Habitual prospective memory in preschool children.

Habitual prospective memory (PM) refers to situations in which individuals have to remember to perform a future task on a regular and frequent basis. Habitual PM tasks are ubiquitous and the ability to successfully complete these tasks (e.g., remembering to bring your lunch to school every day) is necessary for children as they begin to establish their own independence. The current investigation is the first to explore preschool children's ability to complete this kind of task. At the end of a regular testing session during which children engaged in a variety of unrelated cognitive tasks, participants were instructed to ask for a stamp on their card, which was sitting in a box on the table. Over the course of the first experiment, participants did this 13 times, spanning a time period of several months. The results demonstrated that children initially needed prompting from the experimenter to remember, but with experience, participants were able to retrieve this intention without assistance. Experiment 2 demonstrated that removing the box from participants' line of sight after numerous opportunities to perform the task did not negatively impact performance, although it did make a difference at the outset of this requirement to remember to ask for stamps. Together, these results indicate that with somewhat consistent and repeated practice, preschool children can fairly quickly demonstrate the ability to successfully perform future intentions that are likely to be repeated on numerous occasions.

Focality and prospective memory in preschool children.

We examined the influence of prospective memory (PM) cue focality in a sample of preschool children. Prior investigations in older populations indicated that focal targets were associated with enhanced PM performance, perhaps through more automatic retrieval processes. Importantly, this influential variable has not been thoroughly explored in younger samples. Over three test sessions, preschool children completed a memory task where they were shown a series of animals. During retrieval, participants were shown all of the animals except for one, and they had to name the missing animal. While engaged in this task, participants in the focal PM condition were instructed to remove particular animals (e.g., spider) from the game if they saw them. In the nonfocal condition, participants were told to remove any animal that was entirely one color (e.g., black) if they saw them during the game. The results demonstrated no difference in PM remembering between focal and nonfocal conditions. These results suggest that the effects of focality may not be present at the beginning stages of PM development. The implications for PM retrieval processes also are discussed.

Divide and Conquer.

We assessed the ability of preschool children to assign the most difficult tasks to a symbolic helper. First, children were taught that a toy "helper" could aid them in remembering the location of a hidden item. Children preferentially assigned the helper to the objectively most difficult locations to remember. Each child then completed eight more tests, assessing a range of different skills such as counting, object identification, and word reading. Children again could assign some stimuli in each task to the helper, leaving the remaining stimuli for themselves to respond to in the given tasks. They were not explicitly told to assign the hardest stimulus to the helper. However, children consistently still did so in most tasks, although some tasks showed an effect of age where older children were more proficient in assigning the objectively more difficult stimuli to the helper. These results highlight a potential form of metacognition in young children in which they can monitor difficulty across varied kinds of assessments and use a generalized tool for asking for help that does not require verbal responding.

Elevated serum globulin gap as a highly reliable marker of elevated erythrocyte sedimentation rate in patients with systemic rheumatic diseases.

OBJECTIVE: Serum C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) are the two most commonly used markers of inflammation in clinical practice. Reducing the need for these tests could lead to considerable cost savings without sacrificing the quality of patient care. METHODS: The electronic medical records of patients with systemic rheumatic diseases seen between May 2015 and June 2017 in the rheumatology clinics at a single academic medical center were retrospectively reviewed. Correlations and receiver operator characteristic (ROC) curves between serum CRP level and ESR vs serum globulin gap (the difference between levels of total protein and albumin) and albumin-to-globulin (A:G) ratio were determined. RESULTS: In two independent cohorts (discovery: 263 subjects, 446 entries; validation: 438 subjects, 1959 entries), the globulin gap and A:G ratio correlated (p < 0.001) with CRP level and ESR, with correlation coefficients being greater for ESR than for CRP level. ROC curve analyses demonstrated better area-under-curve for ESR than for CRP level. The percentages of entries with elevated globulin gap (≥4.0 g/dl) and low A:G ratio (<0.8) were ∼8.4% and ∼2.6%, respectively, and each had a positive predictive value of ≥0.960 for elevated ESR. Among patients with high globulin gap, the change in globulin gap over time faithfully reflected changes in ESR. CONCLUSION: In the subset of systemic rheumatic disease patients who harbor an elevated globulin gap, the ESR is almost always elevated. This novel observation sets the conceptual foundation and rationale for subsequent prospective studies that assess whether ESR testing in this subset of rheumatic disease patients could be reduced without sacrificing patient care. Ultimately, ordering an ESR test may often be unnecessary, thereby resulting in cost savings.

Working memory in children assessed with serial chaining and Simon tasks.

In the serial chaining task, participants are required to produce a sequence of responses to stimuli in the correct order, and sometimes must determine the sequence at trial outset if stimuli are masked after the first response is made. Similarly, the Simon memory span task presents a participant with a sequence of colors, and the participant must recreate the sequence after the full series is shown. In efforts to directly link the comparative literature on sequential planning behavior and working memory span with the developmental literature, we presented preschool children with the serial chaining task using masked Arabic numerals (N = 44) and the Simon memory span task (N = 65). Older children outperformed younger children in each task, sequencing a longer string of numbers in the serial chaining task and remembering a greater number of items in the Simon task. Controlling for the role of age, there was a significant positive relationship between task scores. These results highlight the emergence of working memory skills that might underlie planning capacities in children using a task developed for nonhuman animals, and the results indicate that improvement in general executive functions could be measured using either or both of these tasks among human children and nonhuman species.

The effects of age and focality on delay-execute prospective memory.

In everyday prospective remembering, individuals must often delay the execution of a retrieved intention until they are in the appropriate setting. These so-called 'delay-execute' tasks are particularly troublesome for older adults, who consistently demonstrate impaired performance in this kind of laboratory task. To better understand this effect, we investigated delay-execute prospective memory performance in younger and older adults. Specifically, we examined the strategies individuals used to maintain intentions over a delay period by analyzing response times to the ongoing task, both before and after the cue event. The results suggest that younger and older individuals perform the task similarly by rehearsing or reformulating the intention. Despite performing the task in a similar manner, older adults showed greater impairments in delay-execute prospective remembering.

Working memory and the strategic control of attention in older and younger adults.

OBJECTIVE: The objective of this study was to investigate the effects of aging on the strategic control of attention and the extent to which this relationship is mediated by working memory capacity (WMC). This study also sought to investigate boundary conditions wherein age differences in selectivity may occur. METHOD: Across 2 studies, the value-directed remembering task used by Castel and colleagues (Castel, A. D., Balota, D. A., & McCabe, D. P. (2009). Memory efficiency and the strategic control of attention at encoding: Impairments of value-directed remembering in Alzheimer's Disease. Neuropsychology, 23, 297-306) was modified to include value-directed forgetting. Study 2 incorporated valence as an additional task demand, and age differences were predicted in both studies due to increased demands of controlled processing. Automated operation span and Stroop span were included as working memory measures, and working memory was predicted to mediate performance. RESULTS: Results confirmed these predictions, as older adults were less efficient in maximizing selectivity scores when high demands were placed on selectivity processes, and working memory was found to mediate performance on this task. DISCUSSION: When list length was increased from previous studies and participants were required to actively forget negative-value words, older adults were not able to selectively encode high-value information to the same degree as younger adults. Furthermore, WMC appears to support the ability to selectively encode information.

Headless compression screw fixation prevents symptomatic metalwork in arthroscopic ankle arthrodesis.

BACKGROUND: Arthroscopic ankle arthrodesis (AAA) is a recognised salvage procedure for end-stage arthritis. Its reported disadvantages include a high rate of re-operation for symptomatic prominence of metalwork. We propose that the use of a headless screw would reduce this re-operation rate. METHODS: We reviewed 32 AAAs, using the Acutrak™6/7 mm headless screw fixation system, to determine peri-operative parameters and complication rates. RESULTS: At an average of 22 months follow-up, 28 (88%) had united radiologically. There were 2 stable fibrous non-unions not requiring further intervention. Of the other 2, one was successfully revised using an open technique, and the other patient died of unrelated causes. There were no other complications in this series, with no cases of metalwork removal for prominence or pain. CONCLUSIONS: Using a headless screw fixation for arthroscopic ankle arthrodesis prevents symptomatic metalwork prominence and the requirement for removal.

Challenges to Aging in Place: Understanding Home Maintenance Difficulties.

Age-related declines in capabilities may compromise older adults' ability to maintain their homes thus threatening successful aging in place. Structured interviews were conducted with forty-four independently living older adults (M(age) = 76.1, SD = 4.7) to discuss difficult home maintenance tasks and how they managed those tasks. Solutions to managing difficulties were categorized as person-related or environment-related. The majority (85%) of responses were person-related solutions. An understanding of the specific challenges that older adults face in maintaining their homes can guide redesign efforts and interventions to effectively support older adults' desire to age in place.

A case of Charcot's feet in a patient with Parkinson's disease: a case report.

INTRODUCTION: Parkinson's Disease (PD), amongst its motor symptoms, can cause dystonia of the limbs and trunk. This can lead to subsequent deformities. CASE PRESENTATION: We describe a case where Parkinson's Disease has gone on to cause bilateral Charcot feet with rocker-bottom deformity. CONCLUSION: There is recognised pattern of foot deformities seen in Parkinson's disease and it is important to realise that patients may go on to develop a Charcot joint. This would warrant early referral to an orthopaedic surgeon so that appropriate management can limit joint damage and deformity.

Implicit learning of predictive relationships in three-element visual sequences by young and old adults.

Knowledge of sequential relationships enables future events to be anticipated and processed efficiently. Research with the serial reaction time task (SRTT) has shown that sequence learning often occurs implicitly without effort or awareness. Here, the authors report 4 experiments that use a triplet-learning task (TLT) to investigate sequence learning in young and older adults. In the TLT, people respond only to the last target event in a series of discrete, 3-event sequences or triplets. Target predictability is manipulated by varying the triplet frequency (joint probability) and/or the statistical relationships (conditional probabilities) among events within the triplets. Results reveal that both groups learned, though older adults showed less learning of both joint and conditional probabilities. Young people used the statistical information in both cues, but older adults relied primarily on information in the 2nd cue alone. The authors conclude that the TLT complements and extends the SRTT and other tasks by offering flexibility in the kinds of sequential statistical regularities that may be studied as well as by controlling event timing and eliminating motor response sequencing.