Treatment of cognitive impairment in multiple sclerosis

Cognitive impairment in multiple sclerosis is an increasingly recognized entity. This article reviews the cognitive impairment of multiple sclerosis, its prevalence, its relationship to different types of multiple sclerosis, and its contribution to long-term functional prognosis. The discussion also focuses on the key elements of cognitive dysfunction in multiple sclerosis which distinguish it from other forms of cognitive impairment. Therapeutic interventions potentially effective for the cognitive impairment of multiple sclerosis are reviewed including the effects of disease modifying therapies and the use of physical and cognitive interventions.     

Visual‐motor and executive functions in children born preterm: The Bender Visual Motor Gestalt Test revisited

Böhm, B., Lundequist, A. & Smedler, A.‐C. (2010). Visual‐motor and executive functions in children born preterm: The Bender Visual Motor Gestalt Test revisited. Scandinavian Journal of Psychology, 51, 376–384. Visual‐motor development and executive functions were investigated with the Bender Test at age 5½ years in 175 children born preterm and 125 full‐term controls, within the longitudinal Stockholm Neonatal Project. Assessment also included WPPSI‐R and NEPSY neuropsychological battery for ages 4–7 ( Korkman, 1990 ). Bender protocols were scored according to Brannigan & Decker (2003) , Koppitz (1963) and a complementary neuropsychological scoring system (ABC), aimed at executive functions and developed for this study. Bender results by all three scoring systems were strongly related to overall cognitive level (Performance IQ), in both groups. The preterm group displayed inferior visual‐motor skills compared to controls also when controlling for IQ. The largest group differences were found on the ABC scoring, which shared unique variance with NEPSY tests of executive function. Multiple regression analyses showed that hyperactive behavior and inattention increased the risk for visual‐motor deficits in children born preterm, whereas no added risk was seen among hyperactive term children. Gender differences favoring girls were strongest within the preterm group, presumably reflecting the specific vulnerability of preterm boys. The results indicate that preterm children develop a different neurobehavioral organization from children born at term, and that the Bender test with a neuropsychological scoring is a useful tool in developmental screening around school start.     

Temporal control in rats: analysis of nonlocalized effects from short interfood intervals.

The present experiment analyzed temporal control of postreinforcement pause duration during within-session changes in the criterion for reinforcement (interfood interval, IFI). Analysis of interval-by-interval changes in the pause revealed localized and nonlocalized effects from short intervals that caused specific changes in performance. In Phase 1, rats were presented with five consecutive 15-s IFIs intercalated into a series of 60-s IFIs. The 15-s set decreased the pause in adjacent and more remote 60-s intervals. In Phase 2, two sets of 15-s intervals were intercalated. The spacing between the two sets varied so that 0, 5, 10, or 15 60-s IFIs separated the sets. The postreinforcement pause tracked all changes in the IFI duration, and the localized effect from a short set extended beyond the next interval to the next few 60-s IFIs. Effects from one set, however, did not combine with a second set: Changes in the pause after two sets were the same regardless of the spacing between sets.     

Imagining Reproduction in Science and History

Reproduction is at the core of many aspects of human existence. It is intrinsic in our biology and in the broad social constructs in which we all reside. The introduction to this special issue is designed to reflect on some of the differences between the humanities/arts and the sciences on the subject of Reproduction now and in the past. The intellectual/cultural distance between humanists and reproductive biologists is vast, yet communication between the Two Cultures has much to offer in guiding future research, pedagogy, and social policy. The challenges to communication include differences in methodology, professional protocols, specialization, and the increasing speed with which reproductive technology advances. The solutions require a new kind of student who can learn and adapt the approaches from both sides of the disciplinary divide to create new ways of understanding how our current and future concepts of reproduction may be informed by the past. This co-authored introduction reviews the range of interests represented in the essays and represents first steps of a dialogue between a humanist and a reproductive biologist who chart some of the possibilities on what the future of the subject might hold.     

Explanatory warrant for scientific realism

Nancy Cartwright relies upon an inference pattern known as inference to the best causal explanation (IBCE) to support a limited form of entity realism, according to which we are warranted in believing in entities that purportively cause observable effects. IBCE, as usually understood, is valid, even though all other forms of inference to the best explanation (IBE) are usually understood to be invalid. We argue that IBCE and IBE are in the same boat with respect to their ability to support realist conclusions. Either rule can be interpreted as valid, this is a matter of semantic convention. However, doing so deprives the rule of the empirical content the realist needs, requiring the realist to find independent warrant for a strong (theoretical or causal) premise. We then examine the proposed means of obtaining this warrant, and find them as inadequate in the case of IBCE as they are in the case of IBE.     

Converging evidence for the functional significance of imagery in problem solving

Two kinds of explanations have been offered for the process by which three-term series problems are solved, one in terms of linguistic principles and the other in terms of visual-spatial imagery. Two experiments are reported in which three different classes of operations are brought to bear on the problem: (1) Manipulation of stimulus attributes (characteristics of problems), (2) manipulation of variables that selectively encourage or inhibit the use of imagery (facilitating instructions; the suppression of visualization by reading), and (3) measurement of relevant individual differences (spatial-reasoning ability). All of the results indicate that imagery plays a functional but not a necessary role in the solution of three-term series problems; it is suggested that imaginal representation is functional because it reduces the load on memory. An adequate explanation of problem-solving will have to address certain general issues, such as the diversity of forms of cognitive representation and differences within and between individuals in the choice of problem-solving strategies.     

Physician Beliefs about Physical and Mental Competency of Patients Applying for Concealed Weapon Permits

Law enforcement officials have asked health care providers to evaluate patient applications for concealed weapon permits. The current study was designed to examine physician beliefs regarding competency to carry a concealed weapon for patients with specific physical and mental conditions. Among 222 North Carolina physicians who participated in this survey (40% response rate), large variation and uncertainty existed for determining competency. Physicians most frequently chose mild dementia, post-traumatic stress disorder, and recent depression as conditions that would render a patient not competent to carry a concealed weapon. Male physicians and those owning a gun were more likely to deem a patient competent. Almost a third of physicians were unsure about competence for most conditions. Physicians asked to assess competency of patients to carry a concealed weapon have quite disparate views on competency and little confidence in their decisions. If physicians are expected to assess patient competence to carry a concealed weapon, more objective criteria and training are needed. Copyright © 2015 John Wiley & Sons, Ltd.     

Does acceptance and relationship focused behavior therapy contribute to bupropion outcomes? A randomized controlled trial of functional analytic psychotherapy and acceptance and commitment therapy for smoking cessation

This study evaluated a treatment combining bupropion with a novel acceptance and relationship focused behavioral intervention based on the acceptance and relationship context (ARC) model. Three hundred and three smokers from a community sample were randomly assigned to bupropion, a widely used smoking cessation medication, or bupropion plus functional analytic psychotherapy (FAP) and acceptance and commitment therapy (ACT). Objective measures of smoking outcomes and self-report measures of acceptance and relationship processes were taken at pretreatment, posttreatment, 6-month, and 1-year follow-up. The combined treatment was significantly better than bupropion alone at 1-year follow-up with 7-day point prevalence quit rates of 31.6% in the combined condition versus 17.5% in the medication-alone condition. Acceptance and the therapeutic relationship at posttreatment statistically mediated 12-month outcomes. Bupropion outcomes were enhanced with an acceptance and relationship focused behavioral treatment.