General and Domain-Specific Effectiveness of Cognitive Remediation after Stroke: Systematic Literature Review and Meta-Analysis

Cognitive remediation (CR) has been shown to improve cognitive abilities following a stroke. However, an updated quantitative literature review is needed to synthesize recent research and build understanding of factors that may optimize training parameters and treatment effects. Randomized controlled trials of CR were retrieved from seven electronic databases. Studies specific to adult stroke populations were included. Treatment effects were estimated using a random effects model, with immediate and longer-term follow-up outcomes, and moderator effects, examined for both overall and domain-specific functioning. Twenty-two studies were identified yielding 1098 patients (583 in CR groups). CR produced a small overall effect (g?=?0.48, 95% CI 0.35–0.60, p?<?0.01) compared with control conditions. This effect was moderated by recovery stage (p?<?0.01), study quality (p?=?0.04), and dose (p?=?0.04), but not CR approach (p?=?0.63). Significant small to medium (g?=?0.25–0.75) post-intervention gains were evident within each individual outcome domain examined. A small overall effect (g?=?0.27, 95% CI 0.04–0.51, p?=?0.02) of CR persisted at follow-up (range 2–52 weeks). CR is effective and efficient at improving cognitive performance after stroke. The degree of efficacy varies across cognitive domains, and further high-quality research is required to enhance and sustain the immediate effects. Increased emphasis on early intervention approaches, brain-behavior relationships, and evaluation of activity and participation outcomes is also recommended.     

Interpersonal effects of parents and adolescents on each other’s health behaviours: a dyadic extension of the theory of planned behaviour

Objective: Interpersonal relationships are important predictors of health outcomes and interpersonal influences on behaviours may be key mechanisms underlying such effects. Most health behaviour theories focus on intrapersonal factors and may not adequately account for interpersonal influences. We evaluate a dyadic extension of the Theory of Planned Behaviour by examining whether parent and adolescent characteristics (attitudes, subjective norms, perceived behavioural control and intentions) are associated with not only their own but also each other’s intentions/behaviours.

Design: Using the Actor-Partner Interdependence Model, we analyse responses from 1717 parent-adolescent dyads from the Family Life, Activity, Sun, Health, and Eating study.

Main Outcome Measures: Adolescents/parents completed self-reports of their fruit and vegetable consumption, junk food and sugary drinks consumption, engagement in physical activity, and engagement in screen time sedentary behaviours.

Results: Parent/adolescent characteristics are associated with each other’s health-relevant intentions/behaviours above the effects of individuals’ own characteristics on their own behaviours. Parent/adolescent characteristics covary with each other’s outcomes with similar strength, but parent characteristics more strongly relate to adolescent intentions, whereas adolescent characteristics more strongly relate to parent behaviours.

Conclusions: Parents and adolescents may bidirectionally influence each other’s health intentions/behaviours. This highlights the importance of dyadic models of health behaviour and suggests intervention targets.     

Prayer spaces in schools: a subversion of policy implementation?

Based on a major evaluation project, this article presents an emerging theme from research on the activities supported by Prayer Spaces in Schools, an organisation supporting ‘pop-up’ prayer spaces in schools across the UK and internationally. Evaluating the activities primarily in terms of their possible contribution to spiritual development, a number of important issues arose relating to policy on education and religion. This article focuses on how some engage with these prayer spaces as a way of reimagining and renegotiating educational policy. Based on data gathered from interviews with staff and students (aged 7–16) across seven schools in England, questionnaire responses from 555 students across 15 schools and feedback from two prayer spaces conferences, a hermeneutic approach is used to compare the interpretations of staff with those of students and the implicit positions of policy documents. This article explores various forms of policy implementation and how staff engagement with prayer spaces can be seen as a form of subversion, with staff tactically subverting policy implementation sometimes in order to promote the very intention of those policies – a form of what we refer to as subversive obedience.     

High functioning children with autism spectrum disorder: a novel test of multitasking

High functioning children with a diagnosis of autism or Asperger's syndrome (HF-ASD) often experience difficulties organising goal-directed actions in their day-to-day lives, requiring support to schedule daily activities. This study aimed to capture these everyday difficulties experimentally using multitasking, a methodology that taps into the cognitive processes necessary for successful goal-directed activities in everyday life. We investigated multitasking in children with HF-ASD using a novel multitask test, the Battersea Multitask Paradigm. Thirty boys participated in the study, 14 with HF-ASD and 16 typically developing controls, matched for age and IQ. Group differences in multitasking were observed. Participants with HF-ASD were less efficient at planning, attempted fewer tasks, switched inflexibly between tasks and broke performance rules more frequently than controls.     

The Utilization and Choices of Aneuploidy Screening in a Midwestern Population

The types, interpretation, and use of first- and second-trimester aneuploidy screening are often unclear for many women. This impairs appropriate decision making and understanding of the implications of prenatal genetic testing options. The purpose of this study was to examine the utilization of Stepwise Sequential screening in our Midwestern population, demographic factors associated with choice of screening and method of risk reporting and it’s potential impact on women’s choices. First trimester screening was performed for 2,634 women during the study period. Results were not reported or “framed” as “positive” or “negative”. Rather, the specific age-risk and screen-risk for T21 were relayed, along with options for follow-up Stepwise Sequential screening and invasive testing. Nearly 80 % of women declined Stepwise Sequential screening. Minorities and women of lower education were least likely to pursue further screening. Less than 4 % of the study population elected invasive testing. First trimester screening was associated with a 53 % reduction in amniocenteses and 20 % fewer CVS’s compared to pre-first trimester screening availability. Reporting age-and screen-risks for T21, rather than classifying results as “positive” or “negative” based on a pre-determined threshold, was associated with a low uptake of further testing.     

Foundations of Probability

The foundations of probability are viewed through the lens of the subjectivist interpretation. This article surveys conditional probability, arguments for probabilism, probability dynamics, and the evidential and subjective interpretations of probability.