Efficacy and specificity of computer-assisted cognitive remediation in schizophrenia: a meta-analytical study.

BACKGROUND: Cognitive remediation is frequently based on computerized training methods that target different cognitive deficits. The aim of this article was to assess the efficacy of computer-assisted cognitive remediation (CACR) in schizophrenia and to determine whether CACR enables selective treatment of specific cognitive domains. METHOD: A meta-analysis was performed on 16 randomized controlled trials evaluating CACR. The effect sizes of differences between CACR and control groups were computed and classified according to the cognitive domain assessed. The possible influences of four potential moderator variables were examined: participants' age, treatment duration, weekly frequency, and control condition type. To test the domain-specific effect, the intended goal of each study was determined and the effect sizes were sorted accordingly. The effect sizes of the cognitive domains explicitly targeted by the interventions were then compared with those that were not. RESULTS: CACR enhanced general cognition with a mean effect size of 0.38 [confidence interval (CI) 0.20-0.55]. A significant medium effect size of 0.64 (CI 0.29-0.99) was found for Social Cognition. Improvements were also significant in Verbal Memory, Working Memory, Attention/Vigilance and Speed of Processing with small effect sizes. Cognitive domains that were specifically targeted by the interventions did not yield higher effects than those that were not. CONCLUSIONS: The results lend support to the efficacy of CACR with particular emphasis on Social Cognition. The difficulty in targeting specific domains suggests a 'non-specific' effect of CACR. These results are discussed in the light of the possible bias in remediation tasks due to computer interface design paradigms.

Implementing sustainable sanitation concepts in Luxembourg: methodological approach and outcomes.

The present paper reports the approaches adopted to involve and inform stakeholders at various levels and to identify barriers and needed actions towards the implementation of sustainable sanitation concepts in Luxembourg. The study was split into two phases, starting with a workshop and interviews of important actors/professionals of the water sector such as public administrations, engineering companies and sanitary firms. The second phase consisted of a survey among end-users, developed in order to analyse enabling and disabling factors with respect to sustainable water use in households, and for which over 200 questionnaires were evaluated. Valuable conclusions for the project orientation were derived from these studies in terms of further needs for awareness raising, information and formation. The water professionals pointed to specific questions with respect to the feasibility of sustainable sanitation, such as hygienic concerns or maintenance issues for decentralised technology. A moderate financial commitment towards environmentally friendly techniques as well as a considerable lack of knowledge concerning innovative sanitation concepts was detected for end-users. Based on these findings, tailor-made communication strategies for key stakeholder groups were elaborated and pilot projects were initiated.

Time estimation in patients with right or left medial-temporal lobe resection.

Patients with either left or right antero-medial-temporal lobe (MTL) resection were investigated as to their ability to reproduce and produce three durations (5, 14, or 38 s) in three conditions (silence, counting, articulatory suppression). The results showed that patients with unilateral MTL lesions did not differ from controls when they had to encode the duration of a visual stimulus in order to reproduce it. By contrast, patients with right MTL lesions underestimated all three durations, compared with controls and with patients with left MTL resection, when they had to produce durations given in chronometric units. This finding suggests that the right MTL retains long-term representations of the conventional units necessary to the accurate production of durations.