important cognitive functions in using complex interfaces. This was found to be the case with the strongest negative correlation occurring between sustained attention (one of the functions of the Central Executive), the time to complete the task and number of errors made by the participants.

Older adults, interface experience and cognitive decline

This paper describes an experiment undertaken to investigate intuitive interaction, particularly in older adults. Previous work has shown that intuitive interaction relies on past experience, and has also suggested that older people demonstrate less intuitive uses and slower times when completing set tasks with various devices. Similarly, this experiment showed that past experience with relevant products allowed people to use the interfaces of two different microwaves more quickly and intuitively. It also revealed that certain aspects of cognitive decline related to aging, such as central executive function, have more impact on time, correct uses and intuitive uses than chronological age. Implications of these results are discussed.

Cognitive behaviour therapy (CBT) for the treatment of co-occurring depression and substance use : current evidence and directions for future research

Issues and Approach: The high rates of co-occurring depression and substance use, and the negative impact of this on illness course and outcomes have been well established. Despite this, few clinical trials have examined the efficacy of cognitive behaviour therapy (CBT). This paper systematically reviews these clinical trials, with an aim of providing recommendations for how future research can develop a more robust evidence base for the treatment of these common comorbidities. Leading electronic databases, including PubMed (ISI) and PsychINFO (CSA), were searched for peer-reviewed journal articles using CBT for the treatment of co-occurring depression and substance use. Of the 55 articles identified, 12 met inclusion criteria and were included in the review. ---------- Key Findings: There is only a limited evidence for the effectiveness of CBT either alone or in combination with antidepressant medication for the treatment of co-occurring depression and substance use. While there is support for the efficacy of CBT over no treatment control conditions, there is little evidence that CBT is more efficacious than other psychotherapies. There is, however, consistent evidence of improvements in both depression and substance use outcomes, regardless of the type of treatment provided and there is growing evidence that that the effects of CBT are durable and increase over time during follow up. ---------- Conclusions. Rather than declaring the ‘dodo bird verdict’ that CBT and all other psychotherapies are equally efficacious, it would be more beneficial to develop more potent forms of CBT by identifying variables that mediate treatment outcomes.

Simulated cataract and low contrast stimuli impair cognitive performance in older adults : implications for neuropsychological assessment and everyday function

Objective: To investigate how age-related declines in vision (particularly contrast sensitivity), simulated using cataract-goggles and low-contrast stimuli, influence the accuracy and speed of cognitive test performance in older adults. An additional aim was to investigate whether declines in vision differentially affect secondary more than primary memory. Method: Using a fully within-subjects design, 50 older drivers aged 66-87 years completed two tests of cognitive performance - letter matching (perceptual speed) and symbol recall (short-term memory) - under different viewing conditions that degraded visual input (low-contrast stimuli, cataract-goggles, and low-contrast stimuli combined with cataract-goggles, compared with normal viewing). However, presentation time was also manipulated for letter matching. Visual function, as measured using standard charts, was taken into account in statistical analyses. Results: Accuracy and speed for cognitive tasks were significantly impaired when visual input was degraded. Furthermore, cognitive performance was positively associated with contrast sensitivity. Presentation time did not influence cognitive performance, and visual gradation did not differentially influence primary and secondary memory. Conclusion: Age-related declines in visual function can impact on the accuracy and speed of cognitive performance, and therefore the cognitive abilities of older adults may be underestimated in neuropsychological testing. It is thus critical that visual function be assessed prior to testing, and that stimuli be adapted to older adults' sensory capabilities (e.g., by maximising stimuli contrast).

Simulated visual impairment leads to cognitive slowing in older adults

PURPOSE: To investigate the impact of different levels of simulated visual impairment on the cognitive test performance of older adults and to compare this with previous findings in younger adults. METHODS.: Cognitive performance was assessed in 30 visually normal, community-dwelling older adults (mean = 70.2 ± 3.9 years). Four standard cognitive tests were used including the Digit Symbol Substitution Test, Trail Making Tests A and B, and the Stroop Color Word Test under three visual conditions: normal baseline vision and two levels of cataract simulating filters (Vistech), which were administered in a random order. Distance high-contrast visual acuity and Pelli-Robson letter contrast sensitivity were also assessed for all three visual conditions. RESULTS.: Simulated cataract significantly impaired performance across all cognitive test performance measures. In addition, the impact of simulated cataract was significantly greater in this older cohort than in a younger cohort previously investigated. Individual differences in contrast sensitivity better predicted cognitive test performance than did visual acuity. CONCLUSIONS.: Visual impairment can lead to slowing of cognitive performance in older adults; these effects are greater than those observed in younger participants. This has important implications for neuropsychological testing of older populations who have a high prevalence of cataract.

Assessing cognitive development in early childhood : a comparison of the Bayley-III and the Stanford-Binet fifth edition

The Bayley Scales of Infant Development, Third Edition (Bayley-III) and Stanford-Binet Intelligence Scale, Fifth Edition (SB5) were administered in a sample of 26 typically developing children (12 males and 14 females) aged 24 – 42 months. Children completed the assessments in two separate sessions, counterbalanced for order of administration. Scores on the two instruments were not significantly related, with the exception of the SB5 Knowledge score, which was moderately correlated with the Language score on the Bayley-III (r = .41, p = 0.04). Despite no other significant correlations, for 22 of the 26 children, scores were very consistent across the two instruments. Implications for test selection are discussed.

Cognitive processes and strategies employed by children to learn spatial representations

Children often have difficulties in learning spatial representations. This study investigated the effect of four different instructional formats on learning outcomes and strategies used when dealing with spatial tasks such as assembly procedures. It was hypothesised that instructional material that imposed least extraneous cognitive load would facilitate enhanced learning. Forty secondary students were presented with four types of instruction; orthographic drawing, isometric drawing, physical model and, isometric and physical model together. The findings provide evidence to suggest that working from physical models caused least extraneous cognitive load compared to the isometric and orthographic groups. The model group took less time, had more correctly completed models, required fewer extra looks, spent less time studying the instruction and made fewer errors. Problem decomposition, forward working and attending to information in the foreground of the graphical representation strategies were analysed.

Sequential development of algebra knowledge : a cognitive analysis

Learning to operate algebraically is a complex process that is dependent upon extending arithmetic knowledge to the more complex concepts of algebra. Current research has shown a gap between arithmetic and algebraic knowledge and suggests a pre-algebraic level as a step between the two knowledge types. This paper examines arithmetic and algebraic knowledge from a cognitive perspective in an effort to determine what constitutes a pre-algebraic level of understanding. Results of a longitudinal study designed to investigate students' readiness for algebra are presented. Thirty-three students in Grades 7, 8, and 9 participated. A model for the transition from arithmetic to pre-algebra to algebra is proposed and students' understanding of relevant knowledge is discussed.

Cognitive skills required in contemporary workplaces

This paper discusses some of the changes occurring in contemporary workplace practices, and the implications these have for the types of knowledge and skills required to work in such environments. Increasingly, workers need to be multi-skilled to function effectively in contemporary work environments. The nature of multi-skilling is explained in terms of cross-skilling, up-skilling and higher-order thinking skills, and the relevance of multi-skilling in today's workplaces is examined. Finally, the paper explores some factors affecting the acquisition of these desired skills in light of current work practices.

Cognitive load and assembly tasks : effect of instructional formats on learning assembly procedures

The study investigated the effect on learning of four different instructional formats used to teach assembly procedures. Cognitive load and spatial information processing theories were used to generate the instructional material. The first group received a physical model to study, the second an isometric drawing, the third an isometric drawing plus a model and the fourth an orthographic drawing. Forty secondary school students were presented with the four different instructional formats and subsequently tested on an assembly task. The findings indicated that there may be evidence to argue that the model format which only required encoding of an already constructed three dimensional representation, caused less extraneous cognitive load compared to the isometric and the orthographic formats. No significant difference was found between the model and the isometric-plus-model formats on all measures because 80% of the students in the isometric-plus-model format chose to use the model format only. The model format also did not differ significantly from other groups in total time taken to complete the assembly, in number of correctly assembled pieces and in time spent on studying the tasks. However, the model group had significantly more correctly completed models and required fewer extra looks than the other groups.

Cognitive load and mental rotation : structuring orthographic projection for learning and problem solving

Cognitive load theory was used to generate a series of three experiments to investigate the effects of various worked example formats on learning orthographic projection. Experiments 1 and 2 investigated the benefits of presenting problems, conventional worked examples incorporating the final 2-D and 3-D representations only, and modified worked examples with several intermediate stages of rotation between the 2-D and 3-D representations. Modified worked examples proved superior to conventional worked examples without intermediate stages while conventional worked examples were, in turn, superior to problems. Experiment 3 investigated the consequences of varying the number and location of intermediate stages in the rotation trajectory and found three stages to be superior to one. A single intermediate stage was superior when nearer the 2-D than the 3-D end of the trajectory. It was concluded that (a) orthographic projection is learned best using worked examples with several intermediate stages and that (b) a linear relation between angle of rotation and problem difficulty did not hold for orthographic projection material. Cognitive load theory could be used to suggest the ideal location of the intermediate stages.

Co-constructing self-efficacy narratives : a study of four mature age university students

This thesis reports on a study in which research participants, four mature aged females starting an undergraduate degree at a regional Australian university, collaborated with the researcher in co-constructing a self-efficacy narrative. For the purpose of the study, self-efficacy was conceptualized as a means by which an individual initiates action to engage in a task or set of tasks, applies effort to perform the task or set of tasks, and persists in the face of obstacles encountered in order to achieve successful completion of the task or set of tasks. Qualitative interviews were conducted with the participants, initially investigating their respective life histories for an understanding of how they made the decision to embark on their respective academic program. Additional data were generated from a written exercise, prompting participants to furnish specific examples of self-efficacy. These data were incorporated into the individual's self-efficacy narrative, produced as the outcome of the "narrative analysis". Another aspect of the study entailed "analysis of narrative" in which analytic procedures were used to identify themes common to the self-efficacy narratives. Five main themes were identified: (a) participants' experience of schooling . for several participants their formative experience of school was not always positive, and yet their narratives demonstrated their agency in persevering and taking on university-level studies as mature aged persons; (b) recognition of family as an early influence . these influences were described as being both positive, in the sense of being supportive and encouraging, as well as posing obstacles that participants had to overcome in order to pursue their goals; (c) availability of supportive persons – the support of particular persons was acknowledged as a factor that enabled participants to persist in their respective endeavours; (d) luck or chance factors were recognised as placing participants at the right place at the right time, from which circumstances they applied considerable effort in order to convert the opportunity into a successful outcome; and (e) self-efficacy was identified as a major theme found in the narratives. The study included an evaluation of the research process by participants. A number of themes were identified in respect of the manner in which the research process was experienced as a helpful process. Participants commented that: (a) the research process was helpful in clarifying their respective career goals; (b) they appreciated opportunities provided by the research process to view their life from a different perspective and to better understand what motivated them, and what their preferred learning styles were; (c) their past successes in a range of different spheres were made more evident to them as they were guided in self-reflection, and their self-efficacious behaviour was affirmed; and (d) the opportunities provided by their participation in the research process to identify strengths of which they had not been consciously aware, to find confirmation of strengths they knew they possessed, and in some instances to rectify misconceptions they had held about aspects of their personality. The study made three important contributions to knowledge. Firstly, it provided a detailed explication of a qualitative narrative method in exploring self-efficacy, with the potential for application to other issues in educational, counselling and psychotherapy research. Secondly, it consolidated and illustrated social cognitive theory by proposing a dynamic model of self-efficacy, drawing on constructivist and interpretivist paradigms and extending extant theory and models. Finally, the study made a contribution to the debate concerning the nexus of qualitative research and counselling by providing guidelines for ethical practice in both endeavours for the practitioner-researcher.