Cognitive remediation therapy (CRT) benefits more to patients with schizophrenia with low initial memory performances.

PubMed

Pillet, Benoit; Morvan, Yannick; Todd, Aurelia; Franck, Nicolas; Duboc, Chloé; Grosz, Aimé; Launay, Corinne; Demily, Caroline; Gaillard, Raphaël; Krebs, Marie-Odile; Amado, Isabelle

2015-01-01

Cognitive deficits in schizophrenia mainly affect memory, attention and executive functions. Cognitive remediation is a technique derived from neuropsychology, which aims to improve or compensate for these deficits. Working memory, verbal learning, and executive functions are crucial factors for functional outcome. Our purpose was to assess the impact of the cognitive remediation therapy (CRT) program on cognitive difficulties in patients with schizophrenia, especially on working memory, verbal memory, and cognitive flexibility. We collected data from clinical and neuropsychological assessments in 24 patients suffering from schizophrenia (Diagnostic and Statistical Manual of mental Disorders-Fourth Edition, DSM-IV) who followed a 3-month (CRT) program. Verbal and visuo-spatial working memory, verbal memory, and cognitive flexibility were assessed before and after CRT. The Wilcoxon test showed significant improvements on the backward digit span, on the visual working memory span, on verbal memory and on flexibility. Cognitive improvement was substantial when baseline performance was low, independently from clinical benefit. CRT is effective on crucial cognitive domains and provides a huge benefit for patients having low baseline performance. Such cognitive amelioration appears highly promising for improving the outcome in cognitively impaired patients.

Designing Clinical Remediation Programs.

ERIC Educational Resources Information Center

Oleszewski, Susan C.

1989-01-01

Elements and considerations in the provision of effective remediation for optometry students not achieving in clinical competence are discussed. Remediation of technical, cognitive, and noncognitive skills are included. A course in professional communication offered by the Pennsylvania College of Optometry is described. (MSE)

"The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs": Correction to McGurk et al. (2017).

PubMed

2017-06-01

Reports an error in "The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs" by Susan R. McGurk, Kim T. Mueser, Melanie A. Watkins, Carline M. Dalton and Heather Deutsch ( Psychiatric Rehabilitation Journal , 2017[Mar], Vol 40[1], 79-86). In the article, the author order was incorrect due to a printer error. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2017-13255-004.) Objective: Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing psychiatric rehabilitation, and suggest that ease of access to vocational services may influence work outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

«Cognitus & Moi»: A Computer-Based Cognitive Remediation Program for Children with Intellectual Disability

PubMed Central

Demily, Caroline; Rigard, Caroline; Peyroux, Elodie; Chesnoy-Servanin, Gabrielle; Morel, Aurore; Franck, Nicolas

2016-01-01

Attentional, visuospatial, and social cognition deficits have a negative impact on children’s adaptative and social competences and, as a result, on their ability to achieve a normal functioning and behavior. Until now and despite the frequency of those deficits, there is a lack of children’s specific cognitive remediation tools specifically dedicated to attentional and visuospatial areas. The «Cognitus & Moi» program involves a variety of exercises in a paper and/or pencil (n = 30) or a computerized format (n = 29) and a strategy coaching approach. Each module of «Cognitus & Moi» targets a single impaired cognitive area, within the limits of cognitive domains’ overlapping. The little cartoon character named Cognitus, who illustrates the program, is supposed to be very friendly and kind toward children. Cognitus will accompany them throughout the program for an effective and positive reinforcement. The main goal of «Cognitus & Moi» is to adjust to children’s difficulties in daily life. Moreover, since the cognitive remediation benefit is complex to apply in daily life, the program is based on a metacognitive strategy. After a complete neuropsychological assessment and a psychoeducational session (with the child and the parents), 16 1-h-sessions of cognitive remediation with the therapist are proposed. Each session is composed of three parts: (1) computerized tasks focusing on specific attentional or visuospatial components (20 min). The attentional module targets hearing, visual, and divided attention. A double attention task is also proposed. The visuospatial module targets eye tracking and gaze direction, spatial orientation, visuospatial memory and construction, and mental imagery; (2) pen and paper tasks focusing on the same processes (20 min) and a facial emotion recognition task; (3) a proposal of a home-based task (during 20 min). Weekly, specific attentional and visuospatial home tasks are proposed to the child and analyzed with the parents and the therapist. Indeed, home exercises are useful to promote the transfer of strategies to daily life and their subsequent automation. The heterogeneity of cognitive deficits in intellectual deficiency necessitates an individualized cognitive remediation therapy. In this regard, «Cognitus & Moi» seems to be a promising tool. PMID:26869942

A Multicenter, Rater-Blinded, Randomized Controlled Study of Auditory Processing-Focused Cognitive Remediation Combined With Open-Label Lurasidone in Patients With Schizophrenia and Schizoaffective Disorder.

PubMed

Kantrowitz, Joshua T; Sharif, Zafar; Medalia, Alice; Keefe, Richard S E; Harvey, Philip; Bruder, Gerard; Barch, Deanna M; Choo, Tse; Lee, Seonjoo; Lieberman, Jeffrey A

2016-06-01

Small-scale studies of auditory processing cognitive remediation programs have demonstrated efficacy in schizophrenia. We describe a multicenter, rater-blinded, randomized, controlled study of auditory-focused cognitive remediation, conducted from June 24, 2010, to June 14, 2013, and approved by the local institutional review board at all sites. Prior to randomization, participants with schizophrenia (DSM-IV-TR) were stabilized on a standardized antipsychotic regimen (lurasidone [40-160 mg/d]), followed by randomization to adjunctive cognitive remediation: auditory focused (Brain Fitness) versus control (nonspecific video games), administered 1-2 times weekly for 30 sessions. Coprimary outcome measures included MATRICS Consensus Cognitive Battery (MCCB) and the University of California, San Diego, Performance-Based Skills Assessment-Brief scale. 120 participants were randomized and completed at least 1 auditory-focused cognitive remediation (n = 56) or video game control session (n = 64). 74 participants completed ≥ 25 sessions and postrandomization assessments. At study completion, the change from prestabilization was statistically significant for MCCB composite score (d = 0.42, P < .0001) across groups. Participants randomized to auditory-focused cognitive remediation had a trend-level higher mean MCCB composite score compared to participants randomized to control cognitive remediation (P = .08). After controlling for scores at the time of randomization, there were no significant between-treatment group differences at study completion. Auditory processing cognitive remediation combined with lurasidone did not lead to differential improvement over nonspecific video games. Across-group improvement from prestabilization baseline to study completion was observed, but since all participants were receiving lurasidone open label, it is difficult to interpret the source of these effects. Future studies comparing both pharmacologic and behavioral cognitive enhancers should consider a 2 × 2 design, using a control for both the medication and the cognitive remediation. ClinicalTrials.gov identifier: NCT01173874. © Copyright 2016 Physicians Postgraduate Press, Inc.

Neural correlates of cognitive improvements following cognitive remediation in schizophrenia: a systematic review of randomized trials

PubMed Central

Isaac, Clémence; Januel, Dominique

2016-01-01

Background Cognitive impairments are a core feature in schizophrenia and are linked to poor social functioning. Numerous studies have shown that cognitive remediation can enhance cognitive and functional abilities in patients with this pathology. The underlying mechanism of these behavioral improvements seems to be related to structural and functional changes in the brain. However, studies on neural correlates of such enhancement remain scarce. Objectives We explored the neural correlates of cognitive enhancement following cognitive remediation interventions in schizophrenia and the differential effect between cognitive training and other therapeutic interventions or patients’ usual care. Method We searched MEDLINE, PsycInfo, and ScienceDirect databases for studies on cognitive remediation therapy in schizophrenia that used neuroimaging techniques and a randomized design. Search terms included randomized controlled trial, cognitive remediation, cognitive training, rehabilitation, magnetic resonance imaging, positron emission tomography, electroencephalography, magnetoencephalography, near infrared spectroscopy, and diffusion tensor imaging. We selected randomized controlled trials that proposed multiple sessions of cognitive training to adult patients with a schizophrenia spectrum disorder and assessed its efficacy with imaging techniques. Results In total, 15 reports involving 19 studies were included in the systematic review. They involved a total of 455 adult patients, 271 of whom received cognitive remediation. Cognitive remediation therapy seems to provide a neurobiological enhancing effect in schizophrenia. After therapy, increased activations are observed in various brain regions mainly in frontal – especially prefrontal – and also in occipital and anterior cingulate regions during working memory and executive tasks. Several studies provide evidence of an improved functional connectivity after cognitive training, suggesting a neuroplastic effect of therapy through mechanisms of functional reorganization. Neurocognitive and social-cognitive training may have a cumulative effect on neural networks involved in social cognition. The variety of proposed programs, imaging tasks, and techniques may explain the heterogeneity of observed neural improvements. Future studies would need to specify the effect of cognitive training depending on those variables. PMID:26993787

Effectiveness of computerized cognitive rehabilitation training on symptomatological, neuropsychological and work function in patients with schizophrenia.

PubMed

Lee, Woo Kyeong

2013-06-01

There has been plenty of interest in cognitive rehabilitation for schizophrenia here in Korea since the year 2000. But the efficacy studies of cognitive remediation intervention are still deficient. The primary purpose of this study was to develop a computer-assisted cognitive remediation program and conduct a clinical trial in a group of schizophrenic patients. Sixty patients with schizophrenia were randomly assigned to a computerized cognitive rehabilitation (Cog-trainer) group plus usual rehabilitation (UR) or to a usual rehabilitation (UR) group only. Clinical, neuropsychological and functional outcome variables were assessed at baseline and after intervention. The Cog-trainer group received 20 sessions of computerized cognitive remediation training over 3 months. This training program consists of 10 units, with each unit being divided into three stages: (i) practice; (ii) application; and (iii) advanced. Compared to the UR group, the Cog-trainer exhibited a significant improvement in attention, concentration and working memory. The Cog-trainer group also showed improvement in the work quality subscale of the work behavior inventory. However, there were no significant benefits of computerized cognitive remediation where symptoms were concerned. These results indicate that computerized cognitive rehabilitation training can contribute to an improvement in the cognitive function of people with schizophrenia. The changes in cognitive outcomes can also contribute to improvement in job functioning. Further study of generalization to other functional outcome measures will be necessary. Long-term follow-up studies are needed to confirm the maintenance of such improvements. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Cognitive remediation in large systems of psychiatric care.

PubMed

Medalia, Alice; Saperstein, Alice M; Erlich, Matthew D; Sederer, Lloyd I

2018-05-02

IntroductionWith the increasing enthusiasm to provide cognitive remediation (CR) as an evidence-based practice, questions arise as to what is involved in implementing CR in a large system of care. This article describes the first statewide implementation of CR in the USA, with the goal of documenting the implementation issues that care providers are likely to face when bringing CR services to their patients. In 2014, the New York State Office of Mental Health set up a Cognitive Health Service that could be implemented throughout the state-operated system of care. This service was intended to broadly address cognitive health, to assure that the cognitive deficits commonly associated with psychiatric illnesses are recognized and addressed, and that cognitive health is embedded in the vocabulary of wellness. It involved creating a mechanism to train staff to recognize how cognitive health could be prioritized in treatment planning as well as implementing CR in state-operated adult outpatient psychiatry clinics. By 2017, CR was available at clinics serving people with serious mental illness in 13 of 16 adult Psychiatric Centers, located in rural and urban settings throughout New York state. The embedded quality assurance program evaluation tools indicated that CR was acceptable, sustainable, and effective. Cognitive remediation can be feasibly implemented in large systems of care that provide a multilevel system of supports, a training program that educates broadly about cognitive health and specifically about the delivery of CR, and embedded, ongoing program evaluation that is linked to staff supervision.

Cognitive dysfunction and competency restoration: using cognitive remediation to help restore the unrestorable.

PubMed

Schwalbe, Evan; Medalia, Alice

2007-01-01

The goal of this article is to present an argument for using cognitive remediation as an adjunctive form of treatment in competency restoration programs. Clinically, it has been generally agreed that the Dusky standard requires a functional analysis of the defendant's current capacities in the current legal context; merely having a mental illness does not mean incompetency. Based on the recent literature that describes the neuropsychological deficits associated with major psychiatric illnesses such as schizophrenia, bipolar disorder, and depression, it is believed that many psychiatrically ill patients are hindered from returning to the legal process by their inability to understand and acquire the information necessary to be found competent. We argue that cognitive remediation would serve as a helpful form of treatment for incompetent patients to improve their cognitive functioning and consequently, their likelihood of being found competent.

Work, Recovery, and Comorbidity in Schizophrenia: A Randomized Controlled Trial of Cognitive Remediation

PubMed Central

McGurk, Susan R.; Mueser, Kim T.; DeRosa, Thomas J.; Wolfe, Rosemarie

2009-01-01

Employment is central to the concept of recovery in severe mental illness. However, common comorbid conditions present significant obstacles to consumers seeking employment and benefiting from vocational rehabilitation. We review research on the effects of three common comorbid conditions on work and response to vocational rehabilitation, including cognitive impairment, substance abuse, and medical conditions, followed by research on vocational rehabilitation. We then present the results of a randomized controlled trial evaluating the effects of adding cognitive remediation to a vocational rehabilitation program compared with vocational rehabilitation alone in 34 consumers with severe mental illness. Consumers who received both cognitive remediation and vocational rehabilitation demonstrated significantly greater improvements on a cognitive battery over 3 months than those who received vocational rehabilitation alone and had better work outcomes over the 2-year follow-up period. Substance abuse was associated with worse employment outcomes, but did not interact with treatment group, whereas medical comorbidity was not related to work outcomes. More research is warranted to evaluate the interactions between substance abuse and medical comorbidity with vocational rehabilitation and cognitive remediation. PMID:19269925

Cognitive remediation training improves performance in patients with chronic fatigue syndrome.

PubMed

McBride, Richard L; Horsfield, Sarah; Sandler, Carolina X; Cassar, Joanne; Casson, Sally; Cvejic, Erin; Vollmer-Conna, Uté; Lloyd, Andrew R

2017-11-01

Neurocognitive disturbance with subjectively-impaired concentration and memory is a common, disabling symptom reported by patients with chronic fatigue syndrome (CFS). We recently reported preliminary evidence for benefits of cognitive remediation as part of an integrated cognitive-behavioral therapy (CBT)/ graded exercise therapy (GET) program. Here, we describe a contemporaneous, case-control trial evaluating the effectiveness of an online cognitive remediation training program (cognitive exercise therapy; CET) in addition to CBT/GET (n=36), compared to CBT/GET alone (n=36). The study was conducted in an academic, tertiary referral outpatient setting over 12 weeks (11 visits) with structured, home-based activities between visits. Participants self-reported standardized measures of symptom severity and functional status before and after the intervention. Those in the CET arm also completed standardized neurocognitive assessment before, and following, treatment. The addition of formal CET led to significantly greater improvements in self-reported neurocognitive symptoms compared to CBT/GET alone. Subjective improvement was predicted by CET group and lower baseline mood disturbance. In the CET group, significant improvements in objectively-measured executive function, processing speed, and working memory were observed. These subjective and objective performance improvements suggest that a computerized, home-based cognitive training program may be an effective intervention for patients with CFS, warranting randomized controlled trials. Copyright © 2017 Elsevier B.V. All rights reserved.

Cognitive remediation versus active computer control in bipolar disorder with psychosis: study protocol for a randomized controlled trial.

PubMed

Lewandowski, Kathryn Eve; Sperry, Sarah H; Ongur, Dost; Cohen, Bruce M; Norris, Lesley A; Keshavan, Matcheri S

2016-03-12

Cognitive dysfunction is a major feature of bipolar disorder with psychosis and is strongly associated with functional outcomes. Computer-based cognitive remediation has shown promise in improving cognition in patients with schizophrenia. However, despite similar neurocognitive deficits between patients with schizophrenia and bipolar disorder, few studies have extended neuroscience-based cognitive remediation programs to this population. The Treatment to Enhance Cognition in Bipolar Disorder study is an investigator-initiated, parallel group, randomized, blinded clinical trial of an Internet-based cognitive remediation protocol for patients with bipolar disorder I with psychosis (n = 100). We also describe the development of our dose-matched active control paradigm. Both conditions involve 70 sessions of computer-based activities over 24 weeks. The control intervention was developed to mirror the treatment condition in dose and format but without the neuroplasticity-based task design and structure. All participants undergo neuropsychological and clinical assessment at baseline, after approximately 25 hours of study activities, post treatment, and after 6 months of no study contact to assess durability. Neuroimaging at baseline and post treatment are offered in an "opt-in" format. The primary outcomes are scores on the MATRICS battery; secondary and exploratory outcomes include measures of clinical symptoms, community functioning, and neuroimaging changes. Associations between change in cognitive measures and change in community functioning will be assessed. Baseline predictors of treatment response will be examined. The present study is the first we are aware of to implement an Internet-based cognitive remediation program in patients with bipolar disorder with psychosis and to develop a comparable web-based control paradigm. The mixed online and study-site format allows accessible treatment while providing weekly staff contact and bridging. Based on user-provided feedback, participant blinding is feasible. ClinicalTrials.gov NCT01470781 ; 11 July 2011.

Feasibility of group Cognitive Remediation Therapy in an adult eating disorder day program in New Zealand.

PubMed

Roberts, Marion E

2018-05-02

To explore the feasibility of integrating group Cognitive Remediation Therapy (gCRT) into an eating disorder day program in Auckland, New Zealand. A consecutive series of 28 patients took part over an 8-month period in the context of a service audit. Main outcome measures were the Detail and Flexibility Questionnaire (DFlex) and qualitative feedback from patients. Significant shifts in self-report inefficient cognitive style were observed pre/post gCRT with large effect sizes (Cohen's d av ) for both cognitive rigidity and attention to detail outcomes. Patient feedback was positive, with themes of enjoyment, increased insight, and positive social interaction/esteem boosting in the context of the group emerging. Support for the acceptability, adaptation, expansion, practicality, and limited-efficacy testing of gCRT in an Australasian day program setting has been found, suggesting integration of this module into existing day treatment programs is merited. Larger scale trials may help delineate the clinical characteristics of good responders. Copyright © 2018. Published by Elsevier Ltd.

Social-cognitive remediation in schizophrenia: generalization of effects of the Training of Affect Recognition (TAR).

PubMed

Wölwer, Wolfgang; Frommann, Nicole

2011-09-01

In the last decade, several social cognitive remediation programs have been developed for use in schizophrenia. Though existing evidence indicates that such programs can improve social cognition, which is essential for successful social functioning, it remains unclear whether the improvements generalize to social cognitive domains not primarily addressed by the intervention and whether the improved test performance transfers into everyday social functioning. The present study investigated whether, beyond its known effects on facial affect recognition, the Training of Affect Recognition (TAR) has effects on prosodic affect recognition, theory of mind (ToM) performance, social competence in a role-play task, and more general social and occupational functioning. Thirty-eight inpatients with a diagnosis of schizophrenia or schizoaffective disorder were randomly assigned to 6 weeks of treatment with the TAR--primarily targeted at facial affect recognition-or Cognitive Remediation Training (CRT)--primarily targeted at neurocognition. Intention-to-treat analyses found significantly larger pre-post improvements with TAR than with CRT in prosodic affect recognition, ToM, and social competence and a trend effect in global social functioning. However, the effects on ToM and social competence were no longer significant in the smaller group of patients who completed treatment according to protocol. Results suggest that TAR effects generalize to other social cognitive domains not primarily addressed. TAR may also enhance social skills and social functioning, although this has to be confirmed. Results are discussed with regard to the need to improve functional outcome in schizophrenia against the background of current evidence from other social cognitive remediation approaches.

Improving Social Cognition in People with Schizophrenia with RC2S: Two Single-Case Studies.

PubMed

Peyroux, Elodie; Franck, Nicolas

2016-01-01

Difficulties in social interactions are a central characteristic of people with schizophrenia, and can be partly explained by impairments of social cognitive processes. New strategies of cognitive remediation have been recently developed to target these deficits. The RC2S therapy is an individualized and partly computerized program through which patients practice social interactions and develop social cognitive abilities with simulation techniques in a realistic environment. Here, we present the results of two case-studies involving two patients with schizophrenia presenting with specific profiles of impaired social cognition. Each patient completed three baseline sessions, 14 treatment sessions, and 3 follow-up sessions at the end of the therapy - and for 1 patient, another 3 sessions 9 months later. We used a multiple baseline design to assess specific components of social cognition according to the patients' profiles. Functioning and symptomatology were also assessed at the end of the treatment and 6 months later. Results highlight significant improvements in the targeted social cognitive processes and positive changes in functioning in the long term. The RC2S program seems, thus, to be a new useful program for social cognitive remediation in schizophrenia.

Improving Social Cognition in People with Schizophrenia with RC2S: Two Single-Case Studies

PubMed Central

Peyroux, Elodie; Franck, Nicolas

2016-01-01

Difficulties in social interactions are a central characteristic of people with schizophrenia, and can be partly explained by impairments of social cognitive processes. New strategies of cognitive remediation have been recently developed to target these deficits. The RC2S therapy is an individualized and partly computerized program through which patients practice social interactions and develop social cognitive abilities with simulation techniques in a realistic environment. Here, we present the results of two case-studies involving two patients with schizophrenia presenting with specific profiles of impaired social cognition. Each patient completed three baseline sessions, 14 treatment sessions, and 3 follow-up sessions at the end of the therapy – and for 1 patient, another 3 sessions 9 months later. We used a multiple baseline design to assess specific components of social cognition according to the patients’ profiles. Functioning and symptomatology were also assessed at the end of the treatment and 6 months later. Results highlight significant improvements in the targeted social cognitive processes and positive changes in functioning in the long term. The RC2S program seems, thus, to be a new useful program for social cognitive remediation in schizophrenia. PMID:27199776

Remediation plans in family medicine residency

PubMed Central

Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

2015-01-01

Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

Predictors of change in life skills in schizophrenia after cognitive remediation.

PubMed

Kurtz, Matthew M; Seltzer, James C; Fujimoto, Marco; Shagan, Dana S; Wexler, Bruce E

2009-02-01

Few studies have investigated predictors of response to cognitive remediation interventions in patients with schizophrenia. Predictor studies to date have selected treatment outcome measures that were either part of the remediation intervention itself or closely linked to the intervention with few studies investigating factors that predict generalization to measures of everyday life-skills as an index of treatment-related improvement. In the current study we investigated the relationship between four measures of neurocognitive function, crystallized verbal ability, auditory sustained attention and working memory, verbal learning and memory, and problem-solving, two measures of symptoms, total positive and negative symptoms, and the process variables of treatment intensity and duration, to change on a performance-based measure of everyday life-skills after a year of computer-assisted cognitive remediation offered as part of intensive outpatient rehabilitation treatment. Thirty-six patients with schizophrenia or schizoaffective disorder were studied. Results of a linear regression model revealed that auditory attention and working memory predicted a significant amount of the variance in change in performance-based measures of everyday life skills after cognitive remediation, even when variance for all other neurocognitive variables in the model was controlled. Stepwise regression revealed that auditory attention and working memory predicted change in everyday life-skills across the trial even when baseline life-skill scores, symptoms and treatment process variables were controlled. These findings emphasize the importance of sustained auditory attention and working memory for benefiting from extended programs of cognitive remediation.

Implementing cognitive remediation and social cognitive interaction training into standard psychosis care.

PubMed

Dark, Frances; Harris, Meredith; Gore-Jones, Victoria; Newman, Ellie; Whiteford, Harvey

2018-06-15

To evaluate the planned implementation of group based Cognitive Remediation therapy (CR) and Social Cognitive Interaction Training (SCIT) into routine psychosis care in a mental health service in Australia. The study was conducted over 3 years in a mental health service in a metropolitan city in Australia. Participants were 22 program facilitators and 128 patients attending the programs. Implementation outcomes were assessed using administrative data, staff surveys and program audits. There was fidelity to the particular therapies at a program level. Programs were assessed as being feasible within the study setting with each hospital district developing a capacity to run CR and SCIT. The establishment of new programs improved the reach, but waiting lists indicate a need to expand capacity. There was a relatively high dropout and several factors impacted on completion of the programs - notably, acute exacerbation of psychosis. Once initiated the therapies were acceptable with no-one ceasing SCIT due to loss of interest and only 10% of participants ceasing CR due to loss of interest. Annual audits of programs found programs established were maintained and facilitators were retained. SCIT and CR programs were successfully implemented in three hospital districts. Several factors impeded participants receiving the recommended "dose" of the programs. The maintenance of the programs in the short term is encouraging in regards to organisational fit. Dissemination of cognitive rehabilitation programs to a service population takes planning. An implementation plan is essential for guiding development and maintenance of programs. These therapies are best suited to people in a stable phase of illness. Service user co-production is recommended to improve recruitment in future studies.

The effect of cognitive remediation in individuals at ultra-high risk for psychosis: a systematic review.

PubMed

Glenthøj, Louise Birkedal; Hjorthøj, Carsten; Kristensen, Tina Dam; Davidson, Charlie Andrew; Nordentoft, Merete

2017-01-01

Cognitive deficits are prominent features of the ultra-high risk state for psychosis that are known to impact functioning and course of illness. Cognitive remediation appears to be the most promising treatment approach to alleviate the cognitive deficits, which may translate into functional improvements. This study systematically reviewed the evidence on the effectiveness of cognitive remediation in the ultra-high risk population. The electronic databases MEDLINE, PsycINFO, and Embase were searched using keywords related to cognitive remediation and the UHR state. Studies were included if they were peer-reviewed, written in English, and included a population meeting standardized ultra-high risk criteria. Six original research articles were identified. All the studies provided computerized, bottom-up-based cognitive remediation, predominantly targeting neurocognitive function. Four out of five studies that reported a cognitive outcome found cognitive remediation to improve cognition in the domains of verbal memory, attention, and processing speed. Two out of four studies that reported on functional outcome found cognitive remediation to improve the functional outcome in the domains of social functioning and social adjustment. Zero out of the five studies that reported such an outcome found cognitive remediation to affect the magnitude of clinical symptoms. Research on the effect of cognitive remediation in the ultra-high risk state is still scarce. The current state of evidence indicates an effect of cognitive remediation on cognition and functioning in ultra-high risk individuals. More research on cognitive remediation in ultra-high risk is needed, notably in large-scale trials assessing the effect of neurocognitive and/or social cognitive remediation on multiple outcomes.

Cognitive remediation for individuals with psychosis in a supported education setting: a randomized controlled trial.

PubMed

Kidd, Sean A; Kaur, Jaswant; Virdee, Gursharan; George, Tony P; McKenzie, Kwame; Herman, Yarissa

2014-08-01

Cognitive remediation (CR) has demonstrated good outcomes when paired with supported employment, however little is known about its effectiveness when integrated into a supported education program. This randomized controlled trial examined the effectiveness of integrating CR within a supported education program compared with supported education without CR. Thirty-seven students with psychosis were recruited into the study in the 2012 academic year. Academic functioning, cognition, self-esteem, and symptomatology were assessed at baseline, at 4months following the first academic term in which CR was provided, and at 8months assessing maintenance of gains. The treatment group demonstrated better retention in the academic program and a trend of improvement across a range of academic functional domains. While both treatment and control groups showed improvement in cognitive measures, the outcomes were not augmented by CR training. CR was also associated with significant and sustained improvements in self esteem. Further research, investigating specific intervention components is required to clarify the mixed findings regarding the effectiveness of CR in an education setting. Copyright © 2014 Elsevier B.V. All rights reserved.

Cognitive Remediation: Potential Novel Brain-Based Treatment for Bipolar Disorder in Children and Adolescents

PubMed Central

Dickstein, Daniel P.; Cushman, Grace K.; Kim, Kerri L.; Weissman, Alexandra B.; Wegbreit, Ezra

2015-01-01

Bipolar disorder (BD) is among the most impairing psychiatric disorders affecting children and adolescents, despite our best psychopharmacological and psychotherapeutic treatments. Cognitive remediation, defined as a behavioral intervention designed to improve cognitive functions so as to reduce psychiatric illness, is an emerging brain-based treatment approach that has thus far not been studied in pediatric BD. The present article reviews the basic principles of cognitive remediation, describes what is known about cognitive remediation in psychiatric disorders, and delineates potential brain/behavior alterations implicated in pediatric BD that might be targets for cognitive remediation. Emerging data shows that cognitive remediation may be useful in children and adults with schizophrenia, ADHD, and anxiety disorders, and in adults with BD. Potential targets for cognitive remediation in pediatric BD include face processing, response inhibition, frustration, and cognitive flexibility. Further study is warranted to determine if cognitive remediation for these targets, or others, may serve as a novel, brain-based treatment for pediatric BD. PMID:26135596

Implementation of the thinking skills for work program in a psychosocial clubhouse.

PubMed

McGurk, Susan R; Schiano, Diane; Mueser, Kim T; Wolfe, Rosemarie

2010-01-01

Cognitive remediation programs aimed at improving role functioning have been implemented in a variety of different mental health treatment settings, but not in psychosocial clubhouses. This study sought to determine the feasibility and preliminary outcomes of providing a cognitive remediation program (the Thinking Skills for Work program), developed and previously implemented in supported employment programs at mental health agencies, in a psychosocial club-house. Twenty-three members with a history of difficulties getting or keeping jobs, who were participating in a supported employment program at a psychosocial clubhouse, were enrolled in the Thinking Skills for Work program. A neurocognitive battery was administered at baseline and 3 months later after completion of the computer cognitive training component of the program. Hours of competitive work were tracked for the 2 years before enrollment and 2 years following enrollment. Other work-related activities (school, volunteer) were also tracked for 2 years following enrollment. Twenty-one members (91%) completed 6 or more computer cognitive training sessions. Participants demonstrated significant improvements on neurocognitive measures of processing speed, verbal learning and memory, and executive functions. Sixty percent of the members obtained a competitive job during the 2-year follow-up, and 74% were involved in some type of work-related activity. Participants worked significantly more competitive hours over the 2 years after joining the Thinking Skills for Work program than before. The findings support the feasibility and promise of implementing the Thinking Skills for Work program in the context of supported employment provided at psychosocial clubhouses.

Meta-cognitive skills training enhances computerized cognitive remediation outcomes among individuals with first-episode psychosis.

PubMed

Breitborde, Nicholas J K; Woolverton, Cindy; Dawson, Spencer C; Bismark, Andrew; Bell, Emily K; Bathgate, Christina J; Norman, Kaila

2017-06-01

Meta-cognitive skills training (MST) is a frequent component of cognitive remediation programmes for individuals with psychosis. However, no study has investigated whether incorporating such activities produces increased clinical benefits compared with computerized cognitive remediation alone. Individuals with first-episode psychosis who completed computerized cognitive remediation with concurrent meta-cognitive skills training (CCR + MST) were compared with a historical control group who received computerized cognitive remediation alone (CCR) and did not differ from the CCR + MST group with regard to pre-intervention cognition, diagnosis, age, duration of psychotic illness or sex. Participants completed assessments of cognition and real-world functioning before and after 6 months of treatment. Individual receiving CCR + MST experience greater gains in cognition and real-world functioning than individuals who received CCR. MST may be an important component within cognitive remediation programmes for first-episode psychosis. © 2015 Wiley Publishing Asia Pty Ltd.

Treatment of Functional Impairment in Patients with Bipolar Disorder.

PubMed

Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Vieta, Eduard

2017-01-01

Traditionally, functional impairment has received little attention in bipolar disorder, despite the fact that many patients experience significant impairments in daily life. In the last decade, research has changed its focus from clinical remission to functional recovery in bipolar patients as a priority. A literature review of this topic will allow us provide an overview of the relevance of functional impairment as well as the potential factors that can predict or contribute to low functioning in bipolar disorder (BD). Treatment approaches should consider not only euthymia as a goal but also cognitive and functional improvement of patients with such a complex disorder. Functional remediation and psychoeducation among psychological interventions may help to enhance functioning. The combination of cognitive enhancers and cognitive/functional remediation programs may help in improving cognitive and functional impairments. Early interventions are essential to prevent cognitive deficits and disability.

Cognitive Deficits in Schizophrenia: Understanding the Biological Correlates and Remediation Strategies

PubMed Central

Tripathi, Adarsh; Shukla, Rashmi

2018-01-01

Cognitive deficits are one of the core symptoms of schizophrenia that evolve during the course of schizophrenia, after being originated even before the onset of illness. Existing pharmacological and biological treatment modalities fall short to meet the needs to improve the cognitive symptoms; hence, various cognitive remediation strategies have been adopted to address these deficits. Research evidences suggest that cognitive remediation measures improve the functioning, limit disability bettering the quality of life. The functional outcomes of cognitive remediation in schizophrenia are resultant of neurobiological changes in specific brain areas. Recent years witnessed significant innovations in cognitive remediation strategies in schizophrenia. This comprehensive review highlights the biological correlates of cognitive deficits in schizophrenia and the remedial measures with evidence base. PMID:29397662

[Preventing violence in schizophrenia with cognitive remediation].

PubMed

Darmedru, C; Demily, C; Franck, N

2018-04-01

The association between schizophrenia and violence represents an important issue in psychiatry. Often highly publicized, violent acts raise the question of their detection, prevention, management and treatment. There is no single, direct and exclusive link between aggressiveness and the underlying psychiatric disorder. On the contrary, the processes underlying this violence are multiple and interlinked. In addition to static and dynamic risk factors, cognitive deficits play an important role in the genesis and maintenance of violent and aggressive behavior. Using recent data from the international literature and the main databases, we first clarify the role played by cognitive deficits in the violence of patients with schizophrenia. We then evaluate the place of psychosocial interventions such as cognitive remediation and social cognitive training in managing the violent and aggressive behavior of these patients. Executive functions and working memory are the most studied neurocognitive functions in the field of violence in schizophrenia. Impulsivity, lack of cognitive flexibility, lack of adaptation and inhibition of automatic motor responses, and altered anger regulation may explain this relationship. Three main components of social cognition are associated with violent behaviors in schizophrenia: (1) the recognition of facial emotions through the inoperability of systems of "emotional monitoring", violent inhibition and recognition of informative facial zones; (2) the theory of the mind through the erroneous interpretation of the intentions of others; (3) the attributional style through the preferentially aggressive over interpretation of social situations and weak capacities of introspection. Overall, cognitive biases inhibit response in a socially acceptable manner and increase the risk of responding impulsively and aggressively to a stressful or provocative situation. In this context, we studied the place held by psychosocial interventions in the management of the violent and aggressive behaviors of these patients. Various cognitive remediation programs have shown their feasibility in people with schizophrenia and neurocognitive deficits with a history of violence as well as their effectiveness in reducing violence, mainly by reducing impulsivity. Similarly, specific programs dedicated to social cognitive training such as Social Cognition and Interaction Training (SCIT), Reasoning and Rehabilitation Mental Health Program (R&R2 MHP) and Metacognitive Training (MCT) have shown their positive impact on the control and reduction of global aggressive attitudes and on the numbers of physical and verbal aggressive incidents in schizophrenia. The improvement of social cognition would be achieved through the amendment of interpersonal relationships and social functioning. These interventions are effective at different stages of disease progression, in patients with varied profiles, on violent attitudes in general and on the number of verbal and physical attacks, whether for in-patients or out-patients. Beneficial effects can last up to 12months after termination of the study program. The interest of these interventions is preventive if the subject never entered in a violent register or curative in case of a personal history of violence. This type of care can be considered from a symptomatic point of view by limiting downstream the heavy consequences of such acts, but also etiologically by acting on one of the causes of violent behavior. Compliance with the eligibility criteria, carrying out a prior functional analysis and confirmation of the major impulsive part of the patient's violence are prerequisites for the use of these programs. Similarly, the early introduction of such therapies, their repetition over time and the integration of the patient into a comprehensive process of psychosocial rehabilitation will ensure the best chance of success. Some cognitive impairments appear to have their place in the genesis, progression and maintenance of violent acts of individuals with schizophrenia. Their management thus opens new therapeutic perspectives such as cognitive remediation, still rarely used in this aim, to complement the action of the traditional care tools. However, further therapeutic trials are needed before considering cognitive remediation and social cognitive training as central care modalities in the therapeutic control of violence in schizophrenia. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Neuroplastic changes in patients with schizophrenia undergoing cognitive remediation: triple-blind trial

PubMed Central

Ramsay, Ian S.; Nienow, Tasha M.; Marggraf, Matthew P.; MacDonald, Angus W.

2017-01-01

Background Patients with schizophrenia have shown cognitive improvements following cognitive remediation, but the neuroplastic changes that support these processes are not fully understood. Aims To use a triple-blind, placebo-controlled trial to examine neural activation before and after cognitive remediation or a computer skills training (CST) placebo (trial registration: NCT00995553)). Method Twenty-seven participants underwent functional magnetic resonance imaging before and after being randomised to either cognitive remediation intervention or CST. Participants completed two variants of the N-back task during scanning and were assessed on measures of cognition, functional capacity, community functioning and symptoms. Results We observed a group × time interaction in the left prefrontal cortex, wherein the cognitive remediation group showed increased activation. These changes correlated with improved task accuracy within the cognitive remediation group, whereas there was no relationship between changes in activation in untrained cognitive measures. Significant changes were not observed in other hypothesised areas for the cognitive remediation group. Conclusions We replicated the finding that cognitive remediation increases left lateral prefrontal activation during a working memory task in patients with schizophrenia, suggesting this may be an important neural target for these types of interventions. PMID:28153927

Neuroplastic changes in patients with schizophrenia undergoing cognitive remediation: triple-blind trial.

PubMed

Ramsay, Ian S; Nienow, Tasha M; Marggraf, Matthew P; MacDonald, Angus W

2017-03-01

Background Patients with schizophrenia have shown cognitive improvements following cognitive remediation, but the neuroplastic changes that support these processes are not fully understood. Aims To use a triple-blind, placebo-controlled trial to examine neural activation before and after cognitive remediation or a computer skills training (CST) placebo (trial registration: NCT00995553)). Method Twenty-seven participants underwent functional magnetic resonance imaging before and after being randomised to either cognitive remediation intervention or CST. Participants completed two variants of the N-back task during scanning and were assessed on measures of cognition, functional capacity, community functioning and symptoms. Results We observed a group × time interaction in the left prefrontal cortex, wherein the cognitive remediation group showed increased activation. These changes correlated with improved task accuracy within the cognitive remediation group, whereas there was no relationship between changes in activation in untrained cognitive measures. Significant changes were not observed in other hypothesised areas for the cognitive remediation group. Conclusions We replicated the finding that cognitive remediation increases left lateral prefrontal activation during a working memory task in patients with schizophrenia, suggesting this may be an important neural target for these types of interventions. © The Royal College of Psychiatrists 2017.

A randomized study of cognitive remediation for forensic and mental health patients with schizophrenia.

PubMed

Ahmed, Anthony O; Hunter, Kristin M; Goodrum, Nada M; Batten, Nancy-Jane; Birgenheir, Denis; Hardison, Erik; Dixon, Thaddeus; Buckley, Peter F

2015-09-01

Cognitive remediation has proven efficacy for improving neurocognition in people with schizophrenia. The current study evaluated the benefits of cognitive remediation on neurocognition, functioning, psychotic symptoms, and aggression in a sample of forensic and mental health patients. Care recipients with schizophrenia or schizoaffective disorder (N = 78) receiving services in the forensic and mental health units of a state hospital were randomized to participate in cognitive remediation versus computer games control activities. Participants' neurocognition, functional capacity, experiential recovery, psychotic symptoms, and aggression incidents were assessed at baseline and posttreatment. Cognitive remediation was associated with improvements in several neurocognitive domains and circumscribed domains of functional capacity. People assigned to cognitive remediation experiences greater reductions in negative symptoms, agitation/excitement, and verbal and physical aggression. In addition to improving neurocognition in long-term hospitalized forensic and mental health patients, cognitive remediation may enhance efforts at reducing negative symptoms, emotion dysregulation, and aggression incidents. Forensic settings may represent a new frontier for the clinical dissemination of cognitive remediation. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Cognitive remediation and nursing care].

PubMed

Schenin-King, Palmyre; Thomas, Fanny; Braha-Zeitoun, Sonia; Bouaziz, Noomane; Januel, Dominique

2016-01-01

Therapies based on cognitive remediation integrate psychiatric care. Cognitive remediation helps to ease cognitive disorders and enable patients to improve their day-to-day lives. It is essential to complete nurses' training in this field. This article presents the example of a patient with schizophrenia who followed the Cognitive Remediation Therapy programme, enabling him to access mainstream employment. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Neural activity during emotion recognition after combined cognitive plus social cognitive training in schizophrenia.

PubMed

Hooker, Christine I; Bruce, Lori; Fisher, Melissa; Verosky, Sara C; Miyakawa, Asako; Vinogradov, Sophia

2012-08-01

Cognitive remediation training has been shown to improve both cognitive and social cognitive deficits in people with schizophrenia, but the mechanisms that support this behavioral improvement are largely unknown. One hypothesis is that intensive behavioral training in cognition and/or social cognition restores the underlying neural mechanisms that support targeted skills. However, there is little research on the neural effects of cognitive remediation training. This study investigated whether a 50 h (10-week) remediation intervention which included both cognitive and social cognitive training would influence neural function in regions that support social cognition. Twenty-two stable, outpatient schizophrenia participants were randomized to a treatment condition consisting of auditory-based cognitive training (AT) [Brain Fitness Program/auditory module ~60 min/day] plus social cognition training (SCT) which was focused on emotion recognition [~5-15 min per day] or a placebo condition of non-specific computer games (CG) for an equal amount of time. Pre and post intervention assessments included an fMRI task of positive and negative facial emotion recognition, and standard behavioral assessments of cognition, emotion processing, and functional outcome. There were no significant intervention-related improvements in general cognition or functional outcome. fMRI results showed the predicted group-by-time interaction. Specifically, in comparison to CG, AT+SCT participants had a greater pre-to-post intervention increase in postcentral gyrus activity during emotion recognition of both positive and negative emotions. Furthermore, among all participants, the increase in postcentral gyrus activity predicted behavioral improvement on a standardized test of emotion processing (MSCEIT: Perceiving Emotions). Results indicate that combined cognition and social cognition training impacts neural mechanisms that support social cognition skills. Copyright © 2012 Elsevier B.V. All rights reserved.

Neural activity during emotion recognition after combined cognitive plus social-cognitive training in schizophrenia

PubMed Central

Hooker, Christine I.; Bruce, Lori; Fisher, Melissa; Verosky, Sara C.; Miyakawa, Asako; Vinogradov, Sophia

2012-01-01

Cognitive remediation training has been shown to improve both cognitive and social-cognitive deficits in people with schizophrenia, but the mechanisms that support this behavioral improvement are largely unknown. One hypothesis is that intensive behavioral training in cognition and/or social-cognition restores the underlying neural mechanisms that support targeted skills. However, there is little research on the neural effects of cognitive remediation training. This study investigated whether a 50 hour (10-week) remediation intervention which included both cognitive and social-cognitive training would influence neural function in regions that support social-cognition. Twenty-two stable, outpatient schizophrenia participants were randomized to a treatment condition consisting of auditory-based cognitive training (AT) [Brain Fitness Program/auditory module ~60 minutes/day] plus social-cognition training (SCT) which was focused on emotion recognition [~5–15 minutes per day] or a placebo condition of non-specific computer games (CG) for an equal amount of time. Pre and post intervention assessments included an fMRI task of positive and negative facial emotion recognition, and standard behavioral assessments of cognition, emotion processing, and functional outcome. There were no significant intervention-related improvements in general cognition or functional outcome. FMRI results showed the predicted group-by-time interaction. Specifically, in comparison to CG, AT+SCT participants had a greater pre-to-post intervention increase in postcentral gyrus activity during emotion recognition of both positive and negative emotions. Furthermore, among all participants, the increase in postcentral gyrus activity predicted behavioral improvement on a standardized test of emotion processing (MSCEIT: Perceiving Emotions). Results indicate that combined cognition and social-cognition training impacts neural mechanisms that support social-cognition skills. PMID:22695257

Cognitive remediation for vocational rehabilitation nonresponders.

PubMed

McGurk, Susan R; Mueser, Kim T; Xie, Haiyi; Feldman, Karin; Shaya, Yaniv; Klein, Leslie; Wolfe, Rosemarie

2016-08-01

Cognitive remediation in people with severe mental illnesses (SMI) that interfere with work, but less research has evaluated its effects in those who have not benefitted from vocational services. Participants with SMI (83% schizophrenia) who had not benefitted from vocational rehabilitation were randomized to vocational services enhanced by training vocational specialists in recognizing cognitive difficulties and providing job-relevant cognitive coping strategies (Enhanced Vocational Rehabilitation: E-VR), or similarly enhanced vocational services and cognitive remediation (Thinking Skills Work: TSW). Cognition and symptoms were assessed at baseline, post-treatment (9months), and follow-up (18months), with work tracked weekly for 3years. Fifty-four participants were randomized to E-VR (N=26) or TSW (N=28). Participants in TSW had high rates of exposure to the program (89%) and improved more than those in E-VR on cognitive functioning post-training, with attenuation of some gains at the 18-months. Participants in TSW and E-VR did not differ significantly in competitive work (57% vs. 48%) or paid employment (61% vs. 48%) over the 3-year study, although those in TSW were more likely to be engaged in any work activity, including paid or volunteer work (75% vs. 50%, p=0.057), and had more weeks of work activity (23.04 vs. 48.82, p=0.051), and improved marginally more on the clinical symptoms. The significantly higher education level of participants in E-VR than TSW at baseline may have obscured the effects of TSW. This study supports the feasibility and potential benefits of cognitive remediation for persons who have not benefited from vocational rehabilitation. Copyright © 2016 Elsevier B.V. All rights reserved.

Increased activation in Broca's area after cognitive remediation in schizophrenia.

PubMed

Vianin, Pascal; Urben, Sébastien; Magistretti, Pierre; Marquet, Pierre; Fornari, Eleonora; Jaugey, Laure

2014-03-30

Functional magnetic resonance imaging (fMRI) was used to measure changes in cerebral activity in patients with schizophrenia after participation in the Cognitive Remediation Program for Schizophrenia and other related disorders (RECOS). As RECOS therapists make use of problem-solving and verbal mediation techniques, known to be beneficial in the rehabilitation of dysexecutive syndromes, we expected an increased activation of frontal areas after remediation. Executive functioning and cerebral activation during a covert verbal fluency task were measured in eight patients with schizophrenia before (T1) and after (T2) 14 weeks of RECOS therapy. The same measures were recorded in eight patients with schizophrenia who did not participate in RECOS at the same intervals of time (TAU group). Increased activation in Broca's area, as well as improvements in performance of executive/frontal tasks, was observed after cognitive training. Metacognitive techniques of verbalization are hypothesized to be the main factor underlying the brain changes observed in the present study. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The effects of cognitive remediation on functional outcomes among people with schizophrenia: a randomised controlled study.

PubMed

Tan, Bhing-Leet; King, Robert

2013-11-01

Cognitive remediation is an intervention to overcome cognitive deficits through drills and use of strategies. Previous studies have reported positive effects for cognitive remediation on neurocognition, but researchers' allegiance effects are not always adequately controlled. Furthermore, its efficacy amongst the Asian population has not been established. Hence, this study aimed to determine if cognitive remediation would have positive effects on neurocognition and functioning within an English-speaking Asian population, when compared against the effects of a credible and balanced control provided by therapists blinded to the study hypothesis. A total of 70 participants with schizophrenia who attended vocational training or day rehabilitation programmes were randomised to receive a 60-hour programme of either cognitive remediation or physical exercise. Neurocognition and functional outcomes were measured at baseline, upon completion of treatment, 6 months after treatment and 1 year after treatment. Participants who received cognitive remediation had significantly greater improvement in all neurocognitive domains. Furthermore, the cognitive remediation group achieved greater attainment of vocational or independent living skills and better functional outcomes at post-intervention and at the end of the 1-year follow-up. When compared against a credible intervention such as physical exercise, cognitive remediation was able to show significant positive effects on both neurocognition and functional outcomes among the Asian population of schizophrenia patients.

Using visual processing training to enhance standard cognitive remediation outcomes in schizophrenia: A pilot study.

PubMed

Contreras, Natalia A; Tan, Eric J; Lee, Stuart J; Castle, David J; Rossell, Susan L

2018-04-01

Approaches to cognitive remediation (CR) that address sensory perceptual skills before higher cognitive skills, have been found to be effective in enhancing cognitive performance in schizophrenia. To date, however, most of the conducted trials have concentrated on auditory processing. The aim of this study was to explore whether the addition of visual processing training could enhance standard cognitive remediation outcomes in a schizophrenia population. Twenty participants were randomised to either receive 20h of computer-assisted cognitive remediation alone or 20h of visual processing training modules and cognitive remediation training. All participants were assessed at baseline and at the end of cognitive remediation training on cognitive and psychosocial (i.e. self-esteem, quality of life) measures. At the end of the study participants across both groups improved significantly in overall cognition and psychosocial functioning. No significant differences were observed between groups on any of the measures. Of potential interest, however, was that the Cohen's d assessing the between group difference in the rates of change were moderate/large for a greater improvement in Visual Learning, Working Memory and Social Cognition for the visual training plus cognitive remediation group. On the basis of our effect sizes on three domains of cognition, we recommend replicating this intervention with a larger sample. Copyright © 2017 Elsevier B.V. All rights reserved.

Exercise Induced Neuroplasticity to Enhance Therapeutic Outcomes of Cognitive Remediation in Schizophrenia: Analyzing the Role of Brai nderived Neurotrophic Factor.

PubMed

Campos, Carlos; Rocha, Nuno B F; Lattari, Eduardo; Nardi, Antonio E; Machado, Sergio

2017-01-01

Cognitive impairment is a major manifestation of schizophrenia and a crucial treatment target as these deficits are closely related to patients' functional outcomes. Cognitive remediation is the gold-standard practice to address cognitive deficits in schizophrenia. There is clear evidence stating that cognitive remediation improves cognitive function and promotes structural neuroplastic changes in patients with schizophrenia, with brain-derived neurotrophic factor (BDNF) expression emerging as a potential biomarker for its efficacy. This is particularly important as there is clear evidence relating atypical BDNF expression to cognitive impairment in patients with schizophrenia. Despite the valuable role of cognitive remediation in the management of schizophrenia, there is still a need to develop methods that allow maximizing its efficacy. In this review, we present a hypothesis arguing that cognitive remediation efficacy for patients with schizophrenia can be enhanced by aerobic exercise-induced BDNF upregulation. There have been a few trials reporting that combining aerobic exercise with cognitive training was superior to cognitive training alone to improve cognitive functioning in patients with schizophrenia. Furthermore, there is preliminary evidence suggesting that combined aerobic and cognitive training can increase peripheral BDNF levels. Thereby, engaging in aerobic exercise in close temporal proximity to cognitive remediation may allow achieving a state of neuroplastic readiness in the brain, facilitating cognitive functioning enhancement. Although this hypothesis still lacks evidence, future clinical trials using cognitive remediation for schizophrenia should explore strategies to maximize neuroplasticity and achieve optimal cognitive improvements. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

INDEX AND SHORT DESCRIPTION OF ALL TESTS.

ERIC Educational Resources Information Center

New York Medical Coll., NY.

THE INSTITUTE'S TEST BATTERY IS INTENDED TO ASSESS THE CHILD'S ACHIEVEMENT IN COGNITIVE STYLE, PERCEPTUAL ABILITY, LANGUAGE DEVELOPMENT, AND READING ACHIEVEMENT. THE TWO MAJOR PHASES IN THE INSTITUTE'S RESEARCH PROGRAM ARE EXPLORATION OF EARLY ENVIRONMENTAL FACTORS AND THE DEVELOPMENT OF SCHOOL REMEDIAL, READING, AND ENRICHMENT PROGRAMS. THE INDEX…

Feasibility and effectiveness of a cognitive remediation programme with original computerised cognitive training and group intervention for schizophrenia: a multicentre randomised trial.

PubMed

Matsuda, Yasuhiro; Morimoto, Tsubasa; Furukawa, Shunichi; Sato, Sayaka; Hatsuse, Norifumi; Iwata, Kazuhiko; Kimura, Mieko; Kishimoto, Toshifumi; Ikebuchi, Emi

2018-04-01

Devising new methods to improve neurocognitive impairment through cognitive remediation is an important research goal. We developed an original computer programme termed the Japanese Cognitive Rehabilitation Programme for Schizophrenia (JCORES) that provides cognitive practice across a broad range of abilities. The current study examined for the first time whether a cognitive remediation programme, including both computerised cognitive training using JCORES and group intervention such as enhancing meta-cognition and teaching strategies, is more effective than treatment as usual for improving neurocognitive and social functioning. Sixty-two outpatients with schizophrenia were randomised to either a cognitive remediation group or a control group. Participants engaged in two computerised cognitive training sessions and one group meeting per week for 12 weeks. The average number of total sessions attended (computerised cognitive practice + group intervention) was 32.3 (89.7%). The cognitive remediation group showed significantly more improvements in verbal memory, composite score of the Brief Assessment of Cognition in Schizophrenia, Japanese version (BACS-J), and general psychopathology on the Positive and Negative Syndrome Scale (PANSS) than the control group. These findings demonstrate that a cognitive remediation programme is feasible in Japan and is a more effective way to improve neurocognitive functioning and psychiatric symptoms.

Cognitive remediation and social cognitive training for violence in schizophrenia: a systematic review.

PubMed

Darmedru, C; Demily, C; Franck, N

2017-05-01

A significant correlation exists between violence and schizophrenia (SCZ). Recent studies matched some cognitive deficits like strong risk factors for violence with interesting applications in terms of treatment. Our objective was to conduct a systematic review of the effectiveness of cognitive remediation (CR) and social cognitive training (SCT) in the management of violent and aggressive behaviors in SCZ. The electronic databases Pubmed, Web of Science, Cochrane Library and ScienceDirect were searched in, using combinations of terms relating to SCZ, CR and violence. Studies were selected and data were extracted using a PRISMA statement. Inclusion criteria were adults with SCZ and a documented collection of disruptive and violent behaviors, for whom researchers had used a CR or SCT program. Eleven studies were identified, two related to non-specific CR intervention and nine to codified CR or SCT programs. Results showed that these programs had a positive impact on the control and reduction of global aggressive attitudes and physical assaults. Therapeutic targets were social cognition and executive functions through the improvement of interpersonal relationships and impulsivity feature respectively. Effectiveness was proved at various stages of the illness, in different types of patients and units, with effects persisting for up to 12 months after interruption of CR. Conclusions are limited by some methodological restrictions. Although current evidences need to be completed with further randomized studies, CR and SCT appear to be promising approaches in the management of violence in SCZ. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

A pilot study of a combined group and individual functional remediation program for patients with bipolar I disorder.

PubMed

Zyto, Susan; Jabben, Nienke; Schulte, Peter F J; Regeer, Barbara J; Kupka, Ralph W

2016-04-01

Bipolar disorder has been associated with a decrease in cognitive functioning affecting the functional outcome of patients independent of mood states. However, there have only been few attempts to investigate the effects of functional remediation for patients with bipolar disorder. The current study investigates the feasibility and effectiveness of a combined group and individual functional remediation program for bipolar disorder, including both patients and their caregivers. Twelve participants diagnosed with bipolar I disorder, and their caregivers, were treated with a combined group and individual functional remediation program. The feasibility of the program was evaluated by dropout rates and participants' evaluations of the program. The effectiveness of the program was explored through the assessment of functional outcome at baseline, immediately post-treatment, and follow-up three months later. The results indicate a high degree of satisfaction and a low dropout rate with the current program. Assessment of outcomes suggests improved functioning in the areas of autonomy and occupational functioning, evolving from baseline to follow-up. Due to a small sample size and the lack of a control group the results are preliminary. This relatively brief intervention offers a more tailor-made approach to functional remediation and shows good feasibility, acceptability and improvement of functioning in patients with bipolar I disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

Job Endings and Work Trajectories of Persons Receiving Supported Employment and Cognitive Remediation.

PubMed

Teixeira, Carina; Mueser, Kim T; Rogers, E Sally; McGurk, Susan R

2018-05-02

This study examined job endings and work trajectories among participants in a study comparing the effects of adding cognitive remediation to supported employment among individuals who had not benefited from supported employment. Data were from a controlled trial of 107 persons with serious mental illness enrolled in supported employment but who had not obtained or sustained competitive work. Participants were randomly assigned to enhanced supported employment only (with employment specialists trained to recognize cognitive difficulties and teach coping strategies) or to the Thinking Skills for Work program (enhanced supported employment plus cognitive remediation). For the 52 participants who worked, the two groups were compared on types of job endings, reasons for job endings, successful versus unsuccessful jobs, and work trajectories over the two-year study period. The two groups did not differ in types of job ending, although participants in Thinking Skills for Work were less likely than those in enhanced supported employment only to cite dissatisfaction with the job as a reason for the job ending. Participants in Thinking Skills for Work were also less likely to have an overall unsuccessful work trajectory, more likely to have only successful jobs, and more likely to be employed at the end of the study. The Thinking Skills for Work program appeared to help participants who had not benefited from supported employment stick with and master their jobs more effectively than those in enhanced supported employment only, resulting in better work trajectories over the course of the study.

[Learning potential and cognitive remediation in schizophrenia].

PubMed

Raffard, S; Gely-Nargeot, M-C; Capdevielle, D; Bayard, S; Boulenger, J-P

2009-09-01

Many studies have stressed the importance of neurocognitive deficits in schizophrenia that represent a core feature of the pathology. Cognitive dysfunctions are present in 80% of schizophrenic patients, including deficits in attention, memory, speed processing and executive functioning, with well-known functional consequences on daily life, social functioning and rehabilitation outcome. Recent studies have stressed that cognitive deficits, rather than the positive or negative symptoms of schizophrenia, predict poor performance in basic activities of daily living. If it is possible to reduce psychotic symptoms and to prevent relapses with antipsychotic medication, it is not yet possible to have the same convincing impact on cognitive or functional impairments. Cognitive remediation is a new psychological treatment which has proved its efficacy in reducing cognitive deficits. A growing literature on cognitive rehabilitation suggests possibilities that in schizophrenia, specific techniques are able to enhance an individual's cognitive functioning. Presently, two distinct and complementary cognitive remediation methods have been developed: the compensatory and the restorative approaches: (A) restorative approaches attempt to improve function by recruiting relatively intact cognitive processes to fill the role of those impaired, or by using prosthetic aids to compensate for the loss of function; (B) in contrast, in the restorative approach cognitive deficits are targeted directly through repeated practice training. However, results concerning cognitive remediation remain inconsistent. It is clear that not all individuals with schizophrenia display cognitive impairment, and even among those who do, the specific pattern of cognitive functioning varies. Moreover, traditional neurocognitive assessment, with a single or static administration of cognitive measures, provides moderately good prediction of skills acquisition in schizophrenia. Among other factors such as motivation, awareness of having a disease and acuteness of symptomatology, some studies have exposed that a cognitive variable, learning potential could mediate in part the effectiveness of cognitive remediation. The concept of learning potential is used to explain some of the observed variability in cognitive functioning. Learning potential is the ability to attain and utilize cognitive skills after cognitive training: it is assessed by individual variation in performance across three consecutive administrations of the Wisconsin Card Sorting Test (WCST): a pretest with standard instruction procedures, a training phase with expanded instruction and a post test with only standard instruction. Three learner subtypes can be identified: "learners" who perform poorly at the pretest but improve performance during the post-test, "non-retainers" who perform poorly at pre-test and do not improve at post-testing and "high achievers" who perform well in the initial pretest and maintain their good performance across the other two administrations. The assessment of learning potential could predict, with other psychological measures such as insight and motivation, the most effective neurocognitive rehabilitation program for an individual patient, and could help the clinician to optimize patient outcome through appropriate individual management. Indeed, learning potential could represent a good cognitive predictor and indicator for rehabilitation in schizophrenia for clinicians and should be used in cognitive assessment practice. However, the individuals most likely to benefit from cognitive remediation, and whether changes in cognitive function translate into functional improvements, are as yet unclear.

Computer-assisted cognitive remediation therapy: cognition, self-esteem and quality of life in schizophrenia.

PubMed

Garrido, Gemma; Barrios, Maite; Penadés, Rafael; Enríquez, Maria; Garolera, Maite; Aragay, Núria; Pajares, Marta; Vallès, Vicenç; Delgado, Luis; Alberni, Joan; Faixa, Carlota; Vendrell, Josep M

2013-11-01

Quality of life (QoL) is an important outcome in the treatment of schizophrenia. Cognitive deficits have an impact on functional outcomes. Cognitive remediation therapy is emerging as a psychological intervention that targets cognitive impairment, but the effect of computer-assisted cognitive remediation on neuropsychology and social functioning and wellbeing remains unclear. The aim of the current study is to investigate the neurocognitive outcomes of computer-assisted cognitive remediation (CACR) therapy in a sample of schizophrenia patients, and to measure the quality of life and self-esteem as secondary outcomes. Sixty-seven people with schizophrenia were randomly assigned to computer-assisted cognitive remediation or an active control condition. The main outcomes were neuropsychological measures and secondary outcomes (self-esteem and quality of life). Measurements were recorded at baseline and post-treatment. The CACR therapy group improved in speed of processing, working memory and reasoning and problem-solving cognitive domains. QoL and self-esteem measures also showed significant improvements over time in this group. Computer-assisted cognitive remediation therapy for people with schizophrenia achieved improvements in neuropsychological performance and in QoL and self-esteem measurements. © 2013 Elsevier B.V. All rights reserved.

Program of arithmetic improvement by means of cognitive enhancement: an intervention in children with special educational needs.

PubMed

Deaño, Manuel Deaño; Alfonso, Sonia; Das, Jagannath Prasad

2015-03-01

This study reports the cognitive and arithmetic improvement of a mathematical model based on the program PASS Remedial Program (PREP), which aims to improve specific cognitive processes underlying academic skills such as arithmetic. For this purpose, a group of 20 students from the last four grades of Primary Education was divided into two groups. One group (n=10) received training in the program and the other served as control. Students were assessed at pre and post intervention in the PASS cognitive processes (planning, attention, simultaneous and successive processing), general level of intelligence, and arithmetic performance in calculus and solving problems. Performance of children from the experimental group was significantly higher than that of the control group in cognitive process and arithmetic. This joint enhancement of cognitive and arithmetic processes was a result of the operationalization of training that promotes the encoding task, attention and planning, and learning by induction, mediation and verbalization. The implications of this are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does the Beck Cognitive Insight Scale Predict Response to Cognitive Remediation in Schizophrenia?

PubMed

Benoit, Audrey; Harvey, Philippe-Olivier; Bherer, Louis; Lepage, Martin

2016-01-01

Cognitive remediation therapy (CRT) has emerged as a viable treatment option for people diagnosed with schizophrenia presenting disabling cognitive deficits. However, it is important to determine which variables can influence response to CRT in order to provide cost-effective treatment. This study's aim was to explore cognitive insight as a potential predictor of cognitive improvement after CRT. Twenty patients with schizophrenia completed a 24-session CRT program involving 18 hours of computer exercises and 6 hours of group discussion to encourage generalization of cognitive training to everyday activities. Pre- and posttest assessments included the CogState Research Battery and the Beck Cognitive Insight Scale (BCIS). Lower self-certainty on the BCIS at baseline was associated with greater improvement in speed of processing (r s = -0.48; p < 0.05) and visual memory (r s = -0.46; p < 0.05). The results of this study point out potential associations between self-certainty and cognitive improvement after CRT, a variable that can easily be measured in clinical settings to help evaluate which patients may benefit most from the intervention. They also underline the need to keep investigating the predictors of good CRT outcomes, which can vary widely between patients.

The role of premorbid adjustment in schizophrenia: Focus on cognitive remediation outcome.

PubMed

Buonocore, Mariachiara; Bosinelli, Francesca; Bechi, Margherita; Spangaro, Marco; Piantanida, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella Rita; Cavallaro, Roberto; Bosia, Marta

2018-02-19

Premorbid adjustment has been associated with several outcomes in schizophrenia and has been proposed as an index of cognitive reserve. This study aims to comprehensively analyse the relation between premorbid adjustment and clinical, neurocognitive, socio-cognitive and functional assessments, as well as to investigate the effect of premorbid adjustment on cognitive improvements after a cognitive remediation therapy protocol. Seventy-nine clinically stabilised outpatients with schizophrenia underwent a combined intervention consisting of cognitive remediation therapy added to standard rehabilitation therapy. All patients were assessed at baseline for psychopathology, premorbid adjustment, intellectual level, cognition and functioning. Cognitive evaluations were also repeated after the intervention. At baseline, significant correlations were observed between premorbid adjustment and working memory. The global cognitive improvement after treatment was significantly predicted by age and premorbid adjustment. This study confirms the association between premorbid adjustment and cognitive impairment and is the first to highlight the possible role of premorbid adjustment on the capacity to recover from cognitive deficits through a cognitive remediation therapy protocol. The data suggest that cognitive remediation may be particularly effective for people in the early course and that the assessment of premorbid adjustment could be of value to design individualised interventions.

Treating impaired cognition in schizophrenia: the case for combining cognitive-enhancing drugs with cognitive remediation.

PubMed

Michalopoulou, Panayiota G; Lewis, Shôn W; Wykes, Til; Jaeger, Judith; Kapur, Shitij

2013-08-01

Cognitive impairment is a well-documented feature of schizophrenia and represents a major impediment to the functional recovery of patients. The therapeutic strategies to improve cognition in schizophrenia have either used medications (collectively referred to as 'cognitive-enhancing drugs' in this article) or non-pharmacological training approaches ('cognitive remediation'). Cognitive-enhancing drugs have not as yet been successful and cognitive remediation has shown modest success. Therefore, we may need to explore new therapeutic paradigms to improve cognition in schizophrenia. The optimal approach may require a combination of cognitive-enhancing drugs with cognitive remediation. We review the available data from animal and human studies that provide the conceptual basis, proof-of-concept and illustrations of success of such combination strategies in experimental and clinical paradigms in other conditions. We address the major design issues relevant to the choice of the cognitive-enhancing drugs and cognitive remediation, as well as the timing and the duration of the intervention as will be relevant for schizophrenia. Finally, we address the practical realities of the development and testing of such combined approaches in the real-world clinical situation and conclude that while scientifically attractive, there are several practical difficulties to be overcome for this approach to be clinically feasible. Copyright © 2013 Elsevier B.V. and ECNP. All rights reserved.

Family Counseling Psychology.

ERIC Educational Resources Information Center

Levant, Ronald F., ed.

1983-01-01

Describes programs for family counseling which use psychological-educational and skills training methods to remediate individual and family problems or enhance family life. The six articles discuss client-centered skills training, behavioral approaches, cognitive behavioral marital therapy, Adlerian parent education, and couple communication. (JAC)

The impact of intrinsic motivation on session attendance and reliable cognitive improvement in cognitive remediation in schizophrenia.

PubMed

Bryce, S D; Lee, S J; Ponsford, J L; Lawrence, R J; Tan, E J; Rossell, S L

2018-06-20

Cognitive remediation (CR) is considered a potentially effective method of improving cognitive function in people with schizophrenia. Few studies, however, have explored the role of intrinsic motivation on treatment utilization or training outcomes in CR in this population. This study explored the impact of task-specific intrinsic motivation on attendance and reliable cognitive improvement in a controlled trial comparing CR with a computer game (CG) playing control. Forty-nine participants with schizophrenia or schizoaffective disorder, allocated to 10 weeks of group-based CR (n = 25) or CG control (n = 24), provided complete outcome data at baseline. Forty-three participants completed their assigned intervention. Cognition, psychopathology and intrinsic motivation were measured at baseline and end-treatment. Regression analyses explored the relative contribution of baseline motivation and other clinical factors to session attendance as well as the association of baseline and change in intrinsic motivation with the odds of reliable cognitive improvement (calculated using reliable change indices). Baseline reports of perceived program value were the only significant multivariable predictor of session attendance when including global cognition and psychiatric symptomatology. The odds of reliable cognitive improvement significantly increased with greater improvements in program interest and value from baseline to end-treatment. Motivational changes over time were highly variable between participants. Task-specific intrinsic motivation in schizophrenia may represent an important patient-related factor that contributes to session attendance and cognitive improvements in CR. Regular evaluation and enhancement of intrinsic motivation in cognitively enhancing interventions may optimize treatment engagement and the likelihood of meaningful training outcomes. Copyright © 2018 Elsevier B.V. All rights reserved.

Counter striking psychosis: Commercial video games as potential treatment in schizophrenia? A systematic review of neuroimaging studies.

PubMed

Suenderhauf, Claudia; Walter, Anna; Lenz, Claudia; Lang, Undine E; Borgwardt, Stefan

2016-09-01

Schizophrenia is a severe, chronic, and strongly disabling neuropsychiatric disorder, characterized by cognitive decline, positive and negative symptoms. Positive symptoms respond well to antipsychotic medication and psycho-social interventions, in contrast to negative symptoms and neurocognitive impairments. Cognitive deficits have been linked to a poorer outcome and hence specific cognitive remediation therapies have been proposed. Their effectiveness is nowadays approved and neurobiological correlates have been reconfirmed by brain imaging studies. Interestingly, recent MRI work showed that commercial video games modified similar brain areas as these specialized training programs. If gray matter increases and functional brain modulations would translate in better cognitive and every day functioning, commercial video game training could be an enjoyable and economically interesting treatment option for patients with neuropsychiatric disorders. This systematic review summarizes advances in the area with emphasis on imaging studies dealing with brain changes upon video game training and contrasts them to conventional cognitive remediation. Moreover, we discuss potential challenges therapeutic video game development and research would have to face in future treatment of schizophrenia. Copyright © 2016. Published by Elsevier Ltd.

Cognitive remediation in schizophrenia—The view from India

PubMed Central

Deshpande, Smita N.; Bhatia, Triptish; Mohandas, E.; Nimgaonkar, Vishwajit L.

2017-01-01

The prevalence and disability due to Schizophrenia (SZ) in India is similar to other parts of the world. Cognitive impairments are also present in a large group of Indian persons with SZ. Interventions to address these impairments – termed cognitive remediation or cognitive retraining – are being tested all over the world. Indian research on remediation in schizophrenia has been eclectic and is reviewed here. Some investigators have focused mainly on symptom control and quality of life, as yoga could be a cost effective and culturally acceptable intervention for remediation and rehabilitation. Although participants were not exhaustively tested for improvement in cognitive function in the majority of such trials, published results are encouraging. PMID:27520912

Cognitive Profile: Increasing Student Performance.

ERIC Educational Resources Information Center

Letteri, Charles A.

Past and ongoing research on cognition indicates that its effects on academic achievement are more direct than those of environmental, affective, or behavioral factors. The research has analyzed cognitive factors, the remediation of cognitive differences, and the transferability of remediation practices. Other cognition researchers have focused on…

[Cognitive remediation and work outcome in schizophrenia].

PubMed

Franck, N

2014-06-01

Recovery is partly defined by the patients' capacity to work, since doing well in a job favors hope and responsibilities' taking. Diminished job placement or tenure is linked with cognitive disorders, which impact directly and indirectly (through negative symptoms) functional outcomes. Attention, executive functions and working memory disorders can result in an alteration of the ability to manage the tasks required in the workplace. Executive function, working memory and social cognition disorders may also have an impact on behavior in relationships. Cognitive disorders do not automatically directly contribute to vocational outcome, yet their effects may be mediated by other variables such as symptoms, metacognition, social skills and intrinsic motivation. Then, since all these dimensions have to be taken into account, reducing the impact of cognitive troubles becomes a major challenge for the care of schizophrenia. Cognitive remediation is the more effective therapeutic tool to reduce cognitive dysfunctions. It rests in particular on the development of new strategies that allow taking concrete situations into account more efficiently. Cognitive remediation reduces the detrimental consequences of cognitive disorders and permits their compensation. It has emerged as an effective treatment, that improves not only cognitive abilities but also functioning, as it has been shown by numerous randomized controlled studies and several meta-analyses. The present article considers the effects on cognitive remediation on work function in schizophrenia. Several randomized controlled trials that compared supported employment alone versus supported employment associated with cognitive remediation showed significant improvement of employment rates in the latter condition. These results favor the use of cognitive remediation before job placement. The specific needs of the occupation that will be provided and the cognitive profile of the user should be taken into account. Copyright © 2014. Published by Elsevier Masson SAS.

Improvements in Negative Symptoms and Functional Outcome After a New Generation Cognitive Remediation Program: A Randomized Controlled Trial

PubMed Central

Ojeda, Natalia

2014-01-01

Cognitive remediation improves cognition in patients with schizophrenia, but its effect on other relevant factors such as negative symptoms and functional outcome has not been extensively studied. In this hospital-based study, 84 inpatients with chronic schizophrenia were recruited from Alava Hospital (Spain). All of the subjects underwent a baseline and a 3-month assessment that examined neurocognition, clinical symptoms, insight, and functional outcome according to the Global Assessment of Functioning (GAF) scale and Disability Assessment Schedule from World Health Organization (DAS-WHO). In addition to receiving standard treatment, patients were randomly assigned either to receive neuropsychological rehabilitation (REHACOP) or to a control group. REHACOP is an integrative program that taps all basic cognitive functions. The program included experts’ latest suggestions about positive feedback and activities of daily living in the patients’ environment. The REHACOP group showed significantly greater improvements at 3 months in the areas of neurocognition, negative symptoms, disorganization, and emotional distress compared with the control group (Cohen’s effect size for these changes ranged from d = 0.47 for emotional distress to d = 0.58 for disorganization symptoms). The REHACOP group also improved significantly in both the GAF (d = 0.61) and DAS-WHO total scores (d = 0.57). Specifically, the patients showed significant improvement in vocational outcomes (d = 0.47), family contact (d = 0.50), and social competence (d = 0.56). In conclusion, neuropsychological rehabilitation may be useful for the reduction of negative symptoms and functional disability in schizophrenia. These findings support the integration of neuropsychological rehabilitation into standard treatment programs for patients with schizophrenia. PMID:23686130

[Cognitive remediation therapy for children and adolescents with anorexia nervosa in France: an exploratory study].

PubMed

Asch, M; Esteves, J; De Hautecloque, D; Bargiacchi, A; Le Heuzey, M-F; Mouren, M-C; Doyen, C

2014-06-01

Cognitive remediation therapy (CRT) seems to be increasingly interesting in the treatment of anorexia nervosa for adult patients. We attempted to apply this support to a group of young inpatients, initially to assess its feasibility and acceptability, and then to improve its content for therapeutic application and future research. Ten 12- to 17-year-old inpatients with primary DSM-IV diagnosis of anorexia nervosa participated in a 10-week intervention program with a one-hour group session of CRT per week. All 10 patients were assessed before the intervention and those who completed the 10 sessions were assessed after. Assessment included a clinical examination by a psychiatrist, a battery of clinical inventories, and set-shifting tests. Moreover, each patient wrote a letter providing feedback on the intervention for subsequent analysis. Only two patients completed all 10 sessions, the other eight who were discharged from the hospital in the meantime could not attend the sessions for practical reasons. After the 10 sessions, an improvement in BMI and in measured levels of some psychopathological symptoms was observed in our two patients. Most neuropsychological task performances were improved after cognitive remediation. Feedback from the 10 patients was generally positive. This preliminary investigation suggests that cognitive remediation therapy is acceptable and feasible in this population. Replication of these findings requires a larger sample, improvement of the trial design, more sensitive measures, and another training format to avoid loss of so many participants. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Cognitive remediation for adolescents with 22q11 deletion syndrome (22q11DS): a preliminary study examining effectiveness, feasibility, and fidelity of a hybrid strategy, remote and computer-based intervention.

PubMed

Mariano, Margaret A; Tang, Kerri; Kurtz, Matthew; Kates, Wendy R

2015-08-01

22q11DS is a multiple anomaly syndrome involving intellectual and behavioral deficits, and increased risk for schizophrenia. As cognitive remediation (CR) has recently been found to improve cognition in younger patients with schizophrenia, we investigated the efficacy, feasibility, and fidelity of a remote, hybrid strategy, computerized CR program in youth with 22q11DS. A longitudinal design was implemented in which 21 participants served as their own controls. Following an eight month baseline period in which no interventions were provided, cognitive coaches met with participants remotely for CR via video conferencing three times a week over a targeted 8month timeframe and facilitated their progress through the intervention, offering task-specific strategies. A subset of strategies were examined for fidelity. Outcomes were evaluated using a neurocognitive test battery at baseline, pre-treatment and post-treatment. All participants adhered to the intervention. The mean length of the treatment phase was 7.96months. A moderately high correlation (intraclass correlation coefficient, 0.73) was found for amount and type of strategies offered by coaches. Participants exhibited significant improvements (ES=.36-.55, p≤.009) in working memory, shifting attention and cognitive flexibility. All significant models were driven by improvements in pre to post-treatment scores. Based on our preliminary investigation, a remote, hybrid strategy, computerized CR program can be implemented with 22q11DS youth despite geographic location, health, and cognitive deficits. It appears effective in enhancing cognitive skills during the developmental period of adolescence, making this type of CR delivery useful for youth with 22q11DS transitioning into post-school environments. Copyright © 2015 Elsevier B.V. All rights reserved.

A Meta-analytic Review of Non-specific Effects in Randomized Controlled Trials of Cognitive Remediation for Schizophrenia.

PubMed

Radhakrishnan, Rajiv; Kiluk, Brian D; Tsai, Jack

2016-03-01

Cognitive remediation (CR) has been found to improve cognitive performance among adults with schizophrenia in randomized controlled trials (RCTs). However, improvements in cognitive performance are often observed in the control groups of RCTs as well. There has been no comprehensive examination of change in control groups for CR, which may inform trial methodology and improve our understanding of measured outcomes for cognitive remediation. In this meta-analysis, we calculated pre-post change in cognitive test performance within control groups of RCTs in 32 CR trials (n = 794 participants) published between 1970 and 2011, and examined the association between pre-post change and sample size, duration of treatment, type of control group, and participants' age, intelligence, duration of illness, and psychiatric symptoms. Results showed that control groups in CR trials showed small effect size changes (Cohen's d = 0.12 ± 0.16) in cognitive test performance over the trial duration. Study characteristics associated with pre-post change included participant age and sample size. These findings suggest attention to change in control groups may help improve detection of cognitive remediation effects for schizophrenia.

Effects of peer social interaction on performance during computerized cognitive remediation therapy in patients with early course schizophrenia: A pilot study.

PubMed

Sandoval, Luis R; González, Betzamel López; Stone, William S; Guimond, Synthia; Rivas, Cristina Torres; Sheynberg, David; Kuo, Susan S; Eack, Shaun; Keshavan, Matcheri S

2017-09-04

Recent studies show that computer-based training enhances cognition in schizophrenia; furthermore, socialization has also been found to improve cognitive functions. It is generally believed that non-social cognitive remediation using computer exercises would be a pre-requisite for therapeutic benefits from social cognitive training. However, it is also possible that social interaction by itself enhances non-social cognitive functions; this possibility has scarcely been explored in schizophrenia patients. This pilot study examined the effects of computer-based neurocognitive training, along with social interaction either with a peer (PSI) or without one (N-PSI). We hypothesized that PSI will enhance cognitive performance during computerized exercises in schizophrenia, as compared with N-PSI. Sixteen adult participants diagnosed with schizophrenia or schizoaffective disorder participating in an ongoing trial of Cognitive Enhancement Therapy completed several computerized neurocognitive remediation training sessions (the Orientation Remedial Module©, or ORM), either with a peer or without a peer. We observed a significant interaction between the effect of PSI and performance on the different cognitive exercises (p<0.05). More precisely, when patients performed the session with PSI, they demonstrated better cognitive performances than with N-PSI in the ORM exercise that provides training in processing speed, alertness, and reaction time (the standard Attention Reaction Conditioner, or ARC) (p<0.01, corrected). PSI did not significantly affect other cognitive domains such as target detection and spatial attention. Our findings suggest that PSI could improve cognitive performance, such as processing speed, during computerized cognitive training in schizophrenia. Additional studies investigating the effect of PSI during cognitive remediation are needed to further evaluate this hypothesis. Copyright © 2017. Published by Elsevier B.V.

Thinking About the Future Cognitive Remediation Therapy—What Works and Could We Do Better?

PubMed Central

Wykes, Til; Spaulding, Will D.

2011-01-01

This article reviews progress in the development of effective cognitive remediation therapy (CRT) and its translational process. There is now enough evidence that cognitive difficulties experienced by people with schizophrenia can change and that the agenda for the next generation of studies is to increase these effects systematically through cognitive remediation. We examine the necessary steps and challenges of moving CRT to treatment dissemination. Theories which have been designed to explain the effects of cognitive remediation, are important but we conclude that they are not essential for dissemination which could progress in an empirical fashion. One apparent barrier is that cognitive remediation therapies look different on the surface. However, they still tend to use many of the same training procedures. The only important marker for outcome identified in the current studies seems to be the training emphasis. Some therapies concentrate on massed practice of cognitive functions, whereas others also use direct training of strategies. These may produce differing effects as noted in the most recent meta-analyses. We recommend attention to several critical issues in the next generation of empirical studies. These include developing more complex models of the therapy effects that take into account participant characteristics, specific and broad cognitive outcomes, the study design, as well as the specific and nonspecific effects of treatment, which have rarely been investigated in this empirical programme. PMID:21860051

[Mindful neuropsychology: Mindfulness-based cognitive remediation].

PubMed

Bulzacka, E; Lavault, S; Pelissolo, A; Bagnis Isnard, C

2018-02-01

Mindfulness based interventions (MBI) have recently gained much interest in western medicine. MBSR paradigm is based on teaching participants to pay complete attention to the present experience and act nonjudgmentally towards stressful events. During this mental practice the meditator focuses his or her attention on the sensations of the body. While the distractions (mental images, thoughts, emotional or somatic states) arise the participant is taught to acknowledge discursive thoughts and cultivate the state of awareness without immediate reaction. The effectiveness of these programs is well documented in the field of emotional response regulation in depression (relapse prevention), anxiety disorders, obsessive-compulsive disorder or eating disorders. Furthermore, converging lines of evidence support the hypothesis that mindfulness practice improves cognition, especially the ability to sustain attention and think in a more flexible manner. Nevertheless, formal rehabilitation programs targeting cognitive disturbances resulting from psychiatric (depression, disorder bipolar, schizophrenia) or neurologic conditions (brain injury, dementia) seldom rely on MBI principles. This review of literature aims at discussing possible links between MBI and clinical neuropsychology. We conducted a review of literature using electronic databases up to December 2016, screening studies with variants of the keywords ("Mindfulness", "MBI", "MBSR", "Meditation") OR/AND ("Cognition", "Attention", "Executive function", "Memory", "Learning") RESULTS: In the first part, we describe key concepts of the neuropsychology of attention in the light of Posner's model of attention control. We also underline the potential scope of different therapeutic contexts where disturbances of attention may be clinically relevant. Second, we review the efficacy of MBI in the field of cognition (thinking disturbances, attention biases, memory and executive processes impairment or low metacognitive abilities), mood (emotional dysregulation, anxiety, depression, mood shifts) and somatic preoccupations (stress induced immune dysregulation, chronic pain, body representation, eating disorders, sleep quality, fatigue). In psychiatry, these three components closely coexist and interact which explains the complexity of patient assessment and care. Numerous studies show that meditation inspired interventions offer a promising solution in the prevention and rehabilitation of cognitive impairment. In the last part, we discuss the benefits and risks of integrating meditation practice into broader programs of cognitive remediation and therapeutic education in patients suffering from cognitive disorders. We propose a number of possible guidelines for developing mindfulness inspired cognitive remediation tools. Along with Jon Kabatt Zinn (Kabatt-Zinn & Maskens, 2012), we suggest that the construction of neuropsychological tools relies on seven attitudinal foundations of mindfulness practice. This paper highlights the importance of referring to holistic approaches such as MBI when dealing with patients with neuropsychological impairment, especially in the field of psychiatry. We advocate introducing mindfulness principles in order to help patients stabilize their attention and improve cognitive flexibility. We believe this transition in neuropsychological care may offer an interesting paradigm shift promoting a more efficient approach towards cognition and its links to emotion, body, and environment. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

The Cognitive Remediation in Bipolar (CRiB) pilot study: study protocol for a randomised controlled trial.

PubMed

Strawbridge, Rebecca; Fish, Jessica; Halari, Rozmin; Hodsoll, John; Reeder, Clare; Macritchie, Karine; McCrone, Paul; Wykes, Til; Young, Allan H

2016-07-29

People with bipolar disorder often show difficulties with cognitive functioning, and though these difficulties are identified as important targets for intervention, few treatment options are available. Preliminary evidence suggests that cognitive remediation therapy (a psychological treatment proven beneficial for people diagnosed as having schizophrenia) is helpful for people with bipolar disorders. We are conducting a pilot trial to determine whether individual, computerised, cognitive remediation therapy (CRT) for people with bipolar disorder 1) increases cognitive function; 2) improves global functioning, goal attainment and mood symptoms; 3) is acceptable and feasible for participants; and 4) can be addressed in a comprehensive, larger, randomised, controlled trial. The study is designed as a two-arm, randomised, controlled trial comparing cognitive remediation therapy with treatment-as-usual (TAU) for euthymic bipolar patients. Participants are eligible to take part if aged between 18 and 65 with a diagnosis of bipolar disorder (type I) and currently in euthymic state, and no neurological, substance or personality disorder diagnoses. Sixty participants will be recruited (mainly through secondary and tertiary care) and will be block-randomised to receive either treatment-as-usual alone or in addition to a 12-week course of cognitive remediation therapy totalling 20-40 therapy hours. The intervention will comprise regular sessions with a therapist and computer-based training. Research assessments will take place before and after the intervention period and at a 12-week follow-up, and will include evaluation of neuropsychological, symptom-related, demographic and social factors, as well as collecting qualitative data regarding CRT expectations and satisfaction. Intention-to-treat analyses will examine the efficacy of cognitive remediation therapy primarily on cognition and additionally on functioning, quality of life and mood symptoms. Furthermore, we will examine the acceptability of CRT and undertake a preliminary health economics analysis to ascertain the cost of delivering the intervention. The results of this trial will provide valuable information about whether cognitive remediation therapy may be beneficial for people diagnosed with bipolar disorder in a euthymic state. ISRCTN registry, ISRCTN32290525 . Registered on 2 March 2016.

Conjunctive Visual Search in Individuals with and without Mental Retardation

ERIC Educational Resources Information Center

Carlin, Michael; Chrysler, Christina; Sullivan, Kate

2007-01-01

A comprehensive understanding of the basic visual and cognitive abilities of individuals with mental retardation is critical for understanding the basis of mental retardation and for the design of remediation programs. We assessed visual search abilities in individuals with mild mental retardation and in MA- and CA-matched comparison groups. Our…

Cognitive Remediation: A New Generation of Psychosocial Interventions for People with Schizophrenia

ERIC Educational Resources Information Center

Eack, Shaun M.

2012-01-01

Schizophrenia is a mental health condition characterized by broad impairments in cognition that place profound limitations on functional recovery. Social work has an enduring legacy in pioneering the development of novel psychosocial interventions for people with schizophrenia, and in this article the author introduces cognitive remediation, the…

Neuropsychological functioning in adolescents with anorexia nervosa before and after cognitive remediation therapy: a feasibility trial.

PubMed

Dahlgren, Camilla Lindvall; Lask, Bryan; Landrø, Nils Inge; Rø, Øyvind

2013-09-01

To investigate neuropsychological functioning in adolescents with anorexia nervosa (AN) before and after receiving cognitive remediation therapy (CRT). Twenty young females with AN participated in an individually-delivered CRT treatment program. Neuropsychological and psychiatric assessments were administered before and after treatment. Weight, depression, anxiety, duration of illness, and level of eating disorder psychopathology were considered as covariates in statistical analyses. Significant changes in weight, depression, visio-spatial memory, perceptual disembedding abilities, and verbal fluency were observed. Changes in weight had a significant effect on improvements in visuo-spatial memory and verbal fluency. Results also revealed a significant effect of depressive symptoms on perceptual disembedding abilities. The results suggest improvements on a number of neuropsychological functions during the course of CRT. Future studies should explore the use of additional assessment instruments, and include control groups to assess the effectiveness of the intervention. Copyright © 2013 Wiley Periodicals, Inc.

Intrinsic motivation and learning in a schizophrenia spectrum sample.

PubMed

Choi, Jimmy; Medalia, Alice

2010-05-01

A motivation is a telling hallmark of negative symptomatology in schizophrenia, and it impacts nearly every facet of behavior, including inclination to attempt the difficult cognitive tasks involved in cognitive remediation therapy. Experiences of external reward, reinforcement, and hedonic anticipatory enjoyment are diminished in psychosis, so therapeutics which instead target intrinsic motivation for cognitive tasks may enhance task engagement, and subsequently, remediation outcome. We examined whether outpatients could attain benefits from an intrinsically motivating instructional approach which (a) presents learning materials in a meaningful game-like context, (b) personalizes elements of the learning materials into themes of high interest value, and (c) offers choices so patients can increase their control over the learning process. We directly compared one learning method that incorporated the motivational paradigm into an arithmetic learning program against another method that carefully manipulated out the motivational variables in the same learning program. Fifty-seven subjects with schizophrenia or schizoaffective disorder were randomly assigned to one of the two learning programs for 10 thirty-minute sessions while an intent-to-treat convenience subsample (n=15) was used to account for practice effect. Outcome measures were arithmetic learning, attention, motivation, self competency, and symptom severity. Results showed the motivational group (a) acquired more arithmetic skill, (b) possessed greater intrinsic motivation for the task, (c) reported greater feelings of self competency post-treatment, and (d) demonstrated better post-test attention. Interestingly, baseline perception of self competency was a significant predictor of post-test arithmetic scores. Results demonstrated that incorporating intrinsically motivating instructional techniques into a difficult cognitive task promoted greater learning of the material, higher levels of intrinsic motivation to attempt the demanding task, and greater feelings of self efficacy and achievement to learn. Copyright (c) 2009 Elsevier B.V. All rights reserved.

Cognitive skill learning and schizophrenia: implications for cognitive remediation.

PubMed

Michel, L; Danion, J M; Grangé, D; Sandner, G

1998-10-01

The ability to acquire a motor and cognitive skill was investigated in 26 patients with schizophrenia and 26 normal participants using repeated testing on the Tower of Toronto puzzle. Seven patients with defective performance were retested using additional trials and immediate feedback designed to facilitate problem solving. A component analysis of performance was used based on J. R. Anderson's (1987) model of cognitive skill learning. Patients exhibited a performance deficit on both motor and cognitive skills. However, their acquisition rate was similar to that of normal participants on most parameters, indicating that skill learning suffered little or no impairment. Performance deficit was accounted for by poor problem-solving ability, explicit memory, and general intellectual capacities. It was remediable in some, but not all, patients. Remediation failure was also related to severe defects of cognitive functions.

Bridging the Gap Between Extrinsic and Intrinsic Motivation in the Cognitive Remediation of Schizophrenia

PubMed Central

Silverstein, Steven M.

2010-01-01

An important development in cognitive remediation of schizophrenia is a focus on motivation. However, following a distinction between the concepts of intrinsic motivation (IM) and extrinsic motivation, discussions of IM-based methods have downplayed or misrepresented the role that extrinsic rewards can, and actually do, serve to promote positive treatment outcomes in cognitive remediation. Therefore, the purpose of this article is to explore the rationale for using techniques incorporating extrinsic rewards into cognitive treatment of people with schizophrenia. To do this, evidence is presented on each of the following points: (1) there is a long history of research demonstrating that delivery of extrinsic reward is associated with positive outcomes in both behavioral and cognitive rehabilitation; (2) basic human brain systems respond strongly to tangible rewards, and this can directly enhance attention, working memory, and other cognitive functions; (3) nearly all data on the negative effects of extrinsic reward on IM have come from studies of healthy children and adults in school or work settings who have adequate IM for target tasks; these findings do not generalize well to cognitive remediation settings for people with schizophrenia, who often have abnormally low levels of IM and low base rates of attentive behaviors; and (4) in real-world situations, cognitive remediation interventions already utilize a combination of intrinsic and extrinsic reinforcers. Future studies are needed to clarify state and trait factors responsible for individual differences in the extent to which extrinsic rewards are necessary to set the conditions under which IM can develop. PMID:20064900

Bridging the gap between extrinsic and intrinsic motivation in the cognitive remediation of schizophrenia.

PubMed

Silverstein, Steven M

2010-09-01

An important development in cognitive remediation of schizophrenia is a focus on motivation. However, following a distinction between the concepts of intrinsic motivation (IM) and extrinsic motivation, discussions of IM-based methods have downplayed or misrepresented the role that extrinsic rewards can, and actually do, serve to promote positive treatment outcomes in cognitive remediation. Therefore, the purpose of this article is to explore the rationale for using techniques incorporating extrinsic rewards into cognitive treatment of people with schizophrenia. To do this, evidence is presented on each of the following points: (1) there is a long history of research demonstrating that delivery of extrinsic reward is associated with positive outcomes in both behavioral and cognitive rehabilitation; (2) basic human brain systems respond strongly to tangible rewards, and this can directly enhance attention, working memory, and other cognitive functions; (3) nearly all data on the negative effects of extrinsic reward on IM have come from studies of healthy children and adults in school or work settings who have adequate IM for target tasks; these findings do not generalize well to cognitive remediation settings for people with schizophrenia, who often have abnormally low levels of IM and low base rates of attentive behaviors; and (4) in real-world situations, cognitive remediation interventions already utilize a combination of intrinsic and extrinsic reinforcers. Future studies are needed to clarify state and trait factors responsible for individual differences in the extent to which extrinsic rewards are necessary to set the conditions under which IM can develop.

Web-Based Cognitive Remediation Improves Supported Employment Outcomes in Severe Mental Illness: Randomized Controlled Trial.

PubMed

Harris, Anthony Wf; Kosic, Tanya; Xu, Jean; Walker, Chris; Gye, William; Redoblado Hodge, Antoinette

2017-09-20

Finding work is a top priority for most people; however, this goal remains out of reach for the majority of individuals with a severe mental illness (SMI) who remain on benefits or are unemployed. Supported employment (SE) programs aimed at returning people with a severe mental illness to work are successful; however, they still leave a significant number of people with severe mental illness unemployed. Cognitive deficits are commonly found in SMI and are a powerful predictor of poor outcome. Fortunately, these deficits are amenable to treatment with cognitive remediation therapy (CRT) that significantly improves cognition in SMI. CRT combined with SE significantly increases the likelihood of individuals with severe mental illness obtaining and staying in work. However, the availability of CRT is limited in many settings. The aim of this study was to examine whether Web-based CRT combined with a SE program can improve the rate return to work of people with severe mental illness. A total of 86 people with severe mental illness (mean age 39.6 years; male: n=55) who were unemployed and who had joined a SE program were randomized to either a Web-based CRT program (CogRem) or an Internet-based control condition (WebInfo). Primary outcome measured was hours worked over 6 months post treatment. At 6 months, those participants randomized to CogRem had worked significantly more hours (P=.01) and had earned significantly more money (P=.03) than those participants randomized to the WebInfo control condition. No change was observed in cognition. This study corroborates other work that has found a synergistic effect of combining CRT with a SE program and extends this to the use of Web-based CRT. The lack of any improvement in cognition obscures the mechanism by which an improved wage outcome for participants randomized to the active treatment was achieved. However, the study substantially lowers the barrier to the deployment of CRT with other psychosocial interventions for severe mental illness. Australian and New Zealand Clinical Trials Registry (ANZCTR) 12611000849998; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=12611000849998&isBasic=True (Archived by WebCite at http://www.webcitation.org/6sMKwpeos). ©Anthony WF Harris, Tanya Kosic, Jean Xu, Chris Walker, William Gye, Antoinette Redoblado Hodge. Originally published in JMIR Mental Health (http://mental.jmir.org), 20.09.2017.

Enhancing work-focused supports for people with severe mental illnesses in australia.

PubMed

Contreras, Natalia; Rossell, Susan L; Castle, David J; Fossey, Ellie; Morgan, Dea; Crosse, Caroline; Harvey, Carol

2012-01-01

Persons with severe mental illness (SMI) have reduced workforce participation, which leads to significant economic and social disadvantage. This theoretical review introduces the strategies that have been implemented to address this issue. These include Individual Placement and Support (IPS) services, the most widely researched form of supported employment, to which cognitive remediation has more recently been recognised in the USA, as an intervention to improve employment outcomes by addressing the cognitive impairments often experienced by people with SMI. The authors review the international literature and discuss specifically the Australian context. They suggest that Australia is in a prime position to engage clients in such a dual intervention, having had recent success with increasing access to supported employment programs and workforce reentry, through implementation of the Health Optimisation Program for Employment (HOPE). Such programs assist with gaining and maintaining employment. However, they do not address the cognitive issues that often prevent persons with SMI from effectively participating in work. Thus, optimising current interventions, with work-focused cognitive skills development is critical to enhancing employment rates that remain low for persons with SMI.

Remediation of Childhood Math Anxiety and Associated Neural Circuits through Cognitive Tutoring

PubMed Central

Iuculano, Teresa; Chen, Lang

2015-01-01

Math anxiety is a negative emotional reaction that is characterized by feelings of stress and anxiety in situations involving mathematical problem solving. High math-anxious individuals tend to avoid situations involving mathematics and are less likely to pursue science, technology, engineering, and math-related careers than those with low math anxiety. Math anxiety during childhood, in particular, has adverse long-term consequences for academic and professional success. Identifying cognitive interventions and brain mechanisms by which math anxiety can be ameliorated in children is therefore critical. Here we investigate whether an intensive 8 week one-to-one cognitive tutoring program designed to improve mathematical skills reduces childhood math anxiety, and we identify the neurobiological mechanisms by which math anxiety can be reduced in affected children. Forty-six children in grade 3, a critical early-onset period for math anxiety, participated in the cognitive tutoring program. High math-anxious children showed a significant reduction in math anxiety after tutoring. Remarkably, tutoring remediated aberrant functional responses and connectivity in emotion-related circuits anchored in the basolateral amygdala. Crucially, children with greater tutoring-induced decreases in amygdala reactivity had larger reductions in math anxiety. Our study demonstrates that sustained exposure to mathematical stimuli can reduce math anxiety and highlights the key role of the amygdala in this process. Our findings are consistent with models of exposure-based therapy for anxiety disorders and have the potential to inform the early treatment of a disability that, if left untreated in childhood, can lead to significant lifelong educational and socioeconomic consequences in affected individuals. SIGNIFICANCE STATEMENT Math anxiety during early childhood has adverse long-term consequences for academic and professional success. It is therefore important to identify ways to alleviate math anxiety in young children. Surprisingly, there have been no studies of cognitive interventions and the underlying neurobiological mechanisms by which math anxiety can be ameliorated in young children. Here, we demonstrate that intensive 8 week one-to-one cognitive tutoring not only reduces math anxiety but also remarkably remediates aberrant functional responses and connectivity in emotion-related circuits anchored in the amygdala. Our findings are likely to propel new ways of thinking about early treatment of a disability that has significant implications for improving each individual's academic and professional chances of success in today's technological society that increasingly demands strong quantitative skills. PMID:26354922

Neuroimaging studies of cognitive remediation in schizophrenia: A systematic and critical review.

PubMed

Penadés, Rafael; González-Rodríguez, Alexandre; Catalán, Rosa; Segura, Bàrbara; Bernardo, Miquel; Junqué, Carme

2017-03-22

To examine the effects of cognitive remediation therapies on brain functioning through neuroimaging procedures in patients with schizophrenia. A systematic, computerised literature search was conducted in the PubMed/Medline and PsychInfo databases. The search was performed through February 2016 without any restrictions on language or publication date. The search was performed using the following search terms: [("cogniti*" and "remediation" or "training" or "enhancement") and ("fMRI" or "MRI" or "PET" or "SPECT") and (schizophrenia or schiz*)]. The search was accompanied by a manual online search and a review of the references from each of the papers selected, and those papers fulfilling our inclusion criteria were also included. A total of 101 studies were found, but only 18 of them fulfilled the inclusion criteria. These studies indicated that cognitive remediation improves brain activation in neuroimaging studies. The most commonly reported changes were those that involved the prefrontal and thalamic regions. Those findings are in agreement with the hypofrontality hypothesis, which proposes that frontal hypoactivation is the underlying mechanism of cognitive impairments in schizophrenia. Nonetheless, great heterogeneity among the studies was found. They presented different hypotheses, different results and different findings. The results of more recent studies interpreted cognitive recovery within broader frameworks, namely, as amelioration of the efficiency of different networks. Furthermore, advances in neuroimaging methodologies, such as the use of whole-brain analysis, tractography, graph analysis, and other sophisticated methodologies of data processing, might be conditioning the interpretation of results and generating new theoretical frameworks. Additionally, structural changes were described in both the grey and white matter, suggesting a neuroprotective effect of cognitive remediation. Cognitive, functional and structural improvements tended to be positively correlated. Neuroimaging studies of cognitive remediation in patients with schizophrenia suggest a positive effect on brain functioning in terms of the functional reorganisation of neural networks.

A feasibility study of a new computerised cognitive remediation for young adults with schizophrenia

PubMed Central

Cellard, Caroline; Reeder, Clare; Paradis-Giroux, Andrée-Anne; Roy, Marc-André; Gilbert, Elsa; Ivers, Hans; Bouchard, Roch-Hugo; Maziade, Michel; Wykes, Til

2016-01-01

Cognitive remediation therapy is effective for improving cognition, symptoms and social functioning in individuals with schizophrenia; however, the impact on visual episodic memory remains unclear. The objectives of this feasibility study were: (1) to explore whether or not CIRCuiTS—a new computerised cognitive remediation therapy programme developed in England—improves visual episodic memory and other cognitive domains in young adults with early course schizophrenia; and (2) to evaluate acceptability of the CIRCuiTS programme in French-Canadians. Three participants with visual episodic memory impairments at baseline were recruited from clinical settings in Canada, and consented to participate. Neuropsychological, clinical and social functioning was evaluated at baseline and post-treatment. Intervention involved 40 sessions of cognitive remediation. First, the reliable change index (RCI) revealed that each participant demonstrated significant post-therapy change in episodic memory and in other cognitive domains. The response profile was characterised by the use of organisational strategies. Second, the treatment was considered acceptable to participants in terms of session frequency (number of sessions per week), intensity (hours per week; total hours), and number of missed sessions and total completed sessions. This preliminary study yielded encouraging data demonstrating the feasibility of the CIRCuiTS programme in French-Canadian young adults with schizophrenia. PMID:25753694

Computerised working-memory focused cognitive remediation therapy for psychosis--A preliminary study.

PubMed

Hargreaves, A; Dillon, R; Anderson-Schmidt, H; Corvin, A; Fitzmaurice, B; Castorina, M; Robertson, I H; Donohoe, G

2015-12-01

Cognitive deficits are a core feature of schizophrenia and related psychotic disorders and are associated with decreased levels of functioning. Behavioural interventions have shown success in remediating these deficits; determining how best to maximise this benefit while minimising the cost is an important next step in optimising this intervention for clinical use. To examine the effects of a novel working-memory focused cognitive remediation (CR) training on cognitive difficulties based on internet delivery of training and weekly telephone support. Participants with a diagnosis of psychosis (n=56) underwent either 8 weeks of CR (approximately 20 h) or 8 weeks of treatment as usual (TAU). General cognitive ability, working memory and episodic memory were measured both pre and post intervention for all participants. In addition to improvements on trained working memory tasks, CR training was associated with significant improvements in two tests of verbal episodic memory. No association between CR and changes in general cognitive ability was observed. Effect sizes for statistically significant changes in memory were comparable to those reported in the literature based primarily on 1:1 training. The cognitive benefits observed in this non-randomised preliminary study indicate that internet-based working memory training can be an effective cognitive remediation therapy. The successes and challenges of an internet-based treatment are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Effects of Endurance Training Combined With Cognitive Remediation on Everyday Functioning, Symptoms, and Cognition in Multiepisode Schizophrenia Patients

PubMed Central

Malchow, Berend; Keller, Katriona; Hasan, Alkomiet; Dörfler, Sebastian; Schneider-Axmann, Thomas; Hillmer-Vogel, Ursula; Honer, William G.; Schulze, Thomas G.; Niklas, Andree; Wobrock, Thomas; Schmitt, Andrea; Falkai, Peter

2015-01-01

Aerobic exercise has been shown to improve symptoms in multiepisode schizophrenia, including cognitive impairments, but results are inconsistent. Therefore, we evaluated the effects of an enriched environment paradigm consisting of bicycle ergometer training and add-on computer-assisted cognitive remediation (CACR) training. To our knowledge, this is the first study to evaluate such an enriched environment paradigm in multiepisode schizophrenia. Twenty-two multiepisode schizophrenia patients and 22 age- and gender-matched healthy controls underwent 3 months of endurance training (30min, 3 times/wk); CACR training (30min, 2 times/wk) was added from week 6. Twenty-one additionally recruited schizophrenia patients played table soccer (known as “foosball” in the United States) over the same period and also received the same CACR training. At baseline and after 6 weeks and 3 months, we measured the Global Assessment of Functioning (GAF), Social Adjustment Scale-II (SAS-II), schizophrenia symptoms (Positive and Negative Syndrome Scale), and cognitive domains (Verbal Learning Memory Test [VLMT], Wisconsin Card Sorting Test [WCST], and Trail Making Test). After 3 months, we observed a significant improvement in GAF and in SAS-II social/leisure activities and household functioning adaptation in the endurance training augmented with cognitive remediation, but not in the table soccer augmented with cognitive remediation group. The severity of negative symptoms and performance in the VLMT and WCST improved significantly in the schizophrenia endurance training augmented with cognitive remediation group from week 6 to the end of the 3-month training period. Future studies should investigate longer intervention periods to show whether endurance training induces stable improvements in everyday functioning. PMID:25782770

Profile of cognitive problems in schizophrenia and implications for vocational functioning.

PubMed

Tan, Bhing-Leet

2009-08-01

This literature review attempts to profile specific areas of cognition that have shown unique and consistent evidence of dysfunction among people with schizophrenia. In addition, their impact on vocational functioning is illustrated, so as to highlight the importance of managing these cognitive difficulties in vocational rehabilitation. Literature search was carried out on seven key cognitive domains identified by the National Institute of Mental Health in the USA. Their impact on vocational function was also reviewed. It is found that attention, declarative and working memory, reasoning, problem-solving and social cognition are areas of impairment that have great impact on vocational functioning. Attention and memory problems affect learning of new work tasks. Executive function is particularly crucial in determining supported and open employment outcomes, as executive dysfunction cannot be easily compensated. Lastly, social cognition plays a major role in determining the success of workplace social exchanges. Occupational therapists need to have a good understanding of the profile of cognitive problems among people with schizophrenia, in order to tailor our intervention according to their cognitive strengths and difficulties. Several cognitive remediation strategies and programs have been designed specifically for people with mental illness. Equipping ourselves with skills in conducting such programs will augment our expertise in vocational rehabilitation.

Multifamily group psychoeducation and cognitive remediation for first-episode psychosis: a randomized controlled trial.

PubMed

Breitborde, Nicholas Jk; Moreno, Francisco A; Mai-Dixon, Natalie; Peterson, Rachele; Durst, Linda; Bernstein, Beth; Byreddy, Seenaiah; McFarlane, William R

2011-01-12

Multifamily group psychoeducation (MFG) has been shown to reduce relapse rates among individuals with first-episode psychosis. However, given the cognitive demands associated with participating in this intervention (e.g., learning and applying a structured problem-solving activity), the cognitive deficits that accompany psychotic disorders may limit the ability of certain individuals to benefit from this intervention. Thus, the goal of this study is to examine whether individuals with first-episode psychosis who participate simultaneously in MFG and cognitive remediation--an intervention shown to improve cognitive functioning among individuals with psychotic disorders--will be less likely to experience a relapse than individuals who participate in MFG alone. Forty individuals with first-episode psychosis and their caregiving relative will be recruited to participate in this study. Individuals with first-episode psychosis will be randomized to one of two conditions: (i) MFG with concurrent participation in cognitive remediation or (ii) MFG alone. The primary outcome for this study is relapse of psychotic symptoms. We will also examine secondary outcomes among both individuals with first-episode psychosis (i.e., social and vocational functioning, health-related quality of life, service utilization, independent living status, and cognitive functioning) and their caregiving relatives (i.e., caregiver burden, anxiety, and depression) Cognitive remediation offers the possibility of ameliorating a specific deficit (i.e., deficits in cognitive functioning) that often accompanies psychotic symptoms and may restrict the magnitude of the clinical benefits derived from MFG. ClinicalTrials (NCT): NCT01196286.

Study protocol: a randomised controlled trial of cognitive remediation for a national cohort of forensic mental health patients with schizophrenia or schizoaffective disorder.

PubMed

O'Reilly, Ken; Donohoe, Gary; O'Sullivan, Danny; Coyle, Ciaran; Mullaney, Ronan; O'Connell, Paul; Maddock, Catherine; Nulty, Andrea; O'Flynn, Padraic; O'Connell, Carina; Kennedy, Harry G

2016-01-13

Evidence is accumulating that cognitive remediation therapy (CRT) is an effective intervention for patients with schizophrenia or schizoaffective disorder. To date there has been no randomised controlled trial (RCT) cohort study of cognitive remediation within a forensic hospital. The goal of this study is to examine the effectiveness of a trial of cognitive remediation for forensic mental health patients with schizophrenia or schizoaffective disorder. An estimated sixty patients will be enrolled in the study. Participants will be randomised to one of two conditions: CRT with treatment as usual (TAU), or TAU. CRT will consist of 42 individual sessions and 14 group sessions. The primary outcome measure for this study is change in cognitive functioning using the MATRICS Consensus Cognitive Battery (MCCB). Secondary outcomes include change in social and occupational functioning, disorganised symptoms, negative symptoms, violence, participation in psychosocial treatment and recovery. In addition to these effectiveness measures, we will examine patient satisfaction. Cognitive difficulties experienced by schizophrenia spectrum patients are associated with general functioning, ability to benefit from psychosocial interventions and quality of life. Research into the treatment of cognitive difficulties within a forensic setting is therefore an important priority. The results of the proposed study will help answer the question whether cognitive remediation improves functional outcomes in forensic mental health patients with schizophrenia or schizoaffective disorder. Forensic mental health patients are detained for the dual purpose of receiving treatment and for public protection. There can be conflict between these two roles perhaps causing forensic services to have an increased length of stay compared to general psychiatric admissions. Ultimately a focus on emphasising cognition and general functioning over symptoms may decrease tension between the core responsibilities of forensic mental health services. ClinicalTrials.gov Identifier: NCT02360813. Trial registered Feb 4th 2015 and last updated May 1(st) 2015.

Neurobiology of cognitive remediation therapy for schizophrenia: a systematic review.

PubMed

Thorsen, Anders Lillevik; Johansson, Kyrre; Løberg, Else-Marie

2014-01-01

Cognitive impairment is an important aspect of schizophrenia, where cognitive remediation therapy (CRT) is a promising treatment for improving cognitive functioning. While neurobiological dysfunction in schizophrenia has been the target of much research, the neural substrate of cognitive remediation and recovery has not been thoroughly examined. The aim of the present article is to systematically review the evidence for neural changes after CRT for schizophrenia. The reviewed studies indicate that CRT affects several brain regions and circuits, including prefrontal, parietal, and limbic areas, both in terms of activity and structure. Changes in prefrontal areas are the most reported finding, fitting to previous evidence of dysfunction in this region. Two limitations of the current research are the few studies and the lack of knowledge on the mechanisms underlying neural and cognitive changes after treatment. Despite these limitations, the current evidence suggests that CRT is associated with both neurobiological and cognitive improvement. The evidence from these findings may shed light on both the neural substrate of cognitive impairment in schizophrenia, and how better treatment can be developed and applied.

The impact of cognitive remediation on cerebral activity in schizophrenia: Systematic review of the literature.

PubMed

Bon, Laura; Franck, Nicolas

2018-03-01

cognitive remediation involves either intensive training of impaired functions or implementing strategies to compensate for these impairments. In cases of schizophrenia, both methods have demonstrated benefits in terms of behavior and cerebral activity. However, despite the major differences between these two approaches, their impact has not yet been compared. We searched the PsychInfo, Pubmed, and ScienceDirect databases using the key words "cognitive remediation," "schizophrenia," "cerebral activity," and "magnetic resonance imaging," in order to select studies investigating the effects of cognitive remediation on patients with schizophrenia. The studies selected had to present their approach in detail and measure its impact in terms of both cerebral activity and cognitive function, both before and after therapy. We divided the studies into two groups, those using the strategy method and those using the training method. Eight studies were included in the review, four for the strategy method (88 patients, 44 of whom underwent remediation) and 4 for the training method (87 patients, 43 of whom underwent remediation). The analysis of the results of this study indicates that the training method is capable of activating more the targeted brain areas than the strategy method. However, the latter appears to encourage more extensive activation of the cerebral networks. The studies used for this review vary widely in terms of the imaging methods and protocol. However, differences were found between the two methods and lead us to suggest that further studies, with proper bias control, should be conducted to systematically compare the two approaches.

The auditory brain-stem response to complex sounds: a potential biomarker for guiding treatment of psychosis.

PubMed

Tarasenko, Melissa A; Swerdlow, Neal R; Makeig, Scott; Braff, David L; Light, Gregory A

2014-01-01

Cognitive deficits limit psychosocial functioning in schizophrenia. For many patients, cognitive remediation approaches have yielded encouraging results. Nevertheless, therapeutic response is variable, and outcome studies consistently identify individuals who respond minimally to these interventions. Biomarkers that can assist in identifying patients likely to benefit from particular forms of cognitive remediation are needed. Here, we describe an event-related potential (ERP) biomarker - the auditory brain-stem response (ABR) to complex sounds (cABR) - that appears to be particularly well-suited for predicting response to at least one form of cognitive remediation that targets auditory information processing. Uniquely, the cABR quantifies the fidelity of sound encoded at the level of the brainstem and midbrain. This ERP biomarker has revealed auditory processing abnormalities in various neurodevelopmental disorders, correlates with functioning across several cognitive domains, and appears to be responsive to targeted auditory training. We present preliminary cABR data from 18 schizophrenia patients and propose further investigation of this biomarker for predicting and tracking response to cognitive interventions.

Use of early remedial services in children with transposition of the great arteries.

PubMed

Calderon, Johanna; Bonnet, Damien; Pinabiaux, Charlotte; Jambaqué, Isabelle; Angeard, Nathalie

2013-10-01

To characterize the prevalence of use of early remedial services and its associated demographic, medical, and cognitive factors in children aged 4-6 years with corrected transposition of the great arteries (TGA). This was a prospective study of neurocognitive outcomes after TGA. Children underwent formal neuropsychological testing including general intelligence and a comprehensive battery of executive functions (EF) including motor and interference control, short-term memory, and working memory as well as cognitive flexibility. Parental reports on the children's behavior and EF were also evaluated. Demographic factors and preoperative, intraoperative, and postoperative factors as well as cognitive factors were examined according to the current use of remediation. Forty-five patients (67% male) and their parents participated in this study. Twenty-four (53%) patients were receiving remedial services. Male sex, a postnatal diagnosis of TGA, and a longer postoperative intensive care unit stay were significantly associated with use of remediation. Children receiving remediation had lower EF scores, had more severe EF deficits as observed by formal testing, and were rated as having more behavioral daily life difficulties. However, in the group without remediation, 13 children (43%) also displayed EF deficits rated as moderate to severe. Demographic and medical factors could help identify children at higher risk for neurocognitive delays. Evaluation of executive functioning from an early age may influence referral for remediation. Copyright © 2013 Mosby, Inc. All rights reserved.

F47. COGNITIVE REMEDIATION AND PHYSICAL EXERCISE IN MULTI-EPISODE SCHIZOPHRENIA: STUDY PROTOCOL FOR A RANDOMISED CONTROLLED TRIAL

PubMed Central

Pujol, Nuria; Pérez-Solà, Víctor; Cortizo, Romina; Ayllon, Lourdes; Salvador, Teresa; Moreno, Daniel; Català, Ferran; Chamorro, Jacobo; Oller, Silvia; Polo-Velasco, Javier; Abellanas, Adelina; Diez-Aja, Cristobal; Mane, Anna

2018-01-01

Abstract Background Cognitive remediation (CR) and physical exercise have separately shown promising results in schizophrenia cognitive improvement, despite this, the impact on daily functionality is still limited. Physical exercise increases Brain Derived Neurotrophic Factor (BDNF) levels, promoting neuronal and cognitive plasticity, which can maximize the impact of CR. We are conducting a randomised controlled trial to determine the efficacy of an intensive program that combines CR and physical exercise on cognition and related outcomes for patients with schizophrenia. In addition, we investigate functional and structural brain effects of this intervention and its association to BDNF. Methods This study protocol describes a randomized controlled trial in which 74 patients are randomly assigned to either CR and physical exercise or CR and health promotion. The interventions are 12-week long and consist of three weekly sessions (90min of CR and 40min of either aerobic exercise or health promotion). To be included in the study, patients must be diagnosed with schizophrenia or schizoaffective disorder, aged 28–60 years, and do low physical activity, as measured by International Physical Activity Questionnaire, IPAQ. Exclusion Criteria for participation in the study are the presence of neurological or substance use disorders, IQ < 70 and somatic illnesses that contraindicate physical exercise. Healthy control participants (n=18) are screened for the presence of lifetime Axis I psychotic disorders and for the presence of a first-degree relative with schizophrenia. Primary outcome measures are cognitive performance, functional outcome, negative symptoms, BDNF levels and neuroimaging measures. Secondary outcome measures are quality of life and metabolic parameters. All measures are blindly assessed at baseline, at 3 months follow up and at 15 months follow up. This trial was approved by the Comité Ètic d’Investigació Clínica de l’Hospital del Mar (CEIC) 2015/6209/I Results This poster is a study protocol. We will correct data from now on. Discussion The results of this trial will provide valuable information about whether cognitive remediation efficacy for patients with schizophrenia can be enhanced by aerobic exercise-induced BDNF upregulation. TRIAL REGISTRATION The trial is registered at www.clinicaltrials.gov (NCT02864576)

From Clozapine to Cognitive Remediation

PubMed Central

Quinn, Jason

2016-01-01

Objective: Although a minority of persons with schizophrenia (SCZ) commits violent acts, SCZ remains a risk factor for violence. Here, we present a broad overview of evidence-based treatments for violence in SCZ, including biological and psychosocial interventions. Method: We conducted MEDLINE and PsychINFO literature searches to retrieve articles relating to treatments for violent, hostile, or aggressive behaviours in SCZ. Results: Clozapine shows the strongest evidence for treating the acute violence of SCZ. Other atypical antipsychotics also possess antiaggressive effects, although the evidence is not as robust as that for clozapine. Psychosocial treatments can be useful adjuncts to pharmacotherapy once patients’ positive symptoms have stabilized. Cognitive behavioural therapy for psychosis and cognitive remediation are 2 psychosocial interventions that have demonstrated positive outcomes for violence in SCZ. Most psychosocial studies that examined violence as an outcome were conducted in forensic psychiatric settings. Conclusions: Effective treatments exist for persons with SCZ who pose a risk for violent and aggressive behaviour, although the overall evidence base remains relatively weak. More randomized controlled trials of programs showing evidence for reduction of violence in SCZ are required. Further research should delineate which patients could benefit from multimodal treatment and where and when such treatments are optimally delivered. PMID:27335156

Multifamily Group Psychoeducation and Cognitive Remediation for First-Episode Psychosis: A Randomized Controlled Trial

PubMed Central

2011-01-01

Background Multifamily group psychoeducation (MFG) has been shown to reduce relapse rates among individuals with first-episode psychosis. However, given the cognitive demands associated with participating in this intervention (e.g., learning and applying a structured problem-solving activity), the cognitive deficits that accompany psychotic disorders may limit the ability of certain individuals to benefit from this intervention. Thus, the goal of this study is to examine whether individuals with first-episode psychosis who participate simultaneously in MFG and cognitive remediation--an intervention shown to improve cognitive functioning among individuals with psychotic disorders--will be less likely to experience a relapse than individuals who participate in MFG alone. Methods/Design Forty individuals with first-episode psychosis and their caregiving relative will be recruited to participate in this study. Individuals with first-episode psychosis will be randomized to one of two conditions: (i) MFG with concurrent participation in cognitive remediation or (ii) MFG alone. The primary outcome for this study is relapse of psychotic symptoms. We will also examine secondary outcomes among both individuals with first-episode psychosis (i.e., social and vocational functioning, health-related quality of life, service utilization, independent living status, and cognitive functioning) and their caregiving relatives (i.e., caregiver burden, anxiety, and depression) Discussion Cognitive remediation offers the possibility of ameliorating a specific deficit (i.e., deficits in cognitive functioning) that often accompanies psychotic symptoms and may restrict the magnitude of the clinical benefits derived from MFG. Trial Registration ClinicalTrials (NCT): NCT01196286 PMID:21226941

The Role of Motivation in Cognitive Remediation for People with Schizophrenia.

PubMed

Saperstein, Alice M; Medalia, Alice

2016-01-01

Motivation impairment is an often prominent component of schizophrenia symptomatology that impacts treatment engagement and reduces the functional benefit from psychosocial interventions. Intrinsic motivation in particular has been shown to be impaired in schizophrenia. Nowhere is the role of intrinsic motivation impairment more evident than in cognitive remediation for schizophrenia. This chapter describes the theoretical determinants of motivation to learn and illustrates how those determinants have been translated into therapeutic techniques that enhance intrinsic motivation in a clinical context. We review the extant research that indicates how motivation enhancing techniques yield treatment-related improvements within cognitive remediation therapy and, more broadly, in other behavioral skills-based interventions for schizophrenia.

Cognitive remediation therapy for eating disorders.

PubMed

Danner, Unna N; Dingemans, Alexandra E; Steinglass, Joanna

2015-11-01

This review compares the literature on cognitive remediation therapy (CRT) for eating disorders with findings in the field of schizophrenia, and discusses future directions for CRT for eating disorders. First studies using a randomized controlled trial design show the added value of CRT for eating disorders. Patients reported lessened symptoms and further improvements in quality of life and cognitive flexibility. Furthermore, the acceptability of the intervention was good and attrition rates for CRT itself were low. Research into the use of cognitive remediation for schizophrenia is extensive and the results on global cognition appeared to be robust at post-treatment and durable at follow-up, with small to medium effect sizes. Recent articles within the field of schizophrenia emphasize the necessity of intrinsic motivation to translate cognitive gains into actual changes in everyday life. A next step is to examine the impact of CRT for eating disorders on motivation. It is also important to focus on the transdiagnostic use of CRT, considering the overlap in cognitive inefficiencies between eating disorders. Another important step may be to develop effective personalized methods of CRT by taking into account individual differences in cognitive processes most relevant to improvement in outcome.

Cognitive Remediation and Bias Modification Strategies in Mood and Anxiety Disorders

PubMed Central

Gold, Alexandra K.; Montana, Rebecca E.; Sylvia, Louisa G.; Nierenberg, Andrew A.; Deckersbach, Thilo

2016-01-01

Purpose of review Cognitive impairments and biases, which are prevalent in patients with mood and anxiety disorders, can affect quality of life and functioning. Traditional treatments are only insufficiently addressing these impairments and biases. We review the cognitive impairments and biases present in these disorders as well as treatments targeting these domains. Recent findings Interventions aimed at improving cognitive impairments and biases may help improve cognitive deficits and overall functioning in patients with mood and anxiety disorders. Direct comparisons of treatments for cognitive impairments or biases versus more traditional psychosocial interventions have produced diverse results. Summary Overall, treatments for cognitive impairments and cognitive biases warrant additional study in clinical trials. Future research should explore cognitive remediation and cognitive bias modification adjunctive to psychosocial treatments to optimize patient outcomes in mood and anxiety disorders. PMID:27917364

Neuroimaging studies of cognitive remediation in schizophrenia: A systematic and critical review

PubMed Central

Penadés, Rafael; González-Rodríguez, Alexandre; Catalán, Rosa; Segura, Bàrbara; Bernardo, Miquel; Junqué, Carme

2017-01-01

AIM To examine the effects of cognitive remediation therapies on brain functioning through neuroimaging procedures in patients with schizophrenia. METHODS A systematic, computerised literature search was conducted in the PubMed/Medline and PsychInfo databases. The search was performed through February 2016 without any restrictions on language or publication date. The search was performed using the following search terms: [(“cogniti*” and “remediation” or “training” or “enhancement”) and (“fMRI” or “MRI” or “PET” or “SPECT”) and (schizophrenia or schiz*)]. The search was accompanied by a manual online search and a review of the references from each of the papers selected, and those papers fulfilling our inclusion criteria were also included. RESULTS A total of 101 studies were found, but only 18 of them fulfilled the inclusion criteria. These studies indicated that cognitive remediation improves brain activation in neuroimaging studies. The most commonly reported changes were those that involved the prefrontal and thalamic regions. Those findings are in agreement with the hypofrontality hypothesis, which proposes that frontal hypoactivation is the underlying mechanism of cognitive impairments in schizophrenia. Nonetheless, great heterogeneity among the studies was found. They presented different hypotheses, different results and different findings. The results of more recent studies interpreted cognitive recovery within broader frameworks, namely, as amelioration of the efficiency of different networks. Furthermore, advances in neuroimaging methodologies, such as the use of whole-brain analysis, tractography, graph analysis, and other sophisticated methodologies of data processing, might be conditioning the interpretation of results and generating new theoretical frameworks. Additionally, structural changes were described in both the grey and white matter, suggesting a neuroprotective effect of cognitive remediation. Cognitive, functional and structural improvements tended to be positively correlated. CONCLUSION Neuroimaging studies of cognitive remediation in patients with schizophrenia suggest a positive effect on brain functioning in terms of the functional reorganisation of neural networks. PMID:28401047

Cognitive Effects of ThinkRx Cognitive Rehabilitation Training for Eleven Soldiers with Brain Injury: A Retrospective Chart Review

PubMed Central

Ledbetter, Christina; Moore, Amy Lawson; Mitchell, Tanya

2017-01-01

Cognitive rehabilitation training is a promising technique for remediating the cognitive deficits associated with brain injury. Extant research is dominated by computer-based interventions with varied results. Results from clinician-delivered cognitive rehabilitation are notably lacking in the literature. The current study examined the cognitive outcomes following ThinkRx, a clinician-delivered cognitive rehabilitation training program for soldiers recovering from traumatic brain injury and acquired brain injury. In a retrospective chart review, we examined cognitive outcomes of 11 cases who had completed an average of 80 h of ThinkRx cognitive rehabilitation training delivered by clinicians and supplemented with digital training exercises. Outcome measures included scores from six cognitive skill batteries on the Woodcock Johnson – III Tests of Cognitive Abilities. Participants achieved gains in all cognitive skills tested and achieved statistically significant changes in long-term memory, processing speed, auditory processing, and fluid reasoning with very large effect sizes. Clinically significant changes in multiple cognitive skills were also noted across cases. Results of the study suggest that ThinkRx clinician-delivered cognitive training supplemented with digital exercises may be a viable method for targeting the cognitive deficits associated with brain injury. PMID:28588534

Remediation of Childhood Math Anxiety and Associated Neural Circuits through Cognitive Tutoring.

PubMed

Supekar, Kaustubh; Iuculano, Teresa; Chen, Lang; Menon, Vinod

2015-09-09

Math anxiety is a negative emotional reaction that is characterized by feelings of stress and anxiety in situations involving mathematical problem solving. High math-anxious individuals tend to avoid situations involving mathematics and are less likely to pursue science, technology, engineering, and math-related careers than those with low math anxiety. Math anxiety during childhood, in particular, has adverse long-term consequences for academic and professional success. Identifying cognitive interventions and brain mechanisms by which math anxiety can be ameliorated in children is therefore critical. Here we investigate whether an intensive 8 week one-to-one cognitive tutoring program designed to improve mathematical skills reduces childhood math anxiety, and we identify the neurobiological mechanisms by which math anxiety can be reduced in affected children. Forty-six children in grade 3, a critical early-onset period for math anxiety, participated in the cognitive tutoring program. High math-anxious children showed a significant reduction in math anxiety after tutoring. Remarkably, tutoring remediated aberrant functional responses and connectivity in emotion-related circuits anchored in the basolateral amygdala. Crucially, children with greater tutoring-induced decreases in amygdala reactivity had larger reductions in math anxiety. Our study demonstrates that sustained exposure to mathematical stimuli can reduce math anxiety and highlights the key role of the amygdala in this process. Our findings are consistent with models of exposure-based therapy for anxiety disorders and have the potential to inform the early treatment of a disability that, if left untreated in childhood, can lead to significant lifelong educational and socioeconomic consequences in affected individuals. Significance statement: Math anxiety during early childhood has adverse long-term consequences for academic and professional success. It is therefore important to identify ways to alleviate math anxiety in young children. Surprisingly, there have been no studies of cognitive interventions and the underlying neurobiological mechanisms by which math anxiety can be ameliorated in young children. Here, we demonstrate that intensive 8 week one-to-one cognitive tutoring not only reduces math anxiety but also remarkably remediates aberrant functional responses and connectivity in emotion-related circuits anchored in the amygdala. Our findings are likely to propel new ways of thinking about early treatment of a disability that has significant implications for improving each individual's academic and professional chances of success in today's technological society that increasingly demands strong quantitative skills. Copyright © 2015 the authors 0270-6474/15/3512574-10$15.00/0.

[The cognitive paradigm in the rehabilitation of schizophrenia - focusing on cognitive remediation].

PubMed

Muth, Veronika; Gyüre, Támas; Váradi, Enikö

2015-09-01

Neurocognitive deficits are core features of schizophrenia and well known to the specialists, concerning researches in Hungary as well. Significance of the topic derives from the fact that according to our present knowledge this is the prime symptom principally affecting everyday functioning and limits benefit of rehabilitation opportunities. The classic psychiatric rehabilitation toolset, either pharmacological or psychosocial, does not provide effective and specific assistance to alleviate the symptoms of the neurocognitive deficits. Despite the increasing presence of the neurocognitive-oriented rehabilitation in international publications and professional forums, cognitive development is rather neglected topic in the Hungarian literature; while the therapeutic practice - with the exception of one institution - is absent from the repertoire of the Hungarian rehabilitation. The purpose of this study is the multi-faceted presentation of recent results in the field of the cognitive remediation, describing the position of cognitive training and its place in the rehabilitation of schizophrenia, with the aim to gain reputation and promote clinical practice among the Hungarian experts. Cognitive remediation is a behavioral training, based on learning theory, with the aim of extensive and long-lasting improvement of cognitive functions of patients suffering from schizophrenia or other mental disorders. Despite the deceptively similar acronym it is important to distinguish this method from the cognitive behavioral therapy which shows similarity in its learning theory basis, but remediation involves much more educational features. Cognitive remediation is not a unified technique, different settings are known, but regardless of form factors it clearly has a specific and positive effect on the neurocognitive functions. It fits well into the rehabilitation methodology, in fact this embeddedness significantly increases its effectiveness and supports emergence of skills in everyday functioning, helping improving disorder outcomes. The generalizing process is partly related to the fact that with the improvement of patients' neurocognitive functions, they become "more accessible" in other therapeutic modalities, increasing their efficiency. Functional and structural changes in relevant cerebral fields correlating with improving neurocognitive performance is proven by growing number of imaging techniques. In addition cost efficiency considerations also support the applicability of the method, which adaptations - in terms of cognitive paradigm - were used in other psychiatric disorders with promising results.

The Auditory Brain-Stem Response to Complex Sounds: A Potential Biomarker for Guiding Treatment of Psychosis

PubMed Central

Tarasenko, Melissa A.; Swerdlow, Neal R.; Makeig, Scott; Braff, David L.; Light, Gregory A.

2014-01-01

Cognitive deficits limit psychosocial functioning in schizophrenia. For many patients, cognitive remediation approaches have yielded encouraging results. Nevertheless, therapeutic response is variable, and outcome studies consistently identify individuals who respond minimally to these interventions. Biomarkers that can assist in identifying patients likely to benefit from particular forms of cognitive remediation are needed. Here, we describe an event-related potential (ERP) biomarker – the auditory brain-stem response (ABR) to complex sounds (cABR) – that appears to be particularly well-suited for predicting response to at least one form of cognitive remediation that targets auditory information processing. Uniquely, the cABR quantifies the fidelity of sound encoded at the level of the brainstem and midbrain. This ERP biomarker has revealed auditory processing abnormalities in various neurodevelopmental disorders, correlates with functioning across several cognitive domains, and appears to be responsive to targeted auditory training. We present preliminary cABR data from 18 schizophrenia patients and propose further investigation of this biomarker for predicting and tracking response to cognitive interventions. PMID:25352811

Computerised working memory based cognitive remediation therapy does not affect Reading the Mind in the Eyes test performance or neural activity during a Facial Emotion Recognition test in psychosis.

PubMed

Mothersill, David; Dillon, Rachael; Hargreaves, April; Castorina, Marco; Furey, Emilia; Fagan, Andrew J; Meaney, James F; Fitzmaurice, Brian; Hallahan, Brian; McDonald, Colm; Wykes, Til; Corvin, Aiden; Robertson, Ian H; Donohoe, Gary

2018-05-27

Working memory based cognitive remediation therapy (CT) for psychosis has recently been associated with broad improvements in performance on untrained tasks measuring working memory, episodic memory and IQ, and changes in associated brain regions. However, it is unclear if these improvements transfer to the domain of social cognition and neural activity related to performance on social cognitive tasks. We examined performance on the Reading the Mind in the Eyes test (Eyes test) in a large sample of participants with psychosis who underwent working memory based CT (N = 43) compared to a Control Group of participants with psychosis (N = 35). In a subset of this sample, we used functional magnetic resonance imaging (fMRI) to examine changes in neural activity during a facial emotion recognition task in participants who underwent CT (N = 15) compared to a Control Group (N = 15). No significant effects of CT were observed on Eyes test performance or on neural activity during facial emotion recognition, either at p<0.05 family-wise error, or at a p<0.001 uncorrected threshold, within a priori social cognitive regions of interest. This study suggests that working memory based CT does not significantly impact an aspect of social cognition which was measured behaviourally and neurally. It provides further evidence that deficits in the ability to decode mental state from facial expressions are dissociable from working memory deficits, and suggests that future CT programs should target social cognition in addition to working memory for the purposes of further enhancing social function. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial.

PubMed

Eack, Shaun M; Hogarty, Susan S; Greenwald, Deborah P; Litschge, Maralee Y; Porton, Shannondora A; Mazefsky, Carla A; Minshew, Nancy J

2018-03-01

Cognitive remediation is a promising approach to treating core cognitive deficits in adults with autism, but rigorously controlled trials of comprehensive interventions that target both social and non-social cognition over a sufficient period of time to impact functioning are lacking. This study examined the efficacy of cognitive enhancement therapy (CET) for improving core cognitive and employment outcomes in adult autism. Verbal adult outpatients with autism spectrum disorder (N = 54) were randomized to an 18-month, single-blind trial of CET, a cognitive remediation approach that integrates computer-based neurocognitive training with group-based training in social cognition, or an active enriched supportive therapy (EST) comparison focused on psychoeducation and condition management. Primary outcomes were composite indexes of neurocognitive and social-cognitive change. Competitive employment was a secondary outcome. Intent-to-treat analyses indicated that CET produced significant differential increases in neurocognitive function relative to EST (d = .46, P = .013). Both CET and EST were associated with large social-cognitive improvements, with CET demonstrating an advantage at 9 (d = .58, P = 0.020), but not 18 months (d = .27, P = 0.298). Effects on employment indicated that participants treated with CET were significantly more likely to gain competitive employment than those in EST, OR = 6.21, P = 0.023, which was mediated by cognitive improvement. CET is a feasible and potentially effective treatment for core cognitive deficits in adult autism spectrum disorder. The treatment of cognitive impairments in this population can contribute to meaningful improvements in adult outcomes. Autism Res 2018, 11: 519-530. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Cognitive enhancement therapy (CET), an 18-month cognitive remediation intervention designed to improve thinking and social understanding, was found to be more effective than supportive therapy at improving mental quickness, attention, and employment in adults living with autism. Social understanding was equally improved in CET and supportive therapy. Cognitive remediation interventions are feasible and may confer significant functional benefits to adults with autism. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Achieving recovery in patients with schizophrenia through psychosocial interventions: A retrospective study.

PubMed

Buonocore, Mariachiara; Bosia, Marta; Baraldi, Maria A; Bechi, Margherita; Spangaro, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella R; Cavallaro, Roberto

2018-01-01

Recovery, or functional remission, represents the ultimate treatment goal in schizophrenia. Despite its importance, a standardized definition of remission is still lacking, thus reported rates significantly vary across studies. Moreover, the effects of rehabilitative interventions on recovery have not been thoroughly investigated. This study aimed to evaluate recovery in a sample of patients with chronic schizophrenia engaged in rehabilitation programs and to explore contributing factors, with a focus on sociocognitive rehabilitative interventions. Data from 104 patients with schizophrenia treated either with a standard rehabilitation program, including cognitive remediation (n = 46), or the latter plus a specific sociocognitive intervention (n = 58), and assessed for psychopathology, cognition, social cognition, and Quality of Life Scale, were retrospectively analyzed for this study. Recovery, evaluated with the Quality of Life Scale, was achieved by 56.76% of patients in our sample. While no effects were observed for clinical, cognitive, or sociocognitive variables, participation in the sociocognitive rehabilitative interventions was positively associated with recovery. Our results indicate that high rates of recovery can be achieved in patients treated with psychosocial interventions and suggest that rehabilitative programs targeting social cognition may further facilitate the process of recovery. If confirmed, these results may have relevant implications for daily clinical practice and service provision, allowing clinicians to develop and optimize specific rehabilitation programs in order to promote recovery. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

The Effect of Cognitive Remediation Therapy on Social Skills in Institutionalized Elderly Patients with Schizophrenia.

PubMed

Mohammadi, Fatemeh; Momtaz, Yadollah Abolfathi; Motallebi, Seyedeh Ameneh; Boosepasi, Shahnaz

2017-01-01

There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia. The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data. The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, p<0.001), behavioral problems with others (t=5.44, p<0.001), and self-care (t=4.70, p<0.001). No significant differences were observed from pretest to post test in control group. The results of the present study may support the efficacy of cognitive remediation therapy on social skills of elderly patients with schizophrenia. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cognitive performance among cohorts of children exposed to a waste disposal site containing heavy metals in Chile

PubMed Central

Burgos, Soledad; Tenorio, Marcela; Zapata, Pamela; Cáceres, Dante D.; Klarian, José; Alvarez, Nancy; Oviedo, Renato; Toro-Campos, Rosario; Claudio, Luz; Iglesias, Verónica

2017-01-01

Between 1984-1998, people living in Arica were involuntarily exposed to metal-containing waste stored in the urban area. The study aims to determine whether children who lived near the waste disposal site during early childhood experienced negative effects on their cognitive development. The cognitive performance was assessed using the Wechsler Intelligence Scale for Children. The exposure variable was defined by the year of birth in three categories: (1) Pre-remediation (born before 1999); (2) During-remediation (born between 1999-2003); and (3) Post-remediation (born after 2003). In the crude analysis a difference of 10 points in the IQ average was observed between the group born in the pre (81.9 points) and post remediation period (91.1 points). The difference between both groups was five times higher as compared to children of similar age and socioeconomic status in other cities of Chile. This result could be related with a period of high potential for exposure to this contaminated site. PMID:28245674

Site Remediation Technology InfoBase: A Guide to Federal Programs, Information Resources, and Publications on Contaminated Site Cleanup Technologies. First Edition

NASA Technical Reports Server (NTRS)

1998-01-01

Table of Contents: Federal Cleanup Programs; Federal Site Remediation Technology Development Assistance Programs; Federal Site Remediation Technology Development Electronic Data Bases; Federal Electronic Resources for Site Remediation Technology Information; Other Electronic Resources for Site Remediation Technology Information; Other Electronic Resources for Site Remediation Technology Information; Selected Bibliography: Federal Publication on Alternative and Innovative Site Remediation; and Appendix: Technology Program Contacts.

49 CFR 573.14 - Accelerated remedy program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Accelerated remedy program. 573.14 Section 573.14... § 573.14 Accelerated remedy program. (a) An accelerated remedy program is one in which the manufacturer expands the sources of replacement parts needed to remedy the defect or noncompliance, or expands the...

49 CFR 573.14 - Accelerated remedy program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Accelerated remedy program. 573.14 Section 573.14... § 573.14 Accelerated remedy program. (a) An accelerated remedy program is one in which the manufacturer expands the sources of replacement parts needed to remedy the defect or noncompliance, or expands the...

Cognitive Remediation Therapy for Children with Anorexia Nervosa.

PubMed

van Noort, Betteke Maria; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Kappel, Viola

2015-09-01

Evidence-based treatment programs for children with anorexia nervosa (AN) are scarce, while their prognosis is negative and the incidence rate rises. A new therapeutic approach recently received positive attention: cognitive remediation therapy (CRT). This intervention targets inflexibility and the inability to perceive the bigger picture in persons with AN. So far, studies and case reports have focused on either adolescent or adult patients and less on young children with AN. This case report therefore describes and evaluates the implementation of CRT with a child with AN. A 12-year-old girl with severe chronic AN was treated with 10 sessions of CRT. Her clinical and neuropsychological evaluations before, directly after and 7 months after CRT are reported. Additionally, the patient's written and verbal feedbacks are reviewed. At the 7-month follow-up the patient showed a stable healthy weight and reported a reduced presence of psychopathology. Her neuropsychological performance directly after CRT and after 7 months did not improve. The clinical evaluation of our case report suggests that CRT may be a promising add-on therapy in the clinical treatment of young girls with AN.

Impact of Learning Model Based on Cognitive Conflict toward Student’s Conceptual Understanding

NASA Astrophysics Data System (ADS)

Mufit, F.; Festiyed, F.; Fauzan, A.; Lufri, L.

2018-04-01

The problems that often occur in the learning of physics is a matter of misconception and low understanding of the concept. Misconceptions do not only happen to students, but also happen to college students and teachers. The existing learning model has not had much impact on improving conceptual understanding and remedial efforts of student misconception. This study aims to see the impact of cognitive-based learning model in improving conceptual understanding and remediating student misconceptions. The research method used is Design / Develop Research. The product developed is a cognitive conflict-based learning model along with its components. This article reports on product design results, validity tests, and practicality test. The study resulted in the design of cognitive conflict-based learning model with 4 learning syntaxes, namely (1) preconception activation, (2) presentation of cognitive conflict, (3) discovery of concepts & equations, (4) Reflection. The results of validity tests by some experts on aspects of content, didactic, appearance or language, indicate very valid criteria. Product trial results also show a very practical product to use. Based on pretest and posttest results, cognitive conflict-based learning models have a good impact on improving conceptual understanding and remediating misconceptions, especially in high-ability students.

Environmental cognitive remediation in schizophrenia: ethical implications of "smart home" technology.

PubMed

Stip, Emmanuel; Rialle, Vincent

2005-04-01

In light of the advent of new technologies, we proposed to reexamine certain challenges posed by cognitive remediation and social reintegration (that is, deinstitutionalization) of patients with severe and persistent mental disorders. We reviewed literature on cognition, remediation, smart homes, as well as on objects and utilities, using medical and computer science electronic library and Internet searches. These technologies provide solutions for disabled persons with respect to care delivery, workload reduction, and socialization. Examples include home support, video conferencing, remote monitoring of medical parameters through sensors, teledetection of critical situations (for example, a fall or malaise), measures of daily living activities, and help with tasks of daily living. One of the key concepts unifying all these technologies is the health-smart home. We present the notion of the health-smart home in general and then examine it more specifically in relation to schizophrenia. Management of people with schizophrenia with cognitive deficits who are being rehabilitated in the community can be improved with the use of technology; however, such technology has ethical ramifications.

75 FR 34625 - Administrative Remedy Program: Exception to Initial Filing Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... Remedy Program: Exception to Initial Filing Procedures AGENCY: Bureau of Prisons, Justice. ACTION... Administrative Remedy Program to add an exception to initial filing of Administrative Remedy appeals at the institution level. The exception will state that formal administrative remedy requests regarding initial...

Resident Evaluation and Remediation: A Comprehensive Approach

PubMed Central

Wu, Jim S.; Siewert, Bettina; Boiselle, Phillip M.

2010-01-01

Background A comprehensive evaluation and remediation program is an essential component of any residency program. The evaluation system should identify problems accurately and early and allow residents with problems to be assigned to a remediation program that effectively deals with them. Elements of a proactive remediation program include a process for outlining deficiencies, providing resources for improvement, communicating clear goals for acceptable performance, and reevaluating performance against these goals. Intervention In recognition of the importance of early detection and prompt remediation of the struggling resident, we sought to develop a multifaceted approach to resident evaluation with the aim of early identification and prompt remediation of difficulties. This article describes our comprehensive evaluation program and remediation program, which uses resources within our radiology department and institutional graduate medical education office. Discussion An effective evaluation system should identify problems accurately and early, whereas a proactive remediation program should effectively deal with issues once they are identified. PMID:21975628

Optimizing Cognitive Function in Persons With Chronic Pain.

PubMed

Baker, Katharine S; Georgiou-Karistianis, Nellie; Gibson, Stephen J; Giummarra, Melita J

2017-05-01

Cognitive functioning is commonly disrupted in people living with chronic pain, yet it is an aspect of pain that is often not routinely assessed in pain management settings, and there is a paucity of research on treatments or strategies to alleviate the problem. The purpose of this review is to outline recent research on cognitive deficits seen in chronic pain, to give an overview of the mechanisms involved, advocate cognitive functioning as an important target for treatment in pain populations, and discuss ways in which it may be assessed and potentially remediated. A narrative review. There are several options for remediation, including compensatory, restorative, and neuromodulatory approaches to directly modify cognitive functioning, as well as physical, psychological, and medication optimization methods to target secondary factors (mood, sleep, and medications) that may interfere with cognition. We highlight the potential to enhance cognitive functions and identify the major gaps in the research literature.

A new computerized cognitive and social cognition training specifically designed for patients with schizophrenia/schizoaffective disorder in early stages of illness: A pilot study.

PubMed

Fernandez-Gonzalo, Sol; Turon, Marc; Jodar, Merce; Pousa, Esther; Hernandez Rambla, Carla; García, Rebeca; Palao, Diego

2015-08-30

People with schizophrenia/schizoaffective disorders at early stages of the illness present cognitive and social cognition deficits that have a great impact in functional outcomes. Cognitive Remediation Therapy (CRT) has demonstrated consistent effect in cognitive performance, symptoms and psychosocial functioning. However, any CRT intervention or social cognition training have been specifically designed for patients in the early stages of psychosis. The aim of this pilot study is to assess the efficacy of a new computerized cognitive and social cognition program for patients with schizophrenia/schizoaffective disorder with recent diagnosis. A comprehensive assessment of clinical, social and non-social cognitive and functional measures was carried out in 53 randomized participants before and after the 4-months treatment. Significant results were observed in Spatial Span Forwards, Immediate Logical Memory and Pictures of Facial Affect (POFA) total score. None of these results were explained by medication, premorbid social functioning or psychopathological symptoms. No impact of the intervention was observed in other cognitive and social cognition outcome neither in clinical and functional outcomes. This new computerized intervention may result effective ameliorating visual attention, logical memory and emotional processing in patients in the early stages of schizophrenia/schizoaffective disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Nuclear facility decommissioning and site remedial actions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Knox, N.P.; Webb, J.R.; Ferguson, S.D.

1990-09-01

The 394 abstracted references on environmental restoration, nuclear facility decommissioning, uranium mill tailings management, and site remedial actions constitute the eleventh in a series of reports prepared annually for the US Department of Energy's Remedial Action Programs. Citations to foreign and domestic literature of all types -- technical reports, progress reports, journal articles, symposia proceedings, theses, books, patents, legislation, and research project descriptions -- have been included. The bibliography contains scientific, technical, economic, regulatory, and legal information pertinent to the US Department of Energy's Remedial Action Programs. Major sections are (1) Surplus Facilities Management Program, (2) Nuclear Facilities Decommissioning, (3)more » Formerly Utilized Sites Remedial Action Programs, (4) Facilities Contaminated with Naturally Occurring Radionuclides, (5) Uranium Mill Tailings Remedial Action Program, (6) Grand Junction Remedial Action Program, (7) Uranium Mill Tailings Management, (8) Technical Measurements Center, (9) Remedial Action Program, and (10) Environmental Restoration Program. Within these categories, references are arranged alphabetically by first author. Those references having no individual author are listed by corporate affiliation or by publication title. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, subject category, and keywords. This report is a product of the Remedial Action Program Information Center (RAPIC), which selects and analyzes information on remedial actions and relevant radioactive waste management technologies.« less

Plasticity-Based Adaptive Cognitive Remediation (PACR) for OIF/OEF Veterans: A Randomized Controlled Trial

DTIC Science & Technology

2015-10-01

TERMS traumatic brain injury, tbi, concussion , persistent post- concussive symptoms, cognition, cognitive function, cognitive rehabilitation...veterans and active duty military personnel suffering from persistent post- concussive symptoms (PPCS) following mild traumatic brain injury (mTBI) at

Comparison of focused cognitive training and portable "brain-games" on functional outcomes for vocational rehabilitation participants.

PubMed

Bell, Morris D; Laws, Holly; Pittman, Brian; Johannesen, Jason K

2018-01-29

Cognitive remediation performed in a cognitive laboratory was compared with a sham control using portable brain games to study effects on vocational, neurocognitive, and functional outcomes for participants with psychotic disorders in vocational rehabilitation (VR). Seventy-seven participants (61% schizophrenia, 39% other psychosis) in transitional (45.5%) or supported employment (54.5%) were randomly assigned to 6 months of portable cognitive-games (CG) or cognitive remediation (CR) plus a weekly goal-setting group, and evaluated during training, post-training and at 12 months. Overall rates of employment did not differ significantly at 12-month follow-up; however, VR + CG attained employment more rapidly during training. A significant time by condition interaction favored VR + CR on Quality of Life Total Score and Instrumental Functioning over 12 months. Neurocognitive outcomes favored VR + CR, particularly on attention. Training hours related significantly to neurocognitive improvement regardless of condition. No differences were found in training adherence despite portability for VR + CG. Results indicate that VR + CR had significantly greater effect than VR + CG on neurocognition and community functioning, but not on employment outcome. Job attainment rates during the training period revealed a potential advantage for portable training raising new questions concerning how cognitive remediation can be most effectively integrated with VR.

Remediating Common Math Errors.

ERIC Educational Resources Information Center

Wagner, Rudolph F.

1981-01-01

Explanations and remediation suggestions for five types of mathematics errors due either to perceptual or cognitive difficulties are given. Error types include directionality problems, mirror writing, visually misperceived signs, diagnosed directionality problems, and mixed process errors. (CL)

Cognitive profiles in euthymic patients with bipolar disorders: results from the FACE-BD cohort.

PubMed

Roux, Paul; Raust, Aurélie; Cannavo, Anne Sophie; Aubin, Valérie; Aouizerate, Bruno; Azorin, Jean-Michel; Bellivier, Frank; Belzeaux, Raoul; Bougerol, Thierry; Cussac, Iréna; Courtet, Philippe; Etain, Bruno; Gard, Sébastien; Job, Sophie; Kahn, Jean-Pierre; Leboyer, Marion; Olié, Emilie; Henry, Chantal; Passerieux, Christine

2017-03-01

Although cognitive deficits are a well-established feature of bipolar disorders (BD), even during periods of euthymia, little is known about cognitive phenotype heterogeneity among patients with BD. We investigated neuropsychological performance in 258 euthymic patients with BD recruited via the French network of expert centers for BD. We used a test battery assessing six domains of cognition. Hierarchical cluster analysis of the cross-sectional data was used to determine the optimal number of subgroups and to assign each patient to a specific cognitive cluster. Subsequently, subjects from each cluster were compared on demographic, clinical functioning, and pharmacological variables. A four-cluster solution was identified. The global cognitive performance was above normal in one cluster and below normal in another. The other two clusters had a near-normal cognitive performance, with above and below average verbal memory, respectively. Among the four clusters, significant differences were observed in estimated intelligence quotient and social functioning, which were lower for the low cognitive performers compared to the high cognitive performers. These results confirm the existence of several distinct cognitive profiles in BD. Identification of these profiles may help to develop profile-specific cognitive remediation programs, which might improve functioning in BD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

77 FR 57074 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-17

... Damage Assessment, Remediation, and Restoration Program for Fiscal Year 2011 AGENCY: National Oceanic and..., Remediation, and Restoration Program for Fiscal Year 2011. SUMMARY: The National Oceanic and Atmospheric Administration's (NOAA's) Damage Assessment, Remediation, and Restoration Program (DARRP) is announcing new...

Cognitive remediation in anorexia nervosa and related conditions: a systematic review.

PubMed

Tchanturia, Kate; Lounes, Naima; Holttum, Sue

2014-11-01

Research evidence for cognitive remediation therapy's (CRT) effectiveness for anorexia nervosa (AN) has been gathering. This approach is also increasingly being implemented in other disorders including major depressive disorder, obsessive-compulsive disorder and autistic spectrum disorder that share commonalities with AN in neuropsychological profiles and clinical presentations. This systematic literature review identified and appraised the current evidence base to see whether evidence from related conditions could be integrated into the theoretical understanding of CRT for AN as well as future AN treatment developments and research. Overall, CRT studies in AN report promising findings, and CRT appears to be associated with improvements in set-shifting and in central coherence. Cognitive remediation approaches in other conditions also show promising evidence in associated improvements in areas of executive functioning and information processing; links are made between AN treatment and what future treatment developments could consider. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Role of cognitive theory in the study of learning disability in mathematics.

PubMed

Geary, David C

2005-01-01

Gersten, Jordan, and Flojo (in this issue) provide the beginnings of an essential bridge between basic research on mathematical disabilities (MD) in young children and the application of this research for the early identification and remediation of these forms of learning disability. As they acknowledge, the field of MD is in the early stages of development, and thus recommendations regarding identification measures and remedial techniques must be considered preliminary. I discuss the importance of maintaining a tight link between theoretical and empirical research on children's developing numerical, arithmetical, and mathematical competencies and future research on learning disabilities in mathematics. This link will provide the foundation for transforming experimental procedures into assessment measures, understanding the cognitive strengths and weaknesses of children with these forms of learning disability, and developing remedial approaches based on the pattern of cognitive strengths and weaknesses for individual children.

[Cognitive deficits in first episode psychosis patients and people at risk for psychosis: from diagnosis to treatment].

PubMed

Lecardeur, L; Meunier-Cussac, S; Dollfus, S

2013-05-01

Up to now, studies have not demonstrated significant efficacy of antipsychotics on cognitive impairments in patients with psychotic disorders. These cognitive deficits are of particular interest since they traditionally start early before the diagnosis of psychosis. They are observed during premorbid and prodromal stages, and during the first episode of psychosis. Moreover, cognitive impairments may be detected without any psychotic symptoms (such as positive symptoms) suggesting their development independently of the psychotic symptoms. Cognitive disturbances consist of impairments of episodic and working memories, intellectual functioning, executive functions (planning, inhibition, and cognitive flexibility), selective and sustained attentions and social cognition (emotion, recognition, theory of mind). The altered cognitive functions observed in schizophrenia are the same as in earlier stages but at a lower level of severity. Data suggest that cognitive deficits can be considered as vulnerability markers of psychosis since they have been described in healthy relatives of psychotic patients with high genetic risk. Cognitive deficits might also be considered as predictive of the occurrence of the disease after the first episode of psychosis. Indeed, retrospective studies suggest cognitive impairments in patients with schizophrenia during premorbid and prodromal phases but not in bipolar patients. Cognitive assessment might be of particular interest in people at risk for psychosis, in order to differentiate diagnostic outcomes. Cognitive functioning impairs until the diagnosis of first episode psychosis, even though cognitive profiles are quite heterogeneous in these patients. Once the diagnosis of schizophrenia is considered, cognitive deficits may be stable, although the literature is still controversial. Several factors such as symptoms and gender can contribute in diversifying the cognitive profiles. Moreover, age of onset might worsen the prognosis because of a disruption of the cognitive development and the disturbance of scholarship in young individuals. Considering these results, the treatment of cognitive deficits should be initiated as soon as possible, e.g. in people at risk for psychosis in order to reinforce the normal cognitive development, prevent cognitive decline and to preserve the educational, professional and social status. Since antipsychotic medications do not impact on cognitive functioning, alternative therapeutics should be developed such as cognitive remediation. Several studies and meta-analyses have shown that cognitive remediation programs are particularly efficient in patients with schizophrenia or bipolar disorders. Contrary to antipsychotics, these techniques should be used in patients with a first psychotic episode, but also in individuals with subpsychotic symptoms, subthreshold to the diagnosis of schizophrenia. Copyright © 2013. Published by Elsevier Masson SAS.

Patterns of Substance Use During Cognitive Enhancement Therapy: An 18-Month Randomized Feasibility Study.

PubMed

Eack, Shaun M; Hogarty, Susan S; Bangalore, Srihari S; Keshavan, Matcheri S; Cornelius, Jack R

2016-01-01

Substance use problems are common among people with schizophrenia, as are significant cognitive impairments. Because of potential shared neurobiological pathways, it is possible that cognitive remediation interventions may be associated with improvements in both substance use and cognition. This study examined the impact of cognitive remediation on alcohol and cannabis use and the cognitive correlates of changes in substance use among outpatients with schizophrenia. Individuals with schizophrenia who were receiving outpatient services at a psychiatric clinic and had moderate or higher addiction severity scores (N = 31) were randomized to 18 months of cognitive enhancement therapy (n = 22) or usual care (n = 9). Cognitive enhancement therapy is a cognitive remediation approach that integrates computer-based training in attention, memory, and problem solving with a group-based social cognition curriculum. Usual care was provided to all participants and consisted of routine psychiatric care. Primary outcomes included days of alcohol and cannabis use, assessed with the Timeline Followback method every six months and modeled using penalized quasi-likelihood growth curves. Participants were on average 38.23 (SD = 13.44) years of age, had been ill for 14.19 (SD = 11.28) years, and were mostly male (n = 22, 71%), and about half were Caucasian (n = 16, 52%). Temporal patterns of substance use days were highly variable and followed nonlinear trajectories. Intent-to-treat analyses indicated that, compared to patients only receiving usual care, those receiving cognitive enhancement therapy were significantly less likely to use alcohol (OR = .22; 95% CI: .05, .90; p = .036), but not cannabis (OR = 1.89; 95% CI: .02, 142.99; p = .774) over time, and they reduced their alcohol use at significantly accelerated rates (OR = 1.02; 95% CI: 1.01, 1.03; p = .003). Changes in cognition were variably associated with substance use outcomes, although improvements in visual learning and reasoning and problem solving were both consistently related to reduced alcohol and cannabis use. Cognitive remediation may be effective for improving some substance use problems in schizophrenia. Visual learning and problem-solving deficits may be particularly important targets of such interventions, given their association with reduced alcohol and cannabis use. This study is registered at clinicaltrials.gov under #NCT01292577.

Integrating psychopharmacology and cognitive remediation to treat cognitive dysfunction in the psychotic disorders.

PubMed

Medalia, Alice; Opler, Lewis A; Saperstein, Alice M

2014-04-01

Cognitive deficits are a prominent and enduring aspect of schizophrenia, which pose a significant barrier to achieving functional goals. The most promising intervention for treating cognitive impairment is cognitive remediation (CR), a behaviorally based therapy associated with medium effect sizes for cognitive and functional outcomes. However, there is a sizeable group of nonresponders whose CR outcomes become limited when the therapeutic approach fails to address individual differences in baseline cognition, motivation variables, and the extent to which CR offers opportunities for generalization. This speaks to a need to develop cognitive interventions that are both personalized and scalable. Emerging data suggest that specific pharmacological agents have the potential to enhance and accelerate behaviorally based CR effects. This article will review the rationale and preliminary evidence to support combining CR and pharmacotherapy. We will review crucial aspects of cognitive interventions that offer the most promise for improving not only cognitive outcomes, but also for enhancing improvement in real-world functioning. Finally, we will address methodological issues to be considered for future research on combined pharmacological and CR interventions.

A Cognitive Developmental Approach to Social Problem Management.

ERIC Educational Resources Information Center

Watts, Walter J.

The paper reviews L. Kohlberg's theory of moral reasoning and its relationship to cognitive development of children. R. Feuerstein's theories of mediated learning experience (MLE) are reviewed, and remediation for individuals deficient in cognitive functions is addressed. The paper notes the existence of deficient cognitive functions, specifically…

Cognitive Enhancement Therapy in Substance Misusing Schizophrenia: Results of an 18-Month Feasibility Trial

PubMed Central

Eack, Shaun M.; Hogarty, Susan S.; Greenwald, Deborah P.; Litschge, Maralee Y.; McKnight, Summer A. F.; Bangalore, Srihari S.; Pogue-Geile, Michael F.; Keshavan, Matcheri S.; Cornelius, Jack R.

2014-01-01

Substance use is a frequent problem in schizophrenia, and although many substance misusing patients with the disorder also experience considerable cognitive impairments, such individuals have been routinely excluded from clinical trials of cognitive remediation that could support their functional and addiction recovery. This study conducted a small-scale feasibility trial of Cognitive Enhancement Therapy (CET) in substance misusing schizophrenia patients to assess the feasibility and efficacy of implementing comprehensive neurocognitive and social-cognitive remediation in this population. A total of 31 schizophrenia outpatients meeting addiction severity criteria for alcohol and/or cannabis use were randomized to 18 months of CET or usual care. Feasibility findings indicated high degrees of satisfaction with CET, but also presented significant challenges in the recruitment and retention of substance misusing patients, with high levels of attrition (50%) over the study period, primarily due to positive symptom exacerbation. Intent-to-treat efficacy analyses showed large and significant improvements in neurocognition (d = .86), social cognition (d = 1.13), and social adjustment (d = .92) favoring CET. Further, individuals treated with CET were more likely to reduce alcohol use (67% vs. 25%) during treatment (p = .021). These results suggest that once engaged and stabilized, CET is a feasible and potentially effective treatment for cognitive impairments in patients with schizophrenia who misuse alcohol and/or cannabis. Substance misusing patients who are able to engage in treatment may be able to benefit from cognitive remediation, and the treatment of cognitive impairments may help improve substance use outcomes among this underserved population. PMID:25510926

Mass Balance, Beneficial Use Products, and Cost Comparisons of Four Sediment Treatment Technologies Near Commercialization

DTIC Science & Technology

2011-03-01

Superfund Innovative Technology Evaluation Program (SITE) • Assessment and Remediation of Contaminated Sediment Program (ARCS) • Contaminated Sediment...Agency (USEPA). 1994. Assessment and Remediation of Contaminated Sediments (ARCS) Program Remediation Guidance Document. EPA/905/R-94/003. Chicago, IL...conducted under one of the four following programs: • Superfund Innovative Technology Evaluation (SITE) Program • Assessment and Remediation of

[The neuropsychology of prodromal schizophrenia. Brief review and proposal of a tests battery for clinical use].

PubMed

Valgimigli, Simona; Padovani, Roberto; Donati, Cristina; Mazzi, Fausto

2013-01-01

The study of the neuropsychological profile of schizophrenic patients has provided systematic results in linking specific deficit (working memory, verbal learning, attentive and executive functioning, social cognition) to the functional outcome of subjects. More recently this approach has been applied to younger subjects, from the age of 14, that show prodromal signs of a possible psychotic conversion (ultra-risk subjects). The review is at first intended to describe the clinical and experimental studies that investigated the cognitive and neuropsychological profile of subjects at ultra-risk for psychosis. These studies show the presence of minor cognitive difficulties in several specific areas (working memory, verbal learning, attentive and executive functioning) that can be indicative of both a possible conversion to psychosis and a need for cognitive remediation programs. Secondarily, the article describes several neuropsychological tools, standardized for the Italian population, that can be used to approach the clinical assessment of ultra-risk subjects considering some critical aspects such as their typical age range (adolescents and young adults).

Cognitive remediation therapy and cognitive behavioral therapy with an older adult with anorexia nervosa: A brief case report.

PubMed

Darcy, Alison M; Fitzpatrick, Kara K; Lock, James

2016-06-01

Cognitive remediation therapy represents a new approach to the treatment of anorexia nervosa (AN) emerging from research, suggesting that adults with chronic AN have specific neurocognitive inefficiencies. Specifically, adults with AN demonstrate an overly detailed cognitive processing bias (Roberts, Tchanturia, & Treasure, 2013) and difficulties shifting set quickly and efficiently (Roberts, Tchanturia, Stahl, Southgate, & Treasure, 2007). These characteristics manifest as rigid, rule-bound, and detail-focused cognitions, beliefs, and behaviors. Versions of these problems appear to persist after weight restoration (Tchanturia et al., 2004) and are observable in patient's healthy sisters (Roberts et al., 2013). Thus, central coherence difficulties and set-shifting problems have been proposed as endophenotypes and maintaining factors of AN (Roberts et al., 2013). (PsycINFO Database Record (c) 2016 APA, all rights reserved).

76 FR 61089 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-03

... Damage Assessment, Remediation, and Restoration Program for Fiscal Years 2009 and 2010 AGENCY: National... Damage Assessment, Remediation, and Restoration Program for Fiscal Years 2009 and 2010. SUMMARY: The National Oceanic and Atmospheric Administration's (NOAA's) Damage Assessment, Remediation, and Restoration...

20 CFR 356.2 - Program Fraud Civil Remedies Act of 1986.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Program Fraud Civil Remedies Act of 1986. 356.2 Section 356.2 Employees' Benefits RAILROAD RETIREMENT BOARD ADMINISTRATIVE REMEDIES FOR FRAUDULENT CLAIMS OR STATEMENTS CIVIL MONETARY PENALTY INFLATION ADJUSTMENT § 356.2 Program Fraud Civil Remedies Act...

Developmental Versus Remedial: Does a Confusion of Terms Exist in Higher Education Reading Programs?

ERIC Educational Resources Information Center

Nist, Sherrie L.

1985-01-01

Examines the differences between remedial and developmental reading programs and their places in higher education. Finds a consistency among definitions of remedial reading but no clear consensus for developmental reading. Sees a clear delineation between remedial and developmental students. Offers guidelines for programs and instruction…

78 FR 53425 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-29

... DEPARTMENT OF COMMERCE Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration.... ACTION: Notice of Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for... Assessment, Remediation, and Restoration Program (DARRP) is announcing new indirect cost rates on the...

Remediation therapy in patients with alcohol use disorders and neurocognitive disorders: A Pilot Study.

PubMed

Frías-Torres, Cindy; Moreno-España, José; Ortega, Lluisa; Barrio, Pablo; Gual, Antoni; Teixidor López, Lídia

2018-04-15

Many alcohol-dependent patients suffer from cognitive impairment of variable severity, manifested by alterations in retrograde and anterograde memory, visuospatial processing, cognitive abilities and attention, some of which are reversible. In this context, cognitive remediation therapies could significantly improve patients' performance; therefore, these are considered a valuable alternative. The aim of this study was to implement cognitive remediation therapy in patients with alcohol dependence and cognitive impairment and evaluate its viability and effectiveness. The participants were sixteen abstinent, alcohol-dependent patients (mean age of 59 years, 63% males) from the Addictive Behaviours Unit of a tertiary hospital. Over 6 months, a nurse led 1-hour weekly sessions (24 sessions in total) during which exercises for improving functional, social and cognitive performance were completed. Patients were assessed at baseline, at the end of the study and 6 months later, using the Mini-Mental State Examination (MMSE) and the Memory Alteration Test (M@T). Their respective scores were 26.4 (SD 3.16), 29 (SD 1.67) and 27 (SD 3.1) for the MMSE and 38.7 (SD 6.81), 45.7 (SD 5.6) and 41.1 (SD 7.86) for the M@T. Changes were assessed with both Friedman and Wilcoxon signed-rank tests, with mostly statistically significant differences (p < 0.05). Assistance and satisfaction were high. Therefore, the therapy was viable, widely accepted and effective.

Nuclear facility decommissioning and site remedial actions: A selected bibliography, Volume 18. Part 1B: Citations with abstracts, sections 10 through 16

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-09-01

This bibliography contains 3,638 citations with abstracts of documents relevant to environmental restoration, nuclear facility decontamination and decommissioning (D and D), uranium mill tailings management, and site remedial actions. The bibliography contains scientific, technical, financial, and regulatory information that pertains to DOE environmental restoration programs. The citations are separated by topic into 16 sections, including (1) DOE Environmental Restoration Program; (2) DOE D and D Program; (3) Nuclear Facilities Decommissioning; (4) DOE Formerly Utilized sites Remedial Action Program; (5) NORM-Contaminated Site Restoration; (6) DOE Uranium Mill Tailings Remedial Action Project; (7) Uranium Mill Tailings Management; (8) DOE Site-Wide Remedial Actions;more » (9) DOE Onsite Remedial Action Projects; (10) Contaminated Site Remedial Actions; (11) DOE Underground Storage Tank Remediation; (12) DOE Technology Development, Demonstration, and Evaluation; (13) Soil Remediation; (14) Groundwater Remediation; (15) Environmental Measurements, Analysis, and Decision-Making; and (16) Environmental Management Issues.« less

Implementing cognitive remediation therapy (CRT) in a mental health service: staff training.

PubMed

Dark, Frances; Newman, Ellie; Harris, Meredith; Cairns, Alice; Simpson, Michael; Gore-Jones, Victoria; Whiteford, Harvey; Harvey, Carol; Crompton, David

2016-04-01

This paper describes the establishment of training in cognitive remediation for psychosis within a community mental health service. Clinical staff working in the community of a mental health service were surveyed to ascertain their interest in cognitive aspects of psychosis and skills training in cognitive remediation (CR). Based on the results of the survey a tiered training programme was established with attendance figures reported for each level of training. Fidelity assessment was conducted on the five CR programmes operating. Of 106 clinical staff working in the community with people diagnosed with a psychotic illness 51 completed the survey (48% response rate). The training needs varied with all 106 staff receiving the fundamental (mandatory) training and 51 staff receiving CR facilitator training. Thirty three percent of staff trained as facilitators were delivering CR. Up skilling the mental health workforce to incorporate an understanding of the cognitive aspects of psychosis into care delivery can be facilitated by a tiered training structure. Fundamental training on the psychosocial aspects of psychosis can act as a platform for focussed CR skills based training. There is also a need for accessible therapy based supervision for staff wishing to develop competencies as CR therapists. © The Royal Australian and New Zealand College of Psychiatrists 2015.

What does remediation and probation status mean? A survey of emergency medicine residency program directors.

PubMed

Weizberg, Moshe; Smith, Jessica L; Murano, Tiffany; Silverberg, Mark; Santen, Sally A

2015-01-01

Emergency medicine (EM) residency program directors (PDs) nationwide place residents on remediation and probation. However, the Accreditation Council for Graduate Medical Education and the EM PDs have not defined these terms, and individual institutions must set guidelines defining a change in resident status from good standing to remediation or probation. The primary objective of this study was to determine if EM PDs follow a common process to guide actions when residents are placed on remediation and probation. An anonymous electronic survey was distributed to EM PDs via e-mail using SurveyMonkey to determine the current practice followed after residents are placed on remediation or probation. The survey queried four designations: informal remediation, formal remediation, informal probation, and formal probation. These designations were compared for deficits in the domains of medical knowledge (MK) and non-MK remediation. The survey asked what process for designation exists and what actions are triggered, specifically if documentation is placed in a resident's file, if the graduate medical education (GME) office is notified, if faculty are informed, or if resident privileges are limited. Descriptive data are reported. Eighty-one of 160 PDs responded. An official policy on remediation and/or probation was reported by 41 (50.6%) programs. The status of informal remediation is used by 73 (90.1%), 80 (98.8%) have formal remediation, 40 (49.4%) have informal probation, and 79 (97.5%) have formal probation. There was great variation among PDs in the management and definition of remediation and probation. Between 81 and 86% of programs place an official letter into the resident's file regarding formal remediation and probation. However, only about 50% notify the GME office when a resident is placed on formal remediation. There were no statistical differences between MK and non-MK remediation practices. There is significant variation among EM programs regarding the process of remediation and probation. The definition of these terms and the actions triggered are variable across programs. Based on these findings, suggestions toward a standardized approach for remediation and probation in GME programs are provided. © 2014 by the Society for Academic Emergency Medicine.

Non-pharmacological Interventions for Adults with Mild Cognitive Impairment and Early Stage Dementia: An Updated Scoping Review

PubMed Central

Rodakowski, Juleen; Saghafi, Ester; Butters, Meryl A.; Skidmore, Elizabeth R.

2015-01-01

The purpose of this scoping review was to examine the science related to non-pharmacological interventions designed to slow decline for older adults with Mild Cognitive Impairment or early-stage dementia. We reviewed 32 unique randomized controlled trials that employed cognitive training (remediation or compensation approaches), physical exercise, or psychotherapeutic interventions that were published before November 2014. Evidence suggests that cognitive training focused on remediation and physical exercise interventions may promote small improvements in selected cognitive abilities. Cognitive training focused on compensation interventions and selected psychotherapeutic interventions may influence how cognitive changes impact daily living. However, confidence in these findings is limited due methodological limitations. To better assess the value of non-pharmacological interventions for this population, we recommend: 1) adoption of universal criteria for “early stage cognitive decline” among studies, 2) adherence to guidelines for the conceptualization, operationalization, and implementation of complex interventions, 3) consistent characterization of the impact of interventions on daily life, and 3) long-term follow-up of clinical outcomes to assess maintenance and meaningfulness of reported effects over time. PMID:26070444

Early Predictors of Need for Remediation in the Australian General Practice Training Program: A Retrospective Cohort Study

ERIC Educational Resources Information Center

Magin, Parker; Stewart, Rebecca; Turnock, Allison; Tapley, Amanda; Holliday, Elizabeth; Cooling, Nick

2017-01-01

Underperforming trainees requiring remediation may threaten patient safety and are challenging for vocational training programs. Decisions to institute remediation are high-stakes--remediation being resource-intensive and emotionally demanding on trainees. Detection of underperformance requiring remediation is particularly problematic in general…

Does metacognitive strategy instruction improve impaired receptive cognitive-communication skills following acquired brain injury?

PubMed

Copley, Anna; Smith, Kathleen; Savill, Katelyn; Finch, Emma

2015-01-01

To investigate if metacognitive strategy instruction (MSI) improves the receptive language skills of adults with cognitive-communication disorders secondary to acquired brain injury (ABI). An ABA intervention programme was implemented with eight adults with ABI, aged 25-70 years. The Measure of Cognitive-Linguistic Abilities (MCLA) was administered at baseline and following treatment. The treatment employed in this study involved three components: individual goal-based therapy, group remediation therapy using self-instruction and home practice. No receptive language sub-tests of the MCLA reached statistical significance. However, participants' raw score improvements in receptive language sub-tests indicated that MSI may be effective at remediating CCDs following ABI. Preliminary findings indicate that MSI may be effective in improving receptive language skills in adults with CCDs following ABI. Further research involving a more rigorous study, a larger sample size and a more reliable outcome measure is necessary and may provide statistically significant evidence for the effectiveness of MSI for remediating receptive language disorders.

Effectiveness of cognitive remediation and emotion skills training (CREST) for anorexia nervosa in group format: a naturalistic pilot study.

PubMed

Tchanturia, Kate; Doris, Eli; Fleming, Caroline

2014-05-01

This study aims to evaluate a novel and brief skills-based therapy for inpatients with anorexia nervosa, which addressed 'cold' and 'hot' cognitions in group format. Adult inpatients with anorexia nervosa participated in the cognitive remediation and emotion skills training groups. Participants who attended all group sessions completed patient satisfaction and self-report questionnaires. Analysis of the data showed that social anhedonia (measured by the Revised Social Anhedonia Scale) decreased significantly between pre- and post-interventions, with small effect size (d=0.39). Motivation (perceived 'importance to change' and 'ability to change') was found to have increased with small effect sizes (d=0.23 and d=0.16), but these changes did not reach statistical significance. The cognitive remediation and emotion skills training group had positive feedback from both the patients and therapists delivering this structured intervention. Improved strategies are needed both in supporting inpatients to tolerate the group therapy setting and in helping them to develop the skills necessary for participation. Further larger-scale research in this area is needed to consolidate these findings. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Examining neural plasticity and cognitive benefit through the unique lens of musical training.

PubMed

Moreno, Sylvain; Bidelman, Gavin M

2014-02-01

Training programs aimed to alleviate or improve auditory-cognitive abilities have either experienced mixed success or remain to be fully validated. The limited benefits of such regimens are largely attributable to our weak understanding of (i) how (and which) interventions provide the most robust and long lasting improvements to cognitive and perceptual abilities and (ii) how the neural mechanisms which underlie such abilities are positively modified by certain activities and experience. Recent studies indicate that music training provides robust, long-lasting biological benefits to auditory function. Importantly, the behavioral advantages conferred by musical experience extend beyond simple enhancements to perceptual abilities and even impact non-auditory functions necessary for higher-order aspects of cognition (e.g., working memory, intelligence). Collectively, preliminary findings indicate that alternative forms of arts engagement (e.g., visual arts training) may not yield such widespread enhancements, suggesting that music expertise uniquely taps and refines a hierarchy of brain networks subserving a variety of auditory as well as domain-general cognitive mechanisms. We infer that transfer from specific music experience to broad cognitive benefit might be mediated by the degree to which a listener's musical training tunes lower- (e.g., perceptual) and higher-order executive functions, and the coordination between these processes. Ultimately, understanding the broad impact of music on the brain will not only provide a more holistic picture of auditory processing and plasticity, but may help inform and tailor remediation and training programs designed to improve perceptual and cognitive benefits in human listeners. Copyright © 2013 Elsevier B.V. All rights reserved.

Nuclear facility decommissioning and site remedial actions. Volume 6. A selected bibliography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P.T.; Michelson, D.C.; Knox, N.P.

1985-09-01

This bibliography of 683 references with abstracts on the subject of nuclear facility decommissioning, uranium mill tailings management, and site remedial actions is the sixth in a series of annual reports prepared for the US Department of Energy's Remedial Action Programs. Foreign as well as domestic literature of all types - technical reports, progress reports, journal articles, conference papers, symposium proceedings, theses, books, patents, legislation, and research project descriptions - has been included. The bibliography contains scientific (basic research as well as applied technology), economic, regulatory, and legal literature pertinent to the US Department of Energy's remedial action program. Majormore » chapters are: (1) Surplus Facilities Management Program; (2) Nuclear Facilities Decommissioning; (3) Formerly Utilized Sites Remedial Action Program; (4) Facilities Contaminated with Natural Radioactivity; (5) Uranium Mill Tailings Remedial Action Program; (6) Grand Junction Remedial Action Program; (7) Uranium Mill Tailings Management; (8) Technical Measurements Center; and (9) General Remedial Action Program Studies. Chapter sections for chapters 1, 2, 5, and 7 include Design, Planning, and Regulations; Environmental Studies and Site Surveys; Health, Safety, and Biomedical Studies; Decontamination Studies; Dismantlement and Demolition; Site Stabilization and Reclamation; Waste Disposal; Remedial Action Experience; and General Studies. The references within each chapter or section are arranged alphabetically by leading author. References having no individual author are arranged by corporate affiliation or by publication description.« less

Forms of attention and attentional disorders.

PubMed

O'Donnell, Brian F

2002-05-01

Difficulties in attention or concentration are observed in many clinical syndromes. Cognitive studies of normal attention and neuropsychological studies of brain dysfunction indicate that attention reflects a variety of mechanisms. These processes include the startle response, the orienting response, selective attention, vigilance, and divided attention. Understanding the specific mechanisms involved in attention deficits or lapses may be helpful in planning and evaluating remediation programs and in altering patients' environments to compensate for specific attention deficits. In this article, forms of attention and disorders of attention are discussed, with emphasis on their importance to every day activities.

Cognitive Load Theory, Educational Research, and Instructional Design: Some Food for Thought

ERIC Educational Resources Information Center

de Jong, Ton

2010-01-01

Cognitive load is a theoretical notion with an increasingly central role in the educational research literature. The basic idea of cognitive load theory is that cognitive capacity in working memory is limited, so that if a learning task requires too much capacity, learning will be hampered. The recommended remedy is to design instructional systems…

Developing Interventions for Cancer-Related Cognitive Dysfunction in Childhood Cancer Survivors

PubMed Central

Ullrich, Nicole J.; Whelen, Megan J.; Lange, Beverly J.

2014-01-01

Survivors of childhood cancer frequently experience cancer-related cognitive dysfunction, commonly months to years after treatment for pediatric brain tumors, acute lymphoblastic leukemia (ALL), or tumors involving the head and neck. Risk factors for cancer-related cognitive dysfunction include young age at diagnosis, treatment with cranial irradiation, use of parenteral or intrathecal methotrexate, female sex, and pre-existing comorbidities. Limiting use and reducing doses and volume of cranial irradiation while intensifying chemotherapy have improved survival and reduced the severity of cognitive dysfunction, especially in leukemia. Nonetheless, problems in core functional domains of attention, processing speed, working memory and visual-motor integration continue to compromise quality of life and performance. We review the epidemiology, pathophysiology and assessment of cancer-related cognitive dysfunction, the impact of treatment changes for prevention, and the broad strategies for educational and pharmacological interventions to remediate established cognitive dysfunction following childhood cancer. The increased years of life saved after childhood cancer warrants continued study toward the prevention and remediation of cancer-related cognitive dysfunction, using uniform assessments anchored in functional outcomes. PMID:25080574

NAREM Journal. Volume 1, 1978.

ERIC Educational Resources Information Center

Narem Journal, 1978

1978-01-01

Eight articles are included in the journal of the National Association for Remedial Education, Malaysia (NAREM). Chua Tee Tee describes the history and objectives of NAREM. Alec Williams reviews philosophical issues in remedial education. Khoo Phon Sai discusses cognitive, social, and emotional characteristics of slow learners and considers…

Mercer County Community College Remedial Program Assessment, August 1988. Two Year Follow-Up of the Fall 1986 Cohort.

ERIC Educational Resources Information Center

Porter, Al

This assessment of New Jersey's Mercer County Community College's (MCCC's) remedial program provides a program overview, results of a two-year follow-up of fall 1986 remedial students, and comparative data from previous years. The program overview examines policies and procedures concerning placement criteria, exit standards, program acceptance,…

Nuclear facility decommissioning and site remedial actions: A selected bibliography, volume 9

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P.T.; Knox, N.P.; Michelson, D.C.

1988-09-01

The 604 abstracted references on nuclear facility decommissioning, uranium mill tailings management, and site remedial actions constitute the ninth in a series of reports prepared annually for the US Department of Energy's Remedial Action Programs. Foreign and domestic literature of all types--technical reports, progress reports, journal articles, symposia proceedings, theses, books, patents, legislation, and research project descriptions--has been included. The bibliography contains scientific, technical, economic, regulatory, and legal information pertinent to the US Department of Energy's remedial action programs. Major sections are (1) Surplus Facilities Management Program, (2) Nuclear Facilities Decommissioning, (3) Formerly Utilized Sites Remedial Action Program, (4) Facilitiesmore » Contaminated with Naturally Occurring Radionuclides, (5) Uranium Mill Tailings Remedial Action Program, (6) Uranium Mill Tailings Management, (7) Technical Measurements Center, and (8) General Remedial Action Program Studies. Subsections for sections 1, 2, 5, and 6 include: Design, Planning, and Regulations; Environmental Studies and Site Surveys; Health, Safety, and Biomedical Studies; Decontamination Studies; Dismantlement and Demolition; Site Stabilization and Reclamation; Waste Disposal; Remedial Action Experience; and General Studies. Within these categories, references are arranged alphabetically by first author. Those references having no individual author are listed by corporate affiliation or by publication description. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, and keywords. This report is a product of the Remedial Action Program Information Center (RAPIC), which selects and analyzes information on remedial actions and relevant radioactive waste management technologies. RAPIC staff and resources are available to meet a variety of information needs. Contact the center at (615) 576-0568 or FTS 626-0568.« less

Applying Cognitive-Behavioral Techniques to Social Skills Instruction. ERIC/OSEP Digest.

ERIC Educational Resources Information Center

Smith, Stephen W.

This digest describes how teachers can use cognitive-behavioral interventions (CBI) to remediate behavioral deficits and excesses by providing students with the tools necessary to control their own behavior. CBIs involve teaching the use of inner speech ("self-talk" )to modify underlying cognitions that affect overt behavior. CBI…

Remediation of problematic residents--A national survey.

PubMed

Bhatti, Nasir I; Ahmed, Aadil; Stewart, Michael G; Miller, Robert H; Choi, Sukgi S

2016-04-01

Despite careful selection processes, residency programs face the challenge of training residents who fall below minimal performance standards. Poor performance of a resident can endanger both patient safety and the reputation of the residency program. It is important, therefore, for a program to identify such residents and implement strategies for their successful remediation. The purpose of our study was to gather information on evaluation and remediation strategies employed by different otolaryngology programs. Cross-sectional survey. We conducted a national survey, sending a questionnaire to the program directors of 106 otolaryngology residency programs. We collected information on demographics of the program, identification of problematic residents, and remediation strategies. The response rate was 74.5%, with a 2% cumulative incidence of problematic residents in otolaryngology programs during the past 10 years. The most frequently reported deficiencies of problematic residents were unprofessional behavior with colleagues/staff (38%), insufficient medical knowledge (37%), and poor clinical judgment (34%). Personal or professional stress was the most frequently identified underlying problem (70.5%). Remediation efforts included general counseling (78%), frequent feedback sessions (73%), assignment of a mentor (58%), and extra didactics (47%). These remediation efforts failed to produce improvement in 23% of the identified residents, ultimately leading to their dismissal. The apparent deficiencies, underlying causes, and remediation strategies vary among otolaryngology residency programs. Based on the results of this survey, we offer recommendations for the early identification of problematic residents and a standardized remediation plan. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Communicative-Pragmatic Treatment in Schizophrenia: A Pilot Study

PubMed Central

Bosco, Francesca M.; Gabbatore, Ilaria; Gastaldo, Luigi; Sacco, Katiuscia

2016-01-01

This paper aims to verify the efficacy of Cognitive Pragmatic Treatment (CPT), a new remediation training for the improvement of the communicative-pragmatic abilities, in patients with schizophrenia. The CPT program is made up of 20 group sessions, focused on a number of communication modalities, i.e., linguistic, extralinguistic and paralinguistic, theory of mind (ToM) and other cognitive functions able to play a role on the communicative performance, such as awareness and planning. A group of 17 patients with schizophrenia took part in the training program. They were evaluated before and after training, through the equivalent forms of the Assessment Battery for Communication (ABaCo), a tool for testing, both in comprehension and in production, a wide range of pragmatic phenomena such as direct and indirect speech acts, irony and deceit, and a series of neuropsychological and ToM tests. The results showed a significant improvement in patients’ performance on both production and comprehension tasks following the program, and in all the communication modalities evaluated through the ABaCo, i.e., linguistic, extralinguistic, paralinguistic, and social appropriateness. This improvement persisted after 3 months from the end of the training program, as shown by the follow-up tests. These preliminary findings provide evidence of the efficacy of the CPT program in improving communicative-pragmatic abilities in schizophrenic individuals. PMID:26941667

The Experiences and Effect of Two Post-Secondary Mathematics Remediation Programs

ERIC Educational Resources Information Center

Izard, Angie D.

2010-01-01

The purpose of this study was to describe the experience and effect of two post-secondary mathematics remediation programs at a Midwest university. The two mathematics remediation programs were provided as part of a summer bridge program designed to assist entering freshmen students who demonstrated low mathematics proficiency levels based on…

Understanding and Remediating Social-Cognitive Dysfunctions in Patients with Serious Mental Illness Using Relational Frame Theory.

PubMed

Hendriks, Annemieke L; Barnes-Holmes, Yvonne; McEnteggart, Ciara; De Mey, Hubert R A; Janssen, Gwenny T L; Egger, Jos I M

2016-01-01

Impairments in social cognition and perspective-taking play an important role in the psychopathology and social functioning of individuals with social anxiety, autism, or schizophrenia-spectrum disorders, among other clinical presentations. Perspective-taking has mostly been studied using the concept of Theory of Mind (ToM), which describes the sequential development of these skills in young children, as well as clinical populations experiencing perspective-taking difficulties. Several studies mention positive results of ToM based training programs; however, the precise processes involved in the achievement of these improvements are difficult to determine. Relational Frame Theory (RFT) is a modern behavioral account of complex cognitive functions, and is argued to provide a more precise approach to the assessment and training of perspective-taking, among other relational skills. Results of RFT-based studies of perspective-taking in developmental and clinical settings are discussed. The development of training methods targeting perspective-taking deficits from an RFT point of view appears to provide promising applications for the enhancement of current treatments of people with social-cognitive dysfunctions.

32 CFR 310.47 - Civil remedies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Civil remedies. 310.47 Section 310.47 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DOD PRIVACY PROGRAM Privacy Act Violations § 310.47 Civil remedies. In addition to specific remedial...

32 CFR 310.47 - Civil remedies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Civil remedies. 310.47 Section 310.47 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DOD PRIVACY PROGRAM Privacy Act Violations § 310.47 Civil remedies. In addition to specific remedial...

32 CFR 310.47 - Civil remedies.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Civil remedies. 310.47 Section 310.47 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DOD PRIVACY PROGRAM Privacy Act Violations § 310.47 Civil remedies. In addition to specific remedial...

32 CFR 310.47 - Civil remedies.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Civil remedies. 310.47 Section 310.47 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DOD PRIVACY PROGRAM Privacy Act Violations § 310.47 Civil remedies. In addition to specific remedial...

32 CFR 310.47 - Civil remedies.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Civil remedies. 310.47 Section 310.47 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DOD PRIVACY PROGRAM Privacy Act Violations § 310.47 Civil remedies. In addition to specific remedial...

Uranium Mill Tailings Remedial Action Project Safety Advancement Field Effort (SAFE) Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1994-02-01

In 1992, the Uranium Mill Tailings Remedial Action (UMTRA) Project experienced several health and safety related incidents at active remediation project sites. As a result, the U.S. Department of Energy (DOE) directed the Technical Assistance Contractor (TAC) to establish a program increasing the DOE`s overall presence at operational remediation sites to identify and minimize risks in operations to the fullest extent possible (Attachments A and B). In response, the TAC, in cooperation with the DOE and the Remedial Action Contractor (RAC), developed the Safety Advancement Field Effort (SAFE) Program.

Feasibility of cognitive remediation therapy for adults with autism spectrum disorders: a single-group pilot study.

PubMed

Okuda, Tomoko; Asano, Kenichi; Numata, Noriko; Hirano, Yoshiyuki; Yamamoto, Tetsuya; Tanaka, Mari; Matsuzawa, Daisuke; Shimizu, Eiji; Iyo, Masaomi; Nakazato, Michiko

2017-01-01

Set-shifting (SS) difficulties and weak central coherence (CC) are commonly associated with autism spectrum disorders (ASD). Cognitive remediation therapy (CRT) aims to improve such cognitive processing; however, there are no reports on CRT for patients with ASD. This pilot study aimed to provide preliminary evidence to support the use of CRT for individuals with ASD and provide data to inform future studies. Nineteen individuals with ASD were recruited and administered a series of neuropsychological and questionnaire measures to examine cognitive function and clinical outcomes such as anxiety and depression. Participants received CRT, and cognitive function and clinical variables were re-evaluated at postintervention and after 3 months. The participants demonstrated significant improvement in CC and anxiety at postintervention, which was maintained at 3-month follow-up. Although SS scores had improved with a large effect size, this was not statistically significant. CRT improved CC and anxiety scores for individuals with ASD, suggesting that CRT is an effective treatment for individuals with ASD.

Baseline Predictors for Success Following Strategy-Based Cognitive Remediation Group Training in Schizophrenia.

PubMed

Farreny, Aida; Aguado, Jaume; Corbera, Silvia; Ochoa, Susana; Huerta-Ramos, Elena; Usall, Judith

2016-08-01

Our aim was to examine predictive variables associated with the improvement in cognitive, clinical, and functional outcomes after outpatient participation in REPYFLEC strategy-based Cognitive Remediation (CR) group training. In addition, we investigated which factors might be associated with some long-lasting effects at 6 months' follow-up. Predictors of improvement after CR were studied in a sample of 29 outpatients with schizophrenia. Partial correlations were computed between targeted variables and outcomes of response to explore significant associations. Subsequently, we built linear regression models for each outcome variable and predictors of improvement. The improvement in negative symptoms at posttreatment was linked to faster performance in the Trail Making Test B. Disorganization and cognitive symptoms were related to changes in executive function at follow-up. Lower levels of positive symptoms were related to durable improvements in life skills. Levels of symptoms and cognition were associated with improvements following CR, but the pattern of resulting associations was nonspecific.

Rehabilitation Interventions to Promote Recovery from Schizophrenia: A Systematic Review

PubMed Central

Morin, Laurent; Franck, Nicolas

2017-01-01

Only one out of seven patients recovers after a first episode of psychosis despite psychiatric care. Rehabilitation interventions have been developed to improve functional outcomes and to promote recovery. We conducted a systematic review of the effectiveness of the main psychiatric rehabilitation interventions following a search of the electronic databases Pubmed, ScienceDirect, and Google Scholar using combinations of terms relating to cognitive remediation, psychoeducation, cognitive-behavioral therapies, and schizophrenia. Eighty articles relevant to the topic of interest were found. According to results, cognitive remediation has been found to be effective in reducing the impact of cognitive impairment, social skills in the learning a variety of skills and to a lesser extent in reducing negative symptoms, psychoeducation in improving compliance and reducing relapses, and cognitive therapy in reducing the intensity of or distress related to positive symptoms. All psychosocial rehabilitation interventions should be considered as evidence-based practices for schizophrenia and need to become a major part of the standard treatment of the disease. PMID:28659832

The Bama Bookworm Program: Motivating Remedial Readers to Read at Home with Their Parents.

ERIC Educational Resources Information Center

Brown, David; Moore, Linda

1992-01-01

The Bama Bookworm Program, developed by a university remedial reading summer school program, encourages parents of remedial readers to listen to their children read and to ask comprehension questions four nights a week for a month. The program provides incentives (pizzas and t-shirts) and was enthusiastically received by parents and children. (DB)

READING AND WRITING, THE REMEDIAL PROGRAM.

ERIC Educational Resources Information Center

Euclid English Demonstration Center, OH.

THE PAPERS IN THIS COLLECTION EXPLAIN THE JUNIOR HIGH SCHOOL REMEDIAL PROGRAM IN READING AND WRITING DEVELOPED BY THE EUCLID ENGLISH DEMONSTRATION CENTER, THEY ARE (1) "REMEDIAL CLASSES AND THE TOTAL ENGLISH PROGRAM," BY GEORGE HILLOCKS, (2) "DEFINITION, ORIGIN, AND TREATMENT OF UNDERACHIEVEMENT," BY JANE W. KESSLER, (3)…

76 FR 65182 - Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Indirect Cost Rates for the Damage Assessment, Remediation, and Restoration Program for Fiscal Years 2009 and 2010 AGENCY: National... Atmospheric Administration's (NOAA's) Damage Assessment, Remediation, and Restoration Program (DARRP) is...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P. T.; Webb, J. R.; Knox, N. P.

The 664 abstracted references on environmental restoration, nuclear facility decommissioning, uranium mill tailings management, and site remedial actions constitute the twelfth in a series of reports prepared annually for the US Department of Energy Remedial Action Programs. Citations to foreign and domestic literature of all types -- technical reports, progress reports, journal articles, symposia proceedings, theses, books, patents, legislation, and research project descriptions -- have been included. The bibliography contains scientific, technical, economic, regulatory, and legal information pertinent to the US Department of Energy Remedial Action Programs. Major sections are (1) Decontamination and Decommissioning Program, (2) Nuclear Facilities Decommissioning, (3)more » Formerly Utilized Sites Remedial Action Program, (4) Facilities Contaminated with Naturally Occurring Radionuclides, (5) Uranium Mill Tailings Remedial Action Program, (6) Uranium Mill Tailings Management, (7) Technical Measurements Center, and (8) Environmental Restoration Program. Within these categories, references are arranged alphabetically by first author. Those references having no individual author are listed by corporate affiliation or by publication title. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, subject category, and key word. This report is a product of the Remedial Action Program Information Center (RAPIC), which selects, analyzes, and disseminates information on environmental restoration and remedial actions. RAPIC staff and resources are available to meet a variety of information needs. Contact the center at FTS 624-7764 or (615) 574-7764.« less

Cognitive Remediation Strategies

PubMed Central

WEINSTEIN, CHERYL S.

1994-01-01

Evidence continues to emerge that childhood symptoms of attention-deficit hyperactivity disorder (ADHD) persist into adulthood. These symptoms include motoric hyperactivity, restlessness, attention deficits, poor organizational skills, impulsivity, and memory impairment. Poor academic and work performance, frustration, humiliation, and shame are also components of adult ADHD. Psychotherapists are challenged to understand the meaning of the disorder and its ramifications in all aspects of life. An active multimodal approach, including somatic treatment and psychotherapy, is needed. In addition, cognitive remediation strategies to enhance attention, organization, memory, and problem-solving skills are an important adjunct to treatment. These strategies serve as psychological tools to circumvent deficits. PMID:22700173

32 CFR 516.68 - Program Fraud Civil Remedies Act (PFCRA).

Code of Federal Regulations, 2010 CFR

2010-07-01

... AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.68 Program Fraud Civil Remedies Act (PFCRA). (a) PFCRA was enacted on 21 October 1986 (Public Law 99-509) and...

Generative Mechanisms of Early Childhood Interventions to Well-Being

PubMed Central

Reynolds, Arthur J.; Mondi, Christina F.; Ou, Suh-Ruu; Hayakawa, Momo

2016-01-01

We describe the contributions of cognitive-scholastic advantage, family support behavior, and school quality and support as processes through which early childhood interventions promote the well-being of vulnerable children and families. Evidence in support of these processes is from longitudinal cohort studies of the Child-Parent Centers and other preventive interventions beginning in the first few years of life. Relatively large effects of program participation have been documented for school readiness skills, parent involvement, K-12 achievement, reduced need for remedial education, educational attainment, and crime prevention. The three processes account for up to half of the program impact on well-being. They also help to explain the positive economic returns of many effective programs. The generalizability of these processes is supported by a sizable knowledge base, including a scale-up of the Child-Parent Centers in two states. PMID:28195326

Effects of cognitive remediation on negative symptoms dimensions: exploring the role of working memory.

PubMed

Cella, M; Stahl, D; Morris, S; Keefe, R S E; Bell, M D; Wykes, T

2017-09-04

Recent theories suggest that poor working memory (WM) may be the cognitive underpinning of negative symptoms in people with schizophrenia. In this study, we first explore the effect of cognitive remediation (CR) on two clusters of negative symptoms (i.e. expressive and social amotivation), and then assess the relevance of WM gains as a possible mediator of symptom improvement. Data were accessed for 309 people with schizophrenia from the NIMH Database of Cognitive Training and Remediation Studies and a separate study. Approximately half the participants received CR and the rest were allocated to a control condition. All participants were assessed before and after therapy and at follow-up. Expressive negative symptoms and social amotivation symptoms scores were calculated from the Positive and Negative Syndrome Scale. WM was assessed with digit span and letter-number span tests. Participants who received CR had a significant improvement in WM scores (d = 0.27) compared with those in the control condition. Improvements in social amotivation levels approached statistical significance (d = -0.19), but change in expressive negative symptoms did not differ between groups. WM change did not mediate the effect of CR on social amotivation. The results suggest that a course of CR may benefit behavioural negative symptoms. Despite hypotheses linking memory problems with negative symptoms, the current findings do not support the role of this cognitive domain as a significant mediator. The results indicate that WM improves independently from negative symptoms reduction.

32 CFR 516.68 - Program Fraud Civil Remedies Act (PFCRA).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Program Fraud Civil Remedies Act (PFCRA). 516.68 Section 516.68 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.68 Program...

The Influence of Textbook Format on Postsecondary Proficient and Remedial Readers: Designing Information Using Visual Language

ERIC Educational Resources Information Center

Tetlan, W. Lou

2009-01-01

This study examined whether the design of textbook material affects comprehension and memory of textbook material under certain cognitive conditions for proficient and remedial readers. Using quantitative and qualitative research methods, format was found to significantly affect comprehension and memory. Proficient Male scored significantly…

Developing a Cognitive Training Strategy for First-Episode Schizophrenia: Integrating Bottom-Up and Top-Down Approaches

PubMed Central

Nuechterlein, Keith H.; Ventura, Joseph; Subotnik, Kenneth L.; Hayata, Jacqueline N.; Medalia, Alice; Bell, Morris D.

2014-01-01

It is clear that people with schizophrenia typically have cognitive problems in multiple domains as part of their illness. The cognitive deficits are among the main contributors to limitations in their everyday functioning, including their work recovery. Cognitive remediation has been applied successfully to help people with long-term, persistent schizophrenia to improve their cognitive functioning, but it is only beginning to be applied with individuals who have recently had a first episode of psychosis. Several different approaches to cognitive training have been developed. Some approaches emphasize extensive systematic practice with lower-level cognitive processes and building toward higher-level processes (“bottom-up”), while others emphasize greater focus on high-level cognitive processes that normally integrate and organize lower-level processes (“top-down”). Each approach has advantages and disadvantages for a disorder like schizophrenia, with its multiple levels of cognitive dysfunction. In addition, approaches to cognitive remediation differ in the extent to which they systematically facilitate transfer of learning to everyday functioning. We describe in this article the cognitive training approach that was developed for a UCLA study of people with a recent first episode of schizophrenia, a group that may benefit greatly from early intervention that focuses on cognition and recovery of work functioning. This approach integrated bottom-up and top-down computerized cognitive training and incorporated an additional weekly group session to bridge between computerized training and application to everyday work and school functioning. PMID:25489275

Group cognitive remediation therapy for chronic schizophrenia: A randomized controlled trial.

PubMed

Tan, Shuping; Zou, Yizhuang; Wykes, Til; Reeder, Clare; Zhu, Xiaolin; Yang, Fude; Zhao, Yanli; Tan, Yunlong; Fan, Fengmei; Zhou, Dongfeng

2016-07-28

Individual-level cognitive remediation therapy (CRT) has been shown to be effective for cognitive improvement and social function amelioration. Here, we aimed to test the efficacy of group-based CRT in Chinese subjects with schizophrenia. One-hundred and four inpatients were randomly assigned to either 40 sessions of small-group CRT therapy or therapeutic contact-matched Musical and Dancing Therapy (MDT). Cognitive and social functioning, as well as clinical symptoms, were evaluated over the course of treatment. Specifically, cognitive function was evaluated using a battery of cognitive measurements, clinical symptoms were evaluated using the Positive and Negative Syndrome Scale, and social function was evaluated using the Nurse's Observation Scale for Inpatient Evaluation-30. All patients were evaluated pre- and post-treatment. Forty-four individuals in the CRT group and 46 in the MDT group completed all of the planned treatments and analyses. Cognitive functions, especially cognitive flexibility and memory, showed significant improvement in the CRT group over the course of the study. The MDT group also showed improvement in several cognitive flexibility assessments, but the degree of improvement was significantly greater in the CRT group. Several social-function factors exhibited a significant improvement in the CRT group, but not in the MDT group. Cognitive function improvement correlated positively with social function without predicting social function change. We conclude that group-based CRT is an effective and promising therapy. Copyright © 2016. Published by Elsevier Ireland Ltd.

Effectiveness of group cognitive-behavioral therapy in reducing self-stigma in Japanese psychiatric patients.

PubMed

Shimotsu, Sakie; Horikawa, Naoshi; Emura, Rina; Ishikawa, Shin-Ichi; Nagao, Ayako; Ogata, Akiko; Hiejima, Shigeto; Hosomi, Jun

2014-08-01

There is evidence that the stigma surrounding mental illness may be greater in Japan than elsewhere. However, few Japanese studies have focused on self-stigma (the internalization of social stigma), and few interventions to reduce self-stigma exist. To remedy this deficiency, we evaluated the efficacy of group cognitive-behavioral therapy (CBT) in reducing self-stigma and examined the relationship between cognitive restructuring and self-stigma. We administered a 10-session group CBT program to 46 Japanese outpatients with anxiety and depressive symptoms (36 men, 10 women; mean age=38.57 years, SD=8.33; 20 diagnosed with mood disorders; 24 with neurotic, stress-related, or somatoform disorders; and 2 with other disorders). A pretest-posttest design was used to examine the relationship between cognitive restructuring and self-stigma. Outcomes were measured using the Japanese versions of the Devaluation-Discrimination Scale, Dysfunctional Attitude Scale, Beck Depression Inventory-II, State-Trait Anxiety Inventory State-Form, and Rosenberg's Self Esteem Scale. Participants exhibited significant improvements in depression, anxiety, and maladjusted cognitive bias and reductions in self-stigma. Cognitive bias was significantly correlated with self-stigma. Group CBT is effective in improving both emotional symptoms and self-stigma in outpatients with anxiety and depressive symptoms. Reduction in self-stigma plays a mediating role in alleviating emotional symptoms and improving cognition. Copyright © 2014 Elsevier B.V. All rights reserved.

Tank waste remediation system privatization infrastructure program requirements and document management process guide

DOE Office of Scientific and Technical Information (OSTI.GOV)

ROOT, R.W.

1999-05-18

This guide provides the Tank Waste Remediation System Privatization Infrastructure Program management with processes and requirements to appropriately control information and documents in accordance with the Tank Waste Remediation System Configuration Management Plan (Vann 1998b). This includes documents and information created by the program, as well as non-program generated materials submitted to the project. It provides appropriate approval/control, distribution and filing systems.

The CIRCuiTS study (Implementation of cognitive remediation in early intervention services): protocol for a randomised controlled trial.

PubMed

Wykes, Til; Joyce, Eileen; Velikonja, Tjasa; Watson, Andrew; Aarons, Gregory; Birchwood, Max; Cella, Matteo; Dopson, Sue; Fowler, David; Greenwood, Kathy; Johnson, Sonia; McCrone, Paul; Perez, Jesus; Pickles, Andrew; Reeder, Clare; Rose, Diana; Singh, Swaran; Stringer, Dominic; Taylor, Matthew; Taylor, Rumina; Upthegrove, Rachel

2018-03-15

Cognitive problems in people with schizophrenia predict poor functional recovery even with the best possible rehabilitation opportunities and optimal medication. A psychological treatment known as cognitive remediation therapy (CRT) aims to improve cognition in neuropsychiatric disorders, with the ultimate goal of improving functional recovery. Studies suggest that intervening early in the course of the disorder will have the most benefit, so this study will be based in early intervention services, which treat individuals in the first few years following the onset of the disorder. The overall aim is to investigate different methods of CRT. This is a multicentre, randomised, single-blinded, controlled trial based in early intervention services in National Health Service Mental Health Trusts in six English research sites. Three different methods of providing CRT (intensive, group, and independent) will be compared with treatment as usual. We will recruit 720 service users aged between 16 and 45 over 3 years who have a research diagnosis of non-affective psychosis and will be at least 3 months from the onset of the first episode of psychosis. The primary outcome measure will be the degree to which participants have achieved their stated goals using the Goal Attainment Scale. Secondary outcome measures will include improvements in cognitive function, social function, self-esteem, and clinical symptoms. It has already been established that cognitive remediation improves cognitive function in people with schizophrenia. Successful implementation in mental health services has the potential to change the recovery trajectory of individuals with schizophrenia-spectrum disorders. However, the best mode of implementation, in terms of efficacy, service user and team preference, and cost-effectiveness is still unclear. The CIRCuiTS trial will provide guidance for a large-scale roll-out of CRT to mental health services where cognitive difficulties impact recovery and resilience. ISRCTN, ISRCTN14678860 , Registered on 6 June 2016.

Role of learning potential in cognitive remediation: Construct and predictive validity.

PubMed

Davidson, Charlie A; Johannesen, Jason K; Fiszdon, Joanna M

2016-03-01

The construct, convergent, discriminant, and predictive validity of Learning Potential (LP) was evaluated in a trial of cognitive remediation for adults with schizophrenia-spectrum disorders. LP utilizes a dynamic assessment approach to prospectively estimate an individual's learning capacity if provided the opportunity for specific related learning. LP was assessed in 75 participants at study entry, of whom 41 completed an eight-week cognitive remediation (CR) intervention, and 22 received treatment-as-usual (TAU). LP was assessed in a "test-train-test" verbal learning paradigm. Incremental predictive validity was assessed as the degree to which LP predicted memory skill acquisition above and beyond prediction by static verbal learning ability. Examination of construct validity confirmed that LP scores reflected use of trained semantic clustering strategy. LP scores correlated with executive functioning and education history, but not other demographics or symptom severity. Following the eight-week active phase, TAU evidenced little substantial change in skill acquisition outcomes, which related to static baseline verbal learning ability but not LP. For the CR group, LP significantly predicted skill acquisition in domains of verbal and visuospatial memory, but not auditory working memory. Furthermore, LP predicted skill acquisition incrementally beyond relevant background characteristics, symptoms, and neurocognitive abilities. Results suggest that LP assessment can significantly improve prediction of specific skill acquisition with cognitive training, particularly for the domain assessed, and thereby may prove useful in individualization of treatment. Published by Elsevier B.V.

Medicinal Effect of Nutraceutical Fruits for the Cognition and Brain Health

PubMed Central

Keservani, Raj K.; Sharma, Anil K.; Kesharwani, Rajesh K.

2016-01-01

The recent era is witnessing evaluation of medicinal and nutritional value of fruits and fruit juices for the management and prevention of brain diseases like headache stress, anxiety, hypertension, and Alzheimer's and Parkinson's diseases by the scientists and researchers worldwide. Fruits possess various chemicals such as antioxidants and polyphenols, which reduce and balance the effect of hormone in brain responsible for brain disease. Natural remedy is cheap, easily available, nontoxic, and easy to prepare and provides good mental health as compared to other remedies. The main objective of this review is to acknowledge medicinal benefits of fruits for the cognition and management of brain disease. PMID:26966612

Afternoon Remedial and Enrichment Program, Buffalo, New York. Elementary Program in Compensatory Education, 2.

ERIC Educational Resources Information Center

American Institutes for Research in the Behavioral Sciences, Palo Alto, CA.

This afternoon remedial and enrichment program was offered to inner-city low income children (grades 3-8). About 75 percent of the children were black, 20 percent white and 5 percent Puerto Rican. Remedial instruction was offered in reading and mathematics. Average class size was six pupils; these small groups allowed for better diagnosis of needs…

"Diamond in the Rough": The Impact of a Remedial Program on College Access and Opportunity for Black Males at an Historically Black Institution

ERIC Educational Resources Information Center

Palmer, Robert T.; Davis, Ryan J.

2012-01-01

Researchers, policymakers, and administrations have shown great concern over the efficacy of college remediation, which has prompted some states to eliminate remedial programs from public 4-year institutions. However, research suggests that eliminating these programs may have unintended consequences on college access and opportunity for…

Factors associated with clinical skill remediation in dental hygiene education programs.

PubMed

Wood, Donna F; Mitchell, Tanya Villalpando; Holt, Lorie A; Branson, Bonnie G

2014-02-01

The purpose of this study was to examine the challenges related to formal clinical remediation in dental hygiene programs, which include timing of student identification, policy development, and the issues of methodology and scheduling. A 23 item investigator-designed survey was electronically distributed to all 303 U.S. entry-level dental hygiene program directors. This questionnaire included 23 forced-choice questions with the options to add comments to 8 of the questions. A total of 111 surveys were returned yielding a response rate of 36%. Descriptive statistics and Chi-square analyses were utilized to analyze relationships between responses and the degree earned from the dental hygiene program. All schools reported having a remediation policy; however, 13.6% of the respondents revealed this information was not readily available to students. The majority of respondents (67.8%) reported identifying students with clinical deficiencies in the preclinical semester, and 15.5% identified students in the second year, second clinical semester. Instrumentation technique was identified as the area in greatest need of remediation (81%), followed by critical thinking and problem solving skills (12%). Coordination of faculty and student schedules to conduct remediation was identified as one of the greatest challenges by respondents (25.2%). Results of this study suggest that challenges exist with the process of remediation. Some of these challenges include involving the student in remedial plan development, the academic consequences associated with remediation and scheduling time and space for remedial activities. These findings indicate that respondents are well aware of the need for remediation policies in dental hygiene programs. The point in time varies when students in need of remediation are identified. Therefore, further research needs to be conducted to determine the reasons for this difference. Some reasons may include inability to grasp the foundational skills and/or the complexity of advanced instrumentation in the second year. Also, it is suggested that investigation regarding methods used to address the challenge of faculty and student scheduling for remediation sessions would be useful.

Evaluation of a cognitive remediation intervention for college students with psychiatric conditions.

PubMed

Mullen, Michelle G; Thompson, Judy L; Murphy, Ann A; Malenczak, Derek; Giacobbe, Giovanna; Karyczak, Sean; Holloway, Katherine E; Twamley, Elizabeth W; Silverstein, Steven M; Gill, Kenneth J

2017-03-01

Given the poor educational outcomes associated with psychiatric conditions, we developed Focused Academic Strength Training (FAST), a 12-week strategy-focused cognitive remediation intervention designed to improve academic functioning among college students with psychiatric conditions. Here we report initial results from a randomized controlled trial of FAST. Seventy-two college students with mood, anxiety, and/or psychotic disorders were randomized to receive FAST or services as usual and were assessed at baseline and 4 months (posttreatment). Repeated-measures analyses of variance indicated FAST-associated improvements in self-reported cognitive strategy use (p < .001), self-efficacy (p = .001), and academic difficulties (p = .025). There were no significant treatment-related improvements in neuropsychological performance. FAST may lead to an increase in self-efficacy and cognitive strategy use, as well as a reduction in academic difficulties among students with psychiatric conditions. Future analyses with follow-up data through 12 months will address the potential of FAST to improve academic functioning among this population. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta-analysis of the Literature.

PubMed

Tchanturia, Kate; Giombini, Lucia; Leppanen, Jenni; Kinnaird, Emma

2017-07-01

Cognitive remediation therapy (CRT) for eating disorders has demonstrated promising findings in adult age groups, with randomised treatment trials and systematic reviews demonstrating medium to large effect sizes in improved cognitive performance. In recent years, several case series have been conducted for young people with anorexia nervosa, but these findings have not been synthesised in the form of a systematic review. This systematic review aimed to evaluate the evidence for the efficacy of CRT in child and adolescent age groups. Nine studies were identified, with a subsequent meta-analysis suggesting improvements in cognitive performance with small effect sizes. Patient feedback was positive, with low dropout rates. These findings suggest that CRT has potential as a supplementary treatment for young people with anorexia nervosa, warranting further investigation using randomised treatment trials. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Intrinsic motivation and metacognition as predictors of learning potential in patients with remitted schizophrenia.

PubMed

Tas, Cumhur; Brown, Elliot C; Esen-Danaci, Aysen; Lysaker, Paul H; Brüne, Martin

2012-08-01

Previous research has suggested that neurocognitive functioning predicts best the potential of patients with schizophrenia to acquire newly learned material, which, in turn may impact patients' social functioning. Recent studies have also shown that intrinsic motivation and metacognitive abilities play a decisive role in social functioning in schizophrenia. Accordingly, the present study sought to examine the relationship between intelligence, motivation, metacognition, and learning during a cognitive remediation experimental training. We hypothesized that metacognition and intrinsic motivation would have a strong relationship and independently predict learning potential. Thirty-two patients with schizophrenia who fulfilled the criteria of functional remission were recruited. In a pre-training-post experimental design, patients' learning potential was assessed using previously defined cognitive remediation training for WCST. Intrinsic motivation was examined using Intrinsic Motivation Inventory for schizophrenia; mastery, a domain of metacognition, was measured using the Metacognitive Assessment Scale. Metacognition significantly correlated with subdomains of intrinsic motivation. Patients with higher intrinsic motivation and preserved metacognition improved more in the learning paradigm compared to poorly motivated patients and patients with reduced metacognitive abilities. In particular, "mastery" was determined as an independent predictor of learning potential. Motivation and metacognition are important predictors of learning in schizophrenia. Psychological interventions in schizophrenia may therefore consider incorporating techniques to stimulate metacognitive and motivational abilities as well as developing individualized training programs. Copyright © 2012 Elsevier Ltd. All rights reserved.

Training the elderly on the ability factors of spatial orientation and inductive reasoning.

PubMed

Willis, S L; Schaie, K W

1986-09-01

We examined the effects of cognitive training with elderly participants from the Seattle Longitudinal Study. Subjects were classified as having remained stable or having declined over the previous 14-year interval on each of two primary abilities, spatial orientation and inductive reasoning. Subjects who had declined on one of these abilities received training on that ability; subjects who had declined on both abilities or who had remained stable on both were randomly assigned to the spatial orientation or inductive reasoning training programs. Training outcomes were examined within an ability-measurement framework with empirically determined factorial structure. Significant training effects, at the level of the latent ability constructs, occurred for both spatial orientation and inductive reasoning. These effects were general, in that no significant interactions with decline status or gender were found. Thus, training interventions were effective both in remediating cognitive decline on the target abilities and in improving the performance of stable subjects.

32 CFR 310.45 - Administrative remedies.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Administrative remedies. 310.45 Section 310.45 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DOD PRIVACY PROGRAM Privacy Act Violations § 310.45 Administrative remedies. Any individual who...

Is longer treatment better? A comparison study of 3 versus 6 months cognitive remediation in schizophrenia.

PubMed

Buonocore, Mariachiara; Bosia, Marta; Bechi, Margherita; Spangaro, Marco; Cavedoni, Silvia; Cocchi, Federica; Guglielmino, Carmelo; Bianchi, Laura; Mastromatteo, Antonella Rita; Cavallaro, Roberto

2017-05-01

Despite its extensive use for treating cognitive deficits in schizophrenia, computer-assisted cognitive remediation (CACR) currently lacks a standardized protocol. Duration is an important feature to be defined, as it may contribute to heterogeneous outcome. This study compares 2 treatment durations, 3 versus 6 months, to analyze their effects on both cognition and daily functioning. Fifty-seven outpatients with schizophrenia received 3 months of CACR and 41 received 6 months of CACR. All patients were assessed at baseline and after 3 and 6 months with the Brief Assessment for Cognition in Schizophrenia and with the Quality of Life Scale (QLS). Repeated measures ANOVA showed significant improvements in all cognitive domains after 3 months. A significant effect of treatment duration was observed only for executive functions, with significantly higher scores among patients treated for 6 months. Significant improvements in QLS were also observed after 6 months in both groups, with a significant time by treatment interaction for QLS Total Score. Results confirm the efficacy of 3-months CACR in terms of both cognitive and functional improvements, suggesting that an extended intervention may lead to further benefits in executive functions and daily functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Changing the focus of Brownfields cleanups

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cichon, E.

The Brownfields Tax Incentive proposed by President Clinton illustrates the remarkable evolution in the government`s view of contaminated property remediation. The current program, spearheaded by the president`s Brownfields Initiative, reflects a significant shift of emphasis. Remedial programs now pinpoint the end use of the affected property as the ultimate objective, with the required cleanup of impacted media regarded as only one of several elements. In place of enforcement, government now is employing incentives--from federal policies limiting landowner liability to proposed tax incentives--to eliminate traditional obstacles to the remediation and reuse of contaminated land. Some three dozen Brownfields Initiative pilot projectsmore » have been launched across the country. These first-generation brownfields remediation efforts demonstrate that to realize the program`s regulatory and economic advantages, practical and cost-effective remedial efforts are required.« less

Nuclear facility decommissioning and site remedial actions: A selected bibliography: Volume 8

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P.T.; Michelson, D.C.; Knox, N.P.

1987-09-01

The 553 abstracted references on nuclear facility decommissioning, uranium mill tailings management, and site remedial actions constitute the eighth in a series of reports. Foreign and domestic literature of all types - technical reports, progress reports, journal articles, symposia proceedings, theses, books, patents, legislation, and research project descriptions - has been included. The bibliography contains scientific, technical, economic, regulatory, and legal information pertinent to the US Department of energy's remedial action program. Major chapters are Surplus Facilities Management Program, Nuclear Facilities Decommissioning, Formerly Utilized Sites Remedial Action Program, Facilities Contaminated with Naturally Occurring Radionuclides, Uranium Mill Tailings Remedial Action Program,more » Uranium Mill Tailings Management, Technical Measurements Center, and General Remedial Action Program Studies. Chapter sections for chapters 1, 2, 5, and 6 include Design, Planning, and Regulations; Environmental Studies and Site Surveys; Health, Safety, and Biomedical Studies; Decontamination Studies; Dismantlement and Demolition; Site Stabilization and Reclamation; Waste Disposal; Remedial Action Experience; and General Studies. Within these categories, references are arranged alphabetically by first author. Those references having no individual author are listed by corporate affiliation or by publication description. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, and keywords. The appendix contains a list of frequently used acronyms and abbreviations.« less

Enhanced Preliminary Assessment Fort Devens, Massachusetts

DTIC Science & Technology

1992-04-30

remedial programs and RCRA corrective actions at Fort Devens . The areas regulated under RCRA will require closure when no longer in...under which the work in the MEP has been developed requires full integration of CERCLA remedial programs and RCRA corrective actions at Fort Devens ...AREEs 65 and 67, asbestos and radon, respectively. Fort Devens has ongoing programs that deal with these concerns. Any remedial action or disturbance

Improving ISTEP Scores through Remediation: An Evaluation of the Language Arts Remediation at Chauncey Rose Middle School, Vigo County School Corporation.

ERIC Educational Resources Information Center

Emmert, Bryan E.

A study examined the effects of a remediation program initiated at Chauncey Rose Middle School, Terre Haute, Indiana, during the 1996-97 school year. After the ISTEP test was administered to the sixth-grade class, a pull-out program for remediation was started the following year using grant monies. Subjects were 14 sixth graders, selected because…

Cognitive-Perceptual Examination of Remediation Approaches to Hypokinetic Dysarthria

ERIC Educational Resources Information Center

McAuliffe, Megan J.; Kerr, Sarah E.; Gibson, Elizabeth M. R.; Anderson, Tim; LaShell, Patrick J.

2014-01-01

Purpose: To determine how increased vocal loudness and reduced speech rate affect listeners' cognitive-perceptual processing of hypokinetic dysarthric speech associated with Parkinson's disease. Method: Fifty-one healthy listener participants completed a speech perception experiment. Listeners repeated phrases produced by 5 individuals…

Self-awareness of cognitive functioning in schizophrenia: patients and their relatives.

PubMed

Poletti, Sara; Anselmetti, Simona; Riccaboni, Roberta; Bosia, Marta; Buonocore, Mariachiara; Smeraldi, Enrico; Cavallaro, Roberto

2012-07-30

Cognitive impairment has been recognized since the earliest descriptions of schizophrenia as a core feature of the illness and different programmes have been developed to remediate these deficits. In all likelihood it is important for compliance and adherence to treatment that not only the patients but also their relatives be aware of the patients; cognitive deficits. Sixty-two patients with a diagnosis of schizophrenia and, for each one of them, one family member and an informant from the medical staff, were recruited and administered the Schizophrenia Cognition Rating Scale (SCoRS) ratings. Patients were tested for cognitive deficits with a neuropsychological battery and their performance was compared to the ratings of cognitive functioning provided by the patient himself, his family member and the informant. Results show no significant association between cognitive performance and SCoRS ratings in patients; only for executive functions the patient's performance was found to be predictive of the respective judgment on the SCoRS that was given by the relative. This is the first study to investigate awareness of the patients' cognitive deficits, both in the patients themselves and in their first degree relatives, through a direct comparison between subjective clinical ratings and objective measures of cognitive performances. When both patients and relatives are unaware of the patients' cognitive deficits, this could affect adherence to remediation treatment and need to be specifically addressed in future rehabilitation strategies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Preschool Education, Educational Attainment, and Crime Prevention: Contributions of Cognitive and Non-Cognitive Skills

PubMed Central

Reynolds, Arthur J.; Temple, Judy A.; Ou, Suh-Ruu

2016-01-01

We investigated the extent to which cognitive and noncognitive skills accounted for the measured links between participation in preschool intervention and high school completion, highest grade completed, and incarceration history in early adulthood. Using data from the Chicago Longitudinal Study, an on-going 20-year investigation of the effects of the school-based Child-Parent Center early intervention program for over 1,500 children, we assessed the contribution of school readiness and achievement test scores up to age 14 and remedial education as well as measures of social adjustment, motivation, educational expectations, problem behavior, and juvenile arrest to the estimated direct effect of preschool. Hierarchical regression analysis indicated that when assessed separately, cognitive factors accounted for 42% of the preschool effect on high school completion, 37% on highest grade completed, and 23% on incarceration history by age 24 while noncognitive factors accounted for, respectively, 36%, 45%, and 59%. Together, cognitive and noncognitive factors explained 46%, 51%, and 59% of the main effect of preschool participation. The set of cognitive skills made greater value-added contributions to educational attainment while noncognitive skills made greater value-added contributions to incarceration history. Our findings support the important role of test scores, school performance, and social and motivational factors in explaining the effect of preschool participation on economically important indicators of well-being. PMID:27667885

Do Supplemental Remedial Reading Programs Address the Motivational Issues of Struggling Readers? An Analysis of Five Popular Programs.

PubMed

Quirk, Matthew P; Schwanenflugel, Paula J

2004-04-01

Five popular, but distinctly different, remedial reading programs were reviewed regarding the potential to motivate children to read. It is argued that current remedial reading program designs and research on program effectiveness ignore the impact that motivation has on struggling readers. In addition, we develop a theory of reading motivation specific to struggling readers that highlights motivational constructs we feel are important to the improvement of reading skill for this population of students. The three aspects of reading motivation most relevant to the instruction of remedial readers include: (a) improving reading self-efficacy; (b) making internal and controllable outcome attributions for successes and failures associated with reading; and (c) establishing personally relevant value in becoming a better reader. We conclude that, while most programs address some motivational issues and other issues not at all, most programs could make minor modifications that would greatly enhance their motivational impact.

Intensive Cardiorespiratory Exercise (ICE) to Remediate Mild Traumatic Brain Injury in Active Duty Service Members

DTIC Science & Technology

2017-09-01

Determine if ICE is associated with cognitive benefits in mTBI. We hypothesize that ICE will be associated with gains in Global Cognition (primary outcome...mechanisms that may mediate or moderate how ICE affects cognition and depressive symptoms. Based on our prior work in older adults, we hypothesize...that gains in CR fitness (VO2peak) will mediate benefits in mTBI symptomatology ( cognitive and depression symptom severity). Three clinical

34 CFR 682.413 - Remedial actions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Remedial actions. 682.413 Section 682.413 Education... Education Loan Programs by a Guaranty Agency § 682.413 Remedial actions. (a)(1) The Secretary requires a... actions against a guaranty agency or third-party servicer administering any aspect of the FFEL programs...

Tutoring Companies Take Over Remedial Teaching at Some Colleges.

ERIC Educational Resources Information Center

Gose, Ben

1997-01-01

Kaplan Educational Centers and Sylvan Learning Centers, private remedial instruction programs, are being used increasingly to move students through college remedial programs more quickly, either through oversight or teaching. One uses its own instructors; the other hires teachers already employed by client colleges. Some find the services…

Nuclear facility decommissioning and site remedial actions: a selected bibliography. Volume 5

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P.T.; Knox, N.P.; Chilton, B.D.

1984-09-01

This bibliography of 756 references with abstracts on the subject of nuclear facility decommissioning, uranium mill tailings management, and site remedial actions is the fifth in a series of annual reports prepared for the US Department of Energy, Division of Remedial Action Projects. Foreign as well as domestic literature of all types - technical reports, progress reports, journal articles, conference papers, symposium proceedings, theses, books, patents, legislation, and research project descriptions - has been included in this publication. The bibliography contains scientific (basic research as well as applied technology), economic, regulatory, and legal literature pertinent to the US Department ofmore » Energy's Remedial Action Program. Major chapters are: (1) Surplus Facilities Management Program; (2) Nuclear Facilities Decommissioning; (3) Formerly Utilized Sites Remedial Action Program; (4) Uranium Mill Tailings Remedial Action Program; (5) Grand Junction Remedial Action Program; (6) Uranium Mill Tailings Management; and (7) Technical Measurements Center. Chapter sections for chapters 1, 2, 4, and 6 include Design, Planning, and Regulations; Environmental Studies and Site Surveys; Decontamination Studies; Dismantlement and Demolition; Site Stabilization and Reclamation; Waste Disposal; Remedial Action Experience; and General Studies. The references within each chapter or section are arranged alphabetically by leading author. References having no individual author are arranged by corporate author or by title. Indexes are provided for the categories of author, corporate affiliation, title, publication description, geographic location, and keywords. The Appendix contains a list of frequently used acronyms.« less

The Use of Microcomputers in the Treatment of Cognitive-Communicative Impairments.

ERIC Educational Resources Information Center

Story, Tamara B.; Sbordone, Robert J.

1988-01-01

The use of microcomputer-assisted therapy as part of the total rehabilitation plan for brain-injured individuals with cognitive-communicative impairments is addressed. Design of effective computer-assisted remediation requires a careful decision-making process. Specific types of software are suggested for dealing with deficits in organization,…

[Practices and interventions related to the work integration of people with a severe mental illness: work outcomes and avenues of research].

PubMed

Pachoud, B; Corbière, M

2014-06-01

Sustained work integration for people with a severe mental illness or handicap psychique in French (e.g., schizophrenia) is an important issue in our society today. Indeed, work is not only an essential factor in people's social integration but is also a stepping-stone toward recovery for this clientele. Well-defined programs and services related to work integration were developed and studied over the last three decades. Although the work integration of people with severe mental illness has been studied extensively in the Anglo-Saxon literature, the impact of these studies on the traditional beliefs and services in France remains uncertain. In terms of the scope of the studies so far, there has been an initial interest lasting over many years to uncover individual characteristics of people with severe mental illness which would best predict job tenure. Since, studies have been increasingly investigating various supports in order to facilitate the work integration process. These supports can be illustrated as direct supports or accommodations offered in the workplace, as needed, particularly when people with severe mental illness choose to disclose their mental disorder in the workplace. This awareness of the impact of the workplace environment on the work integration of people with a severe mental illness increases the need to find solutions and develop environmentally sensitive clinical strategies to overcome difficulties during the work integration. To illustrate this thematic, in this special issue, we have gathered together studies conducted in different countries but who share the focus on work integration of people with a severe mental illness. To reflect the advancement in this domain, this special issue is divided in three parts. The first part consists of the presentation of different types of vocational programs: supported employment programs, social firms, and hybrid models. Supported employment programs are very well documented in the specialised literature and are recognized as an evidence-based practice across the world to help people get competitive employment. Social firms is an another alternative model for facilitating the work integration of people with severe mental illness but has to date scarcely been studied empirically. Other hybrid vocational programs implemented in Québec (Canada) and France and inspired by supported employment programs and social firms' principles, are also described. The second part of this special issue is related to the presentation of two adjunct clinical interventions for helping people with a severe mental illness in their work integration, and more particularly for increasing job tenure: cognitive remediation and group cognitive behavioral therapy. Cognitive remediation was developed to reduce the impact of cognitive deficits, such as memory or attention, in people with a severe mental illness whereas group cognitive behavioral therapy was developed to change the dysfunctional beliefs and behaviours that might hinder job tenure in people receiving supported employment services. Finally, the third part of this special issue presents two papers on the influence of the workplace, of stakeholders from the organization (e.g., employers, supervisors) and of the work environment on the work integration of people with severe mental illness. The first paper discusses disclosure of the mental illness in the workplace and its positive and negative consequences such as receiving work accommodations and experiencing stigma, respectively. In the last paper, psychological processes during the hiring process are presented to better understand the elements related to discrimination and stigma during the work integration of people with severe mental illness. Copyright © 2014. Published by Elsevier Masson SAS.

Nuclear facility decommissioning and site remedial actions: A selected bibliography, Vol. 18. Part 2. Indexes

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-09-01

This bibliography contains 3638 citations with abstracts of documents relevant to environmental restoration, nuclear facility decontamination and decommissioning (D&D), uranium mill tailings management, and site remedial actions. This report is the eighteenth in a series of bibliographies prepared annually for the U.S. Department of Energy (DOE) Office of Environmental Restoration. Citations to foreign and domestic literature of all types - technical reports, progress reports, journal articles, symposia proceedings, theses, books, patents, legislation, and research project descriptions - have been included in Part 1 of the report. The bibliography contains scientific, technical, financial, and regulatory information that pertains to DOE environmentalmore » restoration programs. The citations are separated by topic into 16 sections, including (1) DOE Environmental Restoration Program; (2) DOE D&D Program; (3) Nuclear Facilities Decommissioning; (4) DOE Formerly Utilized Sites Remedial Action Programs; (5) NORM-Contaminated Site Restoration; (6) DOE Uranium Mill Tailings Remedial Action Project; (7) Uranium Mill Tailings Management; (8) DOE Site-Wide Remedial Actions; (9) DOE Onsite Remedial Action Projects; (10) Contaminated Site Remedial Actions; (11) DOE Underground Storage Tank Remediation; (12) DOE Technology Development, Demonstration, and Evaluations; (13) Soil Remediation; (14) Groundwater Remediation; (15) Environmental Measurements, Analysis, and Decision-Making; and (16) Environmental Management Issues. Within the 16 sections, the citations are sorted by geographic location. If a geographic location is not specified, the citations are sorted according to the document title. In Part 2 of the report, indexes are provided for author, author affiliation, selected title phrase, selected title word, publication description, geographic location, and keyword.« less

Neuropsychological benefits of computer-assisted cognitive rehabilitation (using FORAMENRehab program) in children with mild traumatic brain injury or partial epilepsy: A pilot study.

PubMed

Kaldoja, Mari-Liis; Saard, Marianne; Lange, Kirsi; Raud, Triin; Teeveer, Ott-Kaarel; Kolk, Anneli

2015-01-01

The number of children with different cognitive difficulties is constantly increasing. Still, too few evidence-based pediatric neurocognitive rehabilitation programs exist. The main aim of the study was to assess the efficiency and usability of computer-assisted FORAMENRehab program for training specific components of attention in children with mild traumatic brain injury (mTBI) and partial epilepsy (PE). The second aim was to specify short- and long-term effects of the intervention. Eight children between the ages of 9-12 years with attention impairment (3 with PE and 5 with mTBI) and 18 healthy controls participated. FORAMENRehab Attention software, adapted by the authors, was used for intervention. Strict intervention protocol consisting of patients completing 10 sessions over a 6-week-period to train four components of attention (sustaining, focusing, dividing, tracking) was designed and applied. Follow-up assessments were conducted after the end of the last training and 1.63 years later. After the intervention patients' sustained and complex attention improved. Long-term follow-up revealed continuing positive rehabilitation effects. 100% compliance suggested that the used method is attractive for children. These preliminary results of the pilot study give reason to presume that the method is effective in attention impairment remediation. However, more thorough research is needed.

Benefits of group cognitive remediation therapy in anorexia nervosa: case series.

PubMed

Tchanturia, Kate; Larsson, Emma; Brown, Amy

2016-03-01

Cognitive remediation therapy (CRT) is a treatment targeting cognitive difficulties in psychiatric disorders. CRT has been used with patients with severe anorexia nervosa (AN) in individual and group formats. Research of group CRT in AN is limited. Evaluation of a series of CRT groups delivered in inpatient and intensive daycare services was performed. Participants' self-reported cognitive flexibility and central coherence, as well as motivation to change were assessed pre- and post-group. Additionally, patients' evaluative feedback was collected after completion of the group. There was a significant improvement in the patients' self-reported cognitive flexibility and bigger picture thinking, as well as in their self-efficacy to change. The feedback questionnaires highlighted that patients found the sessions useful and reported confidence in using some of the skills and strategies they learnt in the group. In line with evidence from small-scale reports, this larger scale case series study indicates that group CRT leads to increased flexibility and bigger picture thinking, as well as improved confidence in the ability to change for participants. CRT in a group format seems to be a practical and helpful intervention for patients with AN in intensive treatment programmes.

Urban Blight Remediation as a Cost-Beneficial Solution to Firearm Violence.

PubMed

Branas, Charles C; Kondo, Michelle C; Murphy, Sean M; South, Eugenia C; Polsky, Daniel; MacDonald, John M

2016-12-01

To determine if blight remediation of abandoned buildings and vacant lots can be a cost-beneficial solution to firearm violence in US cities. We performed quasi-experimental analyses of the impacts and economic returns on investment of urban blight remediation programs involving 5112 abandoned buildings and vacant lots on the occurrence of firearm and nonfirearm violence in Philadelphia, Pennsylvania, from 1999 to 2013. We adjusted before-after percent changes and returns on investment in treated versus control groups for sociodemographic factors. Abandoned building remediation significantly reduced firearm violence -39% (95% confidence interval [CI] = -28%, -50%; P < .05) as did vacant lot remediation (-4.6%; 95% CI = -4.2%, -5.0%; P < .001). Neither program significantly affected nonfirearm violence. Respectively, taxpayer and societal returns on investment for the prevention of firearm violence were $5 and $79 for every dollar spent on abandoned building remediation and $26 and $333 for every dollar spent on vacant lot remediation. Abandoned buildings and vacant lots are blighted structures seen daily by urban residents that may create physical opportunities for violence by sheltering illegal activity and illegal firearms. Urban blight remediation programs can be cost-beneficial strategies that significantly and sustainably reduce firearm violence.

Title I, ESEA Program Evaluation, 1967-68. Program Research and Development.

ERIC Educational Resources Information Center

Jacobs, James N., Ed.; Felix, Joseph L., Ed.

This report comprises a Title I ESEA Program evaluation for 1967-68 in Cincinnati Public Schools. To make greater concentration of services possible, lesser target schools were phased out of the 1967-68 program. The five projects comprising the 1967-68 program were: Elementary School remediation and enrichment; Secondary School remediation and…

BIOVENTING DEVELOPMENT PROGRAM (TREATMENT AND DESTRUCTION BRANCH, LRPCD, NRMRL)

EPA Science Inventory

In a continuing effort to develop environment-friendly and cost-effective remediation technologies, the Land Remediation and Pollution Control Division (LRPCD) conducts an aggressive research and development program in bioventing. LRPCD's bioventing program is multi-faceted, with...

Training cognitive flexibility in patients with anorexia nervosa: a pilot randomized controlled trial of cognitive remediation therapy.

PubMed

Brockmeyer, Timo; Ingenerf, Katrin; Walther, Stephan; Wild, Beate; Hartmann, Mechthild; Herzog, Wolfgang; Bents, Hinrich; Friederich, Hans-Christoph

2014-01-01

Inefficient cognitive flexibility is considered a neurocognitive trait marker involved in the development and maintenance of anorexia nervosa (AN). Cognitive Remediation Therapy (CRT) is a specific treatment targeting this cognitive style. The aim of this study was to investigate the feasibility and efficacy (by estimating the effect size) of specifically tailored CRT for AN, compared to non-specific cognitive training. A prospective, randomized controlled, superiority pilot trial was conducted. Forty women with AN receiving treatment as usual (TAU) were randomized to receive either CRT or non-specific neurocognitive therapy (NNT) as an add-on. Both conditions comprised 30 sessions of computer-assisted (21 sessions) and face-to-face (9 sessions) training over a 3-week period. CRT focused specifically on cognitive flexibility. NNT was comprised of tasks designed to improve attention and memory. The primary outcome was performance on a neuropsychological post-treatment assessment of cognitive set-shifting. Data available from 25 treatment completers were analyzed. Participants in the CRT condition outperformed participants in the NNT condition in cognitive set-shifting at the end of the treatment (p = 0.027; between-groups effect size d = 0.62). Participants in both conditions showed high treatment acceptance. This study confirms the feasibility of CRT for AN, and provides a first estimate of the effect size that can be achieved using CRT for AN. Furthermore, the present findings corroborate that neurocognitive training for AN should be tailored to the specific cognitive inefficiencies of this patient group. Copyright © 2013 Wiley Periodicals, Inc.

The Theory about CD-CAT Based on FCA and Its Application

ERIC Educational Resources Information Center

Shuqun, Yang; Shuliang, Ding; Zhiqiang, Yao

2009-01-01

Cognitive diagnosis (CD) plays an important role in intelligent tutoring system. Computerized adaptive testing (CAT) is adaptive, fair, and efficient, which is suitable to large-scale examination. Traditional cognitive diagnostic test needs quite large number of items, the efficient and tailored CAT could be a remedy for it, so the CAT with…

Feasibility Study Combining Art Therapy or Cognitive Remediation Therapy with Family-based Treatment for Adolescent Anorexia Nervosa.

PubMed

Lock, James; Fitzpatrick, Kathleen Kara; Agras, William S; Weinbach, Noam; Jo, Booil

2018-01-01

Adolescents with anorexia nervosa who have obsessive-compulsive (OC) features respond poorly to family-based treatment (FBT). This study evaluated the feasibility of combining FBT with either cognitive remediation therapy (CRT) or art therapy (AT) to improve treatment response in this at-risk group. Thirty adolescents with anorexia nervosa and OC features were randomized to 15 sessions of FBT + CRT or AT. Recruitment rate was 1 per month, and treatment attrition was 16.6% with no differences between groups. Suitability, expectancy and therapeutic relationships were acceptable for both combinations. Correlations between changes in OC traits and changes in cognitive inefficiencies were found for both combinations. Moderate changes in cognitive inefficiencies were found in both groups but were larger in the FBT + AT combination. This study suggests that an RCT for poor responders to FBT because of OC traits combining FBT with either CRT or AT is feasible to conduct. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Processes of Early Childhood Interventions to Adult Well-Being.

PubMed

Reynolds, Arthur J; Ou, Suh-Ruu; Mondi, Christina F; Hayakawa, Momoko

2017-03-01

This article describes the contributions of cognitive-scholastic advantage, family support behavior, and school quality and support as processes through which early childhood interventions promote well-being. Evidence in support of these processes is from longitudinal cohort studies of the Child-Parent Centers and other preventive interventions beginning by age 4. Relatively large effects of participation have been documented for school readiness skills at age 5, parent involvement, K-12 achievement, remedial education, educational attainment, and crime prevention. The three processes account for up to half of the program impacts on well-being. They also help to explain the positive economic returns of many effective programs. The generalizability of these processes is supported by a sizable knowledge base, including a scale up of the Child-Parent Centers. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION PROGRAM ANNUAL REPORT TO CONGRESS FY 2002

EPA Science Inventory

This report details the Fiscal Year 2002 activities of the Superfund Innovative Technology Evaluation (SITE) Program. The Program focused on the remediation needs of the hazardous waste remediation community through demonstration and evaluation of innovative technologies for reme...

SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION PROGRAM ANNUAL REPORT TO CONGRESS FY 2001

EPA Science Inventory

This report details the fiscal year 2001 activities of the Superfund Innovative Technology Evaluation (SITE) Program. The Program focuses on the remediation needs of the hazardous waste remediation community through demonstration and evaluation of innovative technologies for re...

Nuclear facility decommissioning and site remedial actions: a selected bibliography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P.T.; Knox, N.P.; Fielden, J.M.

This bibliography contains 693 references with abstracts on the subject of nuclear facility decommissioning, uranium mill tailings management, and site remedial actions. Foreign, as well as domestic, literature of all types - technical reports, progress reports, journal articles, conference papers, symposium proceedings, theses, books, patents, legislation, and research project descriptions - has been included in this publication. The bibliography contains scientific (basic research as well as applied technology), economic, regulatory, and legal literature pertinent to the US Department of Energy's Remedial Action Program. Major chapters are Surplus Facilities Management Program, Nuclear Facilities Decommissioning, Formerly Utilized Sites Remedial Action Program, Uraniummore » Mill Tailings Remedial Action Program, Grand Junction Remedial Action Program, and Uranium Mill Tailings Management. Chapter sections for chapters 1 and 2 include: Design, Planning, and Regulations; Site Surveys; Decontamination Studies; Dismantlement and Demolition; Land Decontamination and Reclamation; Waste Disposal; and General Studies. The references within each chapter are arranged alphabetically by leading author. References having no individual author are arranged by corporate author or by title. Indexes are provided for (1) author; (2) corporate affiliation; (3) title; (4) publication description; (5) geographic location; and (6) keywords. An appendix of 202 bibliographic references without abstracts or indexes has been included in this bibliography. This appendix represents literature identified but not abstracted due to time constraints.« less

Current trends in the empirical study of cognitive remediation for schizophrenia.

PubMed

Saperstein, Alice M; Kurtz, Matthew M

2013-06-01

Cognitive remediation (CR) for schizophrenia is a learning-based behavioural skills training intervention designed to enhance neuro and (or) social cognitive skills, with the ultimate goal of generalization to improve psychosocial outcomes. This review summarizes conceptual approaches to CR for schizophrenia and the evidence for efficacy in clinical research settings. Four issues are at the forefront of ongoing research: the identification of techniques that produce the largest cognitive change, delineation of techniques that enhance transfer of cognitive skills to functional skills, the identification of CR methods that can be personalized to meet the specific cognitive and functional needs of each individual, and, all the while, ensuring that when CR methods are developed in a research setting, they remain scalable for delivery in the larger clinical community. In response to these issues, 3 prominent research trends have emerged: the rise of a new generation of computerized restorative cognitive training, the integration of CR with skills training to promote generalization, and the application of techniques to enhance motivation and learning during CR. As data on the neural basis of learning in people with schizophrenia become available, new technologies that harness the ability of the brain to make sustainable, functional changes may be integrated within a therapeutic context that promotes a personalized approach to learning. The development of transportable and scalable methods of CR that maximize the ability of people with schizophrenia to improve cognition will help them achieve personal goals for recovery.

A Framework for Remediating Number Combination Deficits

ERIC Educational Resources Information Center

Fuchs, Lynn S.; Powell, Sarah R.; Seethaler, Pamela M.; Fuchs, Douglas; Hamlett, Carol L.; Cirino, Paul T.; Fletcher, Jack M.

2010-01-01

This article introduces a framework for the remediation of number combination (NC) deficits. Research on the remediation of NC deficits is summarized, and research program studies are used to illustrate the 3 approaches to remediation. The Framework comprises a 2-stage system of remediation. The less intensive stage implementing 1 of 3…

What is the Prevalence and Success of Remediation of Emergency Medicine Residents?

PubMed Central

Silverberg, Mark; Weizberg, Moshe; Murano, Tiffany; Smith, Jessica L.; Burkhardt, John C.; Santen, Sally A.

2015-01-01

Introduction The primary objective of this study was to determine the prevalence of remediation, competency domains for remediation, the length, and success rates of remediation in emergency medicine (EM). Methods We developed the survey in Surveymonkey™ with attention to content and response process validity. EM program directors responded how many residents had been placed on remediation in the last three years. Details regarding the remediation were collected including indication, length and success. We reported descriptive data and estimated a multinomial logistic regression model. Results We obtained 126/158 responses (79.7%). Ninety percent of programs had at least one resident on remediation in the last three years. The prevalence of remediation was 4.4%. Indications for remediation ranged from difficulties with one core competency to all six competencies (mean 1.9). The most common were medical knowledge (MK) (63.1% of residents), patient care (46.6%) and professionalism (31.5%). Mean length of remediation was eight months (range 1–36 months). Successful remediation was 59.9% of remediated residents; 31.3% reported ongoing remediation. In 8.7%, remediation was deemed “unsuccessful.” Training year at time of identification for remediation (post-graduate year [PGY] 1), longer time spent in remediation, and concerns with practice-based learning (PBLI) and professionalism were found to have statistically significant association with unsuccessful remediation. Conclusion Remediation in EM residencies is common, with the most common areas being MK and patient care. The majority of residents are successfully remediated. PGY level, length of time spent in remediation, and the remediation of the competencies of PBLI and professionalism were associated with unsuccessful remediation. PMID:26594275

The use of cognitive remediation therapy on a child adolescent eating disorder unit: Patients and therapist perspectives.

PubMed

Giombini, Lucia; Turton, Robert; Turco, Matteo; Nesbitt, Sophie; Lask, Bryan

2017-04-01

Cognitive remediation therapy (CRT) is an intervention for anorexia nervosa (AN) that focuses on ameliorating the neuropsychological inefficiencies that underlie the illness. The current literature has reported promising results regarding its efficacy as an intervention for AN. However, there is a scarcity of studies considering the implementation of CRT in a child and adolescent population. This article describes an individual CRT therapy programme for children and adolescents with AN delivered on an inpatient unit for eating disorders. It considers the therapeutic process including the differing viewpoints of the patients and the therapists. The article concludes that CRT can be viewed as an engaging therapeutic intervention that could be useful as an additional treatment for AN.

Savannah River Ecology Laboratory, annual technical progress report of ecological research for the year ending June 30, 1998

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wein, G.; Rosier, B.

1998-12-31

This report provides an overview of the research programs and program components carried out by the Savannah River Ecology Laboratory. Research focused on the following: advanced analytical and spectroscopic techniques for developing novel waste isolation and stabilization technologies as well as cost-effective remediation strategies; ecologically sound management of damaged and remediation of ecological systems; ecotoxicology, remediation, and risk assessment; radioecology, including dose assessments for plants and animals exposed to environmental radiation; and other research support programs.

Savannah River Ecology Laboratory, annual technical progress report of ecological research for the year ending June 30, 1997

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wein, G.; Rosier, B.

1997-12-31

This report provides an overview of the research programs and program components carried out by the Savannah River Ecology Laboratory. Research focused on the following: advanced analytical and spectroscopic techniques for developing novel waste isolation and stabilization technologies as well as cost-effective remediation strategies; ecologically sound management of damaged and remediation of ecological systems; ecotoxicology, remediation, and risk assessment; radioecology, including dose assessments for plants and animals exposed to environmental radiation; and other research support programs.

Multiple-Component Remediation for Developmental Reading Disabilities: IQ, Socioeconomic Status, and Race as Factors in Remedial Outcome

ERIC Educational Resources Information Center

Morris, Robin D.; Lovett, Maureen W.; Wolf, Maryanne; Sevcik, Rose A.; Steinbach, Karen A.; Frijters, Jan C.; Shapiro, Marla B.

2012-01-01

Results from a controlled evaluation of remedial reading interventions are reported: 279 young disabled readers were randomly assigned to a program according to a 2 x 2 x 2 factorial design (IQ, socioeconomic status [SES], and race). The effectiveness of two multiple-component intervention programs for children with reading disabilities (PHAB +…

Nuclear facility decommissioning and site remedial actions: A selected bibliography, Volume 13: Part 1, Main text

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goins, L.F.; Webb, J.R.; Cravens, C.D.

1992-09-01

This publication contains 1035 abstracted references on environmental restoration, nuclear facility decommissioning, uranium mill tailings management, and site remedial actions. These citations constitute the thirteenth in a series of reports prepared annually for the US Department of Energy (DOE) Environmental Restoration programs. Citations to foreign and domestic literature of all types. There are 13 major sections of the publication, including: (1) DOE Decontamination and Decommissioning Program; (2) Nuclear Facilities Decommissioning; (3) DOE Formerly Utilized Sites Remedial Action Program; (4) DOE Uranium Mill Tailings Remedial Action Project; (5) Uranium Mill Tailings Management; (6) DOE Environmental Restoration Program; (7) DOE Site-Specific Remedialmore » Actions; (8) Contaminated Site Restoration; (9) Remediation of Contaminated Soil and Groundwater; (10) Environmental Data Measurements, Management, and Evaluation; (11) Remedial Action Assessment and Decision-Making; (12) Technology Development and Evaluation; and (13) Environmental and Waste Management Issues. Bibliographic references are arranged in nine subject categories by geographic location and then alphabetically by first author, corporate affiliation, or publication title. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, subject category, and key word.« less

The Chief Executive Officer's Leadership Role in Remedial and Developmental Programs.

ERIC Educational Resources Information Center

Lawler, Muriel; Bowes, S. Gregory

1988-01-01

Eighty percent of New Mexico's 17 community college and vocational school CEOs responded to a survey revealing that they have different views on what constitutes remedial and developmental programs; and although these programs are considered compatible with the CEOs' educational philosophy, programs are not viewed on equal basis with other college…

Proceedings: Conference on Compensatory/Remedial Education.

ERIC Educational Resources Information Center

Fea, Henry R., Ed.; And Others

This document presents the papers and discussions from the Conference on Compensatory/Remedial Education. The contents include: "Institutional Programs for the Low Achievers" by Joan G. Roloff; "Communication in Compensatory Education" by Henry R. Fea; "Seminar: Special Programs for Minorities" by Constance Acholonu; "Seminar: Special Programs for…

Urban Blight Remediation as a Cost-Beneficial Solution to Firearm Violence

PubMed Central

Kondo, Michelle C.; Murphy, Sean M.; South, Eugenia C.; Polsky, Daniel; MacDonald, John M.

2016-01-01

Objectives. To determine if blight remediation of abandoned buildings and vacant lots can be a cost-beneficial solution to firearm violence in US cities. Methods. We performed quasi-experimental analyses of the impacts and economic returns on investment of urban blight remediation programs involving 5112 abandoned buildings and vacant lots on the occurrence of firearm and nonfirearm violence in Philadelphia, Pennsylvania, from 1999 to 2013. We adjusted before–after percent changes and returns on investment in treated versus control groups for sociodemographic factors. Results. Abandoned building remediation significantly reduced firearm violence −39% (95% confidence interval [CI] = −28%, −50%; P < .05) as did vacant lot remediation (−4.6%; 95% CI = −4.2%, −5.0%; P < .001). Neither program significantly affected nonfirearm violence. Respectively, taxpayer and societal returns on investment for the prevention of firearm violence were $5 and $79 for every dollar spent on abandoned building remediation and $26 and $333 for every dollar spent on vacant lot remediation. Conclusions. Abandoned buildings and vacant lots are blighted structures seen daily by urban residents that may create physical opportunities for violence by sheltering illegal activity and illegal firearms. Urban blight remediation programs can be cost-beneficial strategies that significantly and sustainably reduce firearm violence. PMID:27736217

[Self-evaluation of physical, cognitive and mood symptoms in a cohort of traumatic and vascular brain injury patients participating in social and neuropsychological remediation programmes].

PubMed

Thomas-Antérion, C; Truche, A; Sciéssère, K; Guyot, E; Hibert, O; Paris, N

2005-01-01

We studied 23 vascular or traumatic head injury subjects, five years after their injury. Neuropsychological testing included language tests, memory performance, frontal lobe tests and standard tests of intelligence (QI). Behavior was evaluated with the neuropsychiatric interview (NPI). Using an analogic visual scale, subjects performed a self-evaluation of their memory, language, attention, physical and thymic complaints. Neuropsychological assessment was heterogeneous but seemed to show severe impairment. Mean NPI score was 31.4: 91 percent of patients showed depression or anxiety and 78 percent of them showed irritability. Mean memory and thymic complaints were scored 6 on the analogic visual scale. Thymic complaint was not correlated with neuropsychological tests but with physical complaints. Thymic complaint was correlated with NPI score. Language complaint was correlated with VIQ, attentional complaint was correlated with PIQ, memory complaint with memory tests. In a second part, we studied 21 patients again 6 months later and 14 patients 1 year later. Mean complaints were scored over 5 after 6 months and over 4 after 1 year. With neuropsychological remediation and social activities, memory complaints improved significantly after 6 months and attentional and thymic complaints after 1 year. Using of analogical visual scales appears to be feasible: patients were able to evaluate their difficulties. This could be useful to elaborate remediation programs and evaluate outcome.

Identifying Cognitive Remediation Change Through Computational Modelling—Effects on Reinforcement Learning in Schizophrenia

PubMed Central

Cella, Matteo; Bishara, Anthony J.; Medin, Evelina; Swan, Sarah; Reeder, Clare; Wykes, Til

2014-01-01

Objective: Converging research suggests that individuals with schizophrenia show a marked impairment in reinforcement learning, particularly in tasks requiring flexibility and adaptation. The problem has been associated with dopamine reward systems. This study explores, for the first time, the characteristics of this impairment and how it is affected by a behavioral intervention—cognitive remediation. Method: Using computational modelling, 3 reinforcement learning parameters based on the Wisconsin Card Sorting Test (WCST) trial-by-trial performance were estimated: R (reward sensitivity), P (punishment sensitivity), and D (choice consistency). In Study 1 the parameters were compared between a group of individuals with schizophrenia (n = 100) and a healthy control group (n = 50). In Study 2 the effect of cognitive remediation therapy (CRT) on these parameters was assessed in 2 groups of individuals with schizophrenia, one receiving CRT (n = 37) and the other receiving treatment as usual (TAU, n = 34). Results: In Study 1 individuals with schizophrenia showed impairment in the R and P parameters compared with healthy controls. Study 2 demonstrated that sensitivity to negative feedback (P) and reward (R) improved in the CRT group after therapy compared with the TAU group. R and P parameter change correlated with WCST outputs. Improvements in R and P after CRT were associated with working memory gains and reduction of negative symptoms, respectively. Conclusion: Schizophrenia reinforcement learning difficulties negatively influence performance in shift learning tasks. CRT can improve sensitivity to reward and punishment. Identifying parameters that show change may be useful in experimental medicine studies to identify cognitive domains susceptible to improvement. PMID:24214932

Reinventing Remedial Education

ERIC Educational Resources Information Center

Stuart, Reginald

2009-01-01

Remedial education, although widely used and disguised with other names, was rarely talked about for it could tarnish a school's reputation if widely discussed. Today, more and more colleges and universities are ditching the old stigma associated with remedial education, reinventing their remedial education and retention programs and, in the…

Computerised training improves cognitive performance in chronic pain: a participant-blinded randomised active-controlled trial with remote supervision.

PubMed

Baker, Katharine S; Georgiou-Karistianis, Nellie; Lampit, Amit; Valenzuela, Michael; Gibson, Stephen J; Giummarra, Melita J

2018-04-01

Chronic pain is associated with reduced efficiency of cognitive performance, and few studies have investigated methods of remediation. We trialled a computerised cognitive training protocol to determine whether it could attenuate cognitive difficulties in a chronic pain sample. Thirty-nine adults with chronic pain (mean age = 43.3, 61.5% females) were randomised to an 8-week online course (3 sessions/week from home) of game-like cognitive training exercises, or an active control involving watching documentary videos. Participants received weekly supervision by video call. Primary outcomes were a global neurocognitive composite (tests of attention, speed, and executive function) and self-reported cognition. Secondary outcomes were pain (intensity; interference), mood symptoms (depression; anxiety), and coping with pain (catastrophising; self-efficacy). Thirty participants (15 training and 15 control) completed the trial. Mixed model intention-to-treat analyses revealed significant effects of training on the global neurocognitive composite (net effect size [ES] = 0.43, P = 0.017), driven by improved executive function performance (attention switching and working memory). The control group reported improvement in pain intensity (net ES = 0.65, P = 0.022). Both groups reported subjective improvements in cognition (ES = 0.28, P = 0.033) and catastrophising (ES = 0.55, P = 0.006). Depression, anxiety, self-efficacy, and pain interference showed no change in either group. This study provides preliminary evidence that supervised cognitive training may be a viable method for enhancing cognitive skills in persons with chronic pain, but transfer to functional and clinical outcomes remains to be demonstrated. Active control results suggest that activities perceived as relaxing or enjoyable contribute to improved perception of well-being. Weekly contact was pivotal to successful program completion.

"Don't Look Now": The Role of Self-Focus in Sexual Dysfunction.

ERIC Educational Resources Information Center

Wiederman, Michael W.

2001-01-01

Couples and family counselors may aid in the remedy of sexual dysfunction when it has a cognitive or psychological basis. One important source of sexual dysfunction is cognitive distraction that results from certain forms of self-focus during sexual activity with a partner, a phenomenon sex therapists have labeled spectatoring. Introduces sensate…

Interventions for the treatment of theory of mind deficits in schizophrenia: Systematic literature review.

PubMed

Vass, Edit; Fekete, Zita; Simon, Viktória; Simon, Lajos

2018-05-22

Theory of Mind (ToM) plays a central role in regulating social interactions and its impairment is consistently reported in schizophrenia. Regarding schizophrenia, ToM is usually discussed as a sub-domain of social cognition. Since social cognitive deficits have drawn the attention of researchers, a variety of novel treatment techniques and approaches targeting social cognitive deficits have been developed. Encouraging results have repeatedly been reported on the modifiability of social cognitive impairment through these techniques. However, emotional perception seems to be over-represented in these approaches at the expense of other areas, such as ToM. This article presents a systematic review on the social cognitive interventions of the last 10 years, which focused on the remediation of ToM or used techniques primarily focusing on one or more social cognitive domains other than ToM, but with hypothetical effects on it. The aim of our systematic review was to compare these intervention techniques in order to see how effective they are in the remediation of ToM, and to find the best techniques to ameliorate ToM deficits in schizophrenia. According to our findings targeted ToM intervention produced more improvement in ToM tasks, while data regarding non-ToM interventions showed contradictory results with limited effects on ToM. Copyright © 2018. Published by Elsevier B.V.

40 CFR 85.2107 - Warranty remedy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Warranty remedy. 85.2107 Section 85... Voluntary Aftermarket Part Certification Program § 85.2107 Warranty remedy. (a) The manufacturer's... Emissions Performance Warranty, the manufacturer shall be liable for the total cost of the remedy for any...

40 CFR 85.2107 - Warranty remedy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 18 2011-07-01 2011-07-01 false Warranty remedy. 85.2107 Section 85... Voluntary Aftermarket Part Certification Program § 85.2107 Warranty remedy. (a) The manufacturer's... Emissions Performance Warranty, the manufacturer shall be liable for the total cost of the remedy for any...

Annual Evaluation Report. Title I ESEA 1974-75.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Education, Oklahoma City.

A description and evaluation of Elementary and Secondary Education Act Title I-funded programs for the state of Oklahoma are reviewed in this report. The project components include the following: remedial reading, speech therapy, learning disabilities, underachievers, remedial math, remedial language arts, remedial science, special education, and…

Neuropsychological and Behavioural Short-Term Effects of Cognitive Remediation Therapy in Adolescent Anorexia Nervosa: A Pilot Study.

PubMed

van Noort, Betteke Maria; Kraus, Manuela Klara Aurelia; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Kappel, Viola

2016-01-01

Cognitive remediation therapy (CRT) aims to strengthen weak cognitive flexibility and central coherence in adult and adolescent anorexia nervosa (AN). Currently, there are no studies in adolescents with AN that control for learning effects because of re-testing while evaluating CRT. Twenty in- and outpatients with AN aged 12 to 18 years received CRT. Assessment took place directly before and after the intervention. Performance was compared to 20 age-, gender-, IQ-, and test-retest interval matched healthy controls, which did not receive CRT. AN patients showed an improvement in flexibility on neuropsychological assessment directly after CRT, whereas HC did not improve over time. Self-report assessment of flexibility, as well as central coherence, did not show significant improvement after CRT. Results suggest that CRT may be beneficial for enhancing flexibility in adolescents with AN. However, randomized controlled studies are essential to determine the actual efficacy of this intervention. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Lessons learnt? The importance of metacognition and its implications for Cognitive Remediation in schizophrenia

PubMed Central

Cella, Matteo; Reeder, Clare; Wykes, Til

2015-01-01

The cognitive problems experienced by people with schizophrenia not only impede recovery but also interfere with treatments designed to improve overall functioning. Hence there has been a proliferation of new therapies to treat cognitive problems with the hope that improvements will benefit future intervention and recovery outcomes. Cognitive remediation therapy (CR) that relies on intensive task practice can support basic cognitive functioning but there is little evidence on how these therapies lead to transfer to real life skills. However, there is increasing evidence that CR including elements of transfer training (e.g., strategy use and problem solving schemas) produce higher functional outcomes. It is hypothesized that these therapies achieve higher transfer by improving metacognition. People with schizophrenia have metacognitive problems; these include poor self-awareness and difficulties in planning for complex tasks. This paper reviews this evidence as well as research on why metacognition needs to be explicitly taught as part of cognitive treatments. The evidence is based on research on learning spanning from neuroscience to the field of education. Learning programmes, and CRT, may be able to achieve better outcomes if they explicitly teach metacognition including metacognitive knowledge (i.e., awareness of the cognitive requirements and approaches to tasks) and metacognitive regulation (i.e., cognitive control over the different task relevant cognitive requirements). These types of metacognition are essential for successful task performance, in particular, for controlling effort, accuracy and efficient strategy use. We consider metacognition vital for the transfer of therapeutic gains to everyday life tasks making it a therapy target that may yield greater gains compared to cognition alone for recovery interventions. PMID:26388797

Evaluation of the 1987-1988 EIA Remedial and Compensatory Program.

ERIC Educational Resources Information Center

South Carolina State Dept. of Education, Columbia. Office of Research.

Evaluation of South Carolina's 1987-88 Remedial and Compensatory Program, funded by the state's Education Improvement Act of 1984 (EIA), shows that the program was successful in raising the participants' achievement. The programs include basic skills learning in reading and mathematics in all grades, and writing in grades 6-12, but not all grades…

Special Studies--A Statewide Remedial Mathematics Program of the University System of Georgia.

ERIC Educational Resources Information Center

Chang, Ping-Tung

Drawing upon selected findings from student and faculty surveys, this report describes the remedial mathematics component of the University of Georgia's Special Studies Program. After examining the need for basic skills programs in an era of declining test scores and open admissions policies, the report describes the Special Studies Program's…

Strategy-Based Cognitive Training for Improving Executive Functions in Older Adults: a Systematic Review.

PubMed

Mowszowski, L; Lampit, A; Walton, C C; Naismith, S L

2016-09-01

Given projected increases in dementia prevalence, emphasising earlier stages of cognitive impairment in older adults enables targeted early intervention strategies. Strategy-based cognitive training (SCT) is a remedial approach involving guidance and practice in compensatory techniques to improve cognition, including memory and attention. It may also be effective for improving executive functions (EF) integral to everyday tasks. This review systematically evaluates SCT effects on EF in older adults without dementia. Following PRISMA guidelines, we reviewed eligible trials according to pre-defined criteria, differentiating SCT from other cognitive interventions and stipulating total EF-focused intervention time, study design and target population (healthy older adults or mild cognitive decline). We then evaluated trials according to design, methodological quality and outcomes. Unfortunately, with too few studies in mild cognitive impairment, we refocused our review only on healthy older adults. Thirteen studies with 4120 participants in total were included, primarily targeting inductive reasoning. Despite heterogeneous study designs and SCT programs, 11/13 trials reported significant EF improvements, generally of moderate effect size (Hedges' g > 0.3). Four studies reported sustained benefits from one month to 10 years. There was some evidence of far transfer. We conclude that there is promising evidence for SCT as a targeted intervention for EF in healthy older adults and preliminary evidence for maintaining effects over time. Fewer trials have investigated far transfer (e.g. improved everyday functioning) or capacity to delay/prevent dementia, which are most relevant to clinical utility. Limitations include the inability to calculate effect sizes for four studies and absence of statistical meta-analysis.

Cognitive remediation therapy during treatment for alcohol dependence.

PubMed

Rupp, Claudia I; Kemmler, Georg; Kurz, Martin; Hinterhuber, Hartmann; Fleischhacker, W Wolfgang

2012-07-01

Cognitive impairments in individuals with alcohol dependence may interfere with the progress of treatment and contribute to the progression of the disease. This study aimed to determine whether cognitive remediation (CR) therapy applied during treatment for alcohol dependence improves cognitive functioning in alcohol-dependent inpatients. A secondary aim was to evaluate whether the benefits of CR generalize to noncognitive clinically meaningful outcomes at the end of inpatient treatment. Forty-one alcohol-dependent patients entering inpatient treatment for alcohol dependence were randomly assigned to receive conventional treatment (n = 21) or an additional 12 sessions of computer-assisted CR focusing on cognitive enhancement in attention/executive function and memory domains (n = 20). Assessments of cognitive abilities in these domains as well as of psychological well-being and alcohol craving were conducted at baseline (at the beginning of inpatient treatment) and after CR (at the end of treatment). Results indicated that, relative to patients completing conventional treatment, those who received supplemental CR showed significant improvement in attention/executive function and memory domains, particularly in attention (alertness, divided attention), working memory, and delayed memory (recall). In addition, patients receiving CR during alcohol-dependence treatment showed significantly greater improvements in psychological well-being (Symptom Checklist-90-Revised) and in the compulsion aspect of craving (Obsessive Compulsive Drinking Scale-German version). CR during inpatient treatment for alcohol dependence is effective in improving cognitive impairments in alcohol-dependent patients. The benefits generalize to noncognitive outcomes, demonstrating that CR may be an efficacious adjunctive intervention for the treatment of alcohol dependence.

Students Leading Students: An Observational Study of a University Remedial Educational Program

ERIC Educational Resources Information Center

Chavez, Michael Juan; Ysais, Michelle

2017-01-01

This article provides a unique insider perspective developing leadership at the undergraduate level. A case study approach was used to examine the efficacy of a peer mentoring program for remedial students.

An Ideal Remedial Reading Program.

ERIC Educational Resources Information Center

Boettcher, Judith A.

An ideal secondary level remedial reading program would be based on the philosophy that both freedom and structure are required, that learning demands involvement and feedback, and that success breeds success. Such programs should be structured (i.e., based on clearly defined content and a clearly designated mode of presentation). There are many…

Generic radiological characterization protocol for surveys conducted for DOE remedial action programs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berven, B.A.; Cottrell, W.D.; Leggett, R.W.

1986-05-01

This report describes goals and methodology that can be used by radiological survey contractors in surveys at properties associated with the Department of Energy's remedial action programs. The description includes: (1) a general discussion of the history of the remedial action programs; (2) the types of surveys that may be employed by the Radiological Survey Activities (RASA) contractor; (3) generic survey methods that may be used during radiological surveys; and (4) a format for presenting information and data in a survey report. 9 refs.

Student supports: developmental education and other academic programs.

PubMed

Bettinger, Eric P; Boatman, Angela; Long, Bridget Terry

2013-01-01

Low rates of college completion are a major problem in the United States. Less than 60 percent of students at four-year colleges graduate within six years, and at some colleges, the graduation rate is less than 10 percent. Additionally, many students enter higher education ill-prepared to comprehend college-level course material. Some estimates suggest that only one-third of high school graduates finish ready for college work; the proportion is even lower among older students. Colleges have responded to the poor preparation of incoming students by placing approximately 35 to 40 percent of entering freshmen into remedial or developmental courses, along with providing academic supports such as summer bridge programs, learning communities, academic counseling, and tutoring, as well as student supports such as financial aid and child care. Eric Bettinger, Angela Boatman, and Bridget Terry Long describe the role, costs, and impact of these college remediation and academic support programs. According to a growing body of research, the effects of remedial courses are considerably nuanced. The courses appear to help or hinder students differently by state, institution, background, and academic preparedness. The mixed findings from earlier research have raised questions ranging from whether remedial programs, on average, improve student academic outcomes to which types of programs are most effective. Administrators, practitioners, and policy makers are responding by redesigning developmental courses and searching for ways to implement effective remediation programs more broadly. In addition, recent research suggests that colleges may be placing too many students into remedial courses unnecessarily, suggesting the need for further examining the placement processes used to assign students to remedial courses. The authors expand the scope of remediation research by discussing other promising areas of academic support commonly offered by colleges, including advising, tutoring, and mentoring programs, as well as supports that target the competing responsibilities of students, namely caring for dependents and balancing employment with schoolwork. They conclude that the limited resources of institutions and equally limited funds of students make it imperative for postsecondary institutions to improve student academic supports and other services.

15 CFR 280.202 - Penalties, remedies, and sanctions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Penalties, remedies, and sanctions. 280.202 Section 280.202 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade... PROGRAMS FASTENER QUALITY Enforcement § 280.202 Penalties, remedies, and sanctions. (a) Civil remedies. The...

7 CFR 625.16 - Violations and remedies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 6 2011-01-01 2011-01-01 false Violations and remedies. 625.16 Section 625.16..., DEPARTMENT OF AGRICULTURE WATER RESOURCES HEALTHY FORESTS RESERVE PROGRAM § 625.16 Violations and remedies... section, NRCS reserves the right to enter upon the easement area at any time to remedy deficiencies or...

Removing Remediation Requirements: Effectiveness of Intervention Programs

ERIC Educational Resources Information Center

Fine, Anne; Duggan, Mickle; Braddy, Linda

2009-01-01

Remediation of incoming college freshman students is a national concern because remediated students are at higher risk of failing to complete their degrees. Some Oklahoma higher education institutions are working to assist K-12 systems in finding ways to reduce the number of incoming college freshman students requiring remediation. This study…

Remediation: Higher Education's Bridge to Nowhere

ERIC Educational Resources Information Center

Complete College America, 2012

2012-01-01

The intentions were noble. It was hoped that remediation programs would be an academic bridge from poor high school preparation to college readiness. Sadly, remediation has become instead higher education's "Bridge to Nowhere." This broken remedial bridge is travelled by some 1.7 million beginning students each year, most of whom will…

34 CFR 682.413 - Remedial actions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 4 2011-07-01 2011-07-01 false Remedial actions. 682.413 Section 682.413 Education... Federal Family Education Loan Programs by a Guaranty Agency § 682.413 Remedial actions. (a)(1) The... take one or more of the following remedial actions against a guaranty agency or third-party servicer...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goins, L.F.; Webb, J.R.; Cravens, C.D.

This publication contains 1035 abstracted references on environmental restoration, nuclear facility decommissioning, uranium mill tailings management, and site remedial actions. These citations constitute the thirteenth in a series of reports prepared annually for the US Department of Energy (DOE) Environmental Restoration programs. Citations to foreign and domestic literature of all types. There are 13 major sections of the publication, including: (1) DOE Decontamination and Decommissioning Program; (2) Nuclear Facilities Decommissioning; (3) DOE Formerly Utilized Sites Remedial Action Program; (4) DOE Uranium Mill Tailings Remedial Action Project; (5) Uranium Mill Tailings Management; (6) DOE Environmental Restoration Program; (7) DOE Site-Specific Remedialmore » Actions; (8) Contaminated Site Restoration; (9) Remediation of Contaminated Soil and Groundwater; (10) Environmental Data Measurements, Management, and Evaluation; (11) Remedial Action Assessment and Decision-Making; (12) Technology Development and Evaluation; and (13) Environmental and Waste Management Issues. Bibliographic references are arranged in nine subject categories by geographic location and then alphabetically by first author, corporate affiliation, or publication title. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, subject category, and key word.« less

Remediation of at-risk medical students: theory in action

PubMed Central

2013-01-01

Background Previous work has shown that a programme that draws on a blend of theories makes a positive difference to outcomes for students who fail and repeat their first semester at medical school. Exploration of student and teacher perspectives revealed that remediation of struggling medical students can be achieved through a cognitive apprenticeship within a small community of inquiry. This community needs expert teachers capable of performing a unique combination of roles (facilitator, nurturing mentor, disciplinarian, diagnostician and role model), with high levels of teaching presence and practical wisdom. Yet, despite participants’ convergent opinions on the elements of effective remediation, significant differences were found between outcomes of students working with experienced and inexperienced teachers. The current study explores the actual practice of teachers on this remediation course, aiming to exemplify elements of our theory of remediation and explore differences between teachers. Methods Since it is in the classroom context that the interactions that constitute the complex process of remediation emerge, this practice-based research has focused on direct observation of classroom teaching. Nineteen hours of small group sessions were recorded and transcribed. Drawing on ethnography and sociocultural discourse analysis, selected samples of talk-in-context demonstrate how the various elements of remediation play out in practice, highlighting aspects that are most effective, and identifying differences between experienced and novice teachers. Results Long-term student outcomes are strongly correlated to teacher experience (r, 0.81). Compared to inexperienced teachers, experienced teachers provide more challenging, disruptive facilitation, and take a dialogic stance that encourages more collaborative group dynamics. They are more expert at diagnosing cognitive errors, provide frequent metacognitive time-outs and make explicit links across the curriculum. Conclusions Remediation is effective in small groups where dialogue is used for collaborative knowledge construction and social regulation. This requires facilitation by experienced teachers who attend to details of both content and process, and use timely interventions to foster curiosity and the will to learn. These teachers should actively challenge students’ language use, logical inconsistencies and uncertainties, problematize their assumptions, and provide a metacognitive regulatory voice that can generate attitudinal shifts and nurture the development of independent critical thinkers. PMID:24070196

Teaching Letter Formation.

ERIC Educational Resources Information Center

Graham, Steve; Madan, Avi J.

1981-01-01

The authors describe a remedial technique for teaching letter formation to students with handwriting difficulties. The approach blends traditional procedures (modeling, physical prompts, tracing, self correction, etc.) with cognitive behavior modification principles. (CL)

Impact of Attention Training on Academic Achievement, Executive Functioning, and Behavior: A Randomized Controlled Trial.

PubMed

Kirk, Hannah; Gray, Kylie; Ellis, Kirsten; Taffe, John; Cornish, Kim

2017-03-01

Children with intellectual and developmental disabilities (IDD) experience significant difficulties in attention, learning, executive functions, and behavioral regulation. Emerging evidence suggests that computerized cognitive training may remediate these impairments. In a double blind controlled trial, 76 children with IDD (4-11 years) were randomized to either an attention training (n = 38) or control program (n = 38). Both programs were completed at home over a 5-week period. Outcome measures assessed literacy, numeracy, executive functioning, and behavioral/emotional problems, and were conducted at baseline, post-training, and 3-month follow-up. No training effects were observed at post-training; however, children in the training group showed greater improvements in numeracy skills at the 3-month follow-up. These results suggest that attention training may be beneficial for children with IDD; however, the modest nature of the intervention effects indicate that caution should be taken when interpreting clinical significance.

ReSCA: decision support tool for remediation planning after the Chernobyl accident.

PubMed

Ulanovsky, A; Jacob, P; Fesenko, S; Bogdevitch, I; Kashparov, V; Sanzharova, N

2011-03-01

Radioactive contamination of the environment following the Chernobyl accident still provide a substantial impact on the population of affected territories in Belarus, Russia, and Ukraine. Reduction of population exposure can be achieved by performing remediation activities in these areas. Resulting from the IAEA Technical Co-operation Projects with these countries, the program ReSCA (Remediation Strategies after the Chernobyl Accident) has been developed to provide assistance to decision makers and to facilitate a selection of an optimized remediation strategy in rural settlements. The paper provides in-depth description of the program, its algorithm, and structure. © Springer-Verlag 2010

Evaluation of Title I Program, Community School Distrlct 31, New York City. 1978-79 School Year. Final Report, E.D.L. Reading Lab.

ERIC Educational Resources Information Center

Knight, Michael E.

This program was designed to improve reading skills and to provide intensive remediation for students in grades six through nine. Specialized materials and equipment were provided by Educational Development Laboratories (EDL). The EDL Reading Laboratory utilized the Learning 100 program, a multi-modality developmental and remedial program. Small…

Welcoming Linguistic Diversity and Saying Adios to Remediation: Stretch and Studio Composition at a Hispanic-Serving Institution

ERIC Educational Resources Information Center

Davila, Bethany A.; Elder, Cristyn L.

2017-01-01

In this program profile, we describe the stretch/studio program recently implemented at the University of New Mexico. This program responds both to an institutional move away from remediation and to the large number of linguistically and racially diverse students at our institution. In this profile, we describe the new program's curriculum, which…

Defining Uniform Processes for Remediation, Probation and Termination in Residency Training.

PubMed

Smith, Jessica L; Lypson, Monica; Silverberg, Mark; Weizberg, Moshe; Murano, Tiffany; Lukela, Michael; Santen, Sally A

2017-01-01

It is important that residency programs identify trainees who progress appropriately, as well as identify residents who fail to achieve educational milestones as expected so they may be remediated. The process of remediation varies greatly across training programs, due in part to the lack of standardized definitions for good standing, remediation, probation, and termination . The purpose of this educational advancement is to propose a clear remediation framework including definitions, management processes, documentation expectations and appropriate notifications. Informal remediation is initiated when a resident's performance is deficient in one or more of the outcomes-based milestones established by the Accreditation Council for Graduate Medical Education, but not significant enough to trigger formal remediation. Formal remediation occurs when deficiencies are significant enough to warrant formal documentation because informal remediation failed or because issues are substantial. The process includes documentation in the resident's file and notification of the graduate medical education office; however, the documentation is not disclosed if the resident successfully remediates. Probation is initiated when a resident is unsuccessful in meeting the terms of formal remediation or if initial problems are significant enough to warrant immediate probation. The process is similar to formal remediation but also includes documentation extending to the final verification of training and employment letters. Termination involves other stakeholders and occurs when a resident is unsuccessful in meeting the terms of probation or if initial problems are significant enough to warrant immediate termination.

A Multisite, Randomized Controlled Clinical Trial of Computerized Cognitive Remediation Therapy for Schizophrenia.

PubMed

Gomar, Jesús J; Valls, Elia; Radua, Joaquim; Mareca, Celia; Tristany, Josep; del Olmo, Francisco; Rebolleda-Gil, Carlos; Jañez-Álvarez, María; de Álvaro, Francisco J; Ovejero, María R; Llorente, Ana; Teixidó, Cristina; Donaire, Ana M; García-Laredo, Eduardo; Lazcanoiturburu, Andrea; Granell, Luis; Mozo, Cristina de Pablo; Pérez-Hernández, Mónica; Moreno-Alcázar, Ana; Pomarol-Clotet, Edith; McKenna, Peter J

2015-11-01

The effectiveness of cognitive remediation therapy (CRT) for the neuropsychological deficits seen in schizophrenia is supported by meta-analysis. However, a recent methodologically rigorous trial had negative findings. In this study, 130 chronic schizophrenic patients were randomly assigned to computerized CRT, an active computerized control condition (CC) or treatment as usual (TAU). Primary outcome measures were 2 ecologically valid batteries of executive function and memory, rated under blind conditions; other executive and memory tests and a measure of overall cognitive function were also employed. Carer ratings of executive and memory failures in daily life were obtained before and after treatment. Computerized CRT was found to produce improvement on the training tasks, but this did not transfer to gains on the primary outcome measures and most other neuropsychological tests in comparison to either CC or TAU conditions. Nor did the intervention result in benefits on carer ratings of daily life cognitive failures. According to this study, computerized CRT is not effective in schizophrenia. The use of both active and passive CCs suggests that nature of the control group is not an important factor influencing results. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

Cognitive Training for Impaired Neural Systems in Neuropsychiatric Illness

PubMed Central

Vinogradov, Sophia; Fisher, Melissa; de Villers-Sidani, Etienne

2012-01-01

Neuropsychiatric illnesses are associated with dysfunction in distributed prefrontal neural systems that underlie perception, cognition, social interactions, emotion regulation, and motivation. The high degree of learning-dependent plasticity in these networks—combined with the availability of advanced computerized technology—suggests that we should be able to engineer very specific training programs that drive meaningful and enduring improvements in impaired neural systems relevant to neuropsychiatric illness. However, cognitive training approaches for mental and addictive disorders must take into account possible inherent limitations in the underlying brain ‘learning machinery' due to pathophysiology, must grapple with the presence of complex overlearned maladaptive patterns of neural functioning, and must find a way to ally with developmental and psychosocial factors that influence response to illness and to treatment. In this review, we briefly examine the current state of knowledge from studies of cognitive remediation in psychiatry and we highlight open questions. We then present a systems neuroscience rationale for successful cognitive training for neuropsychiatric illnesses, one that emphasizes the distributed nature of neural assemblies that support cognitive and affective processing, as well as their plasticity. It is based on the notion that, during successful learning, the brain represents the relevant perceptual and cognitive/affective inputs and action outputs with disproportionately larger and more coordinated populations of neurons that are distributed (and that are interacting) across multiple levels of processing and throughout multiple brain regions. This approach allows us to address limitations found in earlier research and to introduce important principles for the design and evaluation of the next generation of cognitive training for impaired neural systems. We summarize work to date using such neuroscience-informed methods and indicate some of the exciting future directions of this field. PMID:22048465

Cognitive variability in bipolar II disorder: who is cognitively impaired and who is preserved.

PubMed

Solé, Brisa; Jiménez, Esther; Torrent, Carla; Del Mar Bonnin, Caterina; Torres, Imma; Reinares, María; Priego, Ángel; Salamero, Manel; Colom, Francesc; Varo, Cristina; Vieta, Eduard; Martínez-Arán, Anabel

2016-05-01

Although it is well established that euthymic patients with bipolar disorder can have cognitive impairment, substantial heterogeneity exists and little is known about the extent and severity of impairment within the bipolar II disorder subtype. Therefore, the main aim of this study was to analyze cognitive variability in a sample of patients with bipolar II disorder. The neuropsychological performance of 116 subjects, including 64 euthymic patients with bipolar II disorder and 52 healthy control subjects, was examined and compared by means of a comprehensive neurocognitive battery. Neurocognitive data were analyzed using a cluster analysis to examine whether there were specific groups based on neurocognitive patterns. Subsequently, subjects from each cluster were compared on demographic, clinical, and functional variables. A three-cluster solution was identified with an intact neurocognitive group (n = 29, 48.3%), an intermediate or selectively impaired group (n = 24, 40.0%), and a globally impaired group (n = 7, 11.6%). Among the three clusters, statistically significant differences were observed in premorbid intelligence quotient (p = 0.002), global functional outcome (p = 0.021), and leisure activities (p = 0.001), with patients in the globally impaired cluster showing the lowest attainments. No differences in other clinical characteristics were found among the groups. These results confirm that neurocognitive variability is also present among patients with bipolar II disorder. Approximately one-half of the patients with bipolar II disorder were cognitively impaired, and among them 12% were severely and globally impaired. The identification of different cognitive profiles may help to develop cognitive remediation programs specifically tailored for each cognitive profile. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Report on College-Level Remedial/Developmental Programs in SREB States.

ERIC Educational Resources Information Center

Abraham, Ansley A., Jr.

Remedial and developmental programs at two-year and four-year colleges in states belonging to the Southern Regional Education Board (SREB) were studied, along with placement standards for degree-credit, college-level work in SREB states and institutions. These programs, courses, and activities were designed specifically for first-time entering…

Regulatory Aspects Of Implementing Electrokinetic Remediation

EPA Science Inventory

A better understanding of the environmental impact of hazardous waste management practices has led to new environmental laws and a comprehensive regulatory program. This program is designed to address remediation of past waste management practices and to ensure that the hazardou...

7 CFR 4288.136 - Remedies.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Remedies. 4288.136 Section 4288.136 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General...

7 CFR 4288.136 - Remedies.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Remedies. 4288.136 Section 4288.136 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General...

7 CFR 4288.136 - Remedies.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Remedies. 4288.136 Section 4288.136 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program General...

7 CFR 633.13 - Violations and remedies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 6 2011-01-01 2011-01-01 false Violations and remedies. 633.13 Section 633.13..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WATER BANK PROGRAM § 633.13 Violations and remedies. (a) In... addition to any and all legal and equitable remedies as may be available to the NRCS under applicable law...

7 CFR 633.13 - Violations and remedies.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Violations and remedies. 633.13 Section 633.13..., DEPARTMENT OF AGRICULTURE LONG TERM CONTRACTING WATER BANK PROGRAM § 633.13 Violations and remedies. (a) In... addition to any and all legal and equitable remedies as may be available to the NRCS under applicable law...

Building Sustainability into the Air Force Remediation Process

DTIC Science & Technology

2009-05-06

Sustainability in AF Remediation: “Green” Remediation Phytoremediation , Travis AFB, CA  Sustainability metrics not new endeavor  ER programs focus on cost, risk...remediation technology examples:  Phytoremediation – 5  LNAPL recovery – 16  Passive in situ treatment Wetlands  Enh bio – 114  MNA – 105

Preparing Underprepared Students for College: Remedial Education and Early Assessment Programs

ERIC Educational Resources Information Center

Tierney, William G.; Garcia, Lisa D.

2008-01-01

Postsecondary level remediation has recently received a great deal of attention with the public questioning the efficacy of spending money on remedial classes, and scholars questioning whether such courses are effective in helping students graduate. The California State University (CSU) system has responded to the challenge of remediation by…

Toward an objective assessment of technical skills: a national survey of surgical program directors in Saudi Arabia.

PubMed

Alkhayal, Abdullah; Aldhukair, Shahla; Alselaim, Nahar; Aldekhayel, Salah; Alhabdan, Sultan; Altaweel, Waleed; Magzoub, Mohi Elden; Zamakhshary, Mohammed

2012-01-01

After almost a decade of implementing competency-based programs in postgraduate training programs, the assessment of technical skills remains more subjective than objective. National data on the assessment of technical skills during surgical training are lacking. We conducted this study to document the assessment tools for technical skills currently used in different surgical specialties, their relationship with remediation, the recommended tools from the program directors' perspective, and program directors' attitudes toward the available objective tools to assess technical skills. This study was a cross-sectional survey of surgical program directors (PDs). The survey was initially developed using a focus group and was then sent to 116 PDs. The survey contains demographic information about the program, the objective assessment tools used, and the reason for not using assessment tools. The last section discusses the recommended tools to be used from the PDs' perspective and the PDs' attitude and motivation to apply these tools in each program. The associations between the responses to the assessment questions and remediation were statistically evaluated. Seventy-one (61%) participants responded. Of the respondents, 59% mentioned using only nonstandardized, subjective, direct observation for technical skills assessment. Sixty percent use only summative evaluation, whereas 15% perform only formative evaluations of their residents, and the remaining 22% conduct both summative and formative evaluations of their residents' technical skills. Operative portfolios are kept by 53% of programs. The percentage of programs with mechanisms for remediation is 29% (19 of 65). The survey showed that surgical training programs use different tools to assess surgical skills competency. Having a clear remediation mechanism was highly associated with reporting remediation, which reflects the capability to detect struggling residents. Surgical training leadership should invest more in standardizing the assessment of surgical skills.

Performance-Based Contingency Management in Cognitive Remediation Training: A Pilot Study.

PubMed

Kiluk, Brian D; Buck, Matthew B; Devore, Kathleen A; Babuscio, Theresa A; Nich, Charla; Carroll, Kathleen M

2017-01-01

Impairments in attention, working memory, and executive function are common among substance users and may adversely affect SUD treatment outcomes. The ability of cognitive remediation (CR) interventions to improve these deficits is hindered in part because levels of engagement in CR training may be inadequate to achieve benefit. This pilot study aimed to increase CR engagement and improve outcome by implementing contingency management (CM) procedures that reinforce performance improvements on CR tasks. Participants were forty individuals (50% male; 65% African American) in an outpatient substance use treatment facility with mild cognitive impairment who had ≥30-days of abstinence from alcohol and drugs. They were randomized to standard (CR-S; n=21) or CM-enhanced (CR-CM; n=19) cognitive remediation training. CR consisted of 1-hour sessions, three times per week for four weeks (12 sessions). A neuropsychological assessment battery was administered prior to and after the four-week intervention. Both groups had high rates of CR session attendance (mean CR-S=11.7, CR-CM=10.9 sessions). Performance on 8 of the 9 CR tasks significantly improved over time for both conditions, with the CR-CM condition demonstrating greater improvement on a CR Sequenced Recall task [F(1,37)=5.81, p<.05]. Significant improvement was also evident on 4 of 9 neuropsychological assessment measures, with the CR-CM condition showing differential improvement on the Trail Making Test - Part B [F (1,37)=5.34, p<.05]. These findings support the feasibility of using CM procedures to enhance substance users' engagement with CR training and suggest the potential value of more research in this area. Copyright © 2016 Elsevier Inc. All rights reserved.

Identifying cognitive remediation change through computational modelling--effects on reinforcement learning in schizophrenia.

PubMed

Cella, Matteo; Bishara, Anthony J; Medin, Evelina; Swan, Sarah; Reeder, Clare; Wykes, Til

2014-11-01

Converging research suggests that individuals with schizophrenia show a marked impairment in reinforcement learning, particularly in tasks requiring flexibility and adaptation. The problem has been associated with dopamine reward systems. This study explores, for the first time, the characteristics of this impairment and how it is affected by a behavioral intervention-cognitive remediation. Using computational modelling, 3 reinforcement learning parameters based on the Wisconsin Card Sorting Test (WCST) trial-by-trial performance were estimated: R (reward sensitivity), P (punishment sensitivity), and D (choice consistency). In Study 1 the parameters were compared between a group of individuals with schizophrenia (n = 100) and a healthy control group (n = 50). In Study 2 the effect of cognitive remediation therapy (CRT) on these parameters was assessed in 2 groups of individuals with schizophrenia, one receiving CRT (n = 37) and the other receiving treatment as usual (TAU, n = 34). In Study 1 individuals with schizophrenia showed impairment in the R and P parameters compared with healthy controls. Study 2 demonstrated that sensitivity to negative feedback (P) and reward (R) improved in the CRT group after therapy compared with the TAU group. R and P parameter change correlated with WCST outputs. Improvements in R and P after CRT were associated with working memory gains and reduction of negative symptoms, respectively. Schizophrenia reinforcement learning difficulties negatively influence performance in shift learning tasks. CRT can improve sensitivity to reward and punishment. Identifying parameters that show change may be useful in experimental medicine studies to identify cognitive domains susceptible to improvement. © The Author 2013. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Can cognitive exercises help treat anorexia nervosa?

PubMed

Tchanturia, K; Whitney, J; Treasure, J

2006-12-01

Cognitive remediation therapy (CRT) is used as an intervention for people with brain lesions and psychosis. This case report demonstrates the possible benefits of introducing CRT into treatment packages for anorexia nervosa (AN). In our previous work, we reported that people with AN demonstrate inflexibility in cognitive set-shifting tasks. Weight gain alone does not improve the neuropsychological profile in set-shifting tasks. This case report illustrates how training programmes can address problems in cognitive rigidity. We acknowledge the limitations of case studies, however, this is a starting point in exploring the possibilities of introducing CRT as part of the treatment of AN.

Socio-cognitive habilitation using the math interactive learning experience program for alcohol-affected children.

PubMed

Kable, Julie A; Coles, Claire D; Taddeo, Elles

2007-08-01

Fetal alcohol syndrome (FAS) has been recognized as a disabling condition with a significant impact on the neurobehavioral functioning of affected individuals, including cognition, behavior, and academic functioning, but little research has been performed on targeted interventions for these children. A socio-cognitive habilitative program focused on improving behavior and math functioning in children 3 to 10 years of age (n=61) was developed and evaluated. The intervention provided parental instruction on FAS, advocacy, and behavioral regulation via workshops and interactive math tutoring with children. All families received parental instruction and were then randomly assigned to either the math instruction or standard psychoeducational care groups. Satisfaction with workshops was very high, with over 90% agreeing that trainers were knowledgeable and materials easy to understand and helpful. Significant gains in knowledge were found for information provided in the instructional groups. At posttesting, caregivers reported fewer problem behaviors on the Achenbach Child Behavior Checklist, Internalizing Problem Behavior, Externalizing Problem Behavior, and Total Problem Behavior summary scales. After 5 months, both groups of children demonstrated gains in math knowledge but significantly higher gains were found in the group receiving direct math instruction. The math treatment group was also more likely to demonstrate a gain of over 1 standard deviation on any of the 4 math outcome measures used. These findings suggest that parents of children with fetal alcohol spectrum disorders (FAS(D)) benefit from instruction in understanding their child's alcohol-related neurological damage and strategies to provide positive behavioral supports and that targeted psychoeducational programs may be able to remediate some of the math deficits associated with prenatal alcohol exposure.

USGS Toxic Substances Hydrology Program, 2010

USGS Publications Warehouse

Buxton, Herbert T.

2010-01-01

The U.S. Geological Survey (USGS) Toxic Substances Hydrology Program adapts research priorities to address the most important contamination issues facing the Nation and to identify new threats to environmental health. The Program investigates two major types of contamination problems: * Subsurface Point-Source Contamination, and * Watershed and Regional Contamination. Research objectives include developing remediation methods that use natural processes, characterizing and remediating contaminant plumes in fractured-rock aquifers, identifying new environmental contaminants, characterizing new and understudied pesticides in common pesticide-use settings, explaining mercury methylation and bioaccumulation, and developing approaches for remediating watersheds affected by active and historic mining.

[Secondary benefits of cognitive rehabilitation for a chronic ethylic patient: effects on disorder consciousness, motivation, and global therapeutic cooperation].

PubMed

Siccardi, L; Vautel-Pons, D; dos Santos, M Teixera; Camus, N; Louchart de la Chapelle, S

2014-06-01

Alcoholism causes psychological, behavioral and cognitive symptoms that need to be addressed together. The neuropsychological alterations among alcohol-dependent people are considered to make the therapeutic work complex and longer. A cognitive rehabilitation program is sometimes difficult to achieve with these patients. Functional results are often difficult to anticipate. However, the consequences of this therapeutic approach are multiple and there are many interactions between psycho-affective, behavioral and cognitive components. A neuropsychological approach can be used like a tool to improve metacognition. A bad contribution to treatment programs is often secondary to the illusion of a satisfying intellectual functioning. Patients' motivation for the therapeutic work is very changeable. A complete consciousness of impairments can help them to stay involved. The following case shows the cognitive effects and secondary benefits associated with a neuropsychological work, which was carried out by a chronic ethylic patient with severe physical and cognitive symptoms. The patient aged 50, with a good qualification level (scientific section in the final year of secondary school, with no diploma, then attended a training program to become a croupier) was suffering from chronic alcoholism since his adolescence. He arrived in the closed unit after many hospitalizations in psychiatric and hepato-gastroenterology units. He had been showing mental confusion. He presented a frontal and subcortical profile of alcohol-related dementia according to Oslin's criteria. MRI revealed global cerebral atrophy, more pronounced on the fronto-parietal cortex with cerebellar leukoencephalopathy, but no pontine central myelinolysis. The neurocognitive program had two main lines: reducing attentional, executive and graphical deficits with training exercises (individual and group sessions) and compensating memory, and executive disorders with an external aid. The cognitive program had been assessed by means of repeated psychometric measures, behavior and metacognition estimated by direct clinical observations. The cognitive remediation was carried out during a 10-month hospitalization, and then in an outpatient rehabilitation setting over a 12-month period. The external individual sessions were associated with medical consultations and support for reintegration at home provided by the mobile psychiatric team. The test results showed a significant improvement in attentional processes and executive functions. On graphic level, his writing was recovered after 10 months. Impairment within episodic memory processes-encoding was observed, and prospective memory was reinforced by external aids. At the end of the program, the use of an agenda proved to be effective even if updating was difficult once back home. Although a part of these effects could be expected, their psychological influence on the patient must be underlined: his perception of the alcohol related problem had been modified with more consciousness of the neurobiological consequences and a strong desire of personal implication. He worked a lot on his own (always under supervision) on cognitive exercises and succeeded in remaining abstinent for nearly 2 years. He died of complications of acute hepatitis. All the cognitive assessments and rehabilitation results seem to have increased his participation in the global therapeutic care. Therapeutic tools used for cognitive work give a concrete picture of the consequences of alcohol consumption and the necessary time to retrieve brain capacities. Visible improvements in terms of reduction in disability-handicaps encouraged the patient, valued his efforts, and increased his determination to solve his alcohol related problem. Thus, cognitive programs can help to reduce passiveness and develop activeness. This patient regarded therapeutic difficulties as a challenge, not as an obstacle. We can reasonably assume the effect of the cognitive rehabilitation on the Persistence of the Cloninger's biosocial model. This increase in temperament corresponds to a certain form of tenacity, which would facilitate abstinence. Copyright © 2013. Published by Elsevier Masson SAS.

[Computer-assisted therapy and video games in psychosocial rehabilitation for schizophrenia patients].

PubMed

Brun, G; Verdoux, H; Couhet, G; Quiles, C

2018-02-28

Video games and virtual reality have recently become used by clinicians for training or information media or as therapeutic tools. The purpose is to review the use of these technologies for therapy destined for schizophrenia patients. We conducted a review in October 2016 using Pubmed, Scopus and PsychInfo using the following Medical Subject Headings (MESH): "video games", "virtual reality" and "therapy, computer-assisted/methods", each associated with "schizophrenia". Papers were included in the review if: (a) they were published in an English, Spanish or French-language peer-reviewed journal, (b) the study enrolled patients with schizophrenia or schizo-affective disorder, (c) the patients used a therapeutic video game or therapeutic virtual reality device. Eighteen publications were included. The devices studied are mainly therapeutic software developed specifically for therapeutic care. They can be classified according to their therapeutic objectives. These targets corresponded to objectives of psychosocial rehabilitation: improvement of residual symptomatology, cognitive remediation, remediation of cognition and social skills, improvement of everyday life activities, support for occupational integration. Very different devices were proposed. Some researchers analysed programs developed specifically for patients with schizophrenia, while others were interested in the impact of commercial games. Most of the studies were recent, preliminary and European. The impact of these devices was globally positive, particularly concerning cognitive functions. Computer-assisted therapy, video games and virtual reality cannot replace usual care but could be used as adjunctive therapy. However, recommending their use seems premature because of the recent and preliminary character of most studies. Moreover, a link is still lacking between this field of research in psychiatry and other fields of research, particularly game studies. Finally, it might be interesting to analyse more precisely the neuropsychological impact of existing commercial games which could potentially be useful for psychosocial rehabilitation. Copyright © 2018 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Enhancing Neuroplasticity to Augment Cognitive Remediation in Schizophrenia.

PubMed

Jahshan, Carol; Rassovsky, Yuri; Green, Michael F

2017-01-01

There is a burgeoning need for innovative treatment strategies to improve the cognitive deficits in schizophrenia. Cognitive remediation (CR) is effective at the group level, but the variability in treatment response is large. Given that CR may depend on intact neuroplasticity to produce cognitive gains, it is reasonable to combine it with strategies that harness patients' neuroplastic potential. In this review, we discuss two non-pharmacological approaches that can enhance neuroplasticity and possibly augment the effects of CR in schizophrenia: physical exercise and transcranial direct current stimulation (tDCS). Substantial body of evidence supports the beneficial effect of physical exercise on cognition, and a handful of studies in schizophrenia have shown that physical exercise in conjunction with CR has a larger impact on cognition than CR alone. Physical exercise is thought to stimulate neuroplasticity through the regulation of central growth factors, and current evidence points to brain-derived neurotrophic factor as the potential underlying mechanism through which physical exercise might enhance the effectiveness of CR. tDCS has emerged as a potential tool for cognitive enhancement and seems to affect the cellular mechanisms involved in long-term potentiation (LTP). A few reports have demonstrated the feasibility of integrating tDCS with CR in schizophrenia, but there are insufficient data to determine if this multimodal approach leads to incremental performance gain in patients. Larger randomized controlled trials are necessary to understand the mechanisms of the combined tDCS-CR intervention. Future research should take advantage of new developments in neuroplasticity paradigms to examine the effects of these interventions on LTP.

SYNERGIC TRIAL (SYNchronizing Exercises, Remedies in Gait and Cognition) a multi-Centre randomized controlled double blind trial to improve gait and cognition in mild cognitive impairment.

PubMed

Montero-Odasso, Manuel; Almeida, Quincy J; Burhan, Amer M; Camicioli, Richard; Doyon, Julien; Fraser, Sarah; Li, Karen; Liu-Ambrose, Teresa; Middleton, Laura; Muir-Hunter, Susan; McIlroy, William; Morais, José A; Pieruccini-Faria, Frederico; Shoemaker, Kevin; Speechley, Mark; Vasudev, Akshya; Zou, G Y; Berryman, Nicolas; Lussier, Maxime; Vanderhaeghe, Leanne; Bherer, Louis

2018-04-16

Physical exercise, cognitive training, and vitamin D are low cost interventions that have the potential to enhance cognitive function and mobility in older adults, especially in pre-dementia states such as Mild Cognitive Impairment (MCI). Aerobic and progressive resistance exercises have benefits to cognitive performance, though evidence is somewhat inconsistent. We postulate that combined aerobic exercise (AE) and progressive resistance training (RT) (combined exercise) will have a better effect on cognition than a balance and toning control (BAT) intervention in older adults with MCI. We also expect that adding cognitive training and vitamin D supplementation to the combined exercise, as a multimodal intervention, will have synergistic efficacy. The SYNERGIC trial (SYNchronizing Exercises, Remedies in GaIt and Cognition) is a multi-site, double-blinded, five-arm, controlled trial that assesses the potential synergic effect of combined AE and RT on cognition and mobility, with and without cognitive training and vitamin D supplementation in older adults with MCI. Two-hundred participants with MCI aged 60 to 85 years old will be randomized to one of five arms, four of which include combined exercise plus combinations of dual-task cognitive training (real vs. sham) and vitamin D supplementation (3 × 10,000 IU/wk. vs. placebo) in a quasi-factorial design, and one arm which receives all control interventions. The primary outcome measure is the ADAS-Cog (13 and plus modalities) measured at baseline and at 6 months of follow-up. Secondary outcomes include neuroimaging, neuro-cognitive performance, gait and mobility performance, and serum biomarkers of inflammation (C reactive protein and interleukin 6), neuroplasticity (brain-derived neurotropic factor), endothelial markers (vascular endothelial growth factor 1), and vitamin D serum levels. The SYNERGIC Trial will establish the efficacy and feasibility of a multimodal intervention to improve cognitive performance and mobility outcomes in MCI. These interventions may contribute to new approaches to stabilize and reverse cognitive-mobility decline in older individuals with MCI. Identifier: NCT02808676. https://www.clinicaltrials.gov/ct2/show/NCT02808676 .

Defining Uniform Processes for Remediation, Probation and Termination in Residency Training

PubMed Central

Smith, Jessica L.; Lypson, Monica; Silverberg, Mark; Weizberg, Moshe; Murano, Tiffany; Lukela, Michael; Santen, Sally A.

2017-01-01

It is important that residency programs identify trainees who progress appropriately, as well as identify residents who fail to achieve educational milestones as expected so they may be remediated. The process of remediation varies greatly across training programs, due in part to the lack of standardized definitions for good standing, remediation, probation, and termination. The purpose of this educational advancement is to propose a clear remediation framework including definitions, management processes, documentation expectations and appropriate notifications. Informal remediation is initiated when a resident’s performance is deficient in one or more of the outcomes-based milestones established by the Accreditation Council for Graduate Medical Education, but not significant enough to trigger formal remediation. Formal remediation occurs when deficiencies are significant enough to warrant formal documentation because informal remediation failed or because issues are substantial. The process includes documentation in the resident’s file and notification of the graduate medical education office; however, the documentation is not disclosed if the resident successfully remediates. Probation is initiated when a resident is unsuccessful in meeting the terms of formal remediation or if initial problems are significant enough to warrant immediate probation. The process is similar to formal remediation but also includes documentation extending to the final verification of training and employment letters. Termination involves other stakeholders and occurs when a resident is unsuccessful in meeting the terms of probation or if initial problems are significant enough to warrant immediate termination. PMID:28116019

32 CFR 310.45 - Administrative remedies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DOD PRIVACY PROGRAM Privacy Act Violations § 310.45 Administrative remedies. Any individual who... employee concerning any right granted by this part shall be permitted to seek relief through appropriate...

Nurse Managers' Decisions: Fast and Favoring Remediation

PubMed Central

Effken, Judith A.; Verran, Joyce A.; Logue, Melanie D.; Hsu, Ya-Chuan

2010-01-01

How do nurse managers make decisions about quality issues on their units? We asked 10 nurse managers in 3 Arizona hospitals to describe how they resolved a recent quality issue. The managers tended to use a linear, but cognitively expensive strategy, often jumping from problem to solution without a clear goal and selecting solutions biased toward remedial education. Decision support tools should help managers think more systemically, systematically and efficiently, while encouraging consideration of more alternatives to reach targeted goals. PMID:20305465

Conjunctive visual search in individuals with and without mental retardation.

PubMed

Carlin, Michael; Chrysler, Christina; Sullivan, Kate

2007-01-01

A comprehensive understanding of the basic visual and cognitive abilities of individuals with mental retardation is critical for understanding the basis of mental retardation and for the design of remediation programs. We assessed visual search abilities in individuals with mild mental retardation and in MA- and CA-matched comparison groups. Our goal was to determine the effect of decreasing target-distracter disparities on visual search efficiency. Results showed that search rates for the group with mental retardation and the MA-matched comparisons were more negatively affected by decreasing disparities than were those of the CA-matched group. The group with mental retardation and the MA-matched group performed similarly on all tasks. Implications for theory and application are discussed.

Predicting Clinical Outcome Using Brain Activation Associated with Set-Shifting and Central Coherence Skills in Anorexia Nervosa

PubMed Central

Garrett, Amy; Lock, James; Datta, Nandini; Beenhaker, Judy; Kesler, Shelli R.; Reiss, Allan L.

2014-01-01

Background Patients with Anorexia Nervosa (AN) have neuropsychological deficits in set shifting (SS) and central coherence (CC) consistent with an inflexible thinking style and overly detailed processing style, respectively. This study investigates brain activation during SS and CC tasks in patients with AN and tests whether this activation is a biomarker that predicts response to treatment. Methods : FMRI data were collected from 21 females with AN while performing a SS task (the Wisconsin Card Sort) and a CC task (embedded figures), and used to predict outcome following 16 weeks of treatment (either 16 weeks of cognitive behavioral therapy or 8 weeks cognitive remediation training followed by 8 weeks of cognitive behavioral therapy). Results Significant activation during the SS task included bilateral dorsolateral and ventrolateral prefrontal cortex and left anterior middle frontal gyrus. Higher scores on the neuropsychological test of SS (measured outside the scanner at baseline) were correlated with greater DLPFC and VLPFC activation. Improvements in SS following treatment were significantly predicted by a combination of low VLPFC and high anterior middle frontal activation (R squared = .68, p=.001). For the CC task, the visual and parietal areas were activated, but were not significantly correlated with neuropsychological measures of CC and did not predict outcome. Conclusion Cognitive flexibility requires the support of several prefrontal cortex resources. As previous studies suggest that the VLPFC is important for selecting responses, patients who demonstrate that deficit may benefit the most from cognitive therapy with or without cognitive remediation training. The ability to sustain inhibition of an unwanted response, subserved by the anterior middle frontal gyrus, is a cognitive feature that predicts favorable outcome to cognitive treatment. CC deficits may not be an effective predictor of clinical outcome. PMID:25027478

The Effects of the Combination of Cognitive Training and Supported Employment on Improving Clinical and Working Outcomes for People with Schizophrenia in Japan

PubMed Central

Sato, Sayaka; Iwata, Kazuhiko; Furukawa, Shun-Ichi; Matsuda, Yasuhiro; Hatsuse, Norifumi; Ikebuchi, Emi

2014-01-01

Background: In Japan, Job assistance for SMI have been not active. Compared with mental retardation, employment rate of SMI was low. The needs of the effective job assistance for SMI are growing. The purpose of this study was to determine the effectiveness of the combination approach of Cognitive Remediation (CR) and Supported Employment (SE) in clinical outcomes, including cognitive functioning and psychiatric symptoms besides vocational outcomes. Methods: The participants diagnosed with schizophrenia or schizoaffective disorder were assigned to CR+SE group (n=52) and SE group (n=57). CR comprised computer based trainings using COGPACK and group works. SE was individualized vocational support provided by employment specialists. Outcome measures included cognitive functioning, psychiatric symptoms, social functioning, performance of tasks as clinical outcomes, employment rate, duration of employment, and earned wage as vocational outcome. Results: CR+SE group displayed significantly better psychiatric symptoms (F=3.490, p<.10), interpersonal relations (F=11.695, p<.01), and social and cognitive functioning including verbal memory (F=9.439, p<.01), digit sequencing (F=5.544, p<.05), token motor tasks (F=6.685, p<.05), and overall cognitive functioning (F=8.136, p<.01). We did not find any significant difference between two groups in terms of employment rate and earned wage. Discussions: This is the first controlled study to determine the effectiveness of CR on vocational outcomes in Japan. The results showed that CR and SE programs were feasible in Japan and that CR using COGPACK had favorable effects on cognitive functioning, psychiatric symptoms, and social functioning, which is consistent with previous researches. PMID:24600481

Internship - practical education

DOE Office of Scientific and Technical Information (OSTI.GOV)

Porell, A.L.; Bauman, H.F.

1989-01-01

The current emphasis on regulatory compliance with environmental laws has depleted the availability of experienced environmental scientists and engineers needed to initiate critical environmental projects. Further, projects of short duration and long-term commitments to employment situations are considered a high risk for both the employer and the employee. Martin Marietta Energy Systems, Inc., has met this challenge for federal agencies through the US Department of Energy's (DOE's) Hazardous Waste Remedial Actions Program (HAZWRAP). Through unique interdepartmental agency agreements between the DOE and the Department of Defense (DOD) and contractual arrangements between Energy Systems, DOE, and the University of Tennessee's (UT's)more » Waste Management Institute (WMI), an intern program was formulated. HAZWRAP is a DOE headquarters' program for addressing hazardous-waste issues at all DOE facilities. Energy Systems is the support contractor office responsible for developing policies and implementing plans for this program. Under this charter, HAZWRAP assembled a large staff of experienced project managers for developing remedial actions plans, while providing other federal agencies assistance in implementing their remedial actions programs. HAZWRAP project managers are currently managing remedial investigations and feasibility studies at 130 federal facilities located throughout the DOD.« less

Evaluation of Final Radiological Conditions at Areas of the Niagara Falls Storage Site Remediated under the Formerly Utilized Sites Remedial Action Program -12184

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clayton, Christopher; Kothari, Vijendra; Starr, Ken

2012-02-26

The U. S. Department of Energy (DOE) methods and protocols allow evaluation of remediation and final site conditions to determine if remediated sites remain protective. Two case studies are presented that involve the Niagara Falls Storage Site (NFSS) and associated vicinity properties (VPs), which are being remediated under the Formerly Utilized Sites Remedial Action Program (FUSRAP). These properties are a part of the former Lake Ontario Ordnance Works (LOOW). In response to stakeholders concerns about whether certain remediated NFSS VPs were putting them at risk, DOE met with stakeholders and agreed to evaluate protectiveness. Documentation in the DOE records collectionmore » adequately described assessed and final radiological conditions at the completed VPs. All FUSRAP wastes at the completed sites were cleaned up to meet DOE guidelines for unrestricted use. DOE compiled the results of the investigation in a report that was released for public comment. In conducting the review of site conditions, DOE found that stakeholders were also concerned about waste from the Separations Process Research Unit (SPRU) at the Knolls Atomic Power Laboratory (KAPL) that was handled at LOOW. DOE agreed to determine if SPRU waste remained at that needed to be remediated. DOE reviewed records of waste characterization, historical handling locations and methods, and assessment and remediation data. DOE concluded that the SPRU waste was remediated on the LOOW to levels that pose no unacceptable risk and allow unrestricted use and unlimited exposure. This work confirms the following points as tenets of an effective long-term surveillance and maintenance (LTS&M) program: Stakeholder interaction must be open and transparent, and DOE must respond promptly to stakeholder concerns. DOE, as the long-term custodian, must collect and preserve site records in order to demonstrate that remediated sites pose no unacceptable risk. DOE must continue to maintain constructive relationships with the U.S. Army Corps of Engineers and state and federal regulators.« less

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 4 2012-07-01 2011-07-01 true Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

32 CFR 634.10 - Remedial driver training programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 4 2014-07-01 2013-07-01 true Remedial driver training programs. 634.10 Section 634.10 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW... individual driving history or incidents requiring additional training. The curriculum should provide...

ORNL Remedial Action Program strategy (FY 1987-FY 1992)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Trabalka, J.R.; Myrick, T.E.

1987-12-01

Over 40 years of Oak Ridge National Laboratory (ORNL) operations have produced a diverse legacy of contaminated inactive facilities, research areas, and waste disposal areas that are potential candidates for remedial action. The ORNL Remedial Action Program (RAP) represents a comprehensive effort to meet new regulatory requirements and ensure adequate protection of on-site workers, the public, and the environment by providing appropriate corrective measures at over 130 sites contaminated historically with radioactive, hazardous chemical, or mixed wastes. A structured path of program planning, site characterization, alternatives assessment, technology development, engineering design, continued site maintenance and surveillance, interim corrective action, andmore » eventual site closure or decommissioning is required to meet these objectives. This report documents the development of the Remedial Action Program, through its preliminary characterization, regulatory interface, and strategy development activities. It provides recommendations for a comprehensive, long-term strategy consistent with existing technical, institutional, and regulatory information, along with a six-year plan for achieving its initial objectives. 53 refs., 8 figs., 12 tabs.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P.T.; Knox, N.P.; Fielden, J.M.

This bibliography of 657 references with abstracts on the subject of nuclear facility decommissioning, uranium mill tailings management, and site remedial actions is the fourth in a series of annual reports prepared for the US Department of Energy, Division of Remedial Action Projects. Foreign as well as domestic documents of all types - technical reports, progress reports, journal articles, conference papers, symposium proceedings, theses, books, patents, legislation, and research project descriptions - have been references in this publication. The bibliography contains scientific (basic research as well as applied technology), economic, regulatory, and legal literature pertinent to the US Department ofmore » Energy's Remedial Action Program. Major chapters are: (1) Surplus Facilities Management Program; (2) Nuclear Facilities Decommissioning; (3) Formerly Utilized Sites Remedial Action Program; (4) Uranium Mill Tailings Remedial Action Program; (5) Grand Junction Remedial Action Program; and (6) Uranium Mill Tailings Management. Chapter sections for chapters 1 and 2 include: Design, Planning, and Regulations; Site Surveys; Decontamination Studies; Dismantlement and Demolition; Land Decontamination and Reclamation; Waste Disposal; and General studies. The references within each chapter or section are arranged alphabetically by leading author. References having no individual author are arranged by corporate author, or by title. Indexes are provided for the categories of author, corporate affiliation, title, publication description, geographic location, and keywords. Appendix A lists 264 bibliographic references to literature identified during this reporting period but not abstracted due to time constraints. Title and publication description indexes are given for this appendix. Appendix B defines frequently used acronyms, and Appendix C lists the recipients of this report according to their corporate affiliation.« less

Follow-up Assessment of Cognitive Remediation Therapy in Adolescent Anorexia Nervosa: A Pilot Study.

PubMed

Herbrich, Laura; van Noort, Betteke; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Winter, Sibylle; Kappel, Viola

2017-03-01

Cognitive remediation therapy (CRT) is a specialized treatment approach targeting cognitive weaknesses in anorexia nervosa (AN). Regarding follow-up effects of CRT, there are only few studies available; for adolescents, there are no data. Forty-eight adolescents with AN were assigned to receive either CRT and treatment as usual (TAU) or TAU alone. Assessments were performed at baseline (n = 48) and compared with assessments at a 6-month follow-up (n = 33). Outcome measures were set-shifting, central coherence, eating disorder and general psychopathology. The completion rate was higher in CRT compared with TAU. There were no significant differences in neuropsychological and clinical variables. Changes in body mass index percentile showed a trend towards significance for CRT. Dropout analyses revealed no significant predictors. Results provide a first insight into follow-up-assessments of CRT in adolescent AN. More randomized controlled studies are needed to clarify the long-term effects of CRT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

48 CFR 25.702-3 - Remedies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Remedies. 25.702-3 Section 25.702-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Prohibited Sources 25.702-3 Remedies. Upon the determination of a false certification...

48 CFR 25.702-3 - Remedies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Remedies. 25.702-3 Section 25.702-3 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Prohibited Sources 25.702-3 Remedies. Upon the determination of a false certification...

OPTIMIZATION OF IN-SITU THERMAL REMEDIATION: THE LORING AFB STEAM INJECTION PROJECT EXAMPLE

EPA Science Inventory

Environmental remediation programs require that adequate planning be done before field work for characterization or remediation is undertaken. However, the heterogeneous nature of the subsurface can often thwart our best planning efforts. More recently, dynamic work plans which...

Rules of thumb for superfund remedy selection

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-08-01

The guidance document describes key principles and expectations, interspersed with `best practices` based on program experience, that should be consulted during the Superfund remedy selection process. These remedy selection `Rules of Thumb` are organized into three major policy areas: (1) risk assessment and risk management, (2) developing remedial alternatives, and (3) ground-water response actions. The purpose of this guide is to briefly summarize key elements of various remedy selection guidance documents and policies in one publication.

Cognitive errors: thinking clearly when it could be child maltreatment.

PubMed

Laskey, Antoinette L

2014-10-01

Cognitive errors have been studied in a broad array of fields, including medicine. The more that is understood about how the human mind processes complex information, the more it becomes clear that certain situations are particularly susceptible to less than optimal outcomes because of these errors. This article explores how some of the known cognitive errors may influence the diagnosis of child abuse, resulting in both false-negative and false-positive diagnoses. Suggested remedies for these errors are offered. Copyright © 2014 Elsevier Inc. All rights reserved.

Cognitive Deficits in Breast Cancer Survivors After Chemotherapy and Hormonal Therapy.

PubMed

Frank, Jennifer Sandson; Vance, David E; Triebel, Kristen L; Meneses, Karen M

2015-12-01

Adjuvant treatments, specifically chemotherapy and hormonal therapy, have dramatically increased breast cancer survival, resulting in increased attention to the residual effects of treatment. Breast cancer survivors (BCS) frequently report that cognitive deficits are a particular source of distress, interfering with many aspects of quality of life. The literature on neuropsychological performance measures in BCS supports the reality of subtle cognitive deficits after both chemotherapy and hormonal therapy. This premise is supported by recent imaging studies, which reveal anatomical changes after chemotherapy as well as changes in patterns of neural activation while performing cognitive tasks. This review suggests that, even when performance on neuropsychological performance measures is within normal limits, BCS may be using increased cognitive resources in the face of reduced cognitive reserve. Potential interventions for cognitive deficits after adjuvant therapy include prescriptions for healthy living, pharmacotherapy, complementary therapy, and cognitive remediation therapy directed toward specific cognitive deficits or a combination of several strategies.

High Stakes, High Performance: Making Remedial Education Work.

ERIC Educational Resources Information Center

Roueche, John E.; Roueche, Suanne D.

The American Association of Community Colleges commissioned this study of remedial education in community colleges as a framework for describing context, generating discussion, and encouraging improvement. The study reviews current research about open-door policies, underprepared students, faculty, and remedial programs. It also argues that…

7 CFR 623.17 - Violations and remedies.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Violations and remedies. 623.17 Section 623.17 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WETLANDS RESERVE PROGRAM § 623.17 Violations and remedies...

36 CFR 223.198 - Administrative remedies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Administrative remedies. 223.198 Section 223.198 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE... Act of 1990 Program § 223.198 Administrative remedies. In addition to possible debarment action...

7 CFR 623.17 - Violations and remedies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 6 2011-01-01 2011-01-01 false Violations and remedies. 623.17 Section 623.17 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE, DEPARTMENT OF AGRICULTURE WATER RESOURCES EMERGENCY WETLANDS RESERVE PROGRAM § 623.17 Violations and remedies...

ENVIRONMENTAL MONITORING OF REMEDIAL DREDGING AT THE NEW BEDFORD HARBOR, MA, SUPERFUND SITE

EPA Science Inventory

New Bedford Harbor (NBH), MA, is a Superfund site due to high sediment polychlorinated biphenyl (PCB) concentrations. An initial remedial dredging operation removed the most contaminated sediments from the upper harbor ("Hot Spot"). During remediation, a monitoring program assess...

Responding to the professionalism of learners and faculty in orthopaedic surgery.

PubMed

Arnold, Louise

2006-08-01

Recent developments in assessing professionalism and remediating unprofessional behavior can curtail the inaction that often follows observations of negative as well as positive professionalism of learners and faculty. Developments include: longitudinal assessment models promoting professional behavior, not just penalizing lapses; clarity about the assessment's purpose; methods separating formative from summative assessment; conceptual and behavioral definitions of professionalism; techniques increasing the reliability and validity of quantitative and qualitative approaches to assessment such as 360-degree assessments, performance-based assessments, portfolios, and humanism connoisseurs; and systems-design providing infrastructure support for assessment. Models for remediation have been crafted, including: due process, a warning period and, if necessary, confrontation to initiate remediation of the physician who has acted unprofessionally. Principles for appropriate remediation stress matching the intervention to the cause of the professional lapse. Cognitive behavioral therapy, motivational interviewing, and continuous monitoring linked to behavioral contracts are effective remediation techniques. Mounting and maintaining robust systems for professionalism and remediating professional lapses are not easy tasks. They require a sea change in the fundamental goal of academic health care institutions: medical education must not only be a technical undertaking but also a moral process designed to build and sustain character in all its professional citizens.

Handbook for a Self-Programmed Reading Diagnostic/Remediation Approach.

ERIC Educational Resources Information Center

Anderson, Gordon S.

Intended to help reading teachers develop and demonstrate mastery of diagnostic or remediation skills prior to or with application in a real classroom, this handbook provides simulated materials for use within a course or staff development program to supplement lectures, discussions, readings, demonstrations, and films. Following an introduction,…

Changing State Policy in Texas for Remedial/Developmental Education.

ERIC Educational Resources Information Center

Cook, Charles M.

The Texas Academic Skills Program (TASP), implemented in 1989, requires student assessment in reading, writing, and math prior to regular college course work. Students undergo continuous remediation until they are able to pass the assessment test. Though TASP advocates argue that the program helps maintain academic standards and provides students…

45 CFR 79.1 - Basis and purpose.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare Department of Health and Human Services GENERAL ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES § 79.1 Basis and purpose. (a) Basis. This part implements the Program Fraud Civil Remedies Act of 1986, Pub. L... for imposing civil penalties and assessments against persons who make, submit, or present, or cause to...

45 CFR 79.1 - Basis and purpose.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES § 79.1 Basis and purpose. (a) Basis. This part implements the Program Fraud Civil Remedies Act of 1986, Pub. L... for imposing civil penalties and assessments against persons who make, submit, or present, or cause to...

45 CFR 79.1 - Basis and purpose.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES § 79.1 Basis and purpose. (a) Basis. This part implements the Program Fraud Civil Remedies Act of 1986, Pub. L... for imposing civil penalties and assessments against persons who make, submit, or present, or cause to...

45 CFR 79.1 - Basis and purpose.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES § 79.1 Basis and purpose. (a) Basis. This part implements the Program Fraud Civil Remedies Act of 1986, Pub. L... for imposing civil penalties and assessments against persons who make, submit, or present, or cause to...

40 CFR 270.110 - What must I include in my application for a RAP?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) SOLID WASTES (CONTINUED) EPA ADMINISTERED PERMIT PROGRAMS: THE HAZARDOUS WASTE PERMIT PROGRAM... EPA identification number of the remediation waste management site; (b) The name, address, and... States Geological Survey (USGS) or county map showing the location of the remediation waste management...

40 CFR 270.110 - What must I include in my application for a RAP?

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) SOLID WASTES (CONTINUED) EPA ADMINISTERED PERMIT PROGRAMS: THE HAZARDOUS WASTE PERMIT PROGRAM... EPA identification number of the remediation waste management site; (b) The name, address, and... States Geological Survey (USGS) or county map showing the location of the remediation waste management...

40 CFR 270.110 - What must I include in my application for a RAP?

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) SOLID WASTES (CONTINUED) EPA ADMINISTERED PERMIT PROGRAMS: THE HAZARDOUS WASTE PERMIT PROGRAM... EPA identification number of the remediation waste management site; (b) The name, address, and... States Geological Survey (USGS) or county map showing the location of the remediation waste management...

40 CFR 270.110 - What must I include in my application for a RAP?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) SOLID WASTES (CONTINUED) EPA ADMINISTERED PERMIT PROGRAMS: THE HAZARDOUS WASTE PERMIT PROGRAM... EPA identification number of the remediation waste management site; (b) The name, address, and... States Geological Survey (USGS) or county map showing the location of the remediation waste management...

24 CFR 572.225 - Grant agreements; corrective and remedial actions.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES HOPE FOR HOMEOWNERSHIP OF SINGLE FAMILY HOMES PROGRAM (HOPE 3) Grants § 572.225 Grant agreements; corrective and remedial actions. (a) Terms and... not incurring further costs for the affected activities; (iv) Reimbursing its HOPE 3 program account...

Cognitive Skills Training for Homeless Transition-Age Youth: Feasibility and Pilot Efficacy of a Community Based Randomized Controlled Trial.

PubMed

Medalia, Alice; Saperstein, Alice M; Huang, Yanlan; Lee, Seonjoo; Ronan, Elizabeth J

2017-11-01

Cognitive impairments are common in homeless youth and negatively impact academic and vocational outcomes. We examined the feasibility and efficacy of cognitive interventions provided to 18- to 22-year-old homeless youth living in urban supportive housing. Ninety-one homeless youth were randomized to receive either targeted cognitive training (cognitive remediation) or general cognitive activation (computer skills training). Cognitive and psychological outcomes were assessed at baseline, after 13 and 26 sessions, and 1 month postintervention. A high dropout rate highlighted the feasibility challenges of treating this population. Intent-to-treat analysis found significant improvements across groups in specific and global measures of cognition and psychological distress, with no significant group differences. Transition-age homeless youth show improvements in cognitive and psychological functioning when engaged in interventions that address their cognitive development. This speaks to the malleability of cognitive skills in this cohort and lays the groundwork for future research to address their cognitive health.

Training on Movement Figure-Ground Discrimination Remediates Low-Level Visual Timing Deficits in the Dorsal Stream, Improving High-Level Cognitive Functioning, Including Attention, Reading Fluency, and Working Memory.

PubMed

Lawton, Teri; Shelley-Tremblay, John

2017-01-01

The purpose of this study was to determine whether neurotraining to discriminate a moving test pattern relative to a stationary background, figure-ground discrimination, improves vision and cognitive functioning in dyslexics, as well as typically-developing normal students. We predict that improving the speed and sensitivity of figure-ground movement discrimination ( PATH to Reading neurotraining) acts to remediate visual timing deficits in the dorsal stream, thereby improving processing speed, reading fluency, and the executive control functions of attention and working memory in both dyslexic and normal students who had PATH neurotraining more than in those students who had no neurotraining. This prediction was evaluated by measuring whether dyslexic and normal students improved on standardized tests of cognitive skills following neurotraining exercises, more than following computer-based guided reading ( Raz-Kids ( RK )). The neurotraining used in this study was visually-based training designed to improve magnocellular function at both low and high levels in the dorsal stream: the input to the executive control networks coding working memory and attention. This approach represents a paradigm shift from the phonologically-based treatment for dyslexia, which concentrates on high-level speech and reading areas. This randomized controlled-validation study was conducted by training the entire second and third grade classrooms (42 students) for 30 min twice a week before guided reading. Standardized tests were administered at the beginning and end of 12-weeks of intervention training to evaluate improvements in academic skills. Only movement-discrimination training remediated both low-level visual timing deficits and high-level cognitive functioning, including selective and sustained attention, reading fluency and working memory for both dyslexic and normal students. Remediating visual timing deficits in the dorsal stream revealed the causal role of visual movement discrimination training in improving high-level cognitive functions such as attention, reading acquisition and working memory. This study supports the hypothesis that faulty timing in synchronizing the activity of magnocellular with parvocellular visual pathways in the dorsal stream is a fundamental cause of dyslexia and being at-risk for reading problems in normal students, and argues against the assumption that reading deficiencies in dyslexia are caused by phonological or language deficits, requiring a paradigm shift from phonologically-based treatment of dyslexia to a visually-based treatment. This study shows that visual movement-discrimination can be used not only to diagnose dyslexia early, but also for its successful treatment, so that reading problems do not prevent children from readily learning.

Training on Movement Figure-Ground Discrimination Remediates Low-Level Visual Timing Deficits in the Dorsal Stream, Improving High-Level Cognitive Functioning, Including Attention, Reading Fluency, and Working Memory

PubMed Central

Lawton, Teri; Shelley-Tremblay, John

2017-01-01

The purpose of this study was to determine whether neurotraining to discriminate a moving test pattern relative to a stationary background, figure-ground discrimination, improves vision and cognitive functioning in dyslexics, as well as typically-developing normal students. We predict that improving the speed and sensitivity of figure-ground movement discrimination (PATH to Reading neurotraining) acts to remediate visual timing deficits in the dorsal stream, thereby improving processing speed, reading fluency, and the executive control functions of attention and working memory in both dyslexic and normal students who had PATH neurotraining more than in those students who had no neurotraining. This prediction was evaluated by measuring whether dyslexic and normal students improved on standardized tests of cognitive skills following neurotraining exercises, more than following computer-based guided reading (Raz-Kids (RK)). The neurotraining used in this study was visually-based training designed to improve magnocellular function at both low and high levels in the dorsal stream: the input to the executive control networks coding working memory and attention. This approach represents a paradigm shift from the phonologically-based treatment for dyslexia, which concentrates on high-level speech and reading areas. This randomized controlled-validation study was conducted by training the entire second and third grade classrooms (42 students) for 30 min twice a week before guided reading. Standardized tests were administered at the beginning and end of 12-weeks of intervention training to evaluate improvements in academic skills. Only movement-discrimination training remediated both low-level visual timing deficits and high-level cognitive functioning, including selective and sustained attention, reading fluency and working memory for both dyslexic and normal students. Remediating visual timing deficits in the dorsal stream revealed the causal role of visual movement discrimination training in improving high-level cognitive functions such as attention, reading acquisition and working memory. This study supports the hypothesis that faulty timing in synchronizing the activity of magnocellular with parvocellular visual pathways in the dorsal stream is a fundamental cause of dyslexia and being at-risk for reading problems in normal students, and argues against the assumption that reading deficiencies in dyslexia are caused by phonological or language deficits, requiring a paradigm shift from phonologically-based treatment of dyslexia to a visually-based treatment. This study shows that visual movement-discrimination can be used not only to diagnose dyslexia early, but also for its successful treatment, so that reading problems do not prevent children from readily learning. PMID:28555097

42 CFR 51.10 - Remedial actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Remedial actions. 51.10 Section 51.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Basic Requirements § 51.10 Remedial...

24 CFR 1003.703 - Other remedies for noncompliance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Other remedies for noncompliance. 1003.703 Section 1003.703 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN... Program Performance § 1003.703 Other remedies for noncompliance. (a) Secretarial actions. If the Secretary...

10 CFR 431.386 - Remedies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Remedies. 431.386 Section 431.386 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ENERGY EFFICIENCY PROGRAM FOR CERTAIN COMMERCIAL AND INDUSTRIAL EQUIPMENT Enforcement § 431.386 Remedies. If the Secretary determines that a basic model of any covered equipment does...

40 CFR 63.7881 - Am I subject to this subpart?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 63.7881 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS...) National Emission Standards for Hazardous Air Pollutants: Site Remediation What This Subpart Covers § 63... which you conduct a site remediation, as defined in § 63.7957; and this site remediation, unless...

40 CFR 63.7881 - Am I subject to this subpart?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section 63.7881 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS...) National Emission Standards for Hazardous Air Pollutants: Site Remediation What This Subpart Covers § 63... which you conduct a site remediation, as defined in § 63.7957; and this site remediation, unless...

40 CFR 63.7881 - Am I subject to this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 63.7881 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS...) National Emission Standards for Hazardous Air Pollutants: Site Remediation What This Subpart Covers § 63... which you conduct a site remediation, as defined in § 63.7957; and this site remediation, unless...

40 CFR 63.7881 - Am I subject to this subpart?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 63.7881 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS...) National Emission Standards for Hazardous Air Pollutants: Site Remediation What This Subpart Covers § 63... which you conduct a site remediation, as defined in § 63.7957; and this site remediation, unless...

41 CFR 101-8.723 - Remedial action by recipient.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 8-NONDISCRIMINATION IN PROGRAMS RECEIVING FEDERAL FINANCIAL ASSISTANCE 8.7-Discrimination Prohibited on the Basis of Age § 101-8.723 Remedial action... remedial action that GSA may require to overcome the effects of the discrimination. If another recipient...

41 CFR 101-8.723 - Remedial action by recipient.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 8-NONDISCRIMINATION IN PROGRAMS RECEIVING FEDERAL FINANCIAL ASSISTANCE 8.7-Discrimination Prohibited on the Basis of Age § 101-8.723 Remedial action... remedial action that GSA may require to overcome the effects of the discrimination. If another recipient...

15 CFR 8b.6 - Remedial action, voluntary action, and self-evaluation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED PROGRAMS OPERATED BY THE... handicapped individuals, appropriate remedial steps to eliminate the effects of any discrimination that... of handicap in violation of section 504 or this part, the recipient shall take such remedial action...

15 CFR 8b.6 - Remedial action, voluntary action, and self-evaluation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED PROGRAMS OPERATED BY THE... handicapped individuals, appropriate remedial steps to eliminate the effects of any discrimination that... of handicap in violation of section 504 or this part, the recipient shall take such remedial action...

15 CFR 8b.6 - Remedial action, voluntary action, and self-evaluation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED PROGRAMS OPERATED BY THE... handicapped individuals, appropriate remedial steps to eliminate the effects of any discrimination that... of handicap in violation of section 504 or this part, the recipient shall take such remedial action...

15 CFR 8b.6 - Remedial action, voluntary action, and self-evaluation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED PROGRAMS OPERATED BY THE... handicapped individuals, appropriate remedial steps to eliminate the effects of any discrimination that... of handicap in violation of section 504 or this part, the recipient shall take such remedial action...

15 CFR 8b.6 - Remedial action, voluntary action, and self-evaluation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... PROHIBITION OF DISCRIMINATION AGAINST THE HANDICAPPED IN FEDERALLY ASSISTED PROGRAMS OPERATED BY THE... handicapped individuals, appropriate remedial steps to eliminate the effects of any discrimination that... of handicap in violation of section 504 or this part, the recipient shall take such remedial action...

PRELIMINARY ASSESSMENT OF WORKER AND AMBIENT AIR EXPOSURES DURING SOIL REMEDIATION TECHNOLOGY DEMONSTRATIONS

EPA Science Inventory

Hazardous waste site remediation workers or neighboring residents may be exposed to particulates during the remediation of lead contaminated soil sites. An industrial hygiene survey and air monitoring program for both lead and dust were performed during initial soil sampling acti...

New Mexico Math Remediation Taskforce Report

ERIC Educational Resources Information Center

New Mexico Higher Education Department, 2016

2016-01-01

The Math Remediation Task Force is comprised of faculty from two-year, four-year comprehensive, and four-year flagship higher education institutions throughout the state of New Mexico. Its members have varying levels of experience with designing/implementing multiple math remediation programs including traditional, co-requisite and acceleration…

77 FR 37898 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... Activities; Submission to OMB for Review and Approval; Comment Request; Hazardous Remediation Waste....regulations.gov . Title: Hazardous Remediation Waste Management Requirements (HWIR- Media) (Renewal). ICR... program), EPA regulates newly generated hazardous wastes, as well as hazardous remediation wastes (i.e...

Expectancy-value theory in persistence of learning effects in schizophrenia: role of task value and perceived competency.

PubMed

Choi, Jimmy; Fiszdon, Joanna M; Medalia, Alice

2010-09-01

Expectancy-value theory, a widely accepted model of motivation, posits that expectations of success on a learning task and the individual value placed on the task are central determinants of motivation to learn. This is supported by research in healthy controls suggesting that beliefs of self-and-content mastery can be so influential they can predict the degree of improvement on challenging cognitive tasks even more so than general cognitive ability. We examined components of expectancy-value theory (perceived competency and task value), along with baseline arithmetic performance and neuropsychological performance, as possible predictors of learning outcome in a sample of 70 outpatients with schizophrenia randomized to 1 of 2 different arithmetic learning conditions and followed up after 3 months. Results indicated that as with nonpsychiatric samples, perceived self-competency for the learning task was significantly related to perceptions of task value attributed to the learning task. Baseline expectations of success predicted persistence of learning on the task at 3-month follow-up, even after accounting for variance attributable to different arithmetic instruction, baseline arithmetic ability, attention, and self-reports of task interest and task value. We also found that expectation of success is a malleable construct, with posttraining improvements persisting at follow-up. These findings support the notion that expectancy-value theory is operative in schizophrenia. Thus, similar to the nonpsychiatric population, treatment benefits may be enhanced and better maintained if remediation programs also focus on perceptions of self-competency for the training tasks. Treatment issues related to instilling self-efficacy in cognitive recovery programs are discussed.

Cognitive Rehabilitation After Traumatic Brain Injury: A Reference for Occupational Therapists.

PubMed

Stephens, Jaclyn A; Williamson, Karen-Nicole C; Berryhill, Marian E

2015-01-01

Nearly 1.7 million Americans sustain a traumatic brain injury (TBI) each year. These injuries can result in physical, emotional, and cognitive consequences. While many individuals receive cognitive rehabilitation from occupational therapists (OTs), the interdisciplinary nature of TBI research makes it difficult to remain up-to-date on relevant findings. We conducted a literature review to identify and summarize interdisciplinary evidence-based practice targeting cognitive rehabilitation for civilian adults with TBI. Our review summarizes TBI background, and our cognitive remediation section focuses on the findings from 37 recent (since 2006) empirical articles directly related to cognitive rehabilitation for individuals (i.e., excluding special populations such as veterans or athletes). This manuscript is offered as a tool for OTs engaged in cognitive rehabilitation and as a means to highlight arenas where more empirical, interdisciplinary research is needed.

Geometric Form Drawing: A Perceptual-Motor Approach to Preventive Remediation (The Steiner Approach)

ERIC Educational Resources Information Center

Ogletree, Earl J.

1975-01-01

Provided is a rationale for geometric form drawing developed by Rudolf Steiner as a tool to develop motor coordination, perceptual skills, and cognition for mentally retarded and perceptually handicapped children. (Author/CL)

Enhancing informed consent for research and treatment.

PubMed

Dunn, L B; Jeste, D V

2001-06-01

Increased scrutiny of informed consent calls for further research into decision making by patients who may be at risk for impairments. We review interventions designed to improve patient understanding of informed consent. A number of studies, within as well as outside psychiatry, have evaluated the effectiveness of specific interventions, as well as possible "predictors" of understanding of consent, such as subject characteristics, psychiatric symptoms, and cognitive impairment. Deficits in patients' understanding of informed consent may be partially related to poorly conceived, written, or organized informed consent materials; these deficits may be remediable with educational interventions. We find that effective interventions include corrected feedback, multiple learning trials, and more organized or simplified consent forms. Educational levels of patients generally correlate with levels of understanding. Even among individuals with psychiatric illness or cognitive impairment, deficits in understanding can be remedied with certain educational interventions. A variety of interventions can enhance understanding of informed consent.

Real-World Cognitive—and Metacognitive—Dysfunction in Schizophrenia: A New Approach for Measuring (and Remediating) More “Right Stuff”

PubMed Central

Koren, Danny; Seidman, Larry J; Goldsmith, Morris; Harvey, Phillip D

2006-01-01

While the role of impaired cognition in accounting for functional outcome in schizophrenia is generally established by now, the overlap is far from complete. Moreover, little is known about the potential mechanisms that bridge between cognition and functional outcome. The aim of this article is to aid in closing this gap by presenting a novel, more ecologically valid approach for neuropsychological assessment. The new approach is motivated by the view that metacognitive processes of self-monitoring and self-regulation are fundamental determinants of competent functioning in the real world. The new approach incorporates experimental psychological concepts and paradigms used to study metacognition into current standard neuropsychological assessment procedures. Preliminary empirical data that support and demonstrate the utility of the new approach for assessment, as well as remediation efforts, in schizophrenia are presented and discussed. PMID:16397202

Cognitive tutoring induces widespread neuroplasticity and remediates brain function in children with mathematical learning disabilities.

PubMed

Iuculano, Teresa; Rosenberg-Lee, Miriam; Richardson, Jennifer; Tenison, Caitlin; Fuchs, Lynn; Supekar, Kaustubh; Menon, Vinod

2015-09-30

Competency with numbers is essential in today's society; yet, up to 20% of children exhibit moderate to severe mathematical learning disabilities (MLD). Behavioural intervention can be effective, but the neurobiological mechanisms underlying successful intervention are unknown. Here we demonstrate that eight weeks of 1:1 cognitive tutoring not only remediates poor performance in children with MLD, but also induces widespread changes in brain activity. Neuroplasticity manifests as normalization of aberrant functional responses in a distributed network of parietal, prefrontal and ventral temporal-occipital areas that support successful numerical problem solving, and is correlated with performance gains. Remarkably, machine learning algorithms show that brain activity patterns in children with MLD are significantly discriminable from neurotypical peers before, but not after, tutoring, suggesting that behavioural gains are not due to compensatory mechanisms. Our study identifies functional brain mechanisms underlying effective intervention in children with MLD and provides novel metrics for assessing response to intervention.

Expedited Remedial Action Program (SB 923): A California Brownfields initiative

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cambridge, M.; Wolfenden, A.K.

California`s Expedited Remedial Action Program (ERAP) created a comprehensive program that promotes an equitable and expedited approach for redevelopment of properties contaminated with hazardous substances. This bill embodies an emerging trend in environmental policy that permits flexibility, cooperation and creativity without compromising protection to public health or the environment. Within the California Environmental Protection Agency, the Department of Toxic Substances Control (DTSC) is promoting a number of programs to facilitate the restoration of contaminated properties as part of its Brownfields initiative. ERAP represents a potentially more efficient process to remediate sites by minimizing economic risks through a clearly identified liabilitymore » scheme, indemnifying future owners through a covenant not to sue, and providing risk based cleanups that are based on the permanent use of the site.« less

Cognitive Enhancement Therapy Improves Resting-State Functional Connectivity in Early Course Schizophrenia

PubMed Central

Eack, Shaun M.; Newhill, Christina E.; Keshavan, Matcheri S.

2016-01-01

Objective Cognitive remediation is emerging as an effective psychosocial intervention for addressing untreated cognitive and functional impairments in persons with schizophrenia, and might achieve its benefits through neuroplastic changes in brain connectivity. This study seeks to examine the effects of cognitive enhancement therapy (CET) on fronto-temporal brain connectivity in a randomized controlled trial with individuals in the early course of schizophrenia. Method Stabilized, early course outpatients with schizophrenia or schizoaffective disorder (N = 41) were randomly assigned to CET (n = 25) or an active enriched supportive therapy (EST) control (n = 16) and treated for 2 years. Functional MRI data were collected annually, and pseudo resting-state functional connectivity analysis was used to examine differential changes in fronto-temporal connectivity between those treated with CET compared with EST. Results Individuals receiving CET evidenced significantly less functional connectivity loss between the resting-state network and the left dorsolateral prefrontal cortex as well as significantly increased connectivity with the right insular cortex compared to EST (all corrected p < .01). These neural networks are involved in emotion processing and problem-solving. Increased connectivity with the right insula significantly mediated CET effects on improved emotion perception (z′ = −1.96, p = .021), and increased connectivity with the left dorsolateral prefrontal cortex mediated CET-related improvements in emotion regulation (z′ = −1.71, p = .052). Conclusions These findings provide preliminary evidence that CET, a psychosocial cognitive remediation intervention, may enhance connectivity between frontal and temporal brain regions implicated in problem-solving and emotion processing in service of cognitive enhancement in schizophrenia. PMID:27713804

Meta-Modeling-Based Groundwater Remediation Optimization under Flexibility in Environmental Standard.

PubMed

He, Li; Xu, Zongda; Fan, Xing; Li, Jing; Lu, Hongwei

2017-05-01

  This study develops a meta-modeling based mathematical programming approach with flexibility in environmental standards. It integrates numerical simulation, meta-modeling analysis, and fuzzy programming within a general framework. A set of models between remediation strategies and remediation performance can well guarantee the mitigation in computational efforts in the simulation and optimization process. In order to prevent the occurrence of over-optimistic and pessimistic optimization strategies, a high satisfaction level resulting from the implementation of a flexible standard can indicate the degree to which the environmental standard is satisfied. The proposed approach is applied to a naphthalene-contaminated site in China. Results show that a longer remediation period corresponds to a lower total pumping rate and a stringent risk standard implies a high total pumping rate. The wells located near or in the down-gradient direction to the contaminant sources have the most significant efficiency among all of remediation schemes.

Personalised treatment for cognitive dysfunction in individuals with schizophrenia spectrum disorders.

PubMed

Medalia, Alice; Saperstein, Alice M; Hansen, Marie C; Lee, Seonjoo

2018-06-01

Cognitive deficits are a well-recognised issue for individuals diagnosed with schizophrenia spectrum disorders. Despite positive group findings for the use of cognitive remediation (CR) interventions, there are substantial individual differences in response to treatment. In addition, the aggregate CR literature reports low moderate effect sizes for cognitive and functional outcomes. Based on personalised medicine theory, this paper uses extant CR literature to examine the individual characteristics determined to predict treatment response. These characteristics, which fall into the broad categories of cognitive, psychological, and biological can be used as tailoring variables to personalise CR to an individual's unique profile. Personalisation through the use of these tailoring variables has the potential to improve the delivery of CR to maximise treatment outcomes.

28 CFR 542.19 - Access to indexes and responses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Access to indexes and responses. 542.19... ADMINISTRATIVE REMEDY Administrative Remedy Program § 542.19 Access to indexes and responses. Inmates and members of the public may request access to Administrative Remedy indexes and responses, for which inmate...

40 CFR 63.7936 - What requirements must I meet if I transfer remediation material off-site to another facility?

Code of Federal Regulations, 2013 CFR

2013-07-01

... transfer remediation material off-site to another facility? 63.7936 Section 63.7936 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS... Hazardous Air Pollutants: Site Remediation General Compliance Requirements § 63.7936 What requirements must...

40 CFR 63.7936 - What requirements must I meet if I transfer remediation material off-site to another facility?

Code of Federal Regulations, 2011 CFR

2011-07-01

... transfer remediation material off-site to another facility? 63.7936 Section 63.7936 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS... Hazardous Air Pollutants: Site Remediation General Compliance Requirements § 63.7936 What requirements must...

40 CFR 63.7936 - What requirements must I meet if I transfer remediation material off-site to another facility?

Code of Federal Regulations, 2014 CFR

2014-07-01

... transfer remediation material off-site to another facility? 63.7936 Section 63.7936 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS... Hazardous Air Pollutants: Site Remediation General Compliance Requirements § 63.7936 What requirements must...

40 CFR 63.7936 - What requirements must I meet if I transfer remediation material off-site to another facility?

Code of Federal Regulations, 2012 CFR

2012-07-01

... transfer remediation material off-site to another facility? 63.7936 Section 63.7936 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS... Hazardous Air Pollutants: Site Remediation General Compliance Requirements § 63.7936 What requirements must...

How to Increase Reading Ability; A Guide to Developmental and Remedial Methods.

ERIC Educational Resources Information Center

Harris, Albert J.

Intended for beginning students concerned with reading instruction as well as for graduate students, reading teachers, or remedial specialists, the text deals with the overall classroom program, methods for evaluating and diagnosing group and individual needs, and developmental and remedial teaching of specific skills. Chapters explore the…

34 CFR 685.308 - Remedial actions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Remedial actions. 685.308 Section 685.308 Education... Direct Loan Program Schools § 685.308 Remedial actions. (a) General. The Secretary may require the... fine or take an emergency action against a school or limit, suspend, or terminate a school's...

29 CFR 35.15 - Remedial action.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Remedial action. 35.15 Section 35.15 Labor Office of the Secretary of Labor NONDISCRIMINATION ON THE BASIS OF AGE IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL... Remedial action. Even in the absence of a finding of discrimination, a recipient, in administering a...

34 CFR 685.308 - Remedial actions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 4 2011-07-01 2011-07-01 false Remedial actions. 685.308 Section 685.308 Education... Payments for Direct Loan Program Schools § 685.308 Remedial actions. (a) General. The Secretary may require... fine or take an emergency action against a school or limit, suspend, or terminate a school's...

Format and style for environmental documents prepared as part of the Uranium Mill Tailings Remedial Action Program. [Uranium Mill Tailings Remedial Action (UMTRA) Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1980-06-01

The Uranium Mill Tailings Remedial Action Program will require the preparation of several environmental impact statements and several environmental assessments. This guide begins with a section describing in general terms the efforts required to make these documents readable. The sections describe the formats to be used for the pages, headings, front matter, footnotes, lists, figures, tables, references, glossaries, indexes, and appendixes in these documents. A final section presents some rules of style to be followed in writing the texts.

The Relationship between Post Reach Exit Exam (E[superscript 2]) Failure Remediation and NCLEX-RN Success of Graduates of Baccalaureate Nursing Programs

ERIC Educational Resources Information Center

Allen, Patricia Gale

2009-01-01

An ex post facto study was conducted to determine whether any relationship exists between remediation post Reach Exit Exam (E[superscript 2]) failure and NCLEX-RN success of graduates of baccalaureate nursing programs. Data was gathered from responses to the seventh annual validity study (V7S) offered to deans and directors of nursing programs by…

An Investigation of the Relative Effectiveness of the Basic Mathematics Review Program at Essex Community College.

ERIC Educational Resources Information Center

Bloomberg, Jerome

Basic Mathematics Review (BMR) is a remedial non-credit course at Essex Community College (Maryland) being taught on an individualized basis. Following diagnostic testing and placement, instruction utilizes programmed materials, tutors, and self-tests. Evaluation of the new individualized BMR and comparison with the traditional remedial course…

45 CFR 79.1 - Basis and purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Basis and purpose. 79.1 Section 79.1 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES § 79.1 Basis and purpose. (a) Basis. This part implements the Program Fraud Civil Remedies Act of 1986, Pub. L...

7 CFR 15a.3 - Remedial and affirmative action and self-evaluation.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... 15a.3 Section 15a.3 Agriculture Office of the Secretary of Agriculture EDUCATION PROGRAMS OR ACTIVITIES RECEIVING OR BENEFITTING FROM FEDERAL FINANCIAL ASSISTANCE Introduction § 15a.3 Remedial and... discriminated against persons on the basis of sex in an education program or activity, such recipient shall take...

Pretechnical Post Secondary Remedial Programs Training Institute. Final Report.

ERIC Educational Resources Information Center

Tompkins, Jack E.

To promote and accelerate the creation of remedial training programs in technical institutes and community colleges, 46 participants from a wide geographic representation and from varied positions were selected to attend a 5-day training institute. Presentations by consultants and group discussions were utilized to meet the objects of developing a…

Study of the Effectiveness of "Privatizing" Remedial Services.

ERIC Educational Resources Information Center

Maryland State Higher Education Commission, Annapolis.

This study evaluated a pilot project for privatizing or outsourcing remedial education programs in the state of Maryland. The program was conducted by the mathematics department at Howard Community College and Sylvan Learning Systems, a Baltimore-based tutoring company, and covered four periods the summer, spring, and fall semesters of 1995 and…

Action Research of Computer-Assisted-Remediation of Basic Research Concepts.

ERIC Educational Resources Information Center

Packard, Abbot L.; And Others

This study investigated the possibility of creating a computer-assisted remediation program to assist students having difficulties in basic college research and statistics courses. A team approach involving instructors and students drove the research into and creation of the computer program. The effect of student use was reviewed by looking at…

The Effectiveness of a High School Mathematics Remediation Program on Student Achievement

ERIC Educational Resources Information Center

Kingsborough, Joseph

2011-01-01

The landmark educational reform legislation known as the No Child Left Behind Act (2001) brought sweeping change to the educational establishment through clearly defined learning goals and equally clear consequences for poorly performing schools. The present study sought to determine the impact of a remediation program in mathematics at a suburban…

Notification: Audit of EPA's Processes for Managing Background Investigations of Privileged Users and Taking Action to Remediate Weaknesses in Agency's Information Security Program

EPA Pesticide Factsheets

Project #OA-FY17-0139, Feb 15, 2017.The EPA OIG plans to begin preliminary research on an audit of EPA's processes for managing background investigations of privileged users and taking action to remediate weaknesses in agency's info security program.

Early predictors of need for remediation in the Australian general practice training program: a retrospective cohort study.

PubMed

Magin, Parker; Stewart, Rebecca; Turnock, Allison; Tapley, Amanda; Holliday, Elizabeth; Cooling, Nick

2017-10-01

Underperforming trainees requiring remediation may threaten patient safety and are challenging for vocational training programs. Decisions to institute remediation are high-stakes-remediation being resource-intensive and emotionally demanding on trainees. Detection of underperformance requiring remediation is particularly problematic in general (family) practice. We sought to establish early-training assessment instruments predictive of general practice (GP) trainees' subsequently requiring formal remediation. We conducted a retrospective cohort study of trainees from a large Australian regionally-based GP training organization. The outcome factor was requirement for formal remediation. Independent variables were demographic factors and a range of formative assessments conducted immediately prior to or during early-stage training. Analyses employed univariate and multivariate logistic regression of each predictor assessment modality with the outcome, adjusting for potential confounders. Of 248 trainees, 26 (10.5 %) required formal remediation. Performance on the Colleague Feedback Evaluation Tool (entailing feedback from a trainee's clinical colleagues on clinical performance, communication and probity) and External Clinical Teaching Visits (half-day sessions of the trainee's clinical consultations observed directly by an experienced GP), along with non-Australian primary medical qualification, were significantly associated with requiring remediation. There was a non-significant trend for association with performance on the Doctors Interpersonal Skills Questionnaire (patient feedback on interpersonal elements of the consultation). There were no significant associations with entry-selection scores or formative exam or assessment scores. Our finding that 'in vivo' assessments of complex behaviour, but not 'in vitro' knowledge-based assessments, predict need for remediation is consistent with theoretical understanding of the nature of remediation decision-making and should inform remediation practice in GP vocational training.

Evidenced-Based Cognitive Rehabilitation for Persons With Multiple Sclerosis: An Updated Review of the Literature From 2007 to 2016.

PubMed

Goverover, Yael; Chiaravalloti, Nancy D; O'Brien, Amanda R; DeLuca, John

2018-02-01

To update the clinical recommendations for cognitive rehabilitation of people with multiple sclerosis (MS), based on a systematic review of the literature from 2007 through 2016. Searches of MEDLINE, PsycINFO, and CINAHL were conducted with a combination of the following terms: attention, awareness, cognition, cognitive, communication, executive, executive function, language, learning, memory, perception, problem solving, reasoning, rehabilitation, remediation, training, processing speed, and working memory. One hundred twenty-nine articles were identified and underwent initial screening. Fifty-nine articles were selected for inclusion after initial screening. Nineteen studies were excluded after further detailed review. Forty studies were fully reviewed and evaluated. Articles were assigned to 1 of 6 categories: attention, learning and memory, processing speed and working memory, executive functioning, metacognition, or nonspecified/combined cognitive domains. Articles were abstracted and levels of evidence were decided using specific criteria. The current review yielded 6 class I studies, 10 class II studies, and 24 class III studies. One intervention in the area of verbal learning and memory received support for a practice standard, 2 computer programs received support as practice guidelines (in the area of attention and multicognitive domains), and several studies provided support for 5 practice options in the domains of attention and learning and memory. Substantial progress has been made since our previous review regarding the identification of effective treatments for cognitive impairments in persons with MS. However, much work remains to be done to optimize rehabilitation potential by applying the most methodologically rigorous research designs to provide class I evidence in support of a given treatment strategy. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Problem neurology residents: a national survey.

PubMed

Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J

2011-06-14

Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

Evidence-based and occupational perspective of effective interventions for older clients that remediate or support improved driving performance.

PubMed

Hunt, Linda A; Arbesman, Marian

2008-01-01

To assess the effectiveness of person-related interventions on driving ability in older adults, this literature review was completed as a part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. Nineteen articles were incorporated into the systematic review and include interventions in the following areas: visual, cognitive, and motor; educational; passengers; and medical. The results provide inconclusive evidence for the use of interventions such as the Useful Field of View training, home exercise programs, and passenger interactions. Conclusive evidence shows that older adults respond positively to programs stressing self-awareness of driving skills and that some medical interventions affect the ability to drive. Despite limitations, the studies reviewed provide useful information that deserves further exploration. Reading the literature provides therapists with knowledge that might improve client care. Learning about cutting-edge interventions and educating peers and students about evidence-based interventions may lead to safer community mobility for older adults.

The Positive Purpose of Remediation: Getting to the Core of Higher Education

ERIC Educational Resources Information Center

Rose, Mike

2009-01-01

Remedial courses and programs are typically treated in isolation from the core mission of the college or university, an institutional quarantine. The author sees the remedial function as interconnected with foundational concerns: what does it mean to enter higher education in America? What truly is the relationship between the research and…

10 CFR 1040.7 - Remedial and affirmative action and self-evaluation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Remedial and affirmative action and self-evaluation. 1040... ASSISTED PROGRAMS OR ACTIVITIES General Provisions § 1040.7 Remedial and affirmative action and self... to overcome the effects of the discrimination. (b) Affirmative action. In the absence of a finding of...

10 CFR 1040.7 - Remedial and affirmative action and self-evaluation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Remedial and affirmative action and self-evaluation. 1040... ASSISTED PROGRAMS OR ACTIVITIES General Provisions § 1040.7 Remedial and affirmative action and self... to overcome the effects of the discrimination. (b) Affirmative action. In the absence of a finding of...

40 CFR 63.7944 - How do I determine the maximum HAP vapor pressure of my remediation material?

Code of Federal Regulations, 2014 CFR

2014-07-01

... vapor pressure of my remediation material? 63.7944 Section 63.7944 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS... Pollutants: Site Remediation Performance Tests § 63.7944 How do I determine the maximum HAP vapor pressure of...

40 CFR 63.7944 - How do I determine the maximum HAP vapor pressure of my remediation material?

Code of Federal Regulations, 2012 CFR

2012-07-01

... vapor pressure of my remediation material? 63.7944 Section 63.7944 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS... Pollutants: Site Remediation Performance Tests § 63.7944 How do I determine the maximum HAP vapor pressure of...

40 CFR 63.7944 - How do I determine the maximum HAP vapor pressure of my remediation material?

Code of Federal Regulations, 2013 CFR

2013-07-01

... vapor pressure of my remediation material? 63.7944 Section 63.7944 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS... Pollutants: Site Remediation Performance Tests § 63.7944 How do I determine the maximum HAP vapor pressure of...

40 CFR 63.7944 - How do I determine the maximum HAP vapor pressure of my remediation material?

Code of Federal Regulations, 2011 CFR

2011-07-01

... vapor pressure of my remediation material? 63.7944 Section 63.7944 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS... Pollutants: Site Remediation Performance Tests § 63.7944 How do I determine the maximum HAP vapor pressure of...

READING MANUAL, A GUIDEBOOK FOR ILLINOIS WORKSHOPS IN READING REMEDIATION.

ERIC Educational Resources Information Center

COVEY, CATHERINE

THE IMPORTANCE OF ADAPTING READING INSTRUCTION TO EACH CHILD'S NEEDS IS STRESSED IN THIS HANDBOOK FOR TEACHERS OF REMEDIAL READING. INFORMATION IS ORGANIZED AROUND SIX TOPICS--(1) THE NATURE OF THE READING PROCESS, (2) CRITERIA FOR A GOOD ELEMENTARY READING PROGRAM, (3) REMEDIAL READERS, THE SYMPTOMS AND CAUSES (PHYSICAL, INTELLECTUAL,…

40 CFR 1068.510 - How do I prepare and apply my remedial plan?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) AIR POLLUTION CONTROLS GENERAL COMPLIANCE PROVISIONS FOR ENGINE PROGRAMS Reporting Defects and Recalling Engines/Equipment § 1068.510 How do I prepare and apply my remedial plan? (a) In your remedial plan, describe all of the following: (1) The class or category of engines/equipment to be recalled...

Assessment of a Remedial Community College Cohort for Multiple Intelligences.

ERIC Educational Resources Information Center

Ksicinski, Joyce M.

According to a 1996 study by the National Center for Education Statistics, 75% of America's colleges offer remedial courses and 29% of first-time freshmen take them. Community colleges typically spend more on remedial education than do four-year institutions, and they are anticipating increased demand for such programs. The study cites Howard…

Simulation-Based Assessment Identifies Longitudinal Changes in Cognitive Skills in an Anesthesiology Residency Training Program.

PubMed

Sidi, Avner; Gravenstein, Nikolaus; Vasilopoulos, Terrie; Lampotang, Samsun

2017-06-02

We describe observed improvements in nontechnical or "higher-order" deficiencies and cognitive performance skills in an anesthesia residency cohort for a 1-year time interval. Our main objectives were to evaluate higher-order, cognitive performance and to demonstrate that simulation can effectively serve as an assessment of cognitive skills and can help detect "higher-order" deficiencies, which are not as well identified through more traditional assessment tools. We hypothesized that simulation can identify longitudinal changes in cognitive skills and that cognitive performance deficiencies can then be remediated over time. We used 50 scenarios evaluating 35 residents during 2 subsequent years, and 18 of those 35 residents were evaluated in both years (post graduate years 3 then 4) in the same or similar scenarios. Individual basic knowledge and cognitive performance during simulation-based scenarios were assessed using a 20- to 27-item scenario-specific checklist. Items were labeled as basic knowledge/technical (lower-order cognition) or advanced cognitive/nontechnical (higher-order cognition). Identical or similar scenarios were repeated annually by a subset of 18 residents during 2 successive academic years. For every scenario and item, we calculated group error scenario rate (frequency) and individual (resident) item success. Grouped individuals' success rates are calculated as mean (SD), and item success grade and group error rates are calculated and presented as proportions. For all analyses, α level is 0.05. Overall PGY4 residents' error rates were lower and success rates higher for the cognitive items compared with technical item performance in the operating room and resuscitation domains. In all 3 clinical domains, the cognitive error rate by PGY4 residents was fairly low (0.00-0.22) and the cognitive success rate by PGY4 residents was high (0.83-1.00) and significantly better compared with previous annual assessments (P < 0.05). Overall, there was an annual decrease in error rates for 2 years, primarily driven by decreases in cognitive errors. The most commonly observed cognitive error types remained anchoring, availability bias, premature closure, and confirmation bias. Simulation-based assessments can highlight cognitive performance areas of relative strength, weakness, and progress in a resident or resident cohort. We believe that they can therefore be used to inform curriculum development including activities that require higher-level cognitive processing.

Training hospital providers in basic CPR skills in Botswana: Acquisition, retention and impact of novel training techniques☆

PubMed Central

Meaney, Peter A.; Sutton, Robert M.; Tsima, Billy; Steenhoff, Andrew P.; Shilkofski, Nicole; Boulet, John R.; Davis, Amanda; Kestler, Andrew M.; Church, Kasey K.; Niles, Dana E.; Irving, Sharon Y.; Mazhani, Loeto; Nadkarni, Vinay M.

2013-01-01

Objective Globally, one third of deaths each year are from cardiovascular diseases, yet no strong evidence supports any specific method of CPR instruction in a resource-limited setting. We hypothesized that both existing and novel CPR training programs significantly impact skills of hospital-based healthcare providers (HCP) in Botswana. Methods HCP were prospectively randomized to 3 training groups: instructor led, limited instructor with manikin feedback, or self-directed learning. Data was collected prior to training, immediately after and at 3 and 6 months. Excellent CPR was prospectively defined as having at least 4 of 5 characteristics: depth, rate, release, no flow fraction, and no excessive ventilation. GEE was performed to account for within subject correlation. Results Of 214 HCP trained, 40% resuscitate ≥1/month, 28% had previous formal CPR training, and 65% required additional skills remediation to pass using AHA criteria. Excellent CPR skill acquisition was significant (infant: 32% vs. 71%, p < 0.01; adult 28% vs. 48%, p < 0.01). Infant CPR skill retention was significant at 3 (39% vs. 70%, p < 0.01) and 6 months (38% vs. 67%, p < 0.01), and adult CPR skills were retained to 3 months (34% vs. 51%, p = 0.02). On multivariable analysis, low cognitive score and need for skill remediation, but not instruction method, impacted CPR skill performance. Conclusions HCP in resource-limited settings resuscitate frequently, with little CPR training. Using existing training, HCP acquire and retain skills, yet often require remediation. Novel techniques with increased student: instructor ratio and feedback manikins were not different compared to traditional instruction. PMID:22561463

Career Assessment, Remediation, Education, Employment, and Re-entry Program (CAREER). El Paso Community College Career Grant. Final Report.

ERIC Educational Resources Information Center

LaFleur, Carol A.

Objectives of the Career Assessment, Remediation, Education, Employment, and Re-entry (CAREER) project were to establish a series of intensive, short-term job training programs using competency-based instruction to serve Hispanic persons who were economically disadvantaged, displaced, unemployed, or underemployed, as well as Hispanic females who…

Postsecondary Preparation and Remediation: Examining the Effect of the Early Assessment Program at California State University

ERIC Educational Resources Information Center

Howell, Jessica S.; Kurlaender, Michal; Grodsky, Eric

2010-01-01

In this paper we investigate how participation in the Early Assessment Program, which provides California high school juniors with information about their academic readiness for college-level work at California State University campuses, affects their college-going behavior and need for remediation in college. Using administrative records from…

Homogeneous Grouping and the Individualization of Instruction in Remedial Reading in an Intermediate School.

ERIC Educational Resources Information Center

Kelly, Thomas F.

A remedial reading program designed for intermediate-grade students who read from 1 to 7 years below grade level was studied. The program provided individualized instruction within classes homogeneously grouped on the basis of reading level only. Six seventh-grade classes were studied, with three acting as homogeneously grouped experimental…

34 CFR 668.20 - Limitations on remedial coursework that is eligible for Title IV, HEA program assistance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... course in English as a second language, the educational level of instruction provided in that course is... complete a degree or certificate program; (2) The educational level of instruction provided in the noncredit or reduced credit remedial course is below the level needed to pursue successfully the degree or...

10 CFR 13.1 - Basis and purpose.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Basis and purpose. 13.1 Section 13.1 Energy NUCLEAR REGULATORY COMMISSION PROGRAM FRAUD CIVIL REMEDIES § 13.1 Basis and purpose. (a) Basis. This part implements the Program Fraud Civil Remedies Act of 1986, Public Law No. 99-509, §§ 6101-6104, 100 Stat. 1874...

Cognitive remediation therapy for adolescent inpatients with severe and complex anorexia nervosa: A treatment trial.

PubMed

Harrison, Amy; Stavri, Pamela; Ormond, Lynn; McEnemy, Francine; Akyol, Dilan; Qureshi, Annum; Al-Khairulla, Hind

2018-05-01

Cognitive remediation therapy (CRT) is a low-intensity treatment adjunct for individuals with severe and complex anorexia nervosa (AN) with difficulties in globally oriented, flexible thinking. Previously trialled in adults, this study investigated whether individual and group CRT was a feasible, acceptable, and beneficial treatment for 125 adolescent inpatients with severe and complex AN. Seventy patients (mean age = 15.22, SD = 1.44) received 10 sessions of individual CRT, and 55 patients (mean age = 14.89, SD = 1.74) received 10 sessions of group CRT. In individual CRT, 1 patient (1.43%) dropped out, and there were medium-sized improvements in bigger picture thinking and set-shifting, small to large-sized improvements in switching-related initiation and inhibition skills, and large-sized improvements in motivation to recover. Group CRT had higher dropout (9.09%; n = 5) and produced small-sized improvements in global information processing and medium-sized improvements in self-reported cognitive flexibility and high acceptability ratings. Data suggest that a randomised controlled trial for adolescents with AN is warranted. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

Do You Get My Meaning?

ERIC Educational Resources Information Center

Miehle, Caroline

This guide provides an overview of the language process, with sections focusing on the physiological aspects (organization of the brain), language development, environmental variables, cognition, language deficits and evaluation, language remediation, and implications of the reading process. Appendixes provide selected listings of developmental…

Rethinking Remediation: A Model to Support the Detailed Diagnosis of Clinicians' Performance Problems and the Development of Effective Remediation Plans.

PubMed

Prescott-Clements, Linda; Voller, Vicky; Bell, Mark; Nestors, Natasha; van der Vleuten, Cees P M

2017-01-01

The successful remediation of clinicians demonstrating poor performance in the workplace is essential to ensure the provision of safe patient care. Clinicians may develop performance problems for numerous reasons, including health, personal factors, the workplace environment, or outdated knowledge/skills. Performance problems are often complex involving multifactorial issues, encompassing knowledge, skills, and professional behaviors. It is important that (where possible and appropriate) clinicians are supported through effective remediation to return them to safe clinical practice. A review of the literature demonstrated that research into remediation is in its infancy, with little known about the effectiveness of remediation programs currently. Current strategies for the development of remediation programs are mostly "intuitive"; a few draw upon established theories to inform their approach. Similarly, although it has been established that identification of the nature/scope of performance problems through assessment is an essential first step within remediation, the need for a more widespread "diagnosis" of why the problems exist is emerging. These reasons for poor performance, particularly in the context of experienced practicing clinicians, are likely to have an impact on the potential success of remediation and should be considered within the "diagnosis." A new model for diagnosing the performance problems of the clinicians has been developed, using behavioral change theories to explore known barriers to successful remediation, such as insight, motivation, attitude, self-efficacy, and the working environment, in addition to addressing known deficits regarding knowledge and skills. This novel approach is described in this article. An initial feasibility study has demonstrated the acceptability and practical implementation of our model.

What you find is not always what you fix--how other aspects than causes of accidents decide recommendations for remedial actions.

PubMed

Lundberg, Jonas; Rollenhagen, Carl; Hollnagel, Erik

2010-11-01

In accident investigation, the ideal is often to follow the principle "what-you-find-is-what-you-fix", an ideal reflecting that the investigation should be a rational process of first identifying causes, and then implement remedial actions to fix them. Previous research has however identified cognitive and political biases leading away from this ideal. Somewhat surprisingly, however, the same factors that often are highlighted in modern accident models are not perceived in a recursive manner to reflect how they influence the process of accident investigation in itself. Those factors are more extensive than the cognitive and political biases that are often highlighted in theory. Our purpose in this study was to reveal constraints affecting accident investigation practices that lead the investigation towards or away from the ideal of "what-you-find-is-what-you-fix". We conducted a qualitative interview study with 22 accident investigators from different domains in Sweden. We found a wide range of factors that led investigations away from the ideal, most which more resembled factors involved in organizational accidents, rather than reflecting flawed thinking. One particular limitation of investigation was that many investigations stop the analysis at the level of "preventable causes", the level where remedies that were currently practical to implement could be found. This could potentially limit the usefulness of using investigations to get a view on the "big picture" of causes of accidents as a basis for further remedial actions. 2010 Elsevier Ltd. All rights reserved.

Persistence of community college engineering science students: The impact of selected cognitive and noncognitive characteristics

NASA Astrophysics Data System (ADS)

Chatman, Lawrence M., Jr.

If the United States is to remain technologically competitive, persistence in engineering programs must improve. This study on student persistence employed a mixed-method design to identify the cognitive and noncognitive factors which contribute to students remaining in an engineering science curriculum or switching from an engineering curriculum at a community college in the northeast United States. Records from 372 students were evaluated to determine the characteristics of two groups: those students that persisted with the engineering curriculum and those that switched from engineering; also, the dropout phenomenon was evaluated. The quantitative portion of the study used a logistic regression analyses on 22 independent variables, while the qualitative portion of the study used group interviews to investigate the noncognitive factors that influenced persisting or switching. The qualitative portion of the study added depth and credibility to the results from the quantitative portion. The study revealed that (1) high grades in first year calculus, physics and chemistry courses, (2) fewer number of semesters enrolled, (3) attendance with full time status, and (4) not participating in an English as a Second Language (ESL) program were significant variables used to predict student persistence. The group interviews confirmed several of these contributing factors. Students that dropped out of college began with (1) the lowest levels of remediation, (2) the lowest grade point averages, and (3) the fewest credits earned.

Solutions Remediate Contaminated Groundwater

NASA Technical Reports Server (NTRS)

2010-01-01

During the Apollo Program, NASA workers used chlorinated solvents to clean rocket engine components at launch sites. These solvents, known as dense non-aqueous phase liquids, had contaminated launch facilities to the point of near-irreparability. Dr. Jacqueline Quinn and Dr. Kathleen Brooks Loftin of Kennedy Space Center partnered with researchers from the University of Central Florida's chemistry and engineering programs to develop technology capable of remediating the area without great cost or further environmental damage. They called the new invention Emulsified Zero-Valent Iron (EZVI). The groundwater remediation compound is cleaning up polluted areas all around the world and is, to date, NASA's most licensed technology.

Acceptability and feasibility of self-help Cognitive Remediation Therapy for anorexia nervosa delivered in collaboration with carers: a qualitative preliminary evaluation study.

PubMed

Lang, Katie; Treasure, Janet; Tchanturia, Kate

2015-02-28

Anorexia nervosa (AN) is an eating disorder without a recommended first-line treatment. Cognitive Remediation Therapy (CRT) is showing great promise in helping patients reduce cognitive inflexibility and excessive detail focus, thinking styles that could make engaging in psychological therapies difficult. CRT has shown to be effective, feasible and acceptable in both individual and group formats, and positive qualitative data has been gathered from both service users and clinicians. The aim of the current study was to assess the use of CRT as a self-help treatment for individuals with AN delivered in collaboration with carers. Six families underwent a six-week self-help CRT intervention. Feedback was gathered from qualitative interviews and analysed using thematic analysis. Neuropsychological outcomes were also collected. Participant feedback regarding the intervention was generally positive, with participants describing a number of benefits such as it creating a space for families to spend time together outside of the eating disorder, acting as a 'gateway' for more emotional work and helping participants to gain insight into their cognitive profiles. These preliminary findings suggest that self-help CRT delivered in collaboration with carers is an acceptable form of treatment, and adds to the growing literature supporting CRT for AN. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Monitored Natural Attenuation as a Remediation Strategy for Nuclear Power Plant Applications

NASA Astrophysics Data System (ADS)

Kim, K.; Bushart, S.

2009-12-01

A NRC Information Notice (IN 2006-13) was produced to inform holders of nuclear operating licenses “of the occurrence of radioactive contamination of ground water at multiple facilities due to undetected leakage from facility structures, systems, or components (SSCs) that contain or transport radioactive fluids” so that they could consider actions, as appropriate, to avoid similar problems. To reinforce their commitment to environmental stewardship the nuclear energy industry has committed to improving management of situations that have the potential to lead to the inadvertent release of radioactive fluids. This Industry Groundwater Protection Initiative, finalized in June 2007 as [NEI 07-07], calls for implementation and improvement of on-site groundwater monitoring programs and enhanced communications with stakeholders and regulators about situations related to inadvertent releases. EPRI developed its Groundwater Protection Program to provide the nuclear energy industry with the technical support needed to implement the Industry Groundwater Initiative. An objective of the EPRI Groundwater Protection Program is to provide the nuclear industry with technically sound guidance for implementing and enhancing on-site groundwater monitoring programs. EPRI, in collaboration with the EPRI Groundwater Protection Committee of utility members, developed the EPRI Groundwater Protection Guidelines for Nuclear Power Plants (EPRI Report 1015118, November 2007), which provides site-specific guidance for implementing a technically sound groundwater monitoring program. The guidance applies a graded approach for nuclear plants to tailor a technically effective and cost efficient groundwater monitoring program to the site’s hydrogeology and risk for groundwater contamination. As part of the Groundwater Protection Program, EPRI is also investigating innovative remediation technologies for addressing low-level radioactive contamination in soils and groundwater at nuclear power plant sites. One of these remediation technologies is monitored natural attenuation (MNA), which has been widely used in other industries for the remediation of contaminants in soil and groundwater. Monitored natural attenuation (MNA) is a non-intervention, but not a no-action, groundwater and soil remediation approach that involves monitoring the dilution, dispersion, and decay of contaminants to meet remediation objectives. MNA has been commonly applied at sites where soil and groundwater have been contaminated by volatile organic compounds. This method has also been applied to remediation of radiological contamination at U.S. DOE facilities and decommissioning nuclear power plant sites. The EPRI published report (1016764) provides guidance for implementing MNA at nuclear power plants for remediation of radiological contaminants in groundwater and soil. The goal of the EPRI Groundwater Protection program is to bring together experience and technologies - both from within the nuclear industry and other industries - to support the industry’s commitment to environmental stewardship. Results from the program are being published in an extensive series of reports and software, and are being communicated to members in an annual EPRI Groundwater Protection technical exchange workshop.

Cognitive Enhancement Therapy for Adults with Autism Spectrum Disorder: Results of an 18-Month Feasibility Study

PubMed Central

Eack, Shaun M.; Greenwald, Deborah P.; Hogarty, Susan S.; Bahorik, Amber L.; Litschge, Maralee Y.; Mazefsky, Carla A.; Minshew, Nancy J.

2013-01-01

Adults with autism experience significant impairments in social and non-social information processing for which few treatments have been developed. This study conducted an 18-month uncontrolled trial of Cognitive Enhancement Therapy (CET), a comprehensive cognitive rehabilitation intervention, in 14 verbal adults with autism spectrum disorder to investigate its feasibility, acceptability, and initial efficacy in treating these impairments. Results indicated that CET was satisfying to participants, with high treatment attendance and retention. Effects on cognitive deficits and social behavior were also large (d = 1.40 to 2.29) and statistically significant (all p < .001). These findings suggest that CET is a feasible, acceptable, and potentially effective intervention for remediating the social and non-social cognitive impairments in verbal adults with autism. PMID:23619953

Chance-constrained multi-objective optimization of groundwater remediation design at DNAPLs-contaminated sites using a multi-algorithm genetically adaptive method

NASA Astrophysics Data System (ADS)

Ouyang, Qi; Lu, Wenxi; Hou, Zeyu; Zhang, Yu; Li, Shuai; Luo, Jiannan

2017-05-01

In this paper, a multi-algorithm genetically adaptive multi-objective (AMALGAM) method is proposed as a multi-objective optimization solver. It was implemented in the multi-objective optimization of a groundwater remediation design at sites contaminated by dense non-aqueous phase liquids. In this study, there were two objectives: minimization of the total remediation cost, and minimization of the remediation time. A non-dominated sorting genetic algorithm II (NSGA-II) was adopted to compare with the proposed method. For efficiency, the time-consuming surfactant-enhanced aquifer remediation simulation model was replaced by a surrogate model constructed by a multi-gene genetic programming (MGGP) technique. Similarly, two other surrogate modeling methods-support vector regression (SVR) and Kriging (KRG)-were employed to make comparisons with MGGP. In addition, the surrogate-modeling uncertainty was incorporated in the optimization model by chance-constrained programming (CCP). The results showed that, for the problem considered in this study, (1) the solutions obtained by AMALGAM incurred less remediation cost and required less time than those of NSGA-II, indicating that AMALGAM outperformed NSGA-II. It was additionally shown that (2) the MGGP surrogate model was more accurate than SVR and KRG; and (3) the remediation cost and time increased with the confidence level, which can enable decision makers to make a suitable choice by considering the given budget, remediation time, and reliability.

Libra: An Interdisciplinary Approach to Remediation

ERIC Educational Resources Information Center

Fisher, Dexter; Lamdin, Lois

1974-01-01

Describes a program at a community college in Bronx, New York in which English instructors and content area teachers work together to improve the writing of students needing remedial instruction. (RB)

A Review of Remediation Programs in Pharmacy and Other Health Professions

PubMed Central

Fuller, Stephen H.; Hritcko, Philip M.; Matsumoto, Rae R.; Soltis, Denise A.; Taheri, Reza R.; Duncan, Wendy

2010-01-01

The Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards and Guidelines 2007 states that colleges and schools of pharmacy must have a remediation policy. Few comparative studies on remediation have been published by colleges and schools of pharmacy, making it challenging to implement effective and validated approaches. Effective remediation policies should include early detection of problems in academic performance, strategies to help students develop better approaches for academic success, and facilitation of self-directed learning. While the cost of remediation can be significant, revenues generated either cover or exceed the cost of delivering the remediation service. Additional research on remediation in pharmacy education across the United States and abroad is needed to make sound decisions in developing effective policies. This paper provides a review of current practices and recommendations for remediation in pharmacy and health care education. PMID:20414438

Cognitive Remediation in Middle-Aged or Older Inpatients with Chronic Schizophrenia: A Randomized Controlled Trial in Korea.

PubMed

Choi, Kee-Hong; Kang, Jinsook; Kim, Sun-Min; Lee, Seung-Hwan; Park, Seon-Cheol; Lee, Won-Hye; Choi, Sun; Park, Kiho; Hwang, Tae-Yeon

2017-01-01

Background: Accumulating evidence indicates that cognitive remediation (CR) is effective for improving various cognitive deficits in adult patients with schizophrenia. Although reports of brain plasticity in older adults and the service needs for chronic patients with schizophrenia are increasing, very few randomized controlled trials of CR have been conducted in middle-aged or older inpatients with chronic schizophrenia. We investigated the efficacy of individualized CR on the cognitive impairments of middle-aged or older inpatients with chronic schizophrenia within the context of comprehensive psychiatric rehabilitation (PR) by comparing the results obtained with PR only and treatment as usual (TAU). Method: Fifty-seven middle-aged and older individuals with chronic schizophrenia and mild to moderate cognitive deficits were enrolled. Thirty-eight who were undergoing PR were randomly assigned to CR + PR ( N = 19) or PR-only ( N = 19) groups. Nineteen participants who were undergoing TAU without CR or PR were evaluated pre- and post-treatment. Results: CR was easily provided and well received (drop-out rates = 5.3%) by middle-aged or older psychiatric inpatients. Compared to the PR-Only or TAU patients, patients in the CR + PR group showed greater improvement in executive functioning. Compared to TAU patients, CR + PR and PR-only patients showed greater improvement in logical memory. More patients in the CR + PR group improved clinically significantly in executive functioning and logical memory, compared with the PR-only and TAU patients. Conclusions: These results suggested that CR improved some cognitive deficits in middle-aged or older inpatients with chronic schizophrenia and that it was effective as an adjunctive treatment to the usual PR services provided in inpatient settings. Clinical Registration: KCT0002609.

A randomized controlled trial of cognitive remediation and work therapy in the early phase of substance use disorder recovery for older veterans: Neurocognitive and substance use outcomes.

PubMed

Bell, Morris D; Laws, Holly B; Petrakis, Ismene B

2017-03-01

Cognitive remediation therapy (CRT) is reported to improve neurocognitive and substance use disorder (SUD) outcomes in residential treatments. This National Institute of Drug Abuse funded pilot study reports on CRT as an augmentation to outpatient treatment for SUD. Recovering outpatient veterans were randomized into CRT + Work Therapy (n = 24) or work therapy (n = 24) with treatment-as-usual. Blind assessments of neurocognition and substance use were performed at baseline, 3 months (end of treatment), and 6-month follow-up. Baseline assessments revealed high rates of cognitive impairment with 87.5% showing significant decline from premorbid IQ on at least 1 measure (median = 3/14 measures). Adherence to treatment was excellent. Follow-up rates were 95.7% at 3 months and 87.5% at 6 months. Mixed effects models of cognitive change over time revealed significant differences favoring CRT + Work Therapy on working memory (WM) and executive function indices. Global index of cognition showed a nonsignificant trend (effect size [ES] = .37) favoring CRT + Work Therapy. SUD outcomes were excellent for both conditions. CRT + Work Therapy had a mean of 97% days of abstinence at 3 months, 94% in the 30 days prior to 6-month follow-up, and 24/26 weeks of total abstinence; differences between conditions were not significant. CRT was well accepted by outpatient veterans with SUDs and led to significant improvements in WM and executive functions beyond that of normal cognitive recovery. No difference between conditions was found for SUD outcomes, perhaps because work therapy obscured the benefits of CRT. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

40 CFR 63.7884 - What are the general standards I must meet for each site remediation with affected sources?

Code of Federal Regulations, 2011 CFR

2011-07-01

... meet for each site remediation with affected sources? 63.7884 Section 63.7884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS... Pollutants: Site Remediation General Standards § 63.7884 What are the general standards I must meet for each...

40 CFR 63.7884 - What are the general standards I must meet for each site remediation with affected sources?

Code of Federal Regulations, 2012 CFR

2012-07-01

... meet for each site remediation with affected sources? 63.7884 Section 63.7884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS... Pollutants: Site Remediation General Standards § 63.7884 What are the general standards I must meet for each...

40 CFR 63.7884 - What are the general standards I must meet for each site remediation with affected sources?

Code of Federal Regulations, 2013 CFR

2013-07-01

... meet for each site remediation with affected sources? 63.7884 Section 63.7884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS... Pollutants: Site Remediation General Standards § 63.7884 What are the general standards I must meet for each...

40 CFR 63.7884 - What are the general standards I must meet for each site remediation with affected sources?

Code of Federal Regulations, 2014 CFR

2014-07-01

... meet for each site remediation with affected sources? 63.7884 Section 63.7884 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS... Pollutants: Site Remediation General Standards § 63.7884 What are the general standards I must meet for each...

A Six-Year Study of the Effects of a Remedial Course in the Chemistry Curriculum

ERIC Educational Resources Information Center

Bentley, Andrea B.; Gellene, Gregory I.

2005-01-01

The Chemistry and Biochemistry Department at Texas Tech University (TTU) administered an in-house written chemistry placement examination (CPE) to determine whether students were prepared for Chem 1307, or whether a remedial course, Chem 1301, was required. The results indicate that the placement remediation program as implemented at TTU is…

A Study of Extensive Reading with Remedial Reading Students

ERIC Educational Resources Information Center

Lituanas, P. M.; Jacobs, G. M.; Renandya, W. A.

1999-01-01

This book chapter reports a study designed to examine the effectiveness of an English-language ER program for remedial students at a public secondary school in the southern Philippines. Sixty first-year students at the school, 30 females and 30 males, who were to be assigned to remedial reading classes constituted the participants in this study.…

75 FR 35720 - Massachusetts: Final Authorization of State Hazardous Waste Management Program Revisions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-23

...: Robin Biscaia, RCRA Waste Management Section, Office of Site Remediation and Restoration (OSRR 07-1... Restoration and Remediation (OSRR 07-1), EPA New England--Region 1, 5 Post Office Square, Suite 100, Boston... Management Section, Office of Site Remediation and Restoration (OSRR 07-1), EPA New England--Region 1, 5 Post...

Addressing the Needs of Underprepared Students in Higher Education: Does College Remediation Work?

ERIC Educational Resources Information Center

Bettinger, Eric P.; Long, Bridget Terry

2009-01-01

Each year , thousands graduate high school academically underprepared for college. Many must take remedial or developmental postsecondary coursework, and there is a growing debate about the effectiveness of such programs. This paper examines the effects of remediation using a unique data set of over 28,000 students. To account for selection…

CONCEPTUAL BASIS FOR NATURAL ATTENUATION (NA) ...

EPA Pesticide Factsheets

As used in enforcement actions at hazardous waste sites by U.S. EPA, monitored natural attenuation is a remedy fully equivalent to any other remedy. The acceptance of MNA is based on three lines of evidence: historical ground water and/or soil chemistry data that demonstrates a trend of declining contaminant concentration, 2. hydrogeologic and geochemical data that demonstrate NA processes and rates, and 3. Field or microcosm studies. MNA is appropriate as remedial approach only where it can be demonstrated to achieve remedial objectives within reasonable time frame, and meets the applicable remedy selection criteria for the particular regulatory program. To inform the public.

Case Study of Urban Residential Remediation and Restoration in Port Hope, Canada - 13250

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geddes, Brian; DeJong, John; Owen, Michael

2013-07-01

The Canadian Municipality of Port Hope, Ontario, is located some 100 km east of Toronto and has been the location of radium and/or uranium refining since the 1930's. Historically, these activities involved materials containing radium-226, uranium, arsenic and other contaminants generated by the refining process. In years past, properties and sites in Port Hope became contaminated from spillage during transportation, unrecorded, un-monitored or unauthorized diversion of contaminated fill and materials, wind and water erosion and spread from residue storage areas. Residential properties in Port Hope impacted by radioactive materials are being addressed by the Canadian federal government under programs administeredmore » by the Low-Level Radioactive Waste Management Office (LLRWMO) and the Port Hope Area Initiative Management Office (PHAIMO). Issues that currently arise at these properties are addressed by the LLRWMO's Interim Waste Management Program (IWM). In the future, these sites will be included in the PHAIMO's Small Scale Sites (SSS) remedial program. The LLRWMO has recently completed a remediation and restoration program at a residential property in Port Hope that has provided learnings that will be applicable to the PHAIMO's upcoming SSS remedial effort. The work scope at this property involved remediating contaminated refinery materials that had been re-used in the original construction of the residence. Following removal of the contaminated materials, the property was restored for continued residential use. This kind of property represents a relatively small, but potentially challenging subset of the portfolio of sites that will eventually be addressed by the SSS program. (authors)« less

EAAT Training for Injured Brains

ERIC Educational Resources Information Center

Flynn, Perry; Lundgren, Kristine; Mankoff, Lyn; Johnson, Leslie

2011-01-01

Cognitive impairments resulting from traumatic brain injury (TBI) are often long-lasting and difficult to remediate. These include problems with thinking, memory, reasoning, expressing and understanding emotion, social communication and social appropriateness. Survivors are often limited in their ability to return to a previous level of…

32 CFR Appendix E to Part 516 - Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act E Appendix E to Part 516 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Pt...

32 CFR Appendix E to Part 516 - Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act E Appendix E to Part 516 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Pt...

32 CFR Appendix E to Part 516 - Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 3 2012-07-01 2009-07-01 true Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act E Appendix E to Part 516 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Pt...

32 CFR Appendix E to Part 516 - Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act E Appendix E to Part 516 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Pt...

32 CFR Appendix E to Part 516 - Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Department of Defense Directive 5505.5, Implementation of the Program Fraud Civil Remedies Act E Appendix E to Part 516 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Pt...

Remediation Trends in an Undergraduate Anatomy Course and Assessment of an Anatomy Supplemental Study Skills Course

ERIC Educational Resources Information Center

Schutte, Audra Faye

2013-01-01

Anatomy A215: Basic Human Anatomy (Anat A215) is an undergraduate human anatomy course at Indiana University Bloomington (IUB) that serves as a requirement for many degree programs at IUB. The difficulty of the course, coupled with pressure to achieve grades for admittance into specific programs, has resulted in high remediation rates. In an…

Dyslexia and the Need for Teacher Training: A Collaborative Three-Pronged Approach between a University and a Community Partner

ERIC Educational Resources Information Center

Mills, Jeremy R.; Clarke, Monica

2017-01-01

An absent element in many education preparation programs is sufficient training on dyslexia and how to effectively remediate the disorder. Defining characteristics and remedial strategies for dyslexia have been established for decades but have not sufficiently become a part of teacher preparation programs, thus creating a gap in professional…

Preparing High School Students for College: An Exploratory Study of College Readiness Partnership Programs in Texas. NCPR Brief

ERIC Educational Resources Information Center

Barnett, Elisabeth A.; Corrin, William; Nakanishi, Aki; Bork, Rachel Hare; Mitchell, Claire; Sepanik, Susan

2012-01-01

Nationwide, about 40 percent of college students take at least one remedial course to prepare for college-level coursework. One cause of this high rate of remedial enrollment is the misalignment of high school graduation standards and college academic expectations. College readiness partnership programs attempt to address this problem by…

A Longitudinal Examination of the Remediation of Learning Disabilities: IQ, Age at Diagnosis, School SES and Voluntary Transfer

ERIC Educational Resources Information Center

Vandenberg, Brian; Emery, Debra

2009-01-01

This three year longitudinal study examined the effects of IQ, age of diagnosis, school socioeconomic status (SES) and participation in desegregation programs on the remediation of learning disabilities. Participants included 176 children who were diagnosed with a learning disability, 44 of whom were participants in a voluntary transfer program.…

Title I/PSEN Individualized Reading and Math Services for the Handicapped, 1980-81. Final Evaluation Report.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Office of Educational Evaluation.

The Title I Umbrella Program provided compensatory instruction in reading, mathematics, and writing to 24,000 mildly or moderately handicapped students in New York City. The program was comprised of seven discrete components for the remediation of reading and writing skills, five after-school models, and two components for the remediation of math…

Collaboration between the University Pre-Service Teacher Education Program and the Local Elementary School on English Remedial Education

ERIC Educational Resources Information Center

Chien, Chin-Wen

2015-01-01

This study analyzed 24 pre-service elementary school English teachers' design and delivery of remedial education to the fifth and sixth graders in the collaboration between the university pre-service teacher education program and the local elementary school in a city in northwest Taiwan. The pre-service teachers were encouraged by the elementary…

45 CFR 618.110 - Remedial and affirmative action and self-evaluation.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 618.110 Remedial and affirmative action and self...

45 CFR 618.110 - Remedial and affirmative action and self-evaluation.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 618.110 Remedial and affirmative action and self...

45 CFR 618.110 - Remedial and affirmative action and self-evaluation.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Introduction § 618.110 Remedial and affirmative action and self...

The Development of Nitroxide Based Coatings for Biofilm Remediation- 154020

DTIC Science & Technology

2017-06-05

AFRL-AFOSR-JP-TR-2017-0048 The Development of Nitroxide Based Coatings for Biofilm Remediation Kathryn Fairfull-Smith QUEENSLAND UNIVERSITY OF...for Biofilm Remediation - 154020 5a.  CONTRACT NUMBER 5b.  GRANT NUMBER FA2386-15-1-4087 5c.  PROGRAM ELEMENT NUMBER 61102F 6. AUTHOR(S) Kathryn...llisapi.dll Annual Report for AOARD Grant 15IOA087-154020 “The Development of Nitroxide Based Coatings for Biofilm Remediation ” 7th June 2017 PI and Co

Manual Dexterity in Schizophrenia—A Neglected Clinical Marker?

PubMed Central

Térémetz, Maxime; Carment, Loïc; Brénugat-Herne, Lindsay; Croca, Marta; Bleton, Jean-Pierre; Krebs, Marie-Odile; Maier, Marc A.; Amado, Isabelle; Lindberg, Påvel G.

2017-01-01

Impaired manual dexterity is commonly observed in schizophrenia. However, a quantitative description of key sensorimotor components contributing to impaired dexterity is lacking. Whether the key components of dexterity are differentially affected and how they relate to clinical characteristics also remains unclear. We quantified the degree of dexterity in 35 stabilized patients with schizophrenia and in 20 age-matched control subjects using four visuomotor tasks: (i) force tracking to quantify visuomotor precision, (ii) sequential finger tapping to measure motor sequence recall, (iii) single-finger tapping to assess temporal regularity, and (iv) multi-finger tapping to measure independence of finger movements. Diverse clinical and neuropsychological tests were also applied. A patient subgroup (N = 15) participated in a 14-week cognitive remediation protocol and was assessed before and after remediation. Compared to control subjects, patients with schizophrenia showed greater error in force tracking, poorer recall of tapping sequences, decreased tapping regularity, and reduced degree of finger individuation. A composite performance measure discriminated patients from controls with sensitivity = 0.79 and specificity = 0.9. Aside from force-tracking error, no other dexterity components correlated with antipsychotic medication. In patients, some dexterity components correlated with neurological soft signs, Positive and Negative Syndrome Scale (PANSS), or neuropsychological scores. This suggests differential cognitive contributions to these components. Cognitive remediation lead to significant improvement in PANSS, tracking error, and sequence recall (without change in medication). These findings show that multiple aspects of sensorimotor control contribute to impaired manual dexterity in schizophrenia. Only visuomotor precision was related to antipsychotic medication. Good diagnostic accuracy and responsiveness to treatment suggest that manual dexterity may represent a useful clinical marker in schizophrenia. PMID:28740470

A Serious Game to Improve Cognitive Functions in Schizophrenia: A Pilot Study

PubMed Central

Amado, Isabelle; Brénugat-Herné, Lindsay; Orriols, Eric; Desombre, Colombe; Dos Santos, Maxine; Prost, Zelda; Krebs, Marie-Odile; Piolino, Pascale

2016-01-01

Cognitive deficits in schizophrenia impair everyday functioning and instrumental daily living activities. These disabilities can be partly responsible for chronicity and institutionalization. We present here a virtual reality (VR) tool in which patients with schizophrenia performed a virtual game in an imaginary town during a 3-month program. In a pilot study, seven patients with schizophrenia (DSM-5), institutionalized for many years, attended weekly 1-h-and-a-half sessions organized by two clinicians. During the first sessions, they listed together the difficulties they experienced in everyday organization and planning. After being familiarized with the joystick and the VR environment, they navigated in the town, and planned actions that were difficult for them to carry out in their usual life (e.g., shopping, memorizing the way to the supermarket or being on time at a meeting point). They had to look for alternative routes and practice a switch from a 2D Map to the 3D Map. They also gathered their efforts to share strategies for each action, or discussed the action plan they could generate to solve concrete problems. The pre/post-neuropsychological evaluations showed attention, working memory, prospective, and retrospective memory benefits, but no improvement in planning as assessed by the Zoo map test and the action program subtest of Behavioral Assessment of the Dysexecutive Syndrome. Patients also clinically and functionally improved, gaining autonomy. Pragmatically, they reported a strong energy to elaborate concrete plans to search for jobs, or return to activities in the community. Qualitative assessments showed a benefit in sparing time, planning better, enriched relatedness, and better management of their housework. This VR game opens avenue to rehabilitation for patients with schizophrenia experiencing chronicity in their life, less attendance in daycare units, and a better community living. This program might reduce neurocognitive difficulties and might evolve into a true method for cognitive remediation (trial n° 2011-A00988-33). PMID:27148093

Cognitive remediation therapy (CRT) as a treatment enhancer of eating disorders and obsessive compulsive disorders: study protocol for a randomized controlled trial.

PubMed

van Passel, Boris; Danner, Unna; Dingemans, Alexandra; van Furth, Eric; Sternheim, Lot; van Elburg, Annemarie; van Minnen, Agnes; van den Hout, Marcel; Hendriks, Gert-Jan; Cath, Daniëlle

2016-11-10

Anorexia nervosa (AN) and Obsessive Compulsive Disorder (OCD) are among the most incapacitating and costly of mental disorders. Cognitive Behaviour Therapy (CBT), medication, and combination regimens, to which in AN personalised guidance on weight control is added, are moderately successful, leaving room for more effective treatment algorithms. An underlying deficit which the two disorders share is cognitive inflexibility, a trait that is likely to impede treatment engagement and reduce patients' ability to benefit from treatment. Cognitive remediation therapy (CRT) is an easy-to-use intervention aimed at reducing cognitive inflexibility and thereby enhancing treatment outcome, which we aim to test in a controled study. In a randomized-controlled multicenter clinical trial 64 adult patients with AN and 64 with OCD are randomized to 10 bi-weekly sessions with either CRT or a control condition, after which Treatment As Usual (TAU) is started. All patients are evaluated during single-blind assessments at baseline, post-CRT/control intervention, and after 6 months. Indices of treatment effect are disorder-specific symptom severity, quality of life, and cost-effectivity. Also, moderators and mediators of treatment effects will be studied. To our knowledge, this is the first randomized controlled trial using an control condition evaluating the efficacy and effectiveness of CRT as a treatment enhancer preceding TAU for AN, and the first study to investigate CRT in OCD, moreover taking cost-effectiveness of CRT in AN and OCD into account. The Netherlands Trial Register NTR3865 . Registered 20 february 2013.

A review of Indian research on cognitive remediation for schizophrenia.

PubMed

Hegde, Shantala

2017-02-01

Cognitive deficits play a central role in recovery from Schizophrenia (SZ). Cognitive remediation (CR) is increasingly being examined to improve cognitive functions in SZ. It is becoming an inevitable component of treatment for this debilitating illness. This review article presents the current status of research on CR for SZ in India. In contrast to the numerous studies reported from across the globe, there are only five studies on CR for SZ published from India. Of the five, only two are randomized controlled trials, two are non-randomized studies and one is a series of case reports. With different strategies used for CR and a variety of tools and measurements as outcome measures, combined analysis of the data was not feasible. Improvement in cognitive functions and sustenance of the improvement observed at follow-up period ranging from 2 to 6 months duration was underscored by all the four studies. Indigenous methods such as home-based CR techniques and Yoga therapy as an adjunct CR technique have been researched upon. Established method of CR such as the Integrated Psychological Therapy (IPT) has been used with modifications made to suit the cultural scenario. Other treatment methods such as family therapy have been added along with CR for chronic patients. The limited number of research studies has tried to encompass various dimensions. However, there is a dire need for studies with larger sample size with stringent research methods. Culturally feasible CR technique and multi-centric studies with larger sample size can be the next way forward. Copyright © 2016 Elsevier B.V. All rights reserved.

A qualitative study of medical educators' perspectives on remediation: Adopting a holistic approach to struggling residents.

PubMed

Krzyzaniak, Sara M; Wolf, Stephen J; Byyny, Richard; Barker, Lisa; Kaplan, Bonnie; Wall, Stephen; Guerrasio, Jeannette

2017-09-01

During residency, some trainees require the identification and remediation of deficiencies to achieve the knowledge, skills and attitudes necessary for independent practice. Given the limited published frameworks for remediation, we characterize remediation from the perspective of educators and propose a holistic framework to guide the approach to remediation. We conducted semistructured focus groups to: explore methods for identifying struggling residents; categorize common domains of struggle; describe personal factors that contribute to difficulties; define remediation interventions and understand what constitutes successful completion. Data were analyzed through conventional content analysis. Nineteen physicians across multiple specialties and institutions participated in seven focus groups. Thirteen categories emerged around remediation. Some themes addressed practical components of remediation, while others reflected barriers to the process and the impact of remediation on the resident and program. The themes were used to inform development of a novel holistic framework for remediation. The approach to remediation requires comprehensive identification of individual factors impacting performance. The intervention should not only include a tailored learning plan but also address confounders that impact likelihood of remediation success. Our holistic framework intends to guide educators creating remediation plans to ensure all domains are addressed.

45 CFR 1303.4 - Remedies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM APPEAL... from pursuing any other remedies authorized by law. ...

Neuropsychological assessment in autism spectrum disorder and related conditions

PubMed Central

Zwick, Georg Peter

2017-01-01

Neuropsychological assessment provides a profound analysis of cognitive functioning in people with autism spectrum disorder (ASD). Individuals on the autistic spectrum often show a high level of anxiety and are frequently affected by comorbidities that influence their quality of life. Yet, they also have cognitive strengths that should be identified in order to develop effective support strategies. This article presents an overview of five cognitive areas that are essential for neuropsychological evaluation (ie, intelligence, attention, executive function, social cognition, and praxis) and explores the underlying causes of behavioral problems in persons with ASD. Furthermore, it stresses the importance of meticulous neuropsychological testing with regard to cognitive remediation, a method that can help to enhance single cognitive processes in a targeted manner. Objective test results suggest it might be possible to promote an improved sense of coherence. In line with the salutogenic model, this may be fundamental for human health and well-being. PMID:29398932

Remedial Coursetaking at U.S. Public 2- and 4-Year Institutions: Scope, Experiences, and Outcomes. Statistical Analysis Report. NCES 2016-405

ERIC Educational Resources Information Center

Chen, Xianglei

2016-01-01

Every year, millions of new college students arrive on campus lacking the necessary academic skills to perform at the college level. Postsecondary institutions address this problem with extensive remedial programs designed to strengthen students' basic skills. While much research on the effectiveness of remedial education has been conducted,…

Technical approach to groundwater restoration. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-11-01

The Technical Approach to Groundwater Restoration (TAGR) provides general technical guidance to implement the groundwater restoration phase of the Uranium Mill Tailings Remedial Action (UMTRA) Project. The TAGR includes a brief overview of the surface remediation and groundwater restoration phases of the UMTRA Project and describes the regulatory requirements, the National Environmental Policy Act (NEPA) process, and regulatory compliance. A section on program strategy discusses program optimization, the role of risk assessment, the observational approach, strategies for meeting groundwater cleanup standards, and remedial action decision-making. A section on data requirements for groundwater restoration evaluates the data quality objectives (DQO) andmore » minimum data required to implement the options and comply with the standards. A section on sits implementation explores the development of a conceptual site model, approaches to site characterization, development of remedial action alternatives, selection of the groundwater restoration method, and remedial design and implementation in the context of site-specific documentation in the site observational work plan (SOWP) and the remedial action plan (RAP). Finally, the TAGR elaborates on groundwater monitoring necessary to evaluate compliance with the groundwater cleanup standards and protection of human health and the environment, and outlines licensing procedures.« less

Cognitive Remediation Interventions for Gambling Disorder: A Systematic Review.

PubMed

Challet-Bouju, Gaëlle; Bruneau, Mélanie; Victorri-Vigneau, Caroline; Grall-Bronnec, Marie

2017-01-01

Various therapeutic approaches are available for the treatment of gambling disorder (GD), especially cognitive behavioral therapy (CBT; the most widely used treatment). However, CBT has high dropout and relapse rates as well as non-compliance issues, which may be partly due to resistance to changing core characteristics, such as executive functioning, attention, and emotional regulation abnormalities. Finding new therapeutic approaches to treat GD is thus a key challenge. Cognitive remediation (CR) interventions represent a promising approach to GD management, which has recently been demonstrated to have efficacy for treating other addictive disorders. The objective of this review is to describe the possible benefits of CR interventions for GD management. Two systematic searches in MEDLINE and ScienceDirect databases were conducted up until January 2017. Potential neurocognitive targets of CR interventions for GD were reviewed, as is the use and efficacy of such interventions for GD. While there is evidence of several neurocognitive deficits in individuals with GD in terms of impulsive, reflective, and interoceptive processes, the literature on CR interventions is virtually absent. No clinical studies were found in the literature, apart from a trial of a very specific program using Playmancer, a serious videogame, which was tested in cases of bulimia nervosa and GD. However, neurocognitive impairments in individuals with addictive disorders are highly significant, not only affecting quality of life, but also making abstinence and recovery more difficult. Given that CR interventions represent a relatively novel therapeutic approach to addiction and that there is currently a scarcity of studies on clinical populations suffering from GD, further research is needed to examine the potential targets of such interventions and the effectiveness of different training approaches. So far, no consensus has been reached on the optimal parameters of CR interventions (duration, intensity, frequency, group vs. individual, pencil-and-paper vs. computerized delivery, etc.). Although no firm conclusions can be drawn, CR interventions represent a promising adjunct treatment for GD. Such a novel therapy could be associated with common interventions, such as CBT and educational and motivational interventions, in order to make therapies more effective and longer-lasting and to decrease the risk of relapse.

Cognitive Remediation Interventions for Gambling Disorder: A Systematic Review

PubMed Central

Challet-Bouju, Gaëlle; Bruneau, Mélanie; Grall-Bronnec, Marie; Victorri-Vigneau, Caroline; Grall-Bronnec, Marie

2017-01-01

Various therapeutic approaches are available for the treatment of gambling disorder (GD), especially cognitive behavioral therapy (CBT; the most widely used treatment). However, CBT has high dropout and relapse rates as well as non-compliance issues, which may be partly due to resistance to changing core characteristics, such as executive functioning, attention, and emotional regulation abnormalities. Finding new therapeutic approaches to treat GD is thus a key challenge. Cognitive remediation (CR) interventions represent a promising approach to GD management, which has recently been demonstrated to have efficacy for treating other addictive disorders. The objective of this review is to describe the possible benefits of CR interventions for GD management. Two systematic searches in MEDLINE and ScienceDirect databases were conducted up until January 2017. Potential neurocognitive targets of CR interventions for GD were reviewed, as is the use and efficacy of such interventions for GD. While there is evidence of several neurocognitive deficits in individuals with GD in terms of impulsive, reflective, and interoceptive processes, the literature on CR interventions is virtually absent. No clinical studies were found in the literature, apart from a trial of a very specific program using Playmancer, a serious videogame, which was tested in cases of bulimia nervosa and GD. However, neurocognitive impairments in individuals with addictive disorders are highly significant, not only affecting quality of life, but also making abstinence and recovery more difficult. Given that CR interventions represent a relatively novel therapeutic approach to addiction and that there is currently a scarcity of studies on clinical populations suffering from GD, further research is needed to examine the potential targets of such interventions and the effectiveness of different training approaches. So far, no consensus has been reached on the optimal parameters of CR interventions (duration, intensity, frequency, group vs. individual, pencil-and-paper vs. computerized delivery, etc.). Although no firm conclusions can be drawn, CR interventions represent a promising adjunct treatment for GD. Such a novel therapy could be associated with common interventions, such as CBT and educational and motivational interventions, in order to make therapies more effective and longer-lasting and to decrease the risk of relapse. PMID:29255433

Focused Board Intervention (FBI): A Remediation Program for Written Board Preparation and the Medical Knowledge Core Competency.

PubMed

Visconti, Annette; Gaeta, Theodore; Cabezon, Michael; Briggs, William; Pyle, Matthew

2013-09-01

Residents deemed at risk for low performance on standardized examinations require focused attention and remediation. To determine whether a remediation program for residents identified as at risk for failure on the Emergency Medicine (EM) Written Board Examination is associated with improved outcomes. All residents in 8 classes of an EM 1-3 program were assessed using the In-Training Examination. Residents enrolled in the Focused Board Intervention (FBI) remediation program based on an absolute score on the EM 3 examination of <70% or a score more than 1 SD below the national mean on the EM 1 or 2 examination. Individualized education plans (IEPs) were created for residents in the FBI program, combining self-study audio review lectures with short-answer examinations. The association between first-time pass rate for the American Board of Emergency Medicine (ABEM) Written Qualifying Examination (WQE) and completion of all IEPs was examined using the χ(2) test. Of the 64 residents graduating and sitting for the ABEM examination between 2000 and 2008, 26 (41%) were eligible for the program. Of these, 10 (38%) residents were compliant and had a first-time pass rate of 100%. The control group (12 residents who matched criteria but graduated before the FBI program was in place and 4 who were enrolled but failed to complete the program) had a 44% pass rate (7 of 16), which was significantly lower (χ(2)  =  8.6, P  =  .003). The probability of passing the ABEM WQE on the first attempt was improved through the completion of a structured IEP.

Language and Communication.

ERIC Educational Resources Information Center

Ransom, Grayce A.

An analysis of the relationship of language to learning, particularly as it affects "avoidance behaviors" of remedial readers in the classroom, strongly emphasized the importance of greater stress on oral language development. New concern for cognitive and personality development in children stresses the role of language as an interaction medium…

Cognitive tutoring induces widespread neuroplasticity and remediates brain function in children with mathematical learning disabilities

PubMed Central

Iuculano, Teresa; Rosenberg-Lee, Miriam; Richardson, Jennifer; Tenison, Caitlin; Fuchs, Lynn; Supekar, Kaustubh; Menon, Vinod

2015-01-01

Competency with numbers is essential in today's society; yet, up to 20% of children exhibit moderate to severe mathematical learning disabilities (MLD). Behavioural intervention can be effective, but the neurobiological mechanisms underlying successful intervention are unknown. Here we demonstrate that eight weeks of 1:1 cognitive tutoring not only remediates poor performance in children with MLD, but also induces widespread changes in brain activity. Neuroplasticity manifests as normalization of aberrant functional responses in a distributed network of parietal, prefrontal and ventral temporal–occipital areas that support successful numerical problem solving, and is correlated with performance gains. Remarkably, machine learning algorithms show that brain activity patterns in children with MLD are significantly discriminable from neurotypical peers before, but not after, tutoring, suggesting that behavioural gains are not due to compensatory mechanisms. Our study identifies functional brain mechanisms underlying effective intervention in children with MLD and provides novel metrics for assessing response to intervention. PMID:26419418

A Program for Training Special Education Consultants in Remediating Academic and Social Behaviors of Handicapped Children. Final Report.

ERIC Educational Resources Information Center

Harris, Jasper W.; And Others

Presented is the final report of a 4-year project to develop and evaluate a prototype program for training special education consultants who are qualified to assist school personnel and parents in remediating academic and social behaviors of handicapped children in the Kansas City (Missouri) area. An overview and introduction are provided in the…

Tank waste remediation system nuclear criticality safety program management review

DOE Office of Scientific and Technical Information (OSTI.GOV)

BRADY RAAP, M.C.

1999-06-24

This document provides the results of an internal management review of the Tank Waste Remediation System (TWRS) criticality safety program, performed in advance of the DOE/RL assessment for closure of the TWRS Nuclear Criticality Safety Issue, March 1994. Resolution of the safety issue was identified as Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-40-12, due September 1999.

Chance-constrained multi-objective optimization of groundwater remediation design at DNAPLs-contaminated sites using a multi-algorithm genetically adaptive method.

PubMed

Ouyang, Qi; Lu, Wenxi; Hou, Zeyu; Zhang, Yu; Li, Shuai; Luo, Jiannan

2017-05-01

In this paper, a multi-algorithm genetically adaptive multi-objective (AMALGAM) method is proposed as a multi-objective optimization solver. It was implemented in the multi-objective optimization of a groundwater remediation design at sites contaminated by dense non-aqueous phase liquids. In this study, there were two objectives: minimization of the total remediation cost, and minimization of the remediation time. A non-dominated sorting genetic algorithm II (NSGA-II) was adopted to compare with the proposed method. For efficiency, the time-consuming surfactant-enhanced aquifer remediation simulation model was replaced by a surrogate model constructed by a multi-gene genetic programming (MGGP) technique. Similarly, two other surrogate modeling methods-support vector regression (SVR) and Kriging (KRG)-were employed to make comparisons with MGGP. In addition, the surrogate-modeling uncertainty was incorporated in the optimization model by chance-constrained programming (CCP). The results showed that, for the problem considered in this study, (1) the solutions obtained by AMALGAM incurred less remediation cost and required less time than those of NSGA-II, indicating that AMALGAM outperformed NSGA-II. It was additionally shown that (2) the MGGP surrogate model was more accurate than SVR and KRG; and (3) the remediation cost and time increased with the confidence level, which can enable decision makers to make a suitable choice by considering the given budget, remediation time, and reliability. Copyright © 2017 Elsevier B.V. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deeb, Rula A.; Hawley, Elisabeth L.

The goal of United States (U.S.) Department of Energy's (DOE)'s environmental remediation programs is to restore groundwater to beneficial use, similar to many other Federal and state environmental cleanup programs. Based on past experience, groundwater remediation to pre-contamination conditions (i.e., drinking water standards or non-detectable concentrations) can be successfully achieved at many sites. At a subset of the most complex sites, however, complete restoration is not likely achievable within the next 50 to 100 years using today's technology. This presentation describes several approaches used at complex sites in the face of these technical challenges. Many complex sites adopted a long-termmore » management approach, whereby contamination was contained within a specified area using active or passive remediation techniques. Consistent with the requirements of their respective environmental cleanup programs, several complex sites selected land use restrictions and used risk management approaches to accordingly adopt alternative cleanup goals (alternative endpoints). Several sites used long-term management designations and approaches in conjunction with the alternative endpoints. Examples include various state designations for groundwater management zones, technical impracticability (TI) waivers or greater risk waivers at Superfund sites, and the use of Monitored Natural Attenuation (MNA) or other passive long-term management approaches over long time frames. This presentation will focus on findings, statistics, and case studies from a recently-completed report for the Department of Defense's Environmental Security Technology Certification Program (ESTCP) (Project ER-0832) on alternative endpoints and approaches for groundwater remediation at complex sites under a variety of Federal and state cleanup programs. The primary objective of the project was to provide environmental managers and regulators with tools, metrics, and information needed to evaluate alternative endpoints for groundwater remediation at complex sites. A statistical analysis of Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) sites receiving TI waivers will be presented as well as case studies of other types of alternative endpoints and alternative remedial strategies that illustrate the variety of approaches used at complex sites and the technical analyses used to predict and document cost, time frame, and potential remedial effectiveness. This presentation is intended to inform DOE program managers, state regulators, practitioners and other stakeholders who are evaluating technical cleanup challenges within their own programs, and establishing programmatic approaches to evaluating and implementing long-term management approaches. Case studies provide examples of long-term management designations and strategies to manage and remediate groundwater at complex sites. At least 13 states consider some designation for groundwater containment in their corrective action policies, such as groundwater management zones, containment zones, and groundwater classification exemption areas. Long-term management designations are not a way to 'do nothing' or walk away from a site. Instead, soil and groundwater within the zone is managed to be protective of human health and the environment. Understanding when and how to adopt a long-term management approach can lead to cost savings and the more efficient use of resources across DOE and at numerous other industrial and military sites across the U.S. This presentation provides context for assessing the use and appropriate role of alternative endpoints and supporting long-term management designations in final remedies. (authors)« less

77 FR 72366 - National Institute on Drug Abuse; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-05

...: To review and evaluate grant applications. Place: National Institutes of Health Neuroscience Center... Special Emphasis Panel; Cognitive Remediation and Work Therapy. Date: December 13, 2012. Time: 10:00 a.m..., Neuroscience Center, 6001 Executive Boulevard, Rockville, MD 20852, (Telephone Conference Call). Contact Person...

Predictive model for early math skills based on structural equations.

PubMed

Aragón, Estíbaliz; Navarro, José I; Aguilar, Manuel; Cerda, Gamal; García-Sedeño, Manuel

2016-12-01

Early math skills are determined by higher cognitive processes that are particularly important for acquiring and developing skills during a child's early education. Such processes could be a critical target for identifying students at risk for math learning difficulties. Few studies have considered the use of a structural equation method to rationalize these relations. Participating in this study were 207 preschool students ages 59 to 72 months, 108 boys and 99 girls. Performance with respect to early math skills, early literacy, general intelligence, working memory, and short-term memory was assessed. A structural equation model explaining 64.3% of the variance in early math skills was applied. Early literacy exhibited the highest statistical significance (β = 0.443, p < 0.05), followed by intelligence (β = 0.286, p < 0.05), working memory (β = 0.220, p < 0.05), and short-term memory (β = 0.213, p < 0.05). Correlations between the independent variables were also significant (p < 0.05). According to the results, cognitive variables should be included in remedial intervention programs. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Perinatal Risks and Childhood Premorbid Indicators of Later Psychosis: Next Steps for Early Psychosocial Interventions

PubMed Central

Liu, Cindy H.; Keshavan, Matcheri S.; Tronick, Ed; Seidman, Larry J.

2015-01-01

Schizophrenia and affective psychoses are debilitating disorders that together affect 2%–3% of the adult population. Approximately 50%–70% of the offspring of parents with schizophrenia manifest a range of observable difficulties including socioemotional, cognitive, neuromotor, speech-language problems, and psychopathology, and roughly 10% will develop psychosis. Despite the voluminous work on premorbid vulnerabilities to psychosis, especially on schizophrenia, the work on premorbid intervention approaches is scarce. While later interventions during the clinical high-risk (CHR) phase of psychosis, characterized primarily by attenuated positive symptoms, are promising, the CHR period is a relatively late phase of developmental derailment. This article reviews and proposes potential targets for psychosocial interventions during the premorbid period, complementing biological interventions described by others in this Special Theme issue. Beginning with pregnancy, parents with psychoses may benefit from enhanced prenatal care, social support, parenting skills, reduction of symptoms, and programs that are family-centered. For children at risk, we propose preemptive early intervention and cognitive remediation. Empirical research is needed to evaluate these interventions for parents and determine whether interventions for parents and children positively influence the developmental course of the offspring. PMID:25904724

Maywood Interim Storage Site annual environmental report for calendar year 1991, Maywood, New Jersey. Formerly Utilized Sites Remedial Action Program (FUSRAP)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-09-01

This document describes the environmental monitoring program at the Maywood Interim Storage Site (MISS) and surrounding area, implementation of the program, and monitoring results for 1991. Environmental monitoring of MISS began in 1984 when congress added the site to the US Department of Energy`s (DOE) Formerly Utilized Sites Remedial Action Program (FUSRAP). FUSRAP is a DOE program to identify and decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation`s atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program at MISS includesmore » sampling networks for radon and thoron concentrations in air; external gamma radiation-exposure; and total uranium, radium-226, radium-228, thorium-232, and thorium-230 concentrations in surface water, sediment, and groundwater. Additionally, several nonradiological parameters are measured in surface water, sediment, and groundwater. Monitoring results are compared with applicable Environmental Protection Agency standards, DOE derived concentration guides (DCGs), dose limits, and other requirements in DOE orders. Environmental standards are established to protect public health and the environment.« less

The Feasibility and Acceptability to Service Users of CIRCuiTS, a Computerized Cognitive Remediation Therapy Programme for Schizophrenia.

PubMed

Reeder, Clare; Pile, Victoria; Crawford, Polly; Cella, Matteo; Rose, Diana; Wykes, Til; Watson, Andrew; Huddy, Vyv; Callard, Felicity

2016-05-01

Cognitive remediation (CR) is a psychological therapy, effective in improving cognitive performance and functioning in people with schizophrenia. As the therapy becomes more widely implemented within mental health services its longevity and uptake is likely to depend on its feasibility and acceptability to service users and clinicians. To assess the feasibility and acceptability of a new strategy-based computerized CR programme (CIRCuiTS) for people with psychosis. Four studies were conducted using mixed methods. Perceptions of attractiveness, comprehensibility, acceptability and usability were assessed using self-report questionnaires in 34 non-clinical participants (study 1), and five people with a schizophrenia diagnosis and three experienced CR therapists (studies 2 and 3). The ease with which pre-specified therapy programmes could be assembled was also assessed by three therapists (Study 2). Finally, the satisfaction of 20 service users with a diagnosis of schizophrenia regarding their experience of using CIRCuiTS in the context of a course of the CR therapy was assessed in a qualitative interview study (study 4). Ratings of perceived attractiveness, comprehensibility, acceptability and usability consistently exceeded pre-set high targets by non-clinical, clinical and therapist participants. Qualitative analysis of satisfaction with CIRCuiTS showed that receiving the therapy was generally seen to be a positive experience, leading to perceptions that cognitive functioning had improved and attempts to incorporate new strategy use into daily activities. CIRCuiTS demonstrates high acceptability and ease of use for both service users with a schizophrenia diagnosis and clinicians.

T cell deficiency leads to cognitive dysfunction: Implications for therapeutic vaccination for schizophrenia and other psychiatric conditions

PubMed Central

Kipnis, Jonathan; Cohen, Hagit; Cardon, Michal; Ziv, Yaniv; Schwartz, Michal

2004-01-01

The effects of the adaptive immune system on the cognitive performance and abnormal behaviors seen in mental disorders such as schizophrenia have never been documented. Here, we show that mice deprived of mature T cells manifested cognitive deficits and behavioral abnormalities, which were remediable by T cell restoration. T cell-based vaccination, using glatiramer acetate (copolymer-1, a weak agonist of numerous self-reactive T cells), can overcome the behavioral and cognitive abnormalities that accompany neurotransmitter imbalance induced by (+)dizocilpine maleate (MK-801) or amphetamine. The results, by suggesting that peripheral T cell deficit can lead to cognitive and behavioral impairment, highlight the importance of properly functioning adaptive immunity in the maintenance of mental activity and in coping with conditions leading to cognitive deficits. These findings point to critical factors likely to contribute to age- and AIDS-related dementias and might herald the development of a therapeutic vaccination for fighting off cognitive dysfunction and psychiatric conditions. PMID:15141078

Training hospital providers in basic CPR skills in Botswana: acquisition, retention and impact of novel training techniques.

PubMed

Meaney, Peter A; Sutton, Robert M; Tsima, Billy; Steenhoff, Andrew P; Shilkofski, Nicole; Boulet, John R; Davis, Amanda; Kestler, Andrew M; Church, Kasey K; Niles, Dana E; Irving, Sharon Y; Mazhani, Loeto; Nadkarni, Vinay M

2012-12-01

Globally, one third of deaths each year are from cardiovascular diseases, yet no strong evidence supports any specific method of CPR instruction in a resource-limited setting. We hypothesized that both existing and novel CPR training programs significantly impact skills of hospital-based healthcare providers (HCP) in Botswana. HCP were prospectively randomized to 3 training groups: instructor led, limited instructor with manikin feedback, or self-directed learning. Data was collected prior to training, immediately after and at 3 and 6 months. Excellent CPR was prospectively defined as having at least 4 of 5 characteristics: depth, rate, release, no flow fraction, and no excessive ventilation. GEE was performed to account for within subject correlation. Of 214 HCP trained, 40% resuscitate ≥ 1/month, 28% had previous formal CPR training, and 65% required additional skills remediation to pass using AHA criteria. Excellent CPR skill acquisition was significant (infant: 32% vs. 71%, p<0.01; adult 28% vs. 48%, p<0.01). Infant CPR skill retention was significant at 3 (39% vs. 70%, p<0.01) and 6 months (38% vs. 67%, p<0.01), and adult CPR skills were retained to 3 months (34% vs. 51%, p=0.02). On multivariable analysis, low cognitive score and need for skill remediation, but not instruction method, impacted CPR skill performance. HCP in resource-limited settings resuscitate frequently, with little CPR training. Using existing training, HCP acquire and retain skills, yet often require remediation. Novel techniques with increased student: instructor ratio and feedback manikins were not different compared to traditional instruction. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Integrated Hydrogeological Model of the General Separations Area, Vol. 2, Rev. 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

FLACH, GREGORYK.

1999-04-01

The 15 mi2 General Separations Area (GSA) contains more than 35 RCRA and CERCLA waste units, and is the focus of numerous ongoing and anticipated contaminant migration and remedial alternatives studies. To meet the analysis needs of GSA remediation programs, a groundwater flow model of the area based on the FACT code was developed. The model is consistent with detailed characterization and monitoring data through 1996. Model preprocessing has been automated so that future updates and modifications can be performed quickly and efficiently. Most remedial action scenarios can be explicitly simulated, including vertical recirculation wells, vertical barriers, surface caps, pumpingmore » wells at arbitrary locations, specified drawdown within well casings (instead of flowrate), and wetland impacts of remedial actions. The model has a fine scale vertical mesh and heterogeneous conductivity field, and includes the vadose zone. Therefore, the model is well suited to support subsequent contaminant transport simulations. the model can provide a common framework for analyzing groundwater flow, contaminant migration, and remedial alternatives across Environmental Restoration programs within the GSA.« less

Are Universities Providing Non-STEM Students the Mathematics Preparation Required by Their Programs?: A Case Study of A Quantitative Literacy Pathway and Vertical Alignment from Remediation to Degree Completion

ERIC Educational Resources Information Center

Allen, Charles

2017-01-01

Informed by Gagne's belief in the necessity of prerequisite knowledge for new learning, and Bruner's Spiral Curriculum Theory, the objective of this case study was to explore the postsecondary pathway from remedial mathematics, through one gateway mathematics course, and into the quantitative literacy requirements of various non-STEM programs of…

Cost and Performance Report: Solar-Powered Remediation and pH Control

DTIC Science & Technology

2017-04-01

OMB (Office of Management and Budget) Circular A-94. 2016. Guidelines and Discount Rates for Benefit - Cost Analysis of Federal Programs. Rahner D...ER-201033) Solar-Powered Remediation and pH Control April 2017 This document has been cleared for public release; Distribution Statement A...Program (ESTCP). The publication of this report does not indicate endorsement by the Department of Defense, nor should the contents be construed

An Experimental Program Offering Junior College Remedial English Instruction Simultaneously to High School Seniors and Junior College Freshmen via Open Circuit Television. Final Report.

ERIC Educational Resources Information Center

Boettcher, Kenneth D.

American River College (Calif.) devised an experimental program in remedial English intended to better prepare entering freshmen. It was given by open-circuit TV simultaneously to high school seniors and junior college freshmen in the hope that, in subsequent years, there would be fewer inadequately prepared freshmen and that more could enroll…

Remediation Evaluation Model for Chlorinated Solvents (REMChlor)

EPA Science Inventory

A new analytical solution has been developed for simulating the transient effects of groundwater source and plume remediation. This development was performed as part of a Strategic Environmental Research and Development Program (SERDP) research project, which was a joint effort ...

Human Listening: Processes and Behavior.

ERIC Educational Resources Information Center

Weaver, Carl H.

This book is divided into three conceptual areas: a general presentation of listening behavior and its place in the communication process, the major social and psychological processes involved in the selection and cognition of aurally received data, and remedial measures for both the speaker and the auditor. "Listening behavior: an overview"…

Impact of Attention Training on Academic Achievement, Executive Functioning, and Behavior: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Kirk, Hannah; Gray, Kylie; Ellis, Kirsten; Taffe, John; Cornish, Kim

2017-01-01

Children with intellectual and developmental disabilities (IDD) experience significant difficulties in attention, learning, executive functions, and behavioral regulation. Emerging evidence suggests that computerized cognitive training may remediate these impairments. In a double blind controlled trial, 76 children with IDD (4-11 years) were…

Cognitive Dissonance as a Strategy in Social Justice Teaching

ERIC Educational Resources Information Center

Gorski, Paul C.

2009-01-01

Some misunderstandings are remedied easily. But when new information collides with old prejudices--when new truths battle established beliefs for space in people's consciousnesses--they tend to respond with all manner of defense mechanisms. They employ these defenses in response to the psychological stressors that emerge from such inner-battles…

THE DEUTSCH MODEL--INSTITUTE FOR DEVELOPMENTAL STUDIES.

ERIC Educational Resources Information Center

New York Univ., NY. Inst. for Developmental Studies.

THE DEUTSCH INTERVENTION MODEL IS BASED ON THE THEORY THAT ENVIRONMENT PLAYS A MAJOR ROLE IN THE DEVELOPMENT OF COGNITIVE SKILLS AND OF FUNCTIONAL USE OF INTELLECTUAL CAPABILITIES. DISADVANTAGED CHILDREN HAVE INTELLECTUAL DEFICITS WHICH MAY BE OVERCOME BY USE OF MATCHED REMEDIAL MEASURES. LANGUAGE SKILLS AND MOTIVATION CAN BE IMPROVED BY TEACHING…

NEUROPSYCHOLOGICAL REMEDIATION OF HYPERACTIVE CHILDREN

PubMed Central

Agarwal, Neena; Rao, Shobini L.

1997-01-01

Hyperkinesis is associated with deficits of attention (poor allocation of attention resources, susceptibility to interference and perseveration); vigilance and perceptual sensitivity. Three boys aged 7-8 years with simple hyperkinesis were given cognitive tasks to improve the above functions in daily one hour sessions for a month. The children improved significantly in the above functions and behaviour. Three other children aged 5-8 years with simple hyperkinesis who were on medication improved only slightly in their behaviour during this period. Behavioural intervention and parental counselling were additional inputs to the children in both groups. Neuropsychological remediation combined with parental counselling and behavioural intervention shows promise in treating hyperactive children. PMID:21584098

St. Louis airport site annual environmental report for calendar year 1990, St. Louis, Missouri

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1991-08-01

Environmental monitoring of the US Department of Energy's (DOE) St. Louis Airport Site (SLAPS) and surrounding area began in 1984. SLAPS is part of the Formerly Utilized Sites Remedial Action Program (FUSRAP), a DOE program to decontaminate or otherwise control sites where residual radioactive materials remain from the early years of the nation's atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. Monitoring results are compared with applicable Environmental Protection Agency (EPA) standards; federal, state, and local applicable or relevant and appropriate requirements (ARARs); and/or DOE derived concentration guidelines (DCGs). Environmental standards, ARARs,more » and DCGs are established to protect public health and the environment. Results from the 1990 environmental monitoring program demonstrated that the concentrations of contaminants of concern were all below applicable standards, ARARs, and guidelines. Site activities in 1990 were limited to maintenance. SLAPS was in compliance with all applicable regulations during 1990 and has remained in compliance since 1984, when the environmental monitoring program and remedial action began.« less

Installation Restoration Program. Remedial Investigation Report. Volume 2. Sections 4-6. Alpena Combat Readiness Training Center, Alpena County Regional Airport, Michigan Air National Guard, Alpena, Michigan.

DTIC Science & Technology

1995-06-01

Remedial Investigation Report of Sites l-9 at Alpens CRTC Alpena Ml. Volume II Sections 4-6. A remedial investigation was performed on 9 sites at the... Alpena CRTC to determine the extent of contamination at the sites. The sites involved ill this investigation include: Site 1 POL Storage Area; Site 2

The relationship between change in cognition and change in functional ability in schizophrenia during cognitive and psychosocial rehabilitation.

PubMed

Rispaud, Samuel G; Rose, Jennifer; Kurtz, Matthew M

2016-10-30

While a wealth of studies have evaluated cross-sectional links between cognition and functioning in schizophrenia, few have investigated the relationship between change in cognition and change in functioning in the context of treatment trials targeted at cognition. Identifying cognitive skills that, when improved, predict improvement in functioning will guide the development of more targeted rehabilitation for this population. The present study identifies the relationship between change in specific cognitive skills and change in functional ability during one year of cognitive rehabilitation. Ninety-six individuals with schizophrenia were assessed with a battery of cognitive measures and a measure of performance-based functioning before and after cognitive training consisting of either drill-and-practice cognitive remediation or computer skills training. Results revealed that while working and episodic memory, problem-solving, and processing speed skills all improved during the trial, only improved working memory and processing speed skills predicted improvement in functional ability. Secondary analyses revealed these relationships were driven by individuals who showed a moderate level (SD≥0.5) of cognitive improvement during the trial. These findings suggest that while a variety of cognitive skills may improve during training targeted at cognition, only improvements in a subset of cognitive functions may translate into functional gains. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Review of Fermented Foods with Beneficial Effects on Brain and Cognitive Function

PubMed Central

Kim, Binna; Hong, Veronica Minsu; Yang, Jeongwon; Hyun, Heejung; Im, Jooyeon Jamie; Hwang, Jaeuk; Yoon, Sujung; Kim, Jieun E.

2016-01-01

Around the world, fermentation of foods has been adopted over many generations, primarily due to their commercial significance with enriched flavors and high-profile nutrients. The increasing application of fermented foods is further promoted by recent evidence on their health benefits, beyond the traditionally recognized effects on the digestive system. With recent advances in the understanding of gut-brain interactions, there have also been reports suggesting the fermented food’s efficacy, particularly for cognitive function improvements. These results are strengthened by the proposed biological effects of fermented foods, including neuroprotection against neurotoxicity and reactive oxygen species. This paper reviews the beneficial health effects of fermented foods with particular emphasis on cognitive enhancement and neuroprotective effects. With an extensive review of fermented foods and their potential cognitive benefits, this paper may promote commercially feasible applications of fermented foods as natural remedies to cognitive problems. PMID:28078251

28 CFR 542.13 - Informal resolution.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Informal resolution. 542.13 Section 542.13 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT ADMINISTRATIVE REMEDY Administrative Remedy Program § 542.13 Informal resolution. (a) Informal resolution. Except...

Implementation of a DOD ELAP Conforming Quality System at a FUSRAP Site Field Temporary Radiological Screening Laboratory - 13500

DOE Office of Scientific and Technical Information (OSTI.GOV)

Winters, M.S.; McElheny, G.; Houston, L.M.

2013-07-01

A case study is presented on specific program elements that supported the transition of a temporary field radiological screening lab to an accredited operation capable of meeting client quality objectives for definitive results data. The temporary field lab is located at the Formerly Utilized Sites Remedial Action Program Linde Site in Tonawanda, NY. The site is undergoing remediation under the direction of the United States Army Corps of Engineers - Buffalo District, with Cabrera Services Inc. as the remediation contractor and operator of the on-site lab. Analysis methods employed in the on-site lab include gross counting of alpha and betamore » particle activity on swipes and air filters and gamma spectroscopy of soils and other solid samples. A discussion of key program elements and lessons learned may help other organizations considering pursuit of accreditation for on-site screening laboratories. (authors)« less

Evaluation of home lead remediation in an Australian mining community.

PubMed

Boreland, F; Lesjak, M; Lyle, D

2009-12-20

In 1994 a comprehensive program was established to reduce children's blood lead levels in Broken Hill, NSW, Australia. Home remediation (abatement of lead hazards in a child's home) was included as part of a case management strategy for children with blood lead levels >or=15 microg/dL. Children with blood lead levels >or=30 microg/dL were offered immediate home remediation. Children with blood lead levels of 15-29 microg/dL were allocated to 'immediate' or 'delayed' home remediation; a subset of these participated in a randomized controlled trial (RCT) to evaluate the effectiveness of home remediation for reducing blood lead levels. One hundred and seventeen children received home remediation. One hundred and thirteen returned for follow-up blood tests, 88 of whom participated in the RCT. On average children's blood lead levels decreased by 1.7 microg/dL (10%) in the 6 months after remediation and by 2.2 microg/dL (13%) in the 6-12 months after remediation. However, remediation did not significantly change the rate of decline in blood lead levels (P=0.609). There was no evidence of association between change in children's blood lead levels and changes in lead loading in their homes. The results are consistent with the published literature, which suggests that home remediation does not reduce children's exposure to lead sufficiently to cause a moderate or greater decrease in their blood lead level. In communities where lead is widely dispersed, the study suggests that it is important to assess potential sources and pathways by which children are exposed to lead when developing an intervention plan, and the need for multiple interventions to effectively reduce blood lead levels. The findings reinforce the ongoing need for rigorous epidemiological evaluation of lead management programs to improve the evidence base, and for effective primary prevention to avoid children being exposed to lead in the first place.

Sustainable exposure prevention through innovative detection and remediation technologies from the NIEHS Superfund Research Program.

PubMed

Henry, Heather F; Suk, William A

2017-03-01

Innovative devices and tools for exposure assessment and remediation play an integral role in preventing exposure to hazardous substances. New solutions for detecting and remediating organic, inorganic, and mixtures of contaminants can improve public health as a means of primary prevention. Using a public health prevention model, detection and remediation technologies contribute to primary prevention as tools to identify areas of high risk (e.g. contamination hotspots), to recognize hazards (bioassay tests), and to prevent exposure through contaminant cleanups. Primary prevention success is ultimately governed by the widespread acceptance of the prevention tool. And, in like fashion, detection and remediation technologies must convey technical and sustainability advantages to be adopted for use. Hence, sustainability - economic, environmental, and societal - drives innovation in detection and remediation technology. The National Institute of Health (NIH) National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) is mandated to advance innovative detection, remediation, and toxicity screening technology development through grants to universities and small businesses. SRP recognizes the importance of fast, accurate, robust, and advanced detection technologies that allow for portable real-time, on-site characterization, monitoring, and assessment of contaminant concentration and/or toxicity. Advances in non-targeted screening, biological-based assays, passive sampling devices (PSDs), sophisticated modeling approaches, and precision-based analytical tools are making it easier to quickly identify hazardous "hotspots" and, therefore, prevent exposures. Innovation in sustainable remediation uses a variety of approaches: in situ remediation; harnessing the natural catalytic properties of biological processes (such as bioremediation and phytotechnologies); and application of novel materials science (such as nanotechnology, advanced membranes, new carbon materials, and materials reuse). Collectively, the investment in new technologies shows promise to reduce the amount and toxicity of hazardous substances in the environment. This manuscript highlights SRP funded innovative devices and tools for exposure assessment and remediation of organic, inorganic, and mixtures of contaminants with a particular focus on sustainable technologies.

Common social cognitive impairments do not mean common causes: A commentary on Cotter et al. (2018).

PubMed

Dodell-Feder, David; Germine, Laura T

2018-06-06

Many clinical conditions, ranging from psychiatric to neurodegenerative illnesses, are associated with impairments in the processes by which we perceive, interpret, and respond to social information; a suite of abilities known as social cognition. Through a systematic review of meta-analyses, Cotter et al. (2018) present a compelling view of social cognitive deficits as a core phenotype of many clinical conditions. However, we caution against one potential interpretation of their findings, namely, that similar social cognitive outcomes are produced by similar causes. Specifically, we argue that while the outcome may look similar across clinical conditions (i.e., global social cognitive deficits), the cause and nature of those impairments are likely to differ, and, as a consequence, so too will its remediation. We advocate for the development of better methods for assessing social cognition, which may speak to the varying nature of social cognitive impairment across conditions. Ultimately, a better understanding of how social cognition is impaired will facilitate the development of more targeted, more effective treatments, that will improve patient care. Copyright © 2018 Elsevier Ltd. All rights reserved.

Executive summary: Weldon Spring Site Environmental Report for calendar year 1992. Weldon Spring Site Remedial Action Project, Weldon Spring, Missouri

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-06-01

This report has been prepared to provide information about the public safety and environmental protection programs conducted by the Weldon Spring Site Remedial Action Project. The Weldon Spring site is located in southern St. Charles County, Missouri, approximately 48 km (30 mi) west of St. Louis. The site consists of two main areas, the Weldon Spring Chemical Plant and raffinate pits and the Weldon Spring Quarry. The objectives of the Site Environmental Report are to present a summary of data from the environmental monitoring program, to characterize trends and environmental conditions at the site, and to confirm compliance with environmentalmore » and health protection standards and requirements. The report also presents the status of remedial activities and the results of monitoring these activities to assess their impacts on the public and environment. The scope of the environmental monitoring program at the Weldon Spring site has changed since it was initiated. Previously, the program focused on investigations of the extent and level of contaminants in the groundwater, surface waters, buildings, and air at the site. In 1992, the level of remedial activities required monitoring for potential impacts of those activities, particularly on surface water runoff and airborne effluents. This report includes monitoring data from routine radiological and nonradiological sampling activities. These data include estimates of dose to the public from the Weldon Spring site; estimates of effluent releases; and trends in groundwater contaminant levels. Also, applicable compliance requirements, quality assurance programs, and special studies conducted in 1992 to support environmental protection programs are reviewed.« less

Cost Effective, Ultra Sensitive Groundwater Monitoring for Site Remediation and Management: Standard Operating Procedures with QA/QC

DTIC Science & Technology

2015-05-01

in consultation with the site management . 4.0 DATA TYPES AND QUALITY CONTROL A sampling plan must account for the collection, handling, and...GUIDANCE DOCUMENT Cost-Effective, Ultra-Sensitive Groundwater Monitoring for Site Remediation and Management : Standard Operating Procedures...Groundwater Monitoring for Site Remediation and Management 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Halden, R.U., Roll, I.B. 5d

Heartland Engineers: A Century of Superior Service 1907-2007

DTIC Science & Technology

2009-01-01

NJ SUPERFUND SITE, REMEDIAL DESIGN 104. INDEPENDENCE AAF: OEW LMS ASR-NOFA 105. INDEPENDENCE SATELLITE POW CAMP: PA/INPR 106. INVES. & ASSESS IMA-AR...the development of nuclear weaponry, under the Formerly Used Sites Remedial Action Plan (FUSRAP) for the Department of Energy as well as Formerly Used...further assist in the cleanup of Cold War legacy wastes through the U.S. Depart- ment of Energy’s Formerly Utilized Sites Remedial Action Program

Preferential Remedies for Employment Discrimination

ERIC Educational Resources Information Center

Edwards, Harry T.; Zaretsky, Barry L.

1975-01-01

An overview of the problem of preferential remedies to achieve equal employment opportunities for women and minority groups. Contends that "color blindness" will not end discrimination but that some form of "color conscious" affirmative action program must be employed. Temporary preferential treatment is justified, according to…

REGULATORY PROGRAMS. USEPA PERSPECTIVE ON THE REMEDIATION OF CONTAMINATED WOOD PRESERVING SITES.

EPA Science Inventory

Since the enactment of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) and the Resource Conservation and Recovery Act (RCRA), as amended, many directives and initiatives have been established which govern various aspects of remedial activities at...

REMEDIATION TECHNOLOGY EVALUATION AT THE GILT EDGE MINE, SOUTH DAKOTA

EPA Science Inventory

This document reports the findings of the Mine Waste Technology Program's Activity III, Project 29,The Remediation Technology Evaluation Project at the Gilt Edge Mine, S.D. This project consisted of evaluating three emerging acidic waste rock stabilization technologies and compar...

Optimization Strategies for Long-Term Ground Water Remedies (with Particular Emphasis on Pump and Treat Systems)

EPA Pesticide Factsheets

This fact sheet has been prepared to assist environmental case managers from Federal and State agencies, environmental program managers from private organizations, and environmental contractors with optimization of operating long-term ground water remedies

10 CFR 430.73 - Remedies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Certification and Enforcement § 430.73 Remedies. If DOE determines that a basic model of a covered product does not comply with an applicable energy conservation standard or water conservation standard (in the case of faucets...

10 CFR 430.73 - Remedies.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ENERGY ENERGY CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Certification and Enforcement § 430.73 Remedies. If DOE determines that a basic model of a covered product does not comply with an applicable energy conservation standard or water conservation standard (in the case of faucets...