Impact and Implications of Neurocognitive Dysfunction in the Management of Ischemic Heart Failure.

Neurocognitive dysfunction is common in heart failure (HF), with 30% to 80% of patients experiencing some degree of deficits in one or more cognitive domains, including memory, attention, learning ability, executive function, and psychomotor speed. Although the mechanism is not fully understood, reduced cardiac output, comorbidities, chronic cerebral hypoperfusion, and cardioembolic brain injury leading to cerebral hypoxia and brain damage seem to trigger the neurocognitive dysfunction in HF. Cognitive impairment is independently associated with worse outcomes including mortality, rehospitalization, and reduced quality of life. Patients with poorer cognitive function are at an increased risk of severe disease as they tend to have greater difficulty complying with treatment requirements. Coronary revascularization in patients with ischemic HF has the potential to improve cardiovascular outcomes but risks worsening neurocognitive dysfunction even further. Revascularization by coronary artery bypass grafting carries inherent risks for delirium, cognitive impairment, neurologic injury, and stroke, which are known to exacerbate the risk of neurocognitive dysfunction. Alternatively, percutaneous coronary intervention, as a less-invasive approach, has the potential to minimize the risk of cognitive impairment but has not yet been evaluated as an alternative to coronary artery bypass grafting in patients with ischemic HF. Therefore, it is paramount to raise awareness of the neurocognitive consequences in ischemic HF and devise strategies for recognition and prevention as an important target of patient management and personalized decision making that contributes to patient outcomes.

What makes for a competitive fellowship candidate? A survey of clinical neuropsychology postdoctoral training directors.

To obtain objective data about the factors that clinical neuropsychology postdoctoral training directors (TDs) look for and prioritize in their review and selection of fellowship candidates.We identified 167 TDs who were overseeing postdoctoral training programs that provided training consistent with the Houston Conference Guidelines. We invited all TDs to complete an anonymous online survey that assessed their expectations as they relate to the selection of fellowship candidates. Eighty-eight TDs completed the survey in full. We used descriptive statistics to analyze the data and investigate potential between-group differences in TDs' responses across patient populations, training settings, and APPCN member program status.TDs ranked the intensity of candidates' neuropsychology education and training experiences, their fellowship interviews, and letters of recommendation as most important. Increasing the representation of under-represented minorities and other factors were ranked lower. Minimum benchmarks related to candidates' scholarly productivity, dissertation progress, and the time they spent engaged in clinical neuropsychology activities during internship were revealed. There were relatively few differences in TDs' responses when compared across patient populations, training settings, or APPCN member program status.Students may increase their competitiveness for clinical neuropsychology fellowships by obtaining intensive education and training experiences in the specialty, which includes clinical training and coursework, and by producing scholarly work. Students may also benefit from improving their interviewing skills, completing an internship with at least 40% of time spent in neuropsychological activities, and at minimum by having their dissertation data collected before their fellowship interviews.

A review of the use and psychometric properties of the Cognitive Log (Cog-Log) amongst adults with acquired brain injury.

This Rehabilitation Measures Database summary provides a review of the psychometric properties of the Cog-Log in individuals with acquired brain injury. A full review of the Cog-Log as well as reviews of over 400 other instruments for patients with various health conditions can be found at www.sralab.org/rehabilitation-measures. (PsycINFO Database Record

Clinical utility and psychometric properties of the Functional Assessment of Multiple Sclerosis for individuals with multiple sclerosis.

This Rehabilitation Measures Database summary provides a review of the psychometric properties of the FAMS in individuals with MS. A full review of the FAMS as well as reviews of over 300 other instruments can be found at www.rehabmeasures.org. (PsycINFO Database Record

Clinical utility and measurement characteristics of the Hospital Anxiety and Depression Scale for individuals with traumatic brain injury.

This Rehabilitation Measures Database summary provides a review of the psychometric properties of the HADS in individuals with TBI. A full review of the HADS as well as reviews of over 330 other instruments can be found at www.rehabmeasures.org.