Psychosis in acute methamphetamine intoxication is usually self-limiting and can be managed in the emergency department: A retrospective series.

OBJECTIVES: There is little recent published data characterising acute psychosis associated with methamphetamine intoxication. We aim to describe the clinical features of psychosis, management of acute behavioural disturbance and disposition of patients with psychosis associated with acute methamphetamine intoxication. METHODS: This is a retrospective review of patients presenting with acute (use within 24 h) methamphetamine intoxication, with features of psychosis (presence of delusions, hallucinations or formal thought disorder), to an ED over 4 months in 2020. All presentations were extracted from a toxicology unit database and each medical record reviewed. Demographics, past mental health diagnoses, clinical features and disposition were extracted. RESULTS: There were 287 presentations of methamphetamine intoxication over the period. Of these 287 presentations, 205 (71%) had features of acute psychosis, occurring in 171 patients (111 males [65%], median age 36, range 16-57 years). Paranoid delusion occurred in 134 of 205 (65%) presentations and was the most common feature of psychosis. Chemical sedation was given to 194 (95%), with 143 (70%) receiving parenteral sedation to manage acute behavioural disturbance. Complete resolution of psychotic symptoms occurred in 170 of 205 (83%) of exposures. There were 9 of 205 (4%) presentations that resulted in a mental health admission. Most presentations - 200 of 205 (98%) - were managed within the ED, primarily the short-stay unit. The median length of stay was 15 h (interquartile range 11-20 h). CONCLUSIONS: In this series of patients presenting to ED with acute methamphetamine intoxication, psychosis appeared to occur commonly and was mostly short-lived, resolving within 24 h in the majority of patients.

Recognition memory: The probe, the returned signal, and the decision.

In an attempt to better understand recognition memory we look at how three approaches (dual processing, signal detection, and global matching) have addressed the probe, the returned signal and the decision in four recognition paradigms. These are single-item recognition (including the remember/know paradigm), recognition in relational context, associative recognition, and source monitoring. The contrast, with regards to the double-miss rate (the probability of recognizing neither item in intact and rearranged pairs) and the effect of the oldness of the other member of the test pair, between identifying the old words in test pairs (the relational context paradigm) and first identifying the intact test pairs and then identifying the old words (adding associative recognition to the relational context paradigm) suggests that the retrieval of associative information in the relational context paradigm is unintentional, unlike the retrieval of associative information in associative recognition. It also seems possible that the information that is spontaneously retrieved in single-item recognition, possibly including the remember/know paradigm, is also unintentional, unlike the retrieval of information in source monitoring. Probable differences between intentional and unintentional retrieval, together with the pattern of effects with regards to the double-miss rate and the effect of the other member of the test pair, are used to evaluate the three approaches. Our conclusion is that all three approaches have something valid to say about recognition, but none is equally applicable across all four paradigms.

Designing agricultural grasses to help mitigate proteolysis during ensiling to optimize protein feed provisions for livestock.

The efficient preservation of protein in silage for livestock feed is dependent on the rate and extent of proteolysis. Previous research on fresh forage indicated enhanced protein stability in certain Festulolium (ryegrass × fescue hybrids) cultivars compared to ryegrass. This is the first report of an experiment to test the hypothesis that a Lolium perenne × Festuca arundinacea var glaucescens cultivar had reduced proteolysis compared to perennial ryegrass (L. perenne) during the ensiling process. Forages were harvested in May (Cut 2) and August (Cut 4), wilted for 24 h and ensiled in laboratory-scale silos. Silage was destructively sampled at 0 h, 9 h, 24 h, 48 h, 72 h, 14 days and 90 days post-ensiling, and dry matter (DM), pH and chemical composition were determined. At Cut 2, there was no difference in crude protein between treatments but ryegrass had higher soluble nitrogen (SN) (P < 0.001) and grass × time interactions (p = 0.03) indicated higher rates of proteolysis. By Cut 4, Festulolium had (5.5% units) higher CP than ryegrass (p < 0.001) but SN did not differ. Ammonia-N did not differ between silages in either cut. DM differences (11.8% units) between treatments in Cut 4 (v.2.2% in Cut 2) may have masked effects on proteolysis, highlighting the importance of management on silage quality. This was despite higher WSC in ryegrass in both cuts (p < 0.001), with grass × time interactions (Cut 2; p = 0.03) showing slower WSC decline in ryegrass in Cut 4 (p < 0.001). Silage pH values did not differ between grasses in either cut, but grass × time interactions (p < 0.001) showed a slower decline in both ryegrass cuts, resulting in higher (p < 0.05) pH at 24 h and 72 h for Cuts 2 and 4, respectively. Overall, the hypothesis for an enhanced protein stability in Festulolium when ensiled as ruminant feed was evidenced by lower SN but not ammonia-N in an early-cut silage with a comparable DM to ryegrass.

Target learning in event-based prospective memory.

Event-based prospective memory (PM) tasks require individuals to remember to perform a previously planned action when they encounter a specific event. Often, the natural environments in which PM tasks occur are embedded are constantly changing, requiring humans to adapt by learning. We examine one such adaptation by integrating PM target learning with the prospective memory decision control (PMDC) cognitive model. We apply this augmented model to an experiment that manipulated exposure to PM targets, comparing a single-target PM condition where the target was well learned from the outset, to a multiple-target PM condition with less initial PM target exposure, allowing us to examine the effect of continued target learning opportunities. Single-target PM accuracy was near ceiling whereas multiple-target PM accuracy was initially poorer but improved throughout the course of the experiment. PM response times were longer for the multiple- compared with single-target PM task but this difference also decreased over time. The model indicated that PM trial evidence accumulation rates, and the inhibition of competing responses, were initially higher for single compared to multiple PM targets, but that this difference decreased over time due to the learning of multiple-targets over the target repetitions. These outcomes provide insight into how the processes underlying event-based PM can dynamically evolve over time, and a modeling framework to further investigate the effect of learning on event-based PM decision processes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Ketamine as a rescue treatment for severe acute behavioural disturbance: A prospective prehospital study.

OBJECTIVE: Rapidly and safely managing severe acute behavioural disturbance (ABD) in the prehospital setting is important for the welfare of both patient and prehospital clinician alike. We investigated the safety and effectiveness of ketamine as rescue sedation in patients with severe ABD. METHODS: This prospective observational study investigated ketamine use by a state ambulance service as rescue sedation for patients with severe ABD who remained agitated following droperidol administration. The primary outcome was the proportion of adverse events (vomiting, hypersalivation, emergence, over-sedation, airway obstruction, laryngospasm, hypoxia, bradypnoea and intubation). Secondary outcomes included time to sedation, requirement for additional sedation and rate of successful sedation. RESULTS: There were 105 presentations (males 69/102 [69%]; median age 31 years (16-83 years). The commonest causes of ABD were illicit drug (39%) and alcohol (33%) intoxication. The median total dose of intramuscular ketamine was 200 mg (interquartile range [IQR] 150-200 mg). There were 64 adverse events in 40 (38%) patients. Four had vomiting, two had hypersalivation, two had emergence, 15 were oversedated, four had hypoxia, three had bradypnoea and 16 were intubated. Sedation was achieved in 103 (98%) patients at a median time post-ketamine of 8 min (IQR 5-13 min). Additional sedation was administered to 41 patients (nine prehospital and 37 within 1 h of arriving to hospital). In 44 (42%) patients, ketamine successfully sedated the patient with no adverse effects and no ongoing sedation requirement. CONCLUSION: The use of ketamine as rescue sedation in prehospital patients with severe ABD is effective. Adverse events are common but can be managed supportively.

Behavioral and Neural Effects of Familiarization on Object-Background Associations.

Associative memory is the ability to link together components of stimuli. Previous evidence suggests that prior familiarization with study items affects the nature of the association between stimuli. More specifically, novel stimuli are learned in a more context-dependent fashion than stimuli that have been encountered previously without the current context. In the current study, we first acquired behavioral data from 62 human participants to conceptually replicate this effect. Participants were instructed to memorize multiple object-scene pairs (study phase) and were then tested on their recognition memory for the objects (test phase). Importantly, 1 day prior, participants had been familiarized with half of the object stimuli. During the test phase, the objects were either matched to the same scene as during study (intact pair) or swapped with a different object's scene (rearranged pair). Our results conceptually replicated the context-dependency effect by showing that breaking up a studied object-context pairing is more detrimental to object recognition performance for non-familiarized objects than for familiarized objects. Second, we used functional magnetic resonance imaging (fMRI) to determine whether medial temporal lobe encoding-related activity patterns are reflective of this familiarity-related context effect. Data acquired from 25 human participants indicated a larger effect of familiarization on encoding-related hippocampal activity for objects presented within a scene context compared to objects presented alone. Our results showed that both retrieval-related accuracy patterns and hippocampal activation patterns were in line with a familiarization-mediated context-dependency effect.

Explaining short-term memory phenomena with an integrated episodic/semantic framework of long-term memory.

Current thinking about human memory is dominated by distinctions between episodic and semantic memory and between short-term memory (STM) and long-term memory (LTM). However, many memory phenomena seem to cut across these distinctions. This article attempts to set the groundwork for the issues that need to be resolved in generating an integrated model of long-term memory that incorporates semantic, episodic, and short-term memory. We contrast Nairne's (2002, Annual Review of Psychology) consensus account of short-term memory with a relatively generic theory of an integrated episodic-semantic memory. The later consists primarily of a list of principles which we and others argue are necessary to include in any theory of long-term memory. We then add some more specific assumptions to outline a modern theory of forgetting. We then turn to the issue of much of the phenomena thought to necessitate a dedicated short-term memory can be explained by an integrated theory of episodic and semantic memory. Our conclusion is that an integrated theory of long-term memory must be augmented to explain a small number of outstanding memory phenomena. Finally, we ask whether the augmentation needs to involve a dedicated mnemonic system, or sensory or language-based systems, which also have mnemonic capabilities.

Category-length and category-strength effects using images of scenes.

Global matching models have provided an important theoretical framework for recognition memory. Key predictions of this class of models are that (1) increasing the number of occurrences in a study list of some items affects the performance on other items (list-strength effect) and that (2) adding new items results in a deterioration of performance on the other items (list-length effect). Experimental confirmation of these predictions has been difficult, and the results have been inconsistent. A review of the existing literature, however, suggests that robust length and strength effects do occur when sufficiently similar hard-to-label items are used. In an effort to investigate this further, we had participants study lists containing one or more members of visual scene categories (bathrooms, beaches, etc.). Experiments 1 and 2 replicated and extended previous findings showing that the study of additional category members decreased accuracy, providing confirmation of the category-length effect. Experiment 3 showed that repeating some category members decreased the accuracy of nonrepeated members, providing evidence for a category-strength effect. Experiment 4 eliminated a potential challenge to these results. Taken together, these findings provide robust support for global matching models of recognition memory. The overall list lengths, the category sizes, and the number of repetitions used demonstrated that scene categories are well-suited to testing the fundamental assumptions of global matching models. These include (A) interference from memories for similar items and contexts, (B) nondestructive interference, and (C) that conjunctive information is made available through a matching operation.

Why consumers misattribute sponsorships to non-sponsor brands: Differential roles of item and relational communications.

Brands engaged in sponsorship of events commonly have objectives that depend on consumer memory for the sponsor-event relationship (e.g., sponsorship awareness). Consumers however, often misattribute sponsorships to nonsponsor competitor brands, indicating erroneous memory for these relationships. The current research uses an item and relational memory framework to reveal sponsor brands may inadvertently foster this misattribution when they communicate relational linkages to events. Effects can be explained via differential roles of communicating item information (information that supports processing item distinctiveness) versus relational information (information that supports processing relationships among items) in contributing to memory outcomes. Experiment 1 uses event-cued brand recall to show that correct memory retrieval is best supported by communicating relational information when sponsorship relationships are not obvious (low congruence). In contrast, correct retrieval is best supported by communicating item information when relationships are obvious (high congruence). Experiment 2 uses brand-cued event recall to show that, against conventional marketing recommendations, relational information increases misattribution, whereas item information guards against misattribution. Results suggest sponsor brands must distinguish between item and relational communications to enhance correct retrieval and limit misattribution. Methodologically, the work shows that choice of cueing direction is critical in differentially revealing patterns of correct and incorrect retrieval with pair relationships. (PsycINFO Database Record

Brand name confusion: Subjective and objective measures of orthographic similarity.

Determining brand name similarity is vital in areas of trademark registration and brand confusion. Students rated the orthographic (spelling) similarity of word pairs (Experiments 1, 2, and 4) and brand name pairs (Experiment 5). Similarity ratings were consistently higher when words shared beginnings rather than endings, whereas shared pronunciation of the stressed vowel had small and less consistent effects on ratings. In Experiment 3 a behavioral task confirmed the similarity of shared beginnings in lexical processing. Specifically, in a task requiring participants to decide whether 2 words presented in the clear (a probe and a later target) were the same or different, a masked prime word preceding the target shortened response latencies if it shared its initial 3 letters with the target. The ratings of students for word and brand name pairs were strongly predicted by metrics of orthographic similarity from the visual word identification literature based on the number of shared letters and their relative positions. The results indicate a potential use for orthographic metrics in brand name registration and trademark law. (PsycINFO Database Record

Recognition in context: Implications for trade mark law.

Context effects in recognition have played a major role in evaluating theories of recognition. Understanding how context impacts recognition is also important for making sound trade mark law. Consumers attempting to discriminate between the brand they are looking for and a look-alike product often have to differentiate products which share a great deal of common context: positioning on the supermarket shelf, the type of store, aspects of the packaging, or brand claims. Trade mark and related laws aim to protect brands and reduce consumer confusion, but courts assessing allegations of trade mark infringement often lack careful empirical evidence concerning the impact of brand and context similarity, and, in the absence of such evidence, make assumptions about how consumers respond to brands that downplay the importance of context and focus on the similarity of registered marks. The experiments reported in this paper aimed to test certain common assumptions in trade mark law, providing evidence that shared context can cause mistakes even where brand similarity is low.

Internalizing versus externalizing control: different ways to perform a time-based prospective memory task.

Time-based prospective memory (PM) refers to performing intended actions at a future time. Participants with time-based PM tasks can be slower to perform ongoing tasks (costs) than participants without PM tasks because internal control is required to maintain the PM intention or to make prospective-timing estimates. However, external control can be gained, and internal control minimized, by checking clocks or by using PM reminders. We present 3 experiments that examined how individuals externalize and internalize control of time-based PM tasks. The control condition performed a lexical decision task only, whereas the PM conditions were additionally required to make a time-based PM response after 11 min. We manipulated whether participants received a reminder, and whether clock checking was discouraged. In Experiments 1 and 3, no cost was found under standard clock check conditions. In contrast, when participants were discouraged from clock checking (Experiments 2 and 3), significant costs were found, accompanied by a decrease in clock checking. PM reminders prompted participants to check the clock, and improved PM accuracy if those reminders were expected. However, there was no evidence that participants could localize the internal or external control of the PM task to after the presentation of an expected reminder (Experiment 3). We conclude that much of the need for internal control can be transferred to the external world by performing a well-practiced task such as clock checking, which reminds participants of the PM task and reduces the internal control required to maintain the intention to perform the PM task.

A sequential sampling account of response bias and speed-accuracy tradeoffs in a conflict detection task.

Signal Detection Theory (SDT; Green & Swets, 1966) is a popular tool for understanding decision making. However, it does not account for the time taken to make a decision, nor why response bias might change over time. Sequential sampling models provide a way of accounting for speed-accuracy trade-offs and response bias shifts. In this study, we test the validity of a sequential sampling model of conflict detection in a simulated air traffic control task by assessing whether two of its key parameters respond to experimental manipulations in a theoretically consistent way. Through experimental instructions, we manipulated participants' response bias and the relative speed or accuracy of their responses. The sequential sampling model was able to replicate the trends in the conflict responses as well as response time across all conditions. Consistent with our predictions, manipulating response bias was associated primarily with changes in the model's Criterion parameter, whereas manipulating speed-accuracy instructions was associated with changes in the Threshold parameter. The success of the model in replicating the human data suggests we can use the parameters of the model to gain an insight into the underlying response bias and speed-accuracy preferences common to dynamic decision-making tasks.

Reinstating higher order properties of a study list by retrieving a list item.

In two experiments, we looked at the role of higher order list properties in episodic recall. A probabilistic paired-associate paradigm was used in which each cue was repeatedly paired with two different targets. This paradigm permitted us to cue for a target that had been studied with that cue in the last list, or to cue for either of the two targets that had been repeatedly paired with that cue, although neither the cue nor either of its two targets had been studied in the last list. In Experiment 1, the higher order property was whether all of the targets in a given list were animal names or vegetable names. In Experiment 2, the higher order property was whether all of the pairs in a list were associatively related or unrelated. The assumption was that if participants were using these higher order properties when they retrieved a target that had been studied in the last list, they would also use these properties when recalling in response to a cue that had been studied in other lists but not in the most recent list. The results supported the use of both kinds of higher order properties in episodic access. They also showed that these higher order properties were reinstated by retrieving a target, and were then used in the next memory access operation. The questions of why the retrieval of a target would reinstate a higher order list property and how these very different higher order list properties aid in episodic access were also discussed.

Impact of Age at Diagnosis on Outcomes in Men with Castrate-Resistant Prostate Cancer (CRPC).

BACKGROUND: The association between age and outcomes in men with castrate resistant prostate cancer (CRPC) is not well understood. OBJECTIVE: We aimed to evaluate CRPC patients to determine if their age at initial diagnosis impacted their cancer specific outcomes. DESIGN, SETTING, AND PARTICIPANTS: A retrospective chart review was conducted on 333 consecutive CRPC patients treated at the Princess Margaret Hospital (PMH) between 1995 and 2005. Patients were divided into 4 age categories, (A) <55, (B) 55-64, (C) 65-74 (reference), and (D) ≥ 75 years (yrs). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Primary endpoints included impact of age at diagnosis on overall survival (OS) and on prostate cancer specific survival. Secondary endpoints were time from diagnosis to development of CRPC, time from CRPC to death, and time from diagnosis to bone metastases. RESULTS AND LIMITATIONS: The median OS from diagnosis to death was: Group A 5.5 yrs (95% CI 3.0-7.5); Group B 6.7 yrs (95% CI 5.9-8.4); Group C 7.8 yrs (95% CI 6.6-9.3); and Group D 4.3 years (95% CI 2.9-5.0). The hazard ratio (HR) for death in Group D was 2.58 (95% CI 1.58-4.21, p=0.0002); and in Group A was 1.49 (95% CI 0.90-2.46, p=0.13). The duration of hormone sensitivity in Group D was less and predictive of OS, as was Gleason Score ≥8 and Stage 4 disease at diagnosis. CONCLUSIONS: Age at initial diagnosis appears to impact on outcome of patients who subsequently develop CRPC with a bimodal distribution of risk, with the shortest survivals in the ≥75 and <55 groups.

Comparison of protocols for measuring and calculating postmortem submersion intervals for human analogs in fresh water.

Protocols for determining postmortem submersion interval (PMSI) have long been problematic for forensic investigators due to the wide variety of factors affecting the rate of decomposition of submerged carrion. Likewise, it has been equally problematic for researchers to develop standardized experimental protocols to monitor underwater decomposition without artificially affecting the decomposition rate. This study compares two experimental protocols: (i) underwater in situ evaluation with photographic documentation utilizing the Heaton et al. total aquatic decomposition (TAD) score and (ii) weighing the carrion before and after submersion. Complete forensic necropsies were performed as a control. Perinatal piglets were used as human analogs. The results of this study indicate that in order to objectively measure decomposition over time, the human analog should be examined at depth using the TAD scoring system rather than utilizing a carrion weight evaluation. The acquired TAD score can be used to calculate an approximate PMSI.

Examination of histological samples from submerged carrion to aid in the determination of postmortem submersion interval.

The use of histology in the as a tool for estimating postmortem intervals has rarely been explored but it has the potential for offering medical examiners an additional means for estimating the postmortem submersion interval (PMSI) during a death investigation. This study used perinatal piglets as human analogs which were submerged in freshwater for various time intervals. Each piglet was extracted from the water and underwent a necropsy examination during which histological samples were collected. The samples revealed that the necrotic tissue decomposed relatively predictably over time and that this decompositional progression may have the potential to be used via a scoring system to determine or aid in determining the PMSI. This method for calculating PMSI allows for normalization between piglets of various mass and body types. It also prevents any contamination of the remains via algae growth and animal activity that may exacerbate and possibly exaggerate PMSI calculation.

Memory and communication support strategies in dementia: effect of a training program for informal caregivers.

BACKGROUND: People with dementia have a range of needs that are met by informal caregivers. A DVD-based training program was developed using research-based strategies for memory and communication in dementia. The effectiveness of the training on the caregiver experience and the well-being of the person with dementia was evaluated. METHODS: A pre-test/post-test controlled trial was undertaken with caregiver-care-recipient dyads living in the community. Measures of the carers' knowledge of memory and communication strategies, burden, positive perceptions of caregiving, and perceptions of problem behaviors were taken pre- and three months post-intervention. The depression and well-being of the person with dementia were also evaluated. Satisfaction with the training and feedback were measured. RESULTS: Twenty-nine dyads (13 training group, 16 control group) participated. Bonferroni's correction was made to adjust for multiple comparisons, setting α at 0.00385. A significant improvement was found in caregivers' knowledge for the training group compared to the control group (p = 0.0011). The training group caregivers reported a reduction in the frequency of care recipient disruptive behaviors (p = 0.028) and increased perceptions of positive aspects of caregiving (p = 0.039), both at a level approaching significance. The training group care recipients had increased frequency of verbally communicated depressive behaviors at a level approaching significance (p = 0.0126). The frequency of observed depressive behaviors was not significantly different between groups. CONCLUSIONS: This approach to training for caregivers of people with dementia appears promising for its impact on knowledge and the caregiving experience. Further research could monitor the impact of the training on broader measures of depression and well-being, with a larger sample.

Enhanced recognition of words previously presented in a task with nonfocal prospective memory requirements.

Remembering to perform deferred actions when events are encountered in the future is referred to as event-based prospective memory. Individuals can be slower to respond to ongoing tasks when they have prospective memory task requirements. These costs are interpreted as evidence for cognitive control processes allocated to the prospective memory task, but we know little about these processes. In the present article, the recognition of nontargets previously presented in an ongoing task with prospective memory task requirements provided evidence for the differential processing of individual ongoing task items. Participants performed a lexical decision task, where some participants were required to make an alternative prospective memory response either to a specific word (focal) or to exemplars of a category (nonfocal). Participants were slower to respond to the ongoing task in the nonfocal conditions than in the control condition (costs), regardless of whether or not prospective memory task importance was emphasized. Participants were also slower to respond to the ongoing task in the focal conditions than in the control condition, but only when prospective memory task importance was emphasized. This task was followed by a surprise recognition memory test in which nontarget words from the lexical decision task were intermixed with new words. Focal conditions, but not nonfocal conditions, showed better discrimination on the recognition task, as compared with the control condition. Participants in nonfocal conditions mapped the semantic features of the ongoing task letter strings onto the semantic features of their prospective memory category, and this elaboration in the processing of individual nontargets increased incidental learning and produced the recognition benefit.