Effect Estimation of an Innovative Nursing Intervention to Improve Delirium among Home-Dwelling Older Adults: A Randomized Controlled Pilot Trial.

AIMS: Estimating the effect of a nursing intervention in home-dwelling older adults on the occurrence and course of delirium and concomitant cognitive and functional impairment. METHODS: A randomized clinical pilot trial using a before/after design was conducted with older patients discharged from hospital who had a medical prescription to receive home care. A total of 51 patients were randomized into the experimental group (EG) and 52 patients into the control group (CG). Besides usual home care, nursing interventions were offered by a geriatric nurse specialist to the EG at 48 h, 72 h, 7 days, 14 days, and 21 days after discharge. All patients were monitored for symptoms of delirium using the Confusion Assessment Method. Cognitive and functional statuses were measured with the Mini-Mental State Examination and the Katz and Lawton Index. RESULTS: No statistical differences with regard to symptoms of delirium (p = 0.085), cognitive impairment (p = 0.151), and functional status (p = 0.235) were found between the EG and CG at study entry and at 1 month. After adjustment, statistical differences were found in favor of the EG for symptoms of delirium (p = 0.046), cognitive impairment (p = 0.015), and functional status (p = 0.033). CONCLUSION: Nursing interventions to detect delirium at home are feasible and accepted. The nursing interventions produced a promising effect to improve delirium.

Task-induced deactivation from rest extends beyond the default mode brain network

Activity decreases, or deactivations, of midline and parietal cortical brain regions are routinely observed in human functional neuroimaging studies that compare periods of task-based cognitive performance with passive states, such as rest. It is now widely held that such task-induced deactivations index a highly organized"default-mode network" (DMN): a large-scale brain system whose discovery has had broad implications in the study of human brain function and behavior. In this work, we show that common task-induced deactivations from rest also occur outside of the DMN as a function of increased task demand. Fifty healthy adult subjects performed two distinct functional magnetic resonance imaging tasks that were designed to reliably map deactivations from a resting baseline. As primary findings, increases in task demand consistently modulated the regional anatomy of DMN deactivation. At high levels of task demand, robust deactivation was observed in non-DMN regions, most notably, the posterior insular cortex. Deactivation of this region was directly implicated in a performance-based analysis of experienced task difficulty. Together, these findings suggest that task-induced deactivations from rest are not limited to the DMN and extend to brain regions typically associated with integrative sensory and interoceptive processes.

Task complexity, the Cognition Hypothesis and second language learning and performance

In this paper we describe a taxonomy of task demands which distinguishes between Task Complexity, Task Condition and Task Difficulty. We then describe three theoretical claims and predictions of the Cognition Hypothesis (Robinson 2001, 2003b, 2005a) concerning the effects of task complexity on: (a) language production; (b) interaction and uptake of information available in the input to tasks; and (c) individual differences-task interactions. Finally we summarize the findings of the empirical studies in this special issue which all address one or more of these predictions and point to some directions for continuing, future research into the effects of task complexity on learning and performance.

Transferring control demands across incidental learning tasks - Stronger sequence usage in serial reaction task after shortcut option in letter string checking

After incidentally learning about a hidden regularity, participants can either continue to solve the task as instructed or, alternatively, apply a shortcut. Past research suggests that the amount of conflict implied by adopting a shortcut seems to bias the decision for vs. against continuing instruction-coherent task processing. We explored whether this decision might transfer from one incidental learning task to the next. Theories that conceptualize strategy change in incidental learning as a learning-plus-decision phenomenon suggest that high demands to adhere to instruction-coherent task processing in Task 1 will impede shortcut usage in Task 2, whereas low control demands will foster it. We sequentially applied two established incidental learning tasks differing in stimuli, responses and hidden regularity (the alphabet verification task followed by the serial reaction task, SRT). While some participants experienced a complete redundancy in the task material of the alphabet verification task (low demands to adhere to instructions), for others the redundancy was only partial. Thus, shortcut application would have led to errors (high demands to follow instructions). The low control demand condition showed the strongest usage of the fixed and repeating sequence of responses in the SRT. The transfer results are in line with the learning-plus-decision view of strategy change in incidental learning, rather than with resource theories of self-control.

A nursing interface terminology: evaluation of face validity

A range of different language systems for nursing diagnosis, interventions and outcomes are currently available. Nursing terminologies are intended to support nursing practice but they have to be evaluated. This study aims to assess the results of an expert survey to establish the face validity of a nursing interface terminology. The study applied a descriptive design with a cross-sectional survey strategy using a written questionnaire administered to expert nurses working in hospitals. Sample size was estimated at 35 participants. The questionnaire included topics related to validity and reliability criteria for nursing controlled vocabularies described in the literature. Mean global score and criteria scoring at least 7 were considered main outcome measures. The analysis included descriptive statistics with a confidence level of 95%. The mean global score was 8.1. The mean score for the validity criteria was 8.4 and 7.8 for reliability and applicability criteria. Two of the criteria for reliability and applicability evaluation did not achieve minimum scores. According to the experts" responses, this terminology meets face validity, but that improvements are required in some criteria and further research is needed to completely demonstrate its metric properties.

EAACI IG Biologicals task force paper on the use of biologic agents in allergic disorders.

Biologic agents (also termed biologicals or biologics) are therapeutics that are synthesized by living organisms and directed against a specific determinant, for example, a cytokine or receptor. In inflammatory and autoimmune diseases, biologicals have revolutionized the treatment of several immune-mediated disorders. Biologicals have also been tested in allergic disorders. These include agents targeting IgE; T helper 2 (Th2)-type and Th2-promoting cytokines, including interleukin-4 (IL-4), IL-5, IL-9, IL-13, IL-31, and thymic stromal lymphopoietin (TSLP); pro-inflammatory cytokines, such as IL-1β, IL-12, IL-17A, IL-17F, IL-23, and tumor necrosis factor (TNF); chemokine receptor CCR4; and lymphocyte surface and adhesion molecules, including CD2, CD11a, CD20, CD25, CD52, and OX40 ligand. In this task force paper of the Interest Group on Biologicals of the European Academy of Allergy and Clinical Immunology, we review biologicals that are currently available or tested for the use in various allergic and urticarial pathologies, by providing an overview on their state of development, area of use, adverse events, and future research directions.

Effects of manipulating Task Complexity on self-repairs during L2 oral production

This paper analyses the effects of manipulating the cognitive complexity of L2 oral tasks on language production. It specifically focuses on self-repairs, which are taken as a measure of accuracy since they denote both attention to form and an attempt at being accurate. By means of a repeated measures de- sign, 42 lower-intermediate students were asked to perform three different tasks types (a narrative, and instruction-giving task, and a decision-making task) for which two degrees of cognitive complexity were established. The narrative task was manipulated along +/− Here-and-Now, an instruction-giving task ma- nipulated along +/− elements, and the decision-making task which is manipu- lated along +/− reasoning demands. Repeated measures ANOVAs are used for the calculation of differences between degrees of complexity and among task types. One-way ANOVA are used to detect potential differences between low- proficiency and high-proficiency participants. Results show an overall effect of Task Complexity on self-repairs behavior across task types, with different be- haviors existing among the three task types. No differences are found between the self-repair behavior between low and high proficiency groups. Results are discussed in the light of theories of cognition and L2 performance (Robin- son 2001a, 2001b, 2003, 2005, 2007), L1 and L2 language production models (Levelt 1989, 1993; Kormos 2000, 2006), and attention during L2 performance (Skehan 1998; Robinson, 2002).

Resident health-related quality of life in Swiss nursing homes.

BACKGROUND: Health-related quality of life (HRQOL) levels and their determinants in those living in nursing homes are unclear. The aim of this study was to investigate different HRQOL domains as a function of the degree of cognitive impairment and to explore associations between them and possible determinants of HRQOL. METHOD: Five HRQOL domains using the Minimum Data Set - Health Status Index (MDS-HSI) were investigated in a large sample of nursing home residents depending on cognitive performance levels derived from the Cognitive Performance Scale. Large effect size associations between clinical variables and the different HRQOL domains were looked for. RESULTS: HRQOL domains are impaired to variable degrees but with similar profiles depending on the cognitive performance level. Basic activities of daily living are a major factor associated with some but not all HRQOL domains and vary little with the degree of cognitive impairment. LIMITATIONS: This study is limited by the general difficulties related to measuring HRQOL in patients with cognitive impairment and the reduced number of variables considered among those potentially influencing HRQOL. CONCLUSION: HRQOL dimensions are not all linearly associated with increasing cognitive impairment in NH patients. Longitudinal studies are required to determine how the different HRQOL domains evolve over time in NH residents.

Emotional intelligence compensates for low IQ and boosts low emotionality individuals in a self-presentation task

The research on emotional intelligence (EI) has focused mainly on testing the incremental validity of EI with respect to general intelligence and personality; less attention has been devoted to investigating the potential interaction effects. In a self-presentation task that required participants to obtain positive evaluations from others, individuals low in IQ but high in EI performed as well as the high IQ individuals. In addition, the low emotionality individuals performed significantly higher when also high in EI. The results extend the previous findings on the compensatory effect of EI on low IQ to the domain of interpersonal effectiveness and shed light on the effective functioning of personality traits when interpreted with the interaction of EI. Overall this study suggests that the role of EI in predicting performance might have been overlooked by checking solely for main effects and illustrates new venues for understanding the contribution of EI in explaining emotion-laden performance.

Evaluating the impact of filming on the number of errors committed by nursing students to determine the efficacy of simulated clinical situations

Clinic simulation as a training and knowledge method allows people experiment a real event representation with the aim of acquiring knowledge, abilities and aptitudes. The filming of the staging represents a useful tool to review the decisions taken and the actions they did, with the purpose to highlight the strengths, weaknesses and the areas for improvement. The article describes a study carried out by a group of students in second course of nursing, and it tries to evaluate if there is any influence if somebody is filming you during the clinic simulation, does it make you do more errors or not?