Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

Cognitive interventions in Mild Cognitive Impairment (MCI) seek to ameliorate cognitive symptoms in the condition. Cognitive interventions may or may not generalize beyond cognitive outcomes to everyday life. This systematic review and meta-analysis sought to assess the effect of cognitive interventions compared to a control group in MCI on generalizability outcome measures [activities of daily living (ADLs), mood, quality of life (QOL), and metacognition] rather than cognitive outcomes alone. PRISMA guidelines were followed. MEDLINE and PsychInfo were utilized as data sources to locate references related to cognitive interventions in individuals with MCI. The cognitive intervention study was required to have a control or alternative treatment comparison group to be included. Thirty articles met criteria, including six computerized cognitive interventions, 14 therapist-based interventions, and 10 multimodal (i.e., cognitive intervention plus an additional intervention) studies. Small, but significant overall median effects were seen for ADLs (d = 0.23), mood (d = 0.16), and metacognitive outcomes (d = 0.30), but not for QOL (d = 0.10). Computerized studies appeared to benefit mood (depression, anxiety, and apathy) compared to controls, while therapist-based interventions and multimodal interventions had more impact on ADLs and metacognitive outcomes than control conditions. The results are encouraging that cognitive interventions in MCI may impact everyday life, but considerably more research is needed. The current review and meta-analysis is limited by our use of only PsychInfo and MEDLINE databases, our inability to read full text non-English articles, and our reliance on only published data to complete effect sizes.     

Hold it! Memory affects attentional dwell time

The allocation of attention, including the initial orienting and the subsequent dwell time, is affected by several bottom-up and top-down factors. How item memory affects these processes, however, remains unclear. Here, we investigated whether item memory affects attentional dwell time by using a modified version of the attentional blink (AB) paradigm. Across four experiments, our results revealed that the AB was significantly affected by memory status (novel vs. old), but critically, this effect depended on the ongoing memory context. Specifically, items that were unique in terms of memory status demanded more resources, as measured by a protracted AB. The present findings suggest that a more comprehensive understanding of memory’s effects on attention can be obtained by accounting for an item’s memorial context, as well as its individual item memory strength. Our results provide new evidence that item memory and memory context play a significant role in the temporal allocation of attention.     

Dismantling institutional racism: theory and action

Despite a strong commitment to promoting social change and liberation, there are few community psychology models for creating systems change to address oppression. Given how embedded racism is in institutions such as healthcare, a significant shift in the system's policies, practices, and procedures is required to address institutional racism and create organizational and institutional change. This paper describes a systemic intervention to address racial inequities in healthcare quality called dismantling racism. The dismantling racism approach assumes healthcare disparities are the result of the intersection of a complex system (healthcare) and a complex problem (racism). Thus, dismantling racism is a systemic and systematic intervention designed to illuminate where and how to intervene in a given healthcare system to address proximal and distal factors associated with healthcare disparities. This paper describes the theory behind dismantling racism, the elements of the intervention strategy, and the strengths and limitations of this systems change approach.     

Women's bar‐related victimization: Refining and testing a conceptual model

A model of bar victimization is proposed that explores the relationships among a woman's exposure to the bar environment (i.e., frequency of going to bars), her intoxication in that setting (i.e., usual number of drinks), and such individual difference factors as her previous history of victimization (childhood sexual abuse, lifetime violence, and previous partner abuse) and personality characteristics (depression, social anxiety, sensation seeking, and hostility). Earlier findings from work in this area suggest that exposure to the bar environment increases a woman's risk for more severe aggression. The data being used to test the proposed model are from a survey of 198 women bar drinkers in western New York State. These women described bar‐related victimization that ranged from verbal aggression (e.g., threats) through severe physical and sexual violence (e.g., assault and rape). Younger age, history of victimization, greater negative affect, and more frequent drinking in bars were predictive of more severe bar‐related victimization during the past year. These findings are discussed in terms of women's risk for victimization in bars and needed areas of future research. Aggr. Behav. 25:349–364, 1999. © 1999 Wiley‐Liss, Inc.     

Development and Validation of an Instrument to Measure Attitudes Toward Sexist/Nonsexist Language

Despite documented, negative effects of sexist language, some people still strongly oppose inclusive language. Their attitudes need study, but existing measures of attitude lack comprehensiveness or validity. This paper reports construction and validation of the 42-item Inventory of Attitudes Toward Sexist/Nonsexist Language (IASNL), which is based on a conceptual framework related to beliefs about language, recognition of sexist language, and willingness to use inclusive language. Four studies tested the IASNL's content validity (9 content experts, 329 other participants), construct validity, and reliability (31 advocates of inclusive language, 298 additional respondents). Cronbach alphas were high and validity measures were strong. Two short forms of the IASNL were also created—the IASNL-General and the IASNL-Sport. The IASNL-General is in the Appendix.     

Ethical androcentrism and maternal substance addiction

In this paper, I argue that bioethics suffers from a masculinist approach--what I call "ethical androcentrism." Despite the genesis of other legitimate approaches to ethics (such as feminist, narrative, and communicative ethics), this masculinist tradition persists. The first part of my paper concerns the problem of ethical androcentrism, and how it is manifest in our typical ways of "doing" bioethics (as teachers, ethicists, policymakers, and medical practitioners). After arguing that bioethics suffers from a masculinist ethic, I consider the case of maternal substance addiction to show how this ethic negatively affects the treatment of pregnant addicts. I argue that by treatment maternal substance addiction from an androcentric approach, we fail to serve both pregnant addicts and their fetuses; furthermore, we misrepresent the intentional state of pregnant substance addicts and label them "prenatal abusers." If maternal substance addiction is to be ethically addressed--and if pregnant substance addicts are to be effectively treated--we cannot tacitly accept an androcentric ethic.     

Group Discussion as Affected by Number of Alternatives and by a Time Limit

This study examines whether the task-related discussion in problem-solving groups is affected by the number of decision alternatives being considered and/or by the imposition of a decision deadline. Drawing from research on individual decision makers, it was first predicted that the number of alternatives would have an inverse effect on the quantity and quality of group discussion: as the number of alternatives increases, the proportion of information mentioned and the repetition of that information should decrease. Second, it was predicted that a deadline would have a direct effect on quantity: as the deadline gets shorter, a smaller proportion of facts will be mentioned, and mentioned facts will be repeated less often. Results supported the first hypothesis; however, deadlines were found to have a more complex relationship with discussion than was hypothesized. Evidence was also obtained for a "surface evaluation" explanation of how groups narrow the choice set, as was support for the notion that severe deadlines increase the rate of work-related activity within the group. The results are interpreted within an attentional focus framework.