Let me give you something to think about: Does needing to remember something new make it easier to forget something old?

In an item-method directed forgetting task, memory instructions presumably operate by promoting further rehearsal of to-be-remembered (TBR) items and limiting encoding of to-be-forgotten (TBF) items. We asked whether diverting attentional resources away from TBF items and towards a new item that needed to be committed to memory would improve forgetting. To this end, study words in our experiments were presented singly followed by a remember instruction (single-TBR), by a forget instruction (single-TBF), or else were replaced by a new word to be remembered (replace-TBR) in place of the original study word which could be forgotten (replace-TBF). A typical directed forgetting effect was observed across single and replace trials. However, there was no compelling evidence that forgetting was better for replace-TBF compared to single-TBF words, suggesting that, by itself, the explicit redirection of attentional and other processing resources away from forget items may not be sufficient to improve item-method directed forgetting.

Application of the Nursing Process Using Moulage as a Problem-Based Approach to Teaching Dermatologic Content.

ABSTRACT: Teaching dermatologic conditions can be challenging in lecture-style format. A class activity was implemented in a prelicensure nursing course to enhance learning of dermatologic conditions while emphasizing the nursing process, evidence-based treatments, transmission-based precautions, and teamwork. Students worked in teams to identify moulage-based dermatologic conditions and follow the nursing process to develop a plan of care. Students presented their findings to faculty and peers. Positive student feedback on the activity included enhanced teamwork, application of the nursing process, visual emphasis on content, and understanding of holistic care. This activity is an innovative alternative to traditional lecture format.

Forgetting under difficult conditions: Item-method directed forgetting under perceptual processing constraints.

Intentional forgetting of unwanted items is effortful, yet directed forgetting seems to improve when a secondary task is performed. According to the cognitive load hypothesis of directed forgetting, allocating attentional resources to another task improves forgetting by restricting unwanted encoding of to-be-forgotten (TBF) items. Alternatively, it might be that anything that makes studying more difficult will encourage greater effort to perform the task well and therefore lead to improved intentional forgetting. To assess these proposals we imposed data-processing limitations on study words in an item-method directed forgetting paradigm. Across six experiments, the perceptual quality of study words was manipulated by varying: (1) the duration of study word presentation (Experiments 1-4); (2) the contrast of the displayed word against its visual background (Experiment 5); or (3) the amount of visual background noise on which the word was presented (Experiment 6). In Experiments 4-6, a lexical decision task corroborated the difficulty of study word processing. Despite evidence that relatively low visual contrast and relatively high visual background noise, in particular, create challenging conditions, we found no evidence that perceptual quality impacts the magnitude of the directed forgetting effect. This work suggests that data limitations have no discernible effect on forgetting and corroborate that only attentional resource limitations improve directed forgetting.

Decomposing item-method directed forgetting of emotional pictures: Equivalent costs and no benefits.

Using an item-method directed forgetting task, we presented negative, neutral, and positive photographic pictures, one at a time, each followed by an instruction to remember or forget. We determined that the directed forgetting effect, defined as better subsequent recognition of to-be-remembered (TBR) items than to-be-forgotten (TBF) items, was equivalent across negative, neutral, and positive pictures. To disentangle the underlying costs (i.e., decrease in memory for TBF items) and benefits (i.e., increase in memory for TBR items), we compared recognition memory performance in the directed forgetting task to that of a novel within-subjects remember-all control condition (Experiment 1) and to a between-subjects remember-all control group (Experiment 2). We observed costs without benefits across all three emotions-negative, neutral, and positive-in both experiments. These results demonstrate that equivalent directed forgetting effects for emotional stimuli are not attributable to different underlying component processes. Instead, our results suggest that selection for encoding is accomplished in similar ways, regardless of emotional content.

Identification and synthesis of potent and selective pyridyl-isoxazole based agonists of sphingosine-1-phosphate 1 (S1P1).

The synthesis and structure-activity relationship (SAR) of a series of pyridyl-isoxazole based agonists of S1P1 are discussed. Compound 5b provided potent in vitro activity with selectivity, had an acceptable pharmacokinetic profile, and demonstrated efficacy in a dose dependent manner when administered orally in a rodent model of arthritis.

Improving Self-Reported Person-centered Care Competency in Nursing Students: A Pilot Study Using Interactive Case Studies.

BACKGROUND: To prepare nursing students to deliver high-quality care, educators need strategies to foster person-centered care (PCC). PURPOSE: This pilot study evaluated an intervention with interactive case studies on undergraduate nursing students' PCC competency. METHODS: We conducted a pilot study with sophomore undergraduate nursing students (n = 39) from a Midwestern US university. We developed a 90-minute class seminar with interactive case studies highlighting how patient preferences, values, and circumstances could influence fall risk. We assessed PCC using the Patient-Centered Care Competency Scale. RESULTS: Although there was no statistically significant change in overall PCC competency before and after the intervention, we noted a small to medium effect size on PCC competency per Cohen's d standards (d = 0.35). Content analysis of students' open-ended responses reflected PCC and clustered into 5 themes. CONCLUSIONS: Findings suggest that educators may use interactive case studies to foster nursing student PCC competency.

Enhancing the production effect in memory.

The production effect is the finding that subsequent memory is better for words that are produced than for words that are not produced. Whereas the current literature demonstrates that reading aloud is the most effective form of production, the distinctiveness account used to explain the production effect predicts that there is nothing special about reading aloud per se: Other forms of vocal production that include an additional distinct element should produce even greater subsequent memory benefits than reading aloud. To test this, we presented participants with study words that they were instructed to read aloud loudly, read aloud, or read silently (Experiment 1); sing, read aloud, or read silently (Experiment 2); and sing, read aloud loudly, read aloud, or read silently (Experiment 3). We observed that both reading items aloud loudly (Experiments 1 and 3) and singing items (Experiments 2 and 3) at study resulted in greater subsequent recognition than reading items aloud in a normal voice; singing had a larger memory benefit than reading aloud loudly (Experiment 3). Our findings support the distinctiveness hypothesis by demonstrating that there are other forms of production, such as singing and reading aloud loudly that have a more pronounced effect on memory than reading aloud.

Intentional forgetting diminishes memory for continuous events.

In a novel event method directed forgetting task, instructions to Remember (R) or Forget (F) were integrated throughout the presentation of four videos depicting common events (e.g., baking cookies). Participants responded more accurately to cued recall questions (E1) and true/false statements (E2-4) regarding R segments than F segments. This was true even when forced to attend to F segments by virtue of having to perform concurrent discrimination (E2) or conceptual segmentation (E3) tasks. The final experiment (E5) demonstrated a larger R >F difference for specific true/false statements (the woman added three cups of flour) than for general true/false statements (the woman added flour) suggesting that participants likely encoded and retained at least a general representation of the events they had intended to forget, even though this representation was not as specific as the representation of events they had intended to remember.

Crisis resolution home treatment team Clinicians' perceptions of using a recovery approach with people with a diagnosis of borderline personality disorder.

WHAT IS KNOWN ON THE SUBJECT?: It is known that people with a diagnosis of borderline personality disorder often experience crises in their mental wellbeing. There is little evidence about the approaches of mental health nurses in community-based crisis teams when working with people with a diagnosis of BPD. WHAT THE PAPER ADDS TO THE EXISTING KNOWLEDGE?: This paper highlights that limited resources, work-patterns and issues of stigma present challenges to delivering recovery-oriented care. The paper highlights that nurses typically try to navigate the challenges to continue to provide individualized care, though their self-assessment is that this is with mixed success. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest that support is needed to develop brief interventions specific to teams working with people with a diagnosis of BPD who are at a point of crisis. ABSTRACT: Introduction People with a diagnosis of borderline personality disorder (BPD) are often in contact with mental health services at a point of crisis, and in the UK, this includes Crisis Resolution Home Treatment teams (CRHTT). There is a drive for services to be recovery orientated; however, there is little evidence about the degree to which community services achieve this for people with a diagnosis of BPD when in crisis. Research Aim To understand the perceptions held by CRHTT clinicians about their provision of recovery-orientated acute care, for people with a diagnosis of BPD. Method From a purposive sample of a single CRHTT, seven registered mental health nurses were interviewed and Braun and Clarke's thematic analysis framework was used to interpret the data. Results Five themes emerged: person-centred care; the timing is wrong; inconsistent staffing; the risks are too great; and BPD as a label. Discussion The results demonstrate tensions between a drive to deliver person-centred care and a range of challenges that inhibit this, with the possibility of reframing a recovery approach as "recovery-ready". Implications for Practice A whole-system approach is required to enable a consistent recovery-oriented approach, but research is also needed for brief interventions specific to this context.

The Quick FICS: 5 and 10 Item Versions of the Family Inpatient Communication Survey.

CONTEXT: Communication quality in the hospital impacts outcomes like satisfaction, depression, and anxiety for families, and assessment tools must be efficient and reliable. OBJECTIVES: We developed the Quick FICS-5 and -10, shorter versions of the 30-item Family Inpatient Communication Survey (FICS). METHODS: The Quick FICS were developed from the original FICS study of hospitalized patients 65+ and their surrogates. The development sample came from the original FICS-30 scale. The validation sample came from a randomized controlled trial of surrogates for adult ICU patients. Participants were family members of patients on medical ICU or inpatient medicine services at three hospitals in a Midwest metropolitan area. We evaluated validity and reliability using factor analysis, internal consistency, and associations with surrogate psychological and decision-making outcomes. RESULTS: In the development sample of 364 patient/surrogate dyads, most surrogates were adult children (66.8%), female (70.9%), and white (68.9%). We identified 5-item and 10-item surveys. Exploratory factor analysis supported an overall communication score for the FICS-5 and FICS-10, as well as information and emotional support subscales for the FICS-10. There was high internal reliability (Cronbach's alpha was 0.83 for the FICS-5 and 0.90 for the FICS-10; information and emotional support subscales were 0.89 and 0.75 respectively). There was good predictive validity when comparing FICS scores to outcomes six to eight weeks after discharge, including anxiety (P = -0.13; P = 0.0234), and satisfaction with the hospital stay (P = 0.48; P < 0.0001). Similarly, the validation sample (n = 188) revealed Cronbach's alpha ranging from 0.81 to 0.93 and significant correlations (P < 0.05) with concurrent distress, anxiety, depression, and decision regret. CONCLUSIONS: The Quick FICS offers efficient, valid, and reliable evaluation of communication quality in the hospital that can be useful for research and quality improvement.

Effects of Spiritual Care on Well-Being of Intensive Care Family Surrogates: A Clinical Trial.

CONTEXT: Critical illness of a family member is associated with high emotional and spiritual distress and difficult medical decisions. OBJECTIVES: To determine if a semistructured spiritual care intervention improves the well-being of family surrogate decision makers in intensive care (ICU) settings. METHODS: This study is a randomized, allocation-concealed, parallel group, usual care-controlled, single-blind trial of patient/surrogate dyads in five ICUs in one Midwest, academic medical center. Patients were 18 and older admitted to the ICU and unable to make medical decisions. The intervention involved proactive contact from the chaplain, scheduled, semi-structured visits, weekly follow-up, and bereavement calls. The control group received usual care. The primary endpoint was the surrogate's anxiety (Generalized Anxiety Disorders-7 scale), six to eight weeks after discharge. RESULTS: Of 192 patient/surrogate dyads enrolled, 128 completed outcome assessments. At follow-up, anxiety in the intervention group was lower than control (median score 1 (interquartile range 0,6) vs. 4 (1,9), P = 0.0057). The proportion of patients with a minimal clinically important difference (MCID) in anxiety of 2+ was 65.2% in the intervention group vs. 49.2% in control. The odds of an MCID remained higher in adjusted analysis (Odds Ratio 3.11, 95% confidence interval 1.18, 8.21; P = 0.0218) The adjusted odds of an MCID were higher for spiritual well-being (OR 3.79, CI 1.41,10.17; P = 0.0081). Satisfaction with spiritual care was also higher (adjusted mean 3.5 ± 0.4 vs. 2.9 ± 0.1); P < .0001). CONCLUSIONS: Proactive, semistructured spiritual care delivered by chaplains improves well-being for ICU surrogates. Results provide evidence for inclusion of chaplains in palliative and intensive care teams.

Impact of tobacco regulation on animal research: new perspectives and opportunities.

INTRODUCTION: The Family Smoking Prevention and Tobacco Control Act in the United States and the World Health Organization Framework Convention on Tobacco or Health ratified by over 170 countries render scientific investigations into the abuse liability, harm, and effects of tobacco more critical than ever. A key area to explore relates to the potential regulation of nicotine content in cigarettes. Determining the nicotine content per cigarette below which smokers reliably reduce their consumption of and dependence on cigarettes, an idea proposed almost 20 years ago (Benowitz & Henningfield, 1994), could be a powerful approach to reduce the abuse liability and consequent harm from cigarettes. However, this approach is laden with potentially complex issues. Many of these complications can be studied using animal models, but they require a particular perspective. METHODS: Herein, we review several challenges for animal researchers interested in nicotine reduction as examples of how this perspective dictates new approaches to animal research. These include defining the threshold nicotine dose for maintaining self-administration, evaluating the differential impact of various implementation strategies, assessing the factors that could interact with nicotine to alter the reinforcement threshold, describing the role of cues in maintaining low dose nicotine self-administration, and examining individual differences in response to nicotine reduction. CONCLUSIONS: Researchers who study tobacco using animal models have the opportunity to play a central role in the regulatory science of tobacco and conduct studies that directly inform policy decisions that could impact the lives of millions.

Does an instruction to forget enhance memory for other presented items?

In an item-method directed forgetting paradigm, participants were required to attend to one of two colored words presented on opposite sides of a central fixation stimulus; they were instructed to Remember or Forget the attended item. On a subsequent recognition test, the Attended words showed a typical directed forgetting effect with better recognition of Remember words than Forget words. Our interest was in the fate of the Unattended words. When the study display disappeared before the memory instruction, there was no effect of that instruction on unattended words; when the study display remained visible during presentation of the memory instruction, there was a reverse directed forgetting effect with better recognition of unattended words from Forget trials than from Remember trials. Incidental encoding of task-irrelevant stimuli occurs following presentation of a Forget instruction - but only when those task-irrelevant stimuli are still visible in the external environment.

Interplay of the production and picture superiority effects: a signal detection analysis.

Three experiments explored the interaction between the production effect (greater memory for produced compared to non-produced study items) and the picture superiority effect (greater memory for pictures compared to words). Pictures and words were presented in a blocked (E1) or mixed (E2, E3) design, each accompanied by an instruction to silently name (non-produced condition) or quietly mouth (produced condition) the corresponding referent. Memory was then tested for all study items as well as an equal number of foil items using a speeded (E1, E2) or self-paced (E3) yes-no recognition task. Experiments 1, 2, and 3 all revealed a small but reliable production × stimulus interaction. Production was also found to result in a liberal shift in response bias that could result in the overestimation of the production effect when measured using hits instead of sensitivity. Together our findings suggest that the application of multiple distinctive processes at study produces an especially discriminative memory trace at test, more so than the summation of each process individually.

Workplace Experiences of Women With Disability in Sport Organizations.

Women with disability often experience barriers to employment and career progression, most notably in hyper-masculinised industry sectors such as sport. Applying an intersectionality lens and insights from critical disability theory, this research explores the lived experiences of eight women with varying types of disability through their stories of working and volunteering in sport organizations in Victoria (Australia). Analyses of the interviews highlighted the importance that these women attached to their identity as a woman with disability and the intrapersonal and organizational factors that impacted on initial sport workplace attraction and retention. The findings discuss the relationship management strategies adopted to manage these factors in workplace interactions. The interactive effect between disability and gender contributes to building a meaningful understanding of the intersectionality for women with disability in sport organizations.

Intention matters more than attention: Item-method directed forgetting of items at attended and unattended locations.

This study embedded attentional cues in the study phase of an item-method directed forgetting task. We used an unpredictive onset cue (Experiment 1), a predictive onset cue (Experiment 2), or a predictive central cue (Experiments 3-6) to direct attention to the left or right. In Experiments 1-5, this was followed by a pink or blue study word that required a speeded colour discrimination; in Experiment 6, it was followed by a pink or blue word or nonword that required a lexical decision. Each study word was followed by an instruction to Remember or Forget. A yes-no recognition test confirmed better recognition of to-be-remembered words than to-be-forgotten words; a cueing effect confirmed the effectiveness of predictive cues in allocating attentional resources. There was, however, no evidence that the directed forgetting effect differed for attended and unattended words: Encoding depends more on the memory intention formed after a study word has disappeared than on the availability of processing resources when that word first appears.

Bicyclic Ligand-Biased Agonists of S1P1: Exploring Side Chain Modifications to Modulate the PK, PD, and Safety Profiles.

Sphingosine-1-phosphate (S1P) binds to a family of sphingosine-1-phosphate G-protein-coupled receptors (S1P1-5). The interaction of S1P with these S1P receptors has a fundamental role in many physiological processes in the vascular and immune systems. Agonist-induced functional antagonism of S1P1 has been shown to result in lymphopenia. As a result, agonists of this type hold promise as therapeutics for autoimmune disorders. The previously disclosed differentiated S1P1 modulator BMS-986104 (1) exhibited improved preclinical cardiovascular and pulmonary safety profiles as compared to earlier full agonists of S1P1; however, it demonstrated a long pharmacokinetic half-life (T1/2 18 days) in the clinic and limited formation of the desired active phosphate metabolite. Optimization of this series through incorporation of olefins, ethers, thioethers, and glycols into the alkyl side chain afforded an opportunity to reduce the projected human T1/2 and improve the formation of the active phosphate metabolite while maintaining efficacy as well as the improved safety profile. These efforts led to the discovery of 12 and 24, each of which are highly potent, biased agonists of S1P1. These compounds not only exhibited shorter in vivo T1/2 in multiple species but are also projected to have significantly shorter T1/2 values in humans when compared to our first clinical candidate. In models of arthritis, treatment with 12 and 24 demonstrated robust efficacy.

Two mechanisms underlying inhibition of return.

Inhibition of return (IOR) refers to slower reaction times to targets presented at previously stimulated or inspected locations. Taylor and Klein (J Exp Psychol Hum Percept Perform 26(5):1639-1656, 2000) showed that IOR can affect either attentional/perceptual or motor processes, depending on whether the oculomotor system is in a quiescent or in an activated state, respectively. If the motoric flavour of IOR is truly non-perceptual and non-attentional, no IOR should be observed when the responses to targets are not based on spatial information. In the present experiments, we demonstrated that when the eyes moved to the peripheral cue and back to centre before the target appeared (to generate the motoric flavour), IOR was observed in detection tasks, for which the spatial location is an integral feature of the onset that is reported, but not in colour discrimination tasks, for which the outcome of a non-spatial perceptual discrimination is reported. When eye movements were prevented, both tasks showed robust IOR. We, therefore, conclude that the motoric flavour of IOR, elicited by oculomotor activation, does not affect attention or perceptual processing.

Directed forgetting shares mechanisms with attentional withdrawal but not with stop-signal inhibition.

To explore the mechanisms underlying the ability to intentionally forget, the present study combined an item-method directed forgetting paradigm with tasks that measure stop-signal inhibition (Experiments 1 and 2) and inhibition of return (IOR; Experiment 2). Following each study-phase instruction to remember (R) or forget (F), a target was presented centrally (Experiment 1) or to the left or right in the visual periphery (Experiment 2); the target required a speeded response that was sometimes countermanded by a central stop signal. Although stop-signal reaction times were unaffected by the preceding memory instruction (or relationship with word-target location), F instructions improved stopping and delayed responses. Replicating previous findings in the literature, significant IOR was observed following F instructions but not following R instructions (Experiment 2). These findings suggest that intentional forgetting is an active cognitive process that more likely engages attentional mechanisms related to orienting than those related to stop-signal inhibition.