The Large Allen Cognitive Level Screen as an indicator for medication adherence among adults accessing community mental health services

Background: Medication remains the cornerstone treatment for mental illness. Cognition is one of the strongest predictors of non-adherence. The aim of this preliminary investigation was to examine the association between the Large Allen Cognitive Level Screen (LACLS) and medication adherence among a small sample of mental health service users to determine whether the LACLS has potential as a screening tool for capacity to manage medication regimens. Method: Demographic and clinical information was collected from a small sample of people who had recently accessed community mental health services. Participants then completed the LACLS and the Medication Adherence Rating Scale (MARS) at a single time point. The strength of association between the LACLS and MARS was examined using Spearman rank-order correlation. Results: A strong positive correlation between the LACLS and medication adherence (r = 0.71, p = 0.01) was evident. No participants reported the use of medication aids despite evidence of impaired cognitive functioning. Conclusion: This investigation has provided the first empirical evidence indicating that the LACLS may have utility as a screening instrument for capacity to manage medication adherence among this population. While promising, this finding should be interpreted with caveats given its preliminary nature.

Vision, functional and cognitive determinants of motor vehicle incidents in older drivers

Background: The proportion of older individuals in the driving population is predicted to increase in the next 50 years. This has important implications for driving safety as abilities which are important for safe driving, such as vision (which accounts for the majority of the sensory input required for driving), processing ability and cognition have been shown to decline with age. The current methods employed for screening older drivers upon re-licensure are also vision based. This study, which investigated social, behavioural and professional aspects involved with older drivers, aimed to determine: (i) if the current visual standards in place for testing upon re-licensure are effective in reducing the older driver fatality rate in Australia; (ii) if the recommended visual standards are actually implemented as part of the testing procedures by Australian optometrists; and (iii) if there are other non-standardised tests which may be better at predicting the on-road incident-risk (including near misses and minor incidents) in older drivers than those tests recommended in the standards. Methods: For the first phase of the study, state-based age- and gender-stratified numbers of older driver fatalities for 2000-2003 were obtained from the Australian Transportation Safety Bureau database. Poisson regression analyses of fatality rates were considered by renewal frequency and jurisdiction (as separate models), adjusting for possible confounding variables of age, gender and year. For the second phase, all practising optometrists in Australia were surveyed on the vision tests they conduct in consultations relating to driving and their knowledge of vision requirements for older drivers. Finally, for the third phase of the study to investigate determinants of on-road incident risk, a stratified random sample of 600 Brisbane residents aged 60 years and were selected and invited to participate using an introductory letter explaining the project requirements. In order to capture the number and type of road incidents which occurred for each participant over 12 months (including near misses and minor incidents), an important component of the prospective research study was the development and validation of a driving diary. The diary was a tool in which incidents that occurred could be logged at that time (or very close in time to which they occurred) and thus, in comparison with relying on participant memory over time, recall bias of incident occurrence was minimised. Association between all visual tests, cognition and scores obtained for non-standard functional tests with retrospective and prospective incident occurrence was investigated. Results: In the first phase,rivers aged 60-69 years had a 33% lower fatality risk (Rate Ratio [RR] = 0.75, 95% CI 0.32-1.77) in states with vision testing upon re-licensure compared with states with no vision testing upon re-licensure, however, because the CIs are wide, crossing 1.00, this result should be regarded with caution. However, overall fatality rates and fatality rates for those aged 70 years and older (RR=1.17, CI 0.64-2.13) did not differ between states with and without license renewal procedures, indicating no apparent benefit in vision testing legislation. For the second phase of the study, nearly all optometrists measured visual acuity (VA) as part of a vision assessment for re-licensing, however, 20% of optometrists did not perform any visual field (VF) testing and only 20% routinely performed automated VF on older drivers, despite the standards for licensing advocating automated VF as part of the vision standard. This demonstrates the need for more effective communication between the policy makers and those responsible for carrying out the standards. It may also indicate that the overall higher driver fatality rate in jurisdictions with vision testing requirements is resultant as the tests recommended by the standards are only partially being conducted by optometrists. Hence a standardised protocol for the screening of older drivers for re-licensure across the nation must be established. The opinions of Australian optometrists with regard to the responsibility of reporting older drivers who fail to meet the licensing standards highlighted the conflict between maintaining patient confidentiality or upholding public safety. Mandatory reporting requirements of those drivers who fail to reach the standards necessary for driving would minimise potential conflict between the patient and their practitioner, and help maintain patient trust and goodwill. The final phase of the PhD program investigated the efficacy of vision, functional and cognitive tests to discriminate between at-risk and safe older drivers. Nearly 80% of the participants experienced an incident of some form over the prospective 12 months, with the total incident rate being 4.65/10 000 km. Sixty-three percent reported having a near miss and 28% had a minor incident. The results from the prospective diary study indicate that the current vision screening tests (VA and VF) used for re-licensure do not accurately predict older drivers who are at increased odds of having an on-road incident. However, the variation in visual measurements of the cohort was narrow, also affecting the results seen with the visual functon questionnaires. Hence a larger cohort with greater variability should be considered for a future study. A slightly lower cognitive level (as measured with the Mini-Mental State Examination [MMSE]) did show an association with incident involvement as did slower reaction time (RT), however the Useful-Field-of-View (UFOV) provided the most compelling results of the study. Cut-off values of UFOV processing (>23.3ms), divided attention (>113ms), selective attention (>258ms) and overall score (moderate/ high/ very high risk) were effective in determining older drivers at increased odds of having any on-road incident and the occurrence of minor incidents. Discussion: The results have shown that for the 60-69 year age-group, there is a potential benefit in testing vision upon licence renewal. However, overall fatality rates and fatality rates for those aged 70 years and older indicated no benefit in vision testing legislation and suggests a need for inclusion of screening tests which better predict on-road incidents. Although VA is routinely performed by Australian optometrists on older drivers renewing their licence, VF is not. Therefore there is a need for a protocol to be developed and administered which would result in standardised methods conducted throughout the nation for the screening of older drivers upon re-licensure. Communication between the community, policy makers and those conducting the protocol should be maximised. By implementing a standardised screening protocol which incorporates a level of mandatory reporting by the practitioner, the ethical dilemma of breaching patient confidentiality would also be resolved. The tests which should be included in this screening protocol, however, cannot solely be ones which have been implemented in the past. In this investigation, RT, MMSE and UFOV were shown to be better determinants of on-road incidents in older drivers than VA and VF, however, as previously mentioned, there was a lack of variability in visual status within the cohort. Nevertheless, it is the recommendation from this investigation, that subject to appropriate sensitivity and specificity being demonstrated in the future using a cohort with wider variation in vision, functional performance and cognition, these tests of cognition and information processing should be added to the current protocol for the screening of older drivers which may be conducted at licensing centres across the nation.

Behavioral and psychological symptoms and cognitive decline in patients with amnestic MCI and mild AD: a two-year follow-up study.

BACKGROUND: Mild cognitive impairment (MCI) has been defined as a transitional state between normal aging and dementia. In many cases, MCI represents an early stage of developing cognitive impairment. Patients diagnosed with MCI do not meet the criteria for dementia as their general intellect and everyday activities are preserved, although minor changes in instrumental activities of daily living (ADL) may occur. However, they may exhibit significant behavioral and psychological signs and symptoms (BPS), also frequently observed in patients with Alzheimer's disease (AD). Hence, we wondered to what extent specific BPS are associated with cognitive decline in participants with MCI or AD. METHODS: Our sample consisted of 164 participants, including 46 patients with amnestic (single or multi-domain) MCI and 54 patients with AD, as well as 64 control participants without cognitive disorders. Global cognitive performance, BPS, and ADL were assessed using validated clinical methods at baseline and at two-year follow-up. RESULTS: The BPS variability over the follow-up period was more pronounced in the MCI group than in patients with AD: some BPS improve, others occur newly or worsen, while others still remain unchanged. Moreover, specific changes in BPS were associated with a rapid deterioration of the global cognitive level in MCI patients. In particular, an increase of euphoria, eating disorders, and aberrant motor behavior, as well as worsened sleep quality, predicted a decline in cognitive functioning. CONCLUSIONS: Our findings confirm a higher variability of BPS over time in the MCI group than in AD patients. Moreover, our results provide evidence of associations between specific BPS and cognitive decline in the MCI group that might suggest a risk of conversion of individuals with amnestic MCI to AD.

The social cognitive neuroscience of organisations

Social cognitive neuroscience is an emerging branch of cognitive neuroscience that bridges together social psychology and neuroscience. At its core is an understanding of the relationship between the brain and social interaction. The social cognitive neuroscientist places empirical endeavor within a three–stage framework, and questions falling under the SCN rubric undergo interrogation at each of these three levels. Firstly, we seek to understand a neuroscience of social interactions at the social level. Here we need to understand the motivational and other social factors that drive our behavior and experience in the real world. It goes without saying that any study of the cognitive neuroscience of socially interactive behavior must first be informed by social psychological theory to maintain ecological validity. Second, the social cognitive neuroscientist must be an adroit cognitive psychologist and be able to examine interactive behavior from the cognitive level. It is here that information–processing models and theories are applied to the understanding of our social behavior. Finally, studies at the neural level seek to inform us about the cortical structures, as well as the way they interact with other, in the mediation of the previous cognitive level. This volume brings together contributions from leading thinkers in both the social cognitive neurosciences and business to provide a comprehensive introduction and overview of a social cognitive neuroscience of the business brain. NOTE: Annals volumes are available for sale as individual books or as a journal. For information on institutional journal subscriptions, please visit www.blackwellpublishing.com/nyas. ACADEMY MEMBERS: Please contact the New York Academy of Sciences directly to place your order (www.nyas.org). Members of the New York Academy of Science receive full–text access to the Annals online and discounts on print volumes. Please visit http://www.nyas.org/MemberCenter/Join.aspx for more information about becoming a member

Capabilities for strategic flexibility:a cognitive content framework

Different forms of strategic flexibility allow for reactive adaptation to different changing environments and the proactive driving of change. It is therefore becoming increasingly important for decision makers to not only possess marketing capabilities, but also the capabilities for strategic flexibility in its various forms. However, our knowledge of the relationships between decision makers’ different ways of thinking and their capabilities for strategic flexibility is limited. This limitation is constraining research and understanding. In this article we develop a theoretical cognitive content framework that postulates relationships between different ways of thinking about strategy and different information-processing demands. We then outline how the contrasting beliefs of decision makers may influence their capabilities to generate different hybrid forms of strategic flexibility at the cognitive level. Theoretically, the framework is embedded in resource-based theory, personal construct theory and schema theory. The implications for research and theory are discussed.

A magnetoencephalographic study of low-level auditory processing in developmental dyslexia

The possibility that developmental dyslexia results from low-level sensory processing deficits has received renewed interest in recent years. Opponents of such sensory-based explanations argue that dyslexia arises primarily from phonological impairments. However, many behavioural correlates of dyslexia cannot be explained sufficiently by cognitive-level accounts and there is anatomical, psychometric and physiological evidence of sensory deficits in the dyslexic population. This thesis aims to determine whether the low-level (pre-attentive) processing of simple auditory stimuli is disrupted in compensated adult dyslexics. Using psychometric and neurophysiological measures, the nature of auditory processing abnormalities is investigated. Group comparisons are supported by analysis of individual data in order to address the issue of heterogeneity in dyslexia. The participant pool consisted of seven compensated dyslexic adults and seven age and IQ matched controls. The dyslexic group were impaired, relative to the control group, on measures of literacy, phonological awareness, working memory and processing speed. Magnetoencephalographic recordings were conducted during processing of simple, non-speech, auditory stimuli. Results confirm that low-level auditory processing deficits are present in compensated dyslexic adults. The amplitude of N1m responses to tone pair stimuli were reduced in the dyslexic group. However, there was no evidence that manipulating either the silent interval or the frequency separation between the tones had a greater detrimental effect on dyslexic participants specifically. Abnormal MMNm responses were recorded in response to frequency deviant stimuli in the dyslexic group. In addition, complete stimulus omissions, which evoked MMNm responses in all control participants, failed to elicit significant MMNm responses in all but one of the dyslexic individuals. The data indicate both a deficit of frequency resolution at a local level of auditory processing and a higher-level deficit relating to the grouping of auditory stimuli, relevant for auditory scene analysis. Implications and directions for future research are outlined.

Investigating and theorizing discourse during analogy writing in chemistry

Explanations of the role of analogies in learning science at a cognitive level are made in terms of creating bridges between new information and students’ prior knowledge. In this empirical study of learning with analogies in an 11th grade chemistry class, we explore an alternative explanation at the "social" level where analogy shapes classroom discourse. Students in the study developed analogies within small groups and with their teacher. These classroom interactions were monitored to identify changes in discourse that took place through these activities. Beginning from socio-cultural perspectives and hybridity, we investigated classroom discourse during analogical activities. From our analyses, we theorized a merged discourse that explains how the analog discourse becomes intertwined with the target discourse generating a transitional state where meanings, signs, symbols, and practices are in flux. Three categories were developed that capture how students intertwined the analog and target discourses—merged words, merged utterances/sentences, and merged practices.

Spot the differences in traditional and social entrepreneurial intention : highlighting the role of human and social capital

There is general agreement in the scientific community that entrepreneurship plays a central role in the growth and development of an economy in rapidly changing environments (Acs & Virgill 2010). In particular, when business activities are regarded as a vehicle for sustainable growth at large, that goes beyond mere economic returns of singular entities, encompassing also social problems and heavily relying on collaborative actions, then we more precisely fall into the domain of ‘social entrepreneurship’(Robinson et al. 2009). In the entrepreneurship literature, prior studies demonstrated the role of intentionality as the best predictor of planned behavior (Ajzen 1991), and assumed that the intention to start a business derives from the perception of desirability and feasibility and from a propensity to act upon an opportunity (Fishbein & Ajzen 1975). Recognizing that starting a business is an intentional act (Krueger et al. 2000) and entrepreneurship is a planned behaviour (Katz & Gartner 1988), models of entrepreneurial intentions have substantial implications for intentionality research in entrepreneurship. The purpose of this paper is to explore the emerging practice of social entrepreneurship by comparing the determinants of entrepreneurial intention in general versus those leading to startups with a social mission. Social entrepreneurial intentions clearly merit to be investigated given that the opportunity identification process is an intentional process not only typical of for profit start-ups, and yet there is a lack of research examining opportunity recognition in social entrepreneurship (Haugh 2005). The key argument is that intentionality in both traditional and social entrepreneurs during the decision-making process of new venture creation is influenced by an individual's perceptions toward opportunities (Fishbein & Ajzen 1975). Besides opportunity recognition, at least two other aspects can substantially influence intentionality: human and social capital (Davidsson, 2003). This paper is set to establish if and to what extent the social intentions of potential entrepreneurs, at the cognitive level, are influenced by opportunities recognition, human capital, and social capital. By applying established theoretical constructs, the paper draws comparisons between ‘for-profit’ and ‘social’ intentionality using two samples of students enrolled in Economy and Business Administration at the University G. d’Annunzio in Pescara, Italy. A questionnaire was submitted to 310 potential entrepreneurs to test the robustness of the model. The collected data were used to measure the theoretical constructs of the paper. Reliability of the multi-item scale for each dimension was measured using Cronbach alpha, and for all the dimensions measures of reliability are above 0.70. We empirically tested the model using structural equation modeling with AMOS. The results allow us to empirically contribute to the argument regarding the influence of human and social cognitive capital on social and non-social entrepreneurial intentions. Moreover, we highlight the importance for further researchers to look deeper into the determinants of traditional and social entrepreneurial intention so that governments can one day define better polices and regulations that promote sustainable businesses with a social imprint, rather than inhibit their formation and growth.

7-12岁儿童执行功能与智力的关系

The nature of individual differences among children is an important issue in the study of human intelligence. There are close relation between intelligence and executive functions. Traditional theories, which are based mainly on the factor analysis, approach the problem only from the perspective of psychometrics. However, they do not study the relation of cognition and neurobiology. Some researchers try to explore the essential differences in intelligence from the basic cognitive level, by studying the relationship between executive function and intelligence. The aim of this study was to do the followings 1) to delineate and separate the executive function in children into measurable constructs; 2) to establish the relationship between executive function and intelligence in children; 3) to find out the difference and its neural mechanism between intellectually-gifted and normal children’s executive function. The participants were 188 children aged 7-12 year old. There were 6 executive function tasks. The results were follows: 1) The latent variables analyses showed that there was no stable construct of executive function in 7-10 year old children. The executive function construct of 11-12 year old children could be separated into updating, inhibition and shifting. And they had grown to be more or less the same as adults in the executive function. There were only moderate correlations between the three types of executive function, but they were largely independent of each other. 2) The correlations between the indices of updating, inhibition, shifting and intelligence were different in 7-12 year old children. The older the age, the more the indices were related to intelligence. The updating and shifting were related to intelligence in 7-10 year old children. There were significant correlations between the updating, inhibition, shifting and intelligence in 11-12 year old children. The correlation between updating and intelligence was higher than the correlation between shifting and intelligence. Furthermore, in structural equation models controlling for the three executive functions correlations, updating was highly related to intelligence, but the relations of inhibition and shifting to intelligence were not significant. 3) Intellectually-gifted children performed better than normal children in executive function tasks. The neural mechanism differences between intellectually gifted and average children were indicated by ERP component P3. The present study helps us to understand the relationship between intelligence and executive function; and throws light on the issue of individual differences in intelligence. The present results can provide theoretical support for the development a culture-free intelligence test and a method to promote the development of intelligence. Our present study lends support to the neural efficient hypothesis.

Health status of children with cerebral palsy living in Europe: a multi-centre study

Aim The aim of this report is to describe the health status of 8–12-year-old children with cerebral palsy (CP) of all severities in Europe using the Child Health Questionnaire (CHQ).

Method A total of 818 children with CP from nine centres in defined geographical areas participated. CP type, gross and fine motor function, additional impairments were classified and family data were obtained. The CHQ was used to measure the parent's perception of their child's physical (PHY) and psychosocial (PSY) health.

Results PHY scores were lower than the reference samples with a median of 46. The severity of gross motor function influenced the CHQ scores significantly in the PHY scale with the lowest scores for children with least gross motor function. There were significant differences between the CP types in PHY with the higher scores for children with unilateral spastic and the lowest scores for children with bilateral spastic and dyskinetic CP type. Fine motor function severity significantly affected both the PHY and PSY scales. The severity of intellectual impairment was significantly associated with CHQ scores in most dimensions with higher scores for higher IQ level in PHY and PSY. Children with seizures during the last year had a significantly lower health compared with children without seizures. The results of the multivariate regression analyses (forward stepwise regression) of CHQ scores on CP subtype, gross and fine motor function, cognitive function, additional impairments, seizures, parental education and employment revealed gross motor function, cognitive level and type of school attended were significant prognostic factors.

Conclusion This report is based on the largest sample to date of children with CP. Health status as measured using the CHQ was affected in all children and was highly variable. Gross motor function level correlates with health from the PHY well-being perspective but the PSY and emotional aspects do not appear to follow the same pattern.

O questionamento no alinhamento do ensino, aprendizagem e avaliação

O questionamento dos alunos é reconhecido como uma capacidade fundamental, de nível superior, associada ao desenvolvimento de outras competências centrais, como o pensamento crítico, a resolução de problemas ou a capacidade de reflexão, assumindo especial relevância no contexto de disciplinas científicas. O presente estudo surge no atual enquadramento de reestruturação curricular do ensino universitário em Portugal, como um caso de colaboração estreita entre investigadores do Departamento de Educação e professores das Unidades Curriculares de “Microbiologia”, “Genética” e “Temas e Laboratórios de Biologia”, do Departamento de Biologia, na Universidade de Aveiro. Estas unidades curriculares, dirigidas a alunos de várias licenciaturas, são sobretudo frequentadas por alunos do primeiro ano das licenciaturas em Biologia e Biologia/Geologia. Um dos principais objetivos era identificar contextos de prática no âmbito dos quais pudéssemos sugerir estratégias inovadoras de Ensino, Aprendizagem e Avaliação (EAA), que promovessem o questionamento dos estudantes, numa lógica de alinhamento construtivo. Outro dos objetivos era também o de analisar e caracterizar o questionamento dos alunos, associado à diversidade de estratégias adotadas. A presente investigação adota princípios dos paradigmas naturalista e sociocrítico, seguindo uma abordagem metodológica sobretudo de natureza qualitativa. As várias situações de EAA foram desenhadas, implementadas e adaptadas atendendo às particularidades de cada Unidade Curricular (UC), ao longo de dois estudos (2007/2008 e 2008/2009). O questionamento dos alunos foi caracterizado nos diversos contextos de EAA, atendendo ao seu nível cognitivo. Realizaram-se entrevistas semiestruturadas com alunos selecionados, no fim de cada estudo (17 alunos no total), e também com os professores envolvidos (4 professores), no fim do segundo estudo. A análise do questionamento dos alunos nos variados contextos, permitiu confirmar um questionamento espontâneo pouco frequente e tendencialmente de baixo nível cognitivo associado à expressão oral. No entanto, em situações com efeitos sumativos na avaliação, verificou-se um maior envolvimento e uma maior participação dos alunos, associados a uma maior frequência e qualidade do questionamento. Confirmamos o papel fundamental que a avaliação desempenha no decurso da aprendizagem, valorizando o seu papel formativo bem como o feedback proporcionado pelos professores no sentido de alcançar melhores desempenhos em termos de questionamento e, em última análise, em termos de aprendizagem. Todas as evidências recolhidas permitem afirmar que o questionamento constituiu um importante motor para um alinhamento construtivo entre o ensino, a aprendizagem e a avaliação, devidamente articulados com os objetivos de aprendizagem de cada UC. Comprovamos, também, que se não forem criadas situações em que os alunos sejam incentivados a questionar, situações que constituam para si um desafio, um estímulo extrínseco, apenas teremos acesso ao seu questionamento oral e espontâneo, com as características que já lhe são conhecidas. Afirmamos, assim, a relevância de se desenharem situações de ensino, aprendizagem e avaliação, que promovam nos alunos o desenvolvimento da competência de questionamento. Um outro objetivo central de investigação a que nos tínhamos proposto era a caracterização do questionamento dos alunos numa perspetiva mais holística, situando-o como uma competência fundamental que deverá ser desenvolvida em contextos educativos, mas também ao longo da vida. Avançamos com uma proposta de modelo de competência de questionamento, como um dos resultados principais do presente estudo. Este modelo surge de toda a experiência investigativa e, sobretudo, do estudo aprofundado de dois casos, correspondentes a dois alunos selecionados, que permitiu a elucidação das dimensões de competência. Assumindo o questionamento como competência, consideramos que o modelo proposto, e ainda em evolução, poderá representar um importante contributo para a teoria e para a prática do questionamento.

Brincar faz-me feliz: a importância do brincar no desenvolvimento da criança

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

Évaluation de l'acuité visuelle chez la personne âgée atteinte de troubles de la cognition

Objectif : L'évaluation de l'acuité visuelle (AV) chez la personne âgée atteinte de troubles cognitifs peut être limitée par le manque de collaboration ou les difficultés de communication du patient. Très peu d'études ont examiné l'AV chez les patients atteints de déficits sévères de la cognition. L’objectif de cette étude était d’évaluer l'AV chez la personne âgée vulnérable ayant des troubles cognitifs à l'aide d'échelles variées afin de vérifier leur capacité à répondre à ces échelles. Méthodes: Trois groupes de 30 sujets chacun ont été recrutés. Le premier groupe était constitué de sujets jeunes (Moy.±ET: 24.9±3.5ans) et le second, de sujets âgés (70.0±4.5ans), ne présentant aucun trouble de la cognition ou de la communication. Le troisième groupe, composé de sujets atteints de démence faible à sévère (85.6±6.9ans), a été recruté au sein des unités de soins de longue durée de l’Institut Universitaire de Gériatrie de Montréal. Le test du Mini-Mental State Examination (MMSE) a été réalisé pour chaque sujet afin de déterminer leur niveau cognitif. L’AV de chaque participant a été mesurée à l’aide de six échelles validées (Snellen, cartes de Teller, ETDRS-lettres,-chiffres,-Patty Pics,-E directionnel) et présentées selon un ordre aléatoire. Des tests non paramétriques ont été utilisés afin de comparer les scores d’AV entre les différentes échelles, après une correction de Bonferroni-Holm pour comparaisons multiples. Résultats: Le score moyen au MMSE chez les sujets atteints de démence était de 9.8±7.5, alors qu’il était de 17.8±3.7 et 5.2±4.6 respectivement, chez les sujets atteints de démence faible à modérée (MMSE supérieur ou égal à 13; n=11) et sévère (MMSE inférieur à 13; n=19). Tous les sujets des groupes 1 et 2 ont répondu à chacune des échelles. Une grande majorité de sujets avec démence ont répondu à toutes les échelles (n=19) alors qu’un seul sujet n’a répondu à aucune échelle d’AV. Au sein du groupe 3, les échelles d’AV fournissant les scores les plus faibles ont été les cartes de Teller (20/65) et les Patty Pics (20/62), quelque soit le niveau cognitif du sujet, alors que les meilleurs scores d’AV ont été obtenus avec les échelles de Snellen (20/35) et les lettres ETDRS (20/36). Une grande proportion de sujets avec démence sévère ont répondu aux cartes de Teller (n=18) mais le score d’AV obtenu était le plus faible (20/73). Au sein des trois groupes, l’échelle de lettres-ETDRS était la seule dont les scores d’AV ne différaient pas de ceux obtenus avec l’échelle de Snellen traditionnelle. Conclusions: L’acuité visuelle peut être mesurée chez la personne âgée atteinte de troubles cognitifs ou de la communication. Nos résultats indiquent que les échelles les plus universelles, utilisant des lettres comme optotypes, peuvent être utilisées avec de bons résultats chez les personnes âgées atteintes de démence sévère. Nos résultats suggèrent de plus que la mesure d’acuité visuelle doit être tentée chez toutes les personnes, peu importe leur niveau cognitif.

Reflections About the Teaching Methodology Processes Related with the Cognition of the Superior Education Student

In concordance whit permanent global and local changes in superior education, not only in Colombia but in the world, and having in account the relevance of pedagogical actions and their incidence in the student’s cognitive level, it’s necessary analyze and to reflect about the mecanism involved in the learning processes, in order to improve the curriculums and inside of them, the teaching methodologies, pedagogy an didacts that promote better the students cognition. In the present article an analysis is made of teaching methodologies developed in Institutions of superior education with subsequent learnings that not always facilitate the cognitive development of the student, as well as a proposal of educative innovation elements aimed to guide the teachers into a careful consideration of their pedagogical practice.