Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease.

Although visuoconstructive impairment has been reported in both Alzheimer's (DAT) and Huntington's (HD) disease, there is little knowledge concerning how this cognitive deficit differs quantitatively and qualitatively in these two progressive dementias. To address this issue, the present study compared performances on the Clock Drawing Test (CDT: command and copy) of 25 DAT patients, 25 equally demented HD patients, and 25 elderly normal controls (NC). In the command condition, both patients groups were significantly impaired compared to the NC group. Although there was no significant difference between DAT and HD patients' total quantitative scores, a qualitative error analysis revealed a number of dissociations between the two patient groups. Graphic difficulties, very common in HD patients, were virtually absent in DAT patients; in contrast, conceptual errors were almost exclusively seen in DAT patients and were related to the severity of their dementia. Perseveration and "stimulus-bound" responses were also more frequent in DAT patients, and both groups made visuospatial errors. In the copy condition, the DAT, but not the HD, patients evidenced a marked improvement in performance. These results indicate that while both DAT and HD patients have significant visuoconstructive difficulties even in the early stages of their disorders, the specific cognitive processes underlying their quantitative impairments are quite different. It is possible that the DAT patients' conceptual errors are yet another indicator of the deterioration of their semantic knowledge.     

On the Relation Between Time Perception and the Timing of Motor Action: Evidence for a Temporal Oscillator Controlling the Timing of Movement

Studies of time estimation have provided evidence that human time perception is determined by an internal clock containing a temporal oscillator and have also provided estimates of the frequency of this oscillator (Treisman, Faulkner, Naish, & Brogan, 1992; Treisman & Brogan, 1992). These estimates were based on the observation that when the intervals to be estimated are accompanied by auditory clicks that recur at certain critical rates, perturbations in time estimation occur. To test the hypothesis that the mechanisms that underlie the perception of time and those that control the timing of motor performance are similar, analogous experiments were performed on motor timing, with the object of seeing whether evidence for a clock would be obtained and if so whether its properties resemble those of the time perception clock. The prediction was made that perturbations in motor timing would be seen at the same or similar critical auditory click rates. The experiments examined choice reaction time and typing. The results support the hypothesis that a temporal oscillator paces motor performance and that this oscillator is similar to the oscillator underlying time perception. They also provide an estimate of the characteristic frequency of the oscillator.     

Environmental factors in suicide in long-term care facilities.

One major purpose of this study was to identify environmental factors related to suicide in long-term care facilities. Questionnaires were mailed to a random sample of administrators at 1,080 facilities. Information was collected on facility characteristics, overt suicide, and intentional life-threatening behavior. Chi-square analyses revealed 4 environmental characteristics related to suicidal behavior and deaths from suicide: staff turnover, size, auspices, and per diem cost. More suicides occurred in larger facilities and facilities with higher staff turnover. Religious or "other" facilities experienced more suicidal deaths than public or private facilities; facilities charging less experienced more deaths.     

Factors related to sleep quality in healthy elderly women.

Elderly women in subjectively good health--free of acute illness and major sleep pathologies--who were self-identified as good (n = 22) and poor (n = 16) sleepers were compared on measures of physical health, psychological symptoms, psychosocial status, and life-style. Poor sleepers reported longer sleep latencies, less total sleep time, more nonrestorative sleep, and more daytime fatigue than did good sleepers. Sleep recordings confirmed subjective reports, with shorter total sleep times and trends for lower sleep efficiency, longer sleep latencies, and more wake-after-sleep onset among women with subjective poor sleep. Poor sleepers also were more frequent users of sedative-hypnotic medications in the past. Current medication use, alcohol and caffeine use, daytime napping, and exercise were equivalent in both groups. Psychosocial status failed to discriminate groups. Poor sleepers reported significantly more psychological symptoms than did good sleepers. The levels of both psychological symptoms and sleep disturbance were mild.     

Should physicians be Bayesian agents?

Because physicians use scientific inference for the generalizations of individual observations and the application of general knowledge to particular situations, the Bayesian probability solution to the problem of induction has been proposed and frequently utilized. Several problems with the Bayesian approach are introduced and discussed. These include: subjectivity, the favoring of a weak hypothesis, the problem of the false hypothesis, the old evidence/new theory problem and the observation that physicians are not currently Bayesians. To the complaint that the prior probability is subjective, Bayesians reply that there will be ultimate convergence, but the rebuttal to this is that there will not be uniform convergence. Secondly, since the Bayesian scheme favors a weak hypothesis, theories turn out to be a gratuitous risk. The problem with the false hypothesis comes out in the denominator of the theorem, revealing that a factor which is not a theory at all is being considered in the reasoning. On the old evidence/new theory problem old evidence cannot confirm a new theory so that the posterior probability will equal the prior probability. Finally, empiric studies have shown that current physicians are not Bayesians. But on consideration of Bayesian inference as a system of inference, it can be reasoned that physicians should be Bayesians. However, the problem of physicians' and patients' own subjectivity continue to plague this system of medical decision making.     

Brief report: An extension of the sequential alternating treatment design using reversals with subjects not available concurrently

This brief report proposes an extension of the traditional Alternating Treatments Design that would be acceptable to use in hospital and residential settings where subjects are often not concurrently available. Concerns about the inability of traditional designs to work in these special situations and the emergence of a “scientist–practitioner split” are discussed. An example of how the Extended Alternating Treatments Design might be used is provided.     

Age-dependent facilitation of taste-footshock conditioning by prior exposure to the training context

Among adult rats, gustatory stimuli are easily associated with illness, but not with external unconditioned stimuli such as footshock. Recent evidence indicates, however, that this cue-to-consequence specificity may vary ontongenetically. The present studies examined the acquisition of an aversion to a taste paired with footshock in 5- and 15-day-old rats. Consistent with previous reports, 5-day-old rats avoided the taste that preceded footshock, while 15-day-old subjects did not express an aversion to the taste paired with footshock. Exposure to the training context for either 1 or 5 h prior to conditioning disrupted taste-footshock conditioning in the 5-day-old subjects. For the 15-day-old subjects, 1 h of pre-conditioning exposure to the training context had no effect on conditioning, whereas a longer duration of preexposure promoted conditioning to the taste cue. The results suggest ontogenetic differences in stimulus selection.