British academic interested in clinical and educational cognitive/brain sciences. Former Professor of Psychology and Director of the Institute of Neurosciences at Universidad San Francisco de Quito, Ecuador. Now based in Bangkok, Thailand. I have a B.A. in Latin American Studies, a B.Sc. in Psychology and a Ph.D. in Medicine (Clinical Studies).
The neuroscience of education is an approach to the scholarship of learning and teaching that dra... more The neuroscience of education is an approach to the scholarship of learning and teaching that draws on cognitive and brain sciences. It holds potential for enhancing pedagogical understanding, such as the variation between students in terms of ability. One such example is schizotypy, a personality trait that is linked to neurodevelopmental disorders, cognitive weaknesses, and relatively low academic performance. Schizotypy has been reported to be lower in STEM students compared, to other groups, particularly arts students. But less is known about cognitive ability variations between students in different majors. We compared three groups of university students, studying STEM, arts, or social science. All were evaluated with a self-report measure of schizotypy, and a battery of tests focused on cognitive, social cognition, and motor skill. The results confirmed that the study groups did indeed vary on schizotypy and task performance. Contrary to expectations, STEM students were found to be relatively high on positive aspects of schizotypy, scoring higher on the cognitive-perceptual subscale than non-STEM students, and they also scored below non-STEM students on a perceptual task. We also observed associations between schizotypy and performance measures across the full sample. Specifically, students with more negative schizotypy, scoring relatively high on the interpersonal subscale, had significantly better executive function (switching) and significantly worse manual dexterity. We conclude that schizotypy (as a form of neurodiversity), cognitive ability, and motor dexterity, may be important factors linked to selection of study major among university students, which has implications for their educational achievements.
Software Engineering and Formal Methods. SEFM 2023 Collocated Workshops. SEFM 2023. Lecture Notes in Computer Science, vol 14568, 2024
Clinical sciences involved with the mind and brain, including neurology, psychiatry, endocrinolog... more Clinical sciences involved with the mind and brain, including neurology, psychiatry, endocrinology and clinical psychology all frequently deal with cognitive symptoms, side effects, and risk factors. Consequently, there has long been some interaction between those clinical fields and traditional cognitive sciences, focused on computationalist and embodied approaches to understanding natural and machine cognition. Examples include the advances made in understanding the normal cognitive architecture made by studying its breakdown in disease, as well as the enhanced methods of defining and measuring cognitive disorders stemming from understanding the healthy state. Nevertheless, the fields currently fail to fully exploit the potential for mutual advancement. Here we explore the interactions between traditional clinical and cognitive sciences and highlighted strengths of the relationship, and areas that could benefit from greater multidisciplinary emphasis. We argue that original fields of cognitive science (philosophy, linguistics, computer science, anthropology, psychology and neuroscience) remain the core of the multidisciplinary cognitive sciences, but that they can all be applied fruitfully to clinical issues. We explore this in one sample disorder-voice hearing in schizophrenia, showing the potential for clinically applied cognitive sciences. It is our contention that greater achievement is possible, in both academic and applied fields dealing with cognition, if we can foster a mutually symbiotic relationship between the clinical and cognitive sciences.
Respuestas a Problemas Educativos Contemporáneos, 2023
Executive functioning, or the high-level, top-down control of processes, is a concept that origin... more Executive functioning, or the high-level, top-down control of processes, is a concept that originated in computer science, but has since been extensively applied within psychology, pedagogy, and cognitive science to understand intelligent behavior. Furthermore, damage to the frontal lobes of the brain frequently produces a breakdown of executive control, and such patients often fail in education, training, and employment, despite normal intelligence. This suggests a special role for executive functions in real-life achievement. Findings such as these have motivated researchers from diverse disciplines to development a new discipline- educational neuroscience. As an example, I review how research on executive functions and the brain can help us to understand both misbehavior in the classroom, and academic achievement, drawing particularly on research conducted in Latin America. This research indicates an important role for response inhibition in academic achievement, and working memory in classroom behavior. Importantly, executive functions such as these can be improved to enhance educational performance and well-being. Lifestyle changes can improve brain health, and education has a powerful role in improving neurocognitive functions.
Homelessness is associated with multiple risk factors for neurocognitive impairment. Past researc... more Homelessness is associated with multiple risk factors for neurocognitive impairment. Past research with people experiencing homelessness has described “frontal lobe” dysfunction including behavioral disorders and executive cognitive impairments. In the current study, 72 adults experiencing homelessness were assessed with a standardized assessment of executive function, and interviewed regarding neurological and psychiatric history. When compared to a control sample of 25 never-homeless participants, and controlling for level of education, there was little evidence for executive dysfunction in the sample of people experiencing homelessness. Levels of substance abuse, past head injury, and post-traumatic stress disorder were notably high. However, there were no statistically significant associations between cognitive task performance and clinical or substance abuse variables. Gambling was surprisingly infrequent, but risk-taking behavior among intravenous drug users was common. Though in neither case was it linked to executive function. Overall, there was little evidence for executive impairment in this sample of people experiencing homelessness. I suggest that past research has often used inappropriate criteria for “normal” performance, particularly comparing people experiencing homelessness to control data of relatively high education level. This has led to elements of “frontal lobology,” that is, clinical neuroscience research that tends to overly link non-typical or pathological behavior to frontal lobe impairment. When appropriate comparisons are made, controlling for education level, as in this study, associations between executive function impairments and adult homelessness may be weaker than previously reported.
Cognitive and neurosciences provide new ways to advance the scholarship of learning and teaching.... more Cognitive and neurosciences provide new ways to advance the scholarship of learning and teaching. One such application is identification of the cognitive processes that contribute to academic achievement. Intelligence testing has been shown to be of limited use in higher education, and so there is a need to identify other cognitive and neurobehavioral factors that may be important. One possibility, in the context of STEM education, is visuospatial ability, as this has been linked to achievement in several technical, or things-based courses. In the current study, 60 industrial engineering students and 60 social sciences students were assessed on a task of visual size judgement, and the ability of performance to predict grade point average (GPA) scores was estimated. It was found that size judgement was significantly and positively correlated with GPA within the engineering group, but not in the social sciences group. Furthermore, the results could not be explained by demographic factors such as sex or age. It is concluded that visual perceptual ability, specifically size judgement, may be a useful predictor of academic achievement, and may thus help to partly explain why some engineering students excel, and others do not. Furthermore, potential for training of visuospatial skills to enhance attainment in engineering training is discussed.
A general object recognition ability predicts performance across a variety of high-level visual t... more A general object recognition ability predicts performance across a variety of high-level visual tests, categories, and performance in haptic recognition. Does this ability extend to auditory recognition? Vision and haptics tap into similar representations of shape and texture. In contrast, features of auditory perception like pitch, timbre, or loudness do not readily translate into shape percepts related to edges, surfaces, or spatial arrangement of parts. We find that an auditory object recognition ability correlates highly with a visual object recognition ability after controlling for general intelligence, perceptual speed, low-level visual ability, and memory ability. Auditory object recognition was a stronger predictor of visual object recognition than all control measures across two experiments, even though those control variables were also tested visually. These results point towards a single high-level ability used in both vision and audition. Much work highlights how the integration of visual and auditory information is important in specific domains (e.g., speech, music), with evidence for some overlap of visual and auditory neural representations. Our results are the first to reveal a domain-general ability, o, that predicts object recognition performance in both visual and auditory tests. Because o is domain-general, it reveals mechanisms that apply across a wide range of situations, independent of experience and knowledge. As o is distinct from general intelligence, it is well positioned to potentially add predictive validity when explaining individual differences in a variety of tasks, above and beyond measures of common cognitive abilities like general intelligence and working memory.
Research and practice in clinical neurosciences often involve cognitive assessment. However, this... more Research and practice in clinical neurosciences often involve cognitive assessment. However, this has traditionally used a nomothetic approach, comparing the performance of patients to normative samples. This method of defining abnormality places the average test performance of neurologically healthy individuals at its center. However, evidence suggests that neurological ‘abnormalities’ are very common, as is the diversity of cognitive abilities. The veneration of central tendency in cog-nitive assessment, i.e., equating typicality with healthy or ideal, is, I argue, misguided on neurodi-versity, bio-evolutionary, and cognitive neuroscientific grounds. Furthermore, the use of average performance as an anchor point for normal performance is unreliable in practice and frequently leads to the mischaracterization of cognitive impairments. Examples are explored of how individuals who are already vulnerable for socioeconomic reasons can easily be over-pathologized. At a practical level, by valuing diversity rather than typicality, cognitive assessments can become more idiographic and focused on change at the level of the individual. The use of existing methods that approach cognitive assessment ideographically is briefly discussed, including premorbid estimation methods and informant reports. Moving the focus away from averageness to valuing diversity for both clinical cognitive assessments and inclusion of diverse groups in research is, I argue, a more just and effective way forward for clinical neurosciences.
The concept of executive function, as top-down control of processes, originated in computer scien... more The concept of executive function, as top-down control of processes, originated in computer science in the 1950s. However, it has since become an important concept in a range of human sciences, particularly for its explanatory power in psychology, education, and clinical neurosciences. Nevertheless, its use has been limited by vague definitions and confusion between the related conceptualizations of executive process and intelligence. Here we explore the concept of executive control in detail, drawing on psychology, neurology, and computer science/human-machine interaction. We explore both computationalist and embodied cognition approaches. We describe the core goal-directed and resource-limited features of executive control, its fractionation into components, and partial overlap with psychometric conceptions of intelligence. We also examine its associations with neurological systems beyond those usually linked to executive function (i.e., the frontal lobes). We propose that executive functions are ‘intelligent’, and can be defined by their goal-directedness. Furthermore, executive function tasks can be classified by their task goals into one of three types: Those that involve i) convergent, or ii) divergent thinking, or iii) not responding, such as in psychomotor response inhibition. Conventional intelligence tests measure only convergent thinking. The recognition of non-convergent executive functions allows the identification of executively controlled intelligent goal-directed behavior beyond that controlled by domain-general cognitive processes. This reconceptualization may benefit research in education, clinical and cognitive sciences, as well as the quest for artificial general intelligence.
The ABO blood group system is associated with neurological health and cognitive impairment, and a... more The ABO blood group system is associated with neurological health and cognitive impairment, and also with structural differences in the healthy human brain. The current research aimed to examine how blood group may be associated with cognitive functioning in non-clinical participants. Participants were 132 students at two universities in Ecuador. All were assessed for blood group and a range of cognitive abilities with known neurological substrates: shape recognition ('ventral visual route'), spatial vision ('dorsal visual route'), language-syntactical processes (left perisylvian), focused attention (right perisylvian), executive function (dorsal prefrontal), advantageous decision making (ventral prefrontal) and declarative (medial temporal) and procedural (basal ganglia) learning. Socioeconomic status (SES) was assessed as a potential confounding variable. Preliminary analyses revealed that ABO blood type frequencies showed a cline, varying by site of data collection, and Type O blood was more common in participants from lower SES backgrounds. Additionally, higher SES was associated with better cognitive performance. Significant positive correlations were found indicating associations between higher SES and better performance on tasks of language, and executive function, and for declarative and procedural memory processes. With SES and data-collection site covaried, precategorical visual shape recognition task performance was observed to be the only factor significantly associated with blood group, being better in participants with the Type O phenotype. This result was present in two different samples and was significant with or without the use of covariates. I conclude that, in this sample from Ecuador, human blood group classification was linked to variability in adult human neurocognitive function, specifically, shape recognition task performance associated with occipito-temporal processing. This may have implications for understanding variation in neurological and cognitive health, as well as cognitive abilities as individual differences, and potentially provides a biomarker for efficiency of human object-recognition skill.
Human memory systems are commonly divided into different types of store, the most basic distincti... more Human memory systems are commonly divided into different types of store, the most basic distinction being between short-term memory (STM) and long-term memory (LTM). Phonological STM, as proposed in the working memory model is closely linked to semantic LTM. Nevertheless, the mechanisms of maintenance with STM, and transfer of information with LTM are poorly understood. Candidate mechanisms within phonological STM are rehearsal (either articulatory or elaborative), and refreshing. There is also evidence of long-term learning within STM.
In this paper we use the Behavior and Reasoning Descriptive Language (BRDL) to model human memory contents as well as the perceptions that allow humans to input information into STM. By using the Maude rewrite system to provide semantics to BRDL and dynamics to BRDL models, we can explore various cognitive theories about phonological STM maintenance and transfer of information for long-term retention, such as articulatory rehearsal, elaborative rehearsal, and refreshing. This approach has been implemented in a tool that allows cognitive scientists to carry out in silico the simulation of learning processes as well as the replication of experiments conducted with human beings in order to contrast alternative cognitive theories.
Mass migration and people seeking political refuge are critical social issues facing Latin Americ... more Mass migration and people seeking political refuge are critical social issues facing Latin America. Ecuador has the largest population of recognized refugees in the region. Youths from a migration background have an increased risk of becoming NEET (Young people not in employment, education, or training). Such youths struggle more with mental health problems than non-NEET peers. Being a refugee, NEET further increases the risk of having mental health problems and may be linked to lower cognitive functioning, which could maintain exclusion and unemployment. This intervention study was performed with a group of young people of different nationalities who were refugees or belonged to other vulnerable groups attending a six-week employability-support intervention in Ecuador. In order to assess the impact of the intervention, a range of measures of executive cognitive function, mental health, and the potential for positive change were used. We found that post-intervention, the group reported significantly less psychological distress and better self-esteem, self-efficacy, and cognitive response inhibition than before the intervention. We conclude that multicomponent interventions may effectively improve the psychological functioning of vulnerable NEET groups in the Latin American context.
Resumen Una parte fundamental de la evaluación del estado cognitivo es la determinación de la cap... more Resumen Una parte fundamental de la evaluación del estado cognitivo es la determinación de la capacidad cognitiva general. Sin embargo, las pruebas cognitivas más comunes no están estandarizadas para su uso en Ecuador. Esto ha limitado el alcance y la precisión de las evaluaciones clínicas neuropsicológicas en el país. Se aplicó la Escala de Inteligencia para Adultos de Wechsler-IV (WAIS-IV), de 7 subpruebas, a 155 adultos ecuatorianos de 4 ciudades del Ecuador, pertenecientes a distintos estatus socioeconómicos. La muestra se ajustó a la población urbana ecuatoriana en cuanto a género, educación y etnia. Se demostró que esta versión de la WAIS-IV es una evaluación fiable y válida para su uso en este contexto. Adicionalmente, los resultados proporcionan un método para ajustar las puntuaciones estándar derivadas de la población española, y utilizadas en el manual de la WAIS-IV, para que sean más apropiadas para su uso en Ecuador. Este método puede ser potencialmente utilizado para calcular las puntuaciones completas del coeficiente intelectual (CI). Por último, se describen métodos de comparación de las puntuaciones estándar ajustadas en Ecuador para que puedan ser utilizadas en evaluaciones clínicas neuropsicológicas de adultos ecuatorianos.
OBJETIVO: La valoración premórbida de la función cognitiva es esencial para la interpretación de ... more OBJETIVO: La valoración premórbida de la función cognitiva es esencial para la interpretación de la presencia y severidad del deterioro cognitivo. El método más confiable para evaluar esto en países hispanohablantes es el Word Accentuation Test (WAT) / Test de Acentuación de Palabras (TAP), ya que predice los resultados de pruebas de inteligencia mediante una regresión linear.
RESULTADOS: En una muestra ecuatoriana, el TAP tiene buena consistencia interna y confiabilidad test-retest. La correlación del TAP con los puntajes del WAIS-IV es alta (r=.827), permitiendo el desarrollo de una ecuación de regresión para estimar las puntuaciones de CI. Además, se encontró que una muestra de pacientes con demencia funcionaba normalmente en el TAP en comparación con el grupo de control. Esto sugiere que el rendimiento del TAP se mantiene en la presencia de una enfermedad neurológica con un deterioro cognitivo y puede usarse para valorar inteligencia premórbida.
CONCLUSIONES: El TAP tiene buenas propiedades psicométricas y puede ser utilizado para estimar puntuaciones de pruebas de inteligencia en participantes sanos. También puede valorar puntajes de inteligencia premórbida en pacientes con enfermedades neurológicas o psiquiátricas, permitiendo una interpretación clara de la gravedad del deterioro. Esta evaluación podría utilizarse en contextos clínicos y de investigación.
OBJECTIVES: Premorbid estimation of cognitive function is essential for the interpretation of the presence and severity of actual cognitive impairment. The most reliable method in Spanish speaking countries is with the Word Accentuation Test (WAT) / Test de Acentuación de Palabras (TAP). This is used to predict intelligence test scores by linear regression.
RESULTS:
In an Ecuadorian sample the TAP was found to have good internal consistency and test-retest reliability. The correlation of the TAP with WAIS-IV full IQ scores was high (r= .827), allowing the development of a regression equation to estimate IQ scores from TAP performance. Furthermore, a sample of dementia patients was found to perform normally on the WAT compared to a matched control group. This suggests that WAT performance holds in the presence of neurological illness with associated cognitive impairment.
CONCLUSIONS: The WAT has good psychometric properties and can be used to rapidly estimate actual intelligence test scores in healthy participants. It can also estimate premorbid intelligence scores in patients with neurological or psychiatric illnesses, allowing a clearer interpretation of the severity of impairment. This simple assessment could be used in various research and clinical contexts.
Purpose: There are differences in epidemiology, etiology, and outcome in status epilepticus (SE) ... more Purpose: There are differences in epidemiology, etiology, and outcome in status epilepticus (SE) between developing and developed countries, which limits generalizability. We evaluated factors related to outcome at 3 months in SE patients in a developing country- Ecuador. Methods: Retrospective analysis of a prospectively collected dataset of patients treated for SE at a single hospital over 4 years, recording on 107 patients and 109 episodes, including clinical, demographic, and prognosis assessments. Results: Hospital mortality was 33%, and 38% at 3 months. Glasgow Coma Scale score pretreatment ≤ 12 (odds ratio = 7.7), Charlson Index of comorbidities ≥ 3 (odds ratio = 5.6) and brain lesion (odds ratio = 6.4) predicted high disability. History of epilepsy was associated with favorable outcome in general, and showed a positive impact on survival rates (odds ratio = 0.3), while Glasgow Coma Scale scores pretreatment ≤ 12 (odds ratio = 4.1) and refractory SE (odds ratio = 2.1) were associated with reduced survival rates. Acute symptomatic etiology was the most common cause of SE (58%). Etiologies with structural brain lesion showed a significantly lower survival rate (Log ranks = .04 and .003) compared to other groups. Conclusion: Mortality rate at 3 months for SE patients was high. Glasgow Coma Scale, Charlson Index, and brain lesions were associated with unfavorable outcome, including mortality. Overall, the results were similar to those reported in more developed countries, but some differences, including overall higher mortality, prevalence of nonconvulsive SE, and lack of association of age with outcome were evident.
Background:
Few studies have evaluated the incidence, predisposing factors and impact of healthca... more Background: Few studies have evaluated the incidence, predisposing factors and impact of healthcare-associated infections (HCAIs) in relation to outcomes among patients with status epilepticus (SE).
Objective: To investigate the variables associated with development of HCAIs among patients with SE and the impact of factors relating to HCAIs on mortality at three months.
Methods: This study was a retrospective analysis on our prospectively collected dataset, from November 2015 to January 2019. The sample included all consecutive patients diagnosed with SE who were treated at Hospital Eugenio Espejo during that period. In total, 74 patients were included. Clinical variables such as age, etiology of SE, Charlson comorbidity index (CCI), hospital length of stay, refractory SE (RSE) and outcomes were analyzed.
Results: HCAIs were diagnosed in 38 patients (51.4%), with a preponderance of respiratory tract infection (19; 25.7%). Prolonged hospital length of stay (OR=1.09; 95%CI 1.03-1.15) and CCI≥2 (OR=5.50; 95%CI 1.37-22.10) were shown to be independent variables relating to HCAIs. HCAIs were associated with an increased risk of mortality at three months, according to Cox regression analysis (OR=2.23; 95%CI 1.08-4.58), and with infection caused by Gram-negative microorganisms (OR=3.17; 95%CI 1.20-8.39). Kaplan-Meier curve analysis demonstrated that HCAIs had a negative impact on the survival rate at three months (log rank=0.025).
Conclusions: HCAIs are a common complication among Ecuadorian patients with SE and were related to a lower survival rate at three months. Prolonged hospital length of stay, RSE and CCI≥2 were associated with the risk of developing HCAIs.
Street Children in Latin America examines the phenomenon of street-connected youth in Latin Ameri... more Street Children in Latin America examines the phenomenon of street-connected youth in Latin American countries, in particular, associations with mental illness and substance abuse. Children may be street-connected for many reasons, including being homeless. However, many street children do have family homes to return to, and their unsupervised presence in the urban environment is a consequence of their need to work. Nevertheless, exposure to traumatic events is extremely common among street children, some of which is due to family dysfunction, but also to the vulnerability associated with living or spending long periods in the urban environment. Evidence is limited, but street children in Latin American countries appear to be at high risk of developing posttraumatic stress disorder, depression and anxiety disorders. Substance abuse is also a considerable problem, further challenging the mental health of street-connect youth. For geographical reasons, cocaine use is particularly associated with street children in Latin America. Inhalant abuse is also problematic, but as with other substances, this may be more associated with homeless street children as compared to domiciled and working children. Overall, street children in Latin America face a great number of challenges and risks to their mental health, most of which are consequences of the various correlates of extreme poverty, including lack of available mental health care, vulnerability to abuse, and family dysfunction.
The term ‘street children’ is often used as an umbrella category for street-connected children an... more The term ‘street children’ is often used as an umbrella category for street-connected children and youth. In this post, Graham Pluck discusses research approaches to street children, from those documenting their dire situation to those advocating their resourcefulness. However, if researchers are to effectively tackle street children’s problems, facile distinctions should be avoided by acknowledging both their strengths and weaknesses, he writes.
Smartphone use has become ubiquitous. Keeping smartphones close and always on, with alerts for ne... more Smartphone use has become ubiquitous. Keeping smartphones close and always on, with alerts for new messages, etc., means that users experience unprecedented levels of distracting and reinforcing stimulation, with wide-ranging psychological implications. We interviewed 121 students to record aspects of smartphone use, personality, psychological distress (depression/anxiety), cognitive, social-cognitive, and reward processing. We found that questionnaire-measured problematic phone use is linked to poorer academic performance and to higher psychological distress, neuroticism, psychometric impulsivity and image management. Social media use is linked to neuroticism. Keeping a smartphone in hand and frequent checking is associated with extraversion and poorer performance on tests of sustained attention and general intelligence, particularly semantic reasoning. The number of messenger services used is associated with sensitivity to financial rewards and responses to social reinforcement in...
When pure tones of different frequencies are presented dichotically, participants report a subjec... more When pure tones of different frequencies are presented dichotically, participants report a subjective beat at a frequency of the difference between the 2 tones. These binaural beats are illusory in that they do not exist in the physical stimuli. Electro- and magnetoencephalographic evidence suggests that these psychological binaural beats can induce physiological synchronous electric activity in the brain. Therefore, they have potential experimental and therapeutic applications. The present study reports on a fully controlled, double-blind experiment of acute exposure to binaural beats at 6 Hz (theta) on concurrent mood and cognitive function as measured by a range of fluency tasks on healthy adults. The present study could not find any detectable influence of binaural beat exposure on four different measures of cognitive fluency (phonological, semantic, ideational and design). However, regarding moods measured with the Visual Analogue Mood Scales, a significant induction of fear in the binaural beat condition compared to control was detected. A suggested mechanism of action for this fear induction is the entrainment of theta activity in the amygdala or primary auditory cortex. Furthermore, as the beat was embedded within music, participants were unaware of its presence. The present data suggest that no cognitive enhancement, nor for that matter cognitive suppression, at least as measured by fluency tasks, is induced by theta frequency binaural beat stimulation. However, the fact that theta frequency stimulation can induce fear without participants being aware of the stimulation could be of practical experimental use, for example in human anxiety or conditioned fear research.
Introduction: In research, a simple measure of general cognitive ability is often required. One m... more Introduction: In research, a simple measure of general cognitive ability is often required. One method is the Matrix Matching Test, a brief, free-to-use, language-free assessment of general cognitive ability or intelligence in adults, which taps both fluid and crystalized processes. We investigated its reliability and validity with adolescent participants. Methods: The Matrix Matching Test was administered to 111 participants, aged 12 to 17 (46% female). Subsamples also completed two standard measures of cognitive ability: Vocabulary (crystalized) and Matrix Reasoning (fluid) tests from the Wechsler Intelligence Scale for Children IV (WISC-IV). Results: The Matrix Matching Test was found to have acceptable internal consistency and good retest reliability. Criterion validity was indicated by its ability to distinguish between psychosocially deprived participants living in foster care (n = 40) and controls, and by its positive correlation with grade point average. There were large positive correlations between the Matrix Matching Test and the standard measures of Vocabulary, and Matrix Reasoning, suggesting convergent validity. Conclusions: Our preliminary evidence suggests that The Matrix Matching Test is a reliable and valid measure of general cognitive ability for ages 12 to 17.
The neuroscience of education is an approach to the scholarship of learning and teaching that dra... more The neuroscience of education is an approach to the scholarship of learning and teaching that draws on cognitive and brain sciences. It holds potential for enhancing pedagogical understanding, such as the variation between students in terms of ability. One such example is schizotypy, a personality trait that is linked to neurodevelopmental disorders, cognitive weaknesses, and relatively low academic performance. Schizotypy has been reported to be lower in STEM students compared, to other groups, particularly arts students. But less is known about cognitive ability variations between students in different majors. We compared three groups of university students, studying STEM, arts, or social science. All were evaluated with a self-report measure of schizotypy, and a battery of tests focused on cognitive, social cognition, and motor skill. The results confirmed that the study groups did indeed vary on schizotypy and task performance. Contrary to expectations, STEM students were found to be relatively high on positive aspects of schizotypy, scoring higher on the cognitive-perceptual subscale than non-STEM students, and they also scored below non-STEM students on a perceptual task. We also observed associations between schizotypy and performance measures across the full sample. Specifically, students with more negative schizotypy, scoring relatively high on the interpersonal subscale, had significantly better executive function (switching) and significantly worse manual dexterity. We conclude that schizotypy (as a form of neurodiversity), cognitive ability, and motor dexterity, may be important factors linked to selection of study major among university students, which has implications for their educational achievements.
Software Engineering and Formal Methods. SEFM 2023 Collocated Workshops. SEFM 2023. Lecture Notes in Computer Science, vol 14568, 2024
Clinical sciences involved with the mind and brain, including neurology, psychiatry, endocrinolog... more Clinical sciences involved with the mind and brain, including neurology, psychiatry, endocrinology and clinical psychology all frequently deal with cognitive symptoms, side effects, and risk factors. Consequently, there has long been some interaction between those clinical fields and traditional cognitive sciences, focused on computationalist and embodied approaches to understanding natural and machine cognition. Examples include the advances made in understanding the normal cognitive architecture made by studying its breakdown in disease, as well as the enhanced methods of defining and measuring cognitive disorders stemming from understanding the healthy state. Nevertheless, the fields currently fail to fully exploit the potential for mutual advancement. Here we explore the interactions between traditional clinical and cognitive sciences and highlighted strengths of the relationship, and areas that could benefit from greater multidisciplinary emphasis. We argue that original fields of cognitive science (philosophy, linguistics, computer science, anthropology, psychology and neuroscience) remain the core of the multidisciplinary cognitive sciences, but that they can all be applied fruitfully to clinical issues. We explore this in one sample disorder-voice hearing in schizophrenia, showing the potential for clinically applied cognitive sciences. It is our contention that greater achievement is possible, in both academic and applied fields dealing with cognition, if we can foster a mutually symbiotic relationship between the clinical and cognitive sciences.
Respuestas a Problemas Educativos Contemporáneos, 2023
Executive functioning, or the high-level, top-down control of processes, is a concept that origin... more Executive functioning, or the high-level, top-down control of processes, is a concept that originated in computer science, but has since been extensively applied within psychology, pedagogy, and cognitive science to understand intelligent behavior. Furthermore, damage to the frontal lobes of the brain frequently produces a breakdown of executive control, and such patients often fail in education, training, and employment, despite normal intelligence. This suggests a special role for executive functions in real-life achievement. Findings such as these have motivated researchers from diverse disciplines to development a new discipline- educational neuroscience. As an example, I review how research on executive functions and the brain can help us to understand both misbehavior in the classroom, and academic achievement, drawing particularly on research conducted in Latin America. This research indicates an important role for response inhibition in academic achievement, and working memory in classroom behavior. Importantly, executive functions such as these can be improved to enhance educational performance and well-being. Lifestyle changes can improve brain health, and education has a powerful role in improving neurocognitive functions.
Homelessness is associated with multiple risk factors for neurocognitive impairment. Past researc... more Homelessness is associated with multiple risk factors for neurocognitive impairment. Past research with people experiencing homelessness has described “frontal lobe” dysfunction including behavioral disorders and executive cognitive impairments. In the current study, 72 adults experiencing homelessness were assessed with a standardized assessment of executive function, and interviewed regarding neurological and psychiatric history. When compared to a control sample of 25 never-homeless participants, and controlling for level of education, there was little evidence for executive dysfunction in the sample of people experiencing homelessness. Levels of substance abuse, past head injury, and post-traumatic stress disorder were notably high. However, there were no statistically significant associations between cognitive task performance and clinical or substance abuse variables. Gambling was surprisingly infrequent, but risk-taking behavior among intravenous drug users was common. Though in neither case was it linked to executive function. Overall, there was little evidence for executive impairment in this sample of people experiencing homelessness. I suggest that past research has often used inappropriate criteria for “normal” performance, particularly comparing people experiencing homelessness to control data of relatively high education level. This has led to elements of “frontal lobology,” that is, clinical neuroscience research that tends to overly link non-typical or pathological behavior to frontal lobe impairment. When appropriate comparisons are made, controlling for education level, as in this study, associations between executive function impairments and adult homelessness may be weaker than previously reported.
Cognitive and neurosciences provide new ways to advance the scholarship of learning and teaching.... more Cognitive and neurosciences provide new ways to advance the scholarship of learning and teaching. One such application is identification of the cognitive processes that contribute to academic achievement. Intelligence testing has been shown to be of limited use in higher education, and so there is a need to identify other cognitive and neurobehavioral factors that may be important. One possibility, in the context of STEM education, is visuospatial ability, as this has been linked to achievement in several technical, or things-based courses. In the current study, 60 industrial engineering students and 60 social sciences students were assessed on a task of visual size judgement, and the ability of performance to predict grade point average (GPA) scores was estimated. It was found that size judgement was significantly and positively correlated with GPA within the engineering group, but not in the social sciences group. Furthermore, the results could not be explained by demographic factors such as sex or age. It is concluded that visual perceptual ability, specifically size judgement, may be a useful predictor of academic achievement, and may thus help to partly explain why some engineering students excel, and others do not. Furthermore, potential for training of visuospatial skills to enhance attainment in engineering training is discussed.
A general object recognition ability predicts performance across a variety of high-level visual t... more A general object recognition ability predicts performance across a variety of high-level visual tests, categories, and performance in haptic recognition. Does this ability extend to auditory recognition? Vision and haptics tap into similar representations of shape and texture. In contrast, features of auditory perception like pitch, timbre, or loudness do not readily translate into shape percepts related to edges, surfaces, or spatial arrangement of parts. We find that an auditory object recognition ability correlates highly with a visual object recognition ability after controlling for general intelligence, perceptual speed, low-level visual ability, and memory ability. Auditory object recognition was a stronger predictor of visual object recognition than all control measures across two experiments, even though those control variables were also tested visually. These results point towards a single high-level ability used in both vision and audition. Much work highlights how the integration of visual and auditory information is important in specific domains (e.g., speech, music), with evidence for some overlap of visual and auditory neural representations. Our results are the first to reveal a domain-general ability, o, that predicts object recognition performance in both visual and auditory tests. Because o is domain-general, it reveals mechanisms that apply across a wide range of situations, independent of experience and knowledge. As o is distinct from general intelligence, it is well positioned to potentially add predictive validity when explaining individual differences in a variety of tasks, above and beyond measures of common cognitive abilities like general intelligence and working memory.
Research and practice in clinical neurosciences often involve cognitive assessment. However, this... more Research and practice in clinical neurosciences often involve cognitive assessment. However, this has traditionally used a nomothetic approach, comparing the performance of patients to normative samples. This method of defining abnormality places the average test performance of neurologically healthy individuals at its center. However, evidence suggests that neurological ‘abnormalities’ are very common, as is the diversity of cognitive abilities. The veneration of central tendency in cog-nitive assessment, i.e., equating typicality with healthy or ideal, is, I argue, misguided on neurodi-versity, bio-evolutionary, and cognitive neuroscientific grounds. Furthermore, the use of average performance as an anchor point for normal performance is unreliable in practice and frequently leads to the mischaracterization of cognitive impairments. Examples are explored of how individuals who are already vulnerable for socioeconomic reasons can easily be over-pathologized. At a practical level, by valuing diversity rather than typicality, cognitive assessments can become more idiographic and focused on change at the level of the individual. The use of existing methods that approach cognitive assessment ideographically is briefly discussed, including premorbid estimation methods and informant reports. Moving the focus away from averageness to valuing diversity for both clinical cognitive assessments and inclusion of diverse groups in research is, I argue, a more just and effective way forward for clinical neurosciences.
The concept of executive function, as top-down control of processes, originated in computer scien... more The concept of executive function, as top-down control of processes, originated in computer science in the 1950s. However, it has since become an important concept in a range of human sciences, particularly for its explanatory power in psychology, education, and clinical neurosciences. Nevertheless, its use has been limited by vague definitions and confusion between the related conceptualizations of executive process and intelligence. Here we explore the concept of executive control in detail, drawing on psychology, neurology, and computer science/human-machine interaction. We explore both computationalist and embodied cognition approaches. We describe the core goal-directed and resource-limited features of executive control, its fractionation into components, and partial overlap with psychometric conceptions of intelligence. We also examine its associations with neurological systems beyond those usually linked to executive function (i.e., the frontal lobes). We propose that executive functions are ‘intelligent’, and can be defined by their goal-directedness. Furthermore, executive function tasks can be classified by their task goals into one of three types: Those that involve i) convergent, or ii) divergent thinking, or iii) not responding, such as in psychomotor response inhibition. Conventional intelligence tests measure only convergent thinking. The recognition of non-convergent executive functions allows the identification of executively controlled intelligent goal-directed behavior beyond that controlled by domain-general cognitive processes. This reconceptualization may benefit research in education, clinical and cognitive sciences, as well as the quest for artificial general intelligence.
The ABO blood group system is associated with neurological health and cognitive impairment, and a... more The ABO blood group system is associated with neurological health and cognitive impairment, and also with structural differences in the healthy human brain. The current research aimed to examine how blood group may be associated with cognitive functioning in non-clinical participants. Participants were 132 students at two universities in Ecuador. All were assessed for blood group and a range of cognitive abilities with known neurological substrates: shape recognition ('ventral visual route'), spatial vision ('dorsal visual route'), language-syntactical processes (left perisylvian), focused attention (right perisylvian), executive function (dorsal prefrontal), advantageous decision making (ventral prefrontal) and declarative (medial temporal) and procedural (basal ganglia) learning. Socioeconomic status (SES) was assessed as a potential confounding variable. Preliminary analyses revealed that ABO blood type frequencies showed a cline, varying by site of data collection, and Type O blood was more common in participants from lower SES backgrounds. Additionally, higher SES was associated with better cognitive performance. Significant positive correlations were found indicating associations between higher SES and better performance on tasks of language, and executive function, and for declarative and procedural memory processes. With SES and data-collection site covaried, precategorical visual shape recognition task performance was observed to be the only factor significantly associated with blood group, being better in participants with the Type O phenotype. This result was present in two different samples and was significant with or without the use of covariates. I conclude that, in this sample from Ecuador, human blood group classification was linked to variability in adult human neurocognitive function, specifically, shape recognition task performance associated with occipito-temporal processing. This may have implications for understanding variation in neurological and cognitive health, as well as cognitive abilities as individual differences, and potentially provides a biomarker for efficiency of human object-recognition skill.
Human memory systems are commonly divided into different types of store, the most basic distincti... more Human memory systems are commonly divided into different types of store, the most basic distinction being between short-term memory (STM) and long-term memory (LTM). Phonological STM, as proposed in the working memory model is closely linked to semantic LTM. Nevertheless, the mechanisms of maintenance with STM, and transfer of information with LTM are poorly understood. Candidate mechanisms within phonological STM are rehearsal (either articulatory or elaborative), and refreshing. There is also evidence of long-term learning within STM.
In this paper we use the Behavior and Reasoning Descriptive Language (BRDL) to model human memory contents as well as the perceptions that allow humans to input information into STM. By using the Maude rewrite system to provide semantics to BRDL and dynamics to BRDL models, we can explore various cognitive theories about phonological STM maintenance and transfer of information for long-term retention, such as articulatory rehearsal, elaborative rehearsal, and refreshing. This approach has been implemented in a tool that allows cognitive scientists to carry out in silico the simulation of learning processes as well as the replication of experiments conducted with human beings in order to contrast alternative cognitive theories.
Mass migration and people seeking political refuge are critical social issues facing Latin Americ... more Mass migration and people seeking political refuge are critical social issues facing Latin America. Ecuador has the largest population of recognized refugees in the region. Youths from a migration background have an increased risk of becoming NEET (Young people not in employment, education, or training). Such youths struggle more with mental health problems than non-NEET peers. Being a refugee, NEET further increases the risk of having mental health problems and may be linked to lower cognitive functioning, which could maintain exclusion and unemployment. This intervention study was performed with a group of young people of different nationalities who were refugees or belonged to other vulnerable groups attending a six-week employability-support intervention in Ecuador. In order to assess the impact of the intervention, a range of measures of executive cognitive function, mental health, and the potential for positive change were used. We found that post-intervention, the group reported significantly less psychological distress and better self-esteem, self-efficacy, and cognitive response inhibition than before the intervention. We conclude that multicomponent interventions may effectively improve the psychological functioning of vulnerable NEET groups in the Latin American context.
Resumen Una parte fundamental de la evaluación del estado cognitivo es la determinación de la cap... more Resumen Una parte fundamental de la evaluación del estado cognitivo es la determinación de la capacidad cognitiva general. Sin embargo, las pruebas cognitivas más comunes no están estandarizadas para su uso en Ecuador. Esto ha limitado el alcance y la precisión de las evaluaciones clínicas neuropsicológicas en el país. Se aplicó la Escala de Inteligencia para Adultos de Wechsler-IV (WAIS-IV), de 7 subpruebas, a 155 adultos ecuatorianos de 4 ciudades del Ecuador, pertenecientes a distintos estatus socioeconómicos. La muestra se ajustó a la población urbana ecuatoriana en cuanto a género, educación y etnia. Se demostró que esta versión de la WAIS-IV es una evaluación fiable y válida para su uso en este contexto. Adicionalmente, los resultados proporcionan un método para ajustar las puntuaciones estándar derivadas de la población española, y utilizadas en el manual de la WAIS-IV, para que sean más apropiadas para su uso en Ecuador. Este método puede ser potencialmente utilizado para calcular las puntuaciones completas del coeficiente intelectual (CI). Por último, se describen métodos de comparación de las puntuaciones estándar ajustadas en Ecuador para que puedan ser utilizadas en evaluaciones clínicas neuropsicológicas de adultos ecuatorianos.
OBJETIVO: La valoración premórbida de la función cognitiva es esencial para la interpretación de ... more OBJETIVO: La valoración premórbida de la función cognitiva es esencial para la interpretación de la presencia y severidad del deterioro cognitivo. El método más confiable para evaluar esto en países hispanohablantes es el Word Accentuation Test (WAT) / Test de Acentuación de Palabras (TAP), ya que predice los resultados de pruebas de inteligencia mediante una regresión linear.
RESULTADOS: En una muestra ecuatoriana, el TAP tiene buena consistencia interna y confiabilidad test-retest. La correlación del TAP con los puntajes del WAIS-IV es alta (r=.827), permitiendo el desarrollo de una ecuación de regresión para estimar las puntuaciones de CI. Además, se encontró que una muestra de pacientes con demencia funcionaba normalmente en el TAP en comparación con el grupo de control. Esto sugiere que el rendimiento del TAP se mantiene en la presencia de una enfermedad neurológica con un deterioro cognitivo y puede usarse para valorar inteligencia premórbida.
CONCLUSIONES: El TAP tiene buenas propiedades psicométricas y puede ser utilizado para estimar puntuaciones de pruebas de inteligencia en participantes sanos. También puede valorar puntajes de inteligencia premórbida en pacientes con enfermedades neurológicas o psiquiátricas, permitiendo una interpretación clara de la gravedad del deterioro. Esta evaluación podría utilizarse en contextos clínicos y de investigación.
OBJECTIVES: Premorbid estimation of cognitive function is essential for the interpretation of the presence and severity of actual cognitive impairment. The most reliable method in Spanish speaking countries is with the Word Accentuation Test (WAT) / Test de Acentuación de Palabras (TAP). This is used to predict intelligence test scores by linear regression.
RESULTS:
In an Ecuadorian sample the TAP was found to have good internal consistency and test-retest reliability. The correlation of the TAP with WAIS-IV full IQ scores was high (r= .827), allowing the development of a regression equation to estimate IQ scores from TAP performance. Furthermore, a sample of dementia patients was found to perform normally on the WAT compared to a matched control group. This suggests that WAT performance holds in the presence of neurological illness with associated cognitive impairment.
CONCLUSIONS: The WAT has good psychometric properties and can be used to rapidly estimate actual intelligence test scores in healthy participants. It can also estimate premorbid intelligence scores in patients with neurological or psychiatric illnesses, allowing a clearer interpretation of the severity of impairment. This simple assessment could be used in various research and clinical contexts.
Purpose: There are differences in epidemiology, etiology, and outcome in status epilepticus (SE) ... more Purpose: There are differences in epidemiology, etiology, and outcome in status epilepticus (SE) between developing and developed countries, which limits generalizability. We evaluated factors related to outcome at 3 months in SE patients in a developing country- Ecuador. Methods: Retrospective analysis of a prospectively collected dataset of patients treated for SE at a single hospital over 4 years, recording on 107 patients and 109 episodes, including clinical, demographic, and prognosis assessments. Results: Hospital mortality was 33%, and 38% at 3 months. Glasgow Coma Scale score pretreatment ≤ 12 (odds ratio = 7.7), Charlson Index of comorbidities ≥ 3 (odds ratio = 5.6) and brain lesion (odds ratio = 6.4) predicted high disability. History of epilepsy was associated with favorable outcome in general, and showed a positive impact on survival rates (odds ratio = 0.3), while Glasgow Coma Scale scores pretreatment ≤ 12 (odds ratio = 4.1) and refractory SE (odds ratio = 2.1) were associated with reduced survival rates. Acute symptomatic etiology was the most common cause of SE (58%). Etiologies with structural brain lesion showed a significantly lower survival rate (Log ranks = .04 and .003) compared to other groups. Conclusion: Mortality rate at 3 months for SE patients was high. Glasgow Coma Scale, Charlson Index, and brain lesions were associated with unfavorable outcome, including mortality. Overall, the results were similar to those reported in more developed countries, but some differences, including overall higher mortality, prevalence of nonconvulsive SE, and lack of association of age with outcome were evident.
Background:
Few studies have evaluated the incidence, predisposing factors and impact of healthca... more Background: Few studies have evaluated the incidence, predisposing factors and impact of healthcare-associated infections (HCAIs) in relation to outcomes among patients with status epilepticus (SE).
Objective: To investigate the variables associated with development of HCAIs among patients with SE and the impact of factors relating to HCAIs on mortality at three months.
Methods: This study was a retrospective analysis on our prospectively collected dataset, from November 2015 to January 2019. The sample included all consecutive patients diagnosed with SE who were treated at Hospital Eugenio Espejo during that period. In total, 74 patients were included. Clinical variables such as age, etiology of SE, Charlson comorbidity index (CCI), hospital length of stay, refractory SE (RSE) and outcomes were analyzed.
Results: HCAIs were diagnosed in 38 patients (51.4%), with a preponderance of respiratory tract infection (19; 25.7%). Prolonged hospital length of stay (OR=1.09; 95%CI 1.03-1.15) and CCI≥2 (OR=5.50; 95%CI 1.37-22.10) were shown to be independent variables relating to HCAIs. HCAIs were associated with an increased risk of mortality at three months, according to Cox regression analysis (OR=2.23; 95%CI 1.08-4.58), and with infection caused by Gram-negative microorganisms (OR=3.17; 95%CI 1.20-8.39). Kaplan-Meier curve analysis demonstrated that HCAIs had a negative impact on the survival rate at three months (log rank=0.025).
Conclusions: HCAIs are a common complication among Ecuadorian patients with SE and were related to a lower survival rate at three months. Prolonged hospital length of stay, RSE and CCI≥2 were associated with the risk of developing HCAIs.
Street Children in Latin America examines the phenomenon of street-connected youth in Latin Ameri... more Street Children in Latin America examines the phenomenon of street-connected youth in Latin American countries, in particular, associations with mental illness and substance abuse. Children may be street-connected for many reasons, including being homeless. However, many street children do have family homes to return to, and their unsupervised presence in the urban environment is a consequence of their need to work. Nevertheless, exposure to traumatic events is extremely common among street children, some of which is due to family dysfunction, but also to the vulnerability associated with living or spending long periods in the urban environment. Evidence is limited, but street children in Latin American countries appear to be at high risk of developing posttraumatic stress disorder, depression and anxiety disorders. Substance abuse is also a considerable problem, further challenging the mental health of street-connect youth. For geographical reasons, cocaine use is particularly associated with street children in Latin America. Inhalant abuse is also problematic, but as with other substances, this may be more associated with homeless street children as compared to domiciled and working children. Overall, street children in Latin America face a great number of challenges and risks to their mental health, most of which are consequences of the various correlates of extreme poverty, including lack of available mental health care, vulnerability to abuse, and family dysfunction.
The term ‘street children’ is often used as an umbrella category for street-connected children an... more The term ‘street children’ is often used as an umbrella category for street-connected children and youth. In this post, Graham Pluck discusses research approaches to street children, from those documenting their dire situation to those advocating their resourcefulness. However, if researchers are to effectively tackle street children’s problems, facile distinctions should be avoided by acknowledging both their strengths and weaknesses, he writes.
Smartphone use has become ubiquitous. Keeping smartphones close and always on, with alerts for ne... more Smartphone use has become ubiquitous. Keeping smartphones close and always on, with alerts for new messages, etc., means that users experience unprecedented levels of distracting and reinforcing stimulation, with wide-ranging psychological implications. We interviewed 121 students to record aspects of smartphone use, personality, psychological distress (depression/anxiety), cognitive, social-cognitive, and reward processing. We found that questionnaire-measured problematic phone use is linked to poorer academic performance and to higher psychological distress, neuroticism, psychometric impulsivity and image management. Social media use is linked to neuroticism. Keeping a smartphone in hand and frequent checking is associated with extraversion and poorer performance on tests of sustained attention and general intelligence, particularly semantic reasoning. The number of messenger services used is associated with sensitivity to financial rewards and responses to social reinforcement in...
When pure tones of different frequencies are presented dichotically, participants report a subjec... more When pure tones of different frequencies are presented dichotically, participants report a subjective beat at a frequency of the difference between the 2 tones. These binaural beats are illusory in that they do not exist in the physical stimuli. Electro- and magnetoencephalographic evidence suggests that these psychological binaural beats can induce physiological synchronous electric activity in the brain. Therefore, they have potential experimental and therapeutic applications. The present study reports on a fully controlled, double-blind experiment of acute exposure to binaural beats at 6 Hz (theta) on concurrent mood and cognitive function as measured by a range of fluency tasks on healthy adults. The present study could not find any detectable influence of binaural beat exposure on four different measures of cognitive fluency (phonological, semantic, ideational and design). However, regarding moods measured with the Visual Analogue Mood Scales, a significant induction of fear in the binaural beat condition compared to control was detected. A suggested mechanism of action for this fear induction is the entrainment of theta activity in the amygdala or primary auditory cortex. Furthermore, as the beat was embedded within music, participants were unaware of its presence. The present data suggest that no cognitive enhancement, nor for that matter cognitive suppression, at least as measured by fluency tasks, is induced by theta frequency binaural beat stimulation. However, the fact that theta frequency stimulation can induce fear without participants being aware of the stimulation could be of practical experimental use, for example in human anxiety or conditioned fear research.
Introduction: In research, a simple measure of general cognitive ability is often required. One m... more Introduction: In research, a simple measure of general cognitive ability is often required. One method is the Matrix Matching Test, a brief, free-to-use, language-free assessment of general cognitive ability or intelligence in adults, which taps both fluid and crystalized processes. We investigated its reliability and validity with adolescent participants. Methods: The Matrix Matching Test was administered to 111 participants, aged 12 to 17 (46% female). Subsamples also completed two standard measures of cognitive ability: Vocabulary (crystalized) and Matrix Reasoning (fluid) tests from the Wechsler Intelligence Scale for Children IV (WISC-IV). Results: The Matrix Matching Test was found to have acceptable internal consistency and good retest reliability. Criterion validity was indicated by its ability to distinguish between psychosocially deprived participants living in foster care (n = 40) and controls, and by its positive correlation with grade point average. There were large positive correlations between the Matrix Matching Test and the standard measures of Vocabulary, and Matrix Reasoning, suggesting convergent validity. Conclusions: Our preliminary evidence suggests that The Matrix Matching Test is a reliable and valid measure of general cognitive ability for ages 12 to 17.
Homelessness is a major societal issue in most, if not all, countries. Although for some people h... more Homelessness is a major societal issue in most, if not all, countries. Although for some people homelessness is a short-term socioeconomic problem, for many it is a chronic socioeconomic state affecting much of their adult lives. During homelessness, people are at raised risk from a wide range of health challenges, including to psychiatric and neurological health. Such risks include high rates of victimization and violence, post-traumatic stress disorder, traumatic brain injury, exposure to contagious illness and pollution etc. In addition, some disorders such as developmental neurological problems, substance dependence and psychiatric illness may be factors that contribute to people becoming homeless. In accordance with these risk factors, neuropsychologists have observed that cognitive functioning in samples of homeless adults tends to be lower than might be expected. Given the wide range of pathologies and risk factors associated with homelessness, it is perhaps not surprising that the interpretation of this lower ability has not been simple. Cognitive function of homeless adults is sometimes considered as essentially normal, given their life contexts, or from a more medical-neuropsychological perspective it is usually considered as reflecting deficits in performance, suggesting acquired etiology. More recently the role of developmental disorders, such as being on the autistic spectrum, has been recognized, with a possible over representation of undiagnosed developmental disorders within homeless adult populations. These different interpretations have implications for the care and potential treatment of homeless individuals. In this symposium the etiology of assumed lower cognitive ability is explored, as well as how homeless services can better use this neuropsychological knowledge to support homeless people.
Objetivos: Comparar el rendimiento diagnóstico de las escalas pronósticas para predecir mortalida... more Objetivos: Comparar el rendimiento diagnóstico de las escalas pronósticas para predecir mortalidad a los 3 meses, entre pacientes con estatus epiléptico (SE) tratados con anestésicos (FA) y los que solo recibieron fármacos antiepilépticos (FAE). Material y métodos: Se incluyó 109 episodios de SE atendidos consecutivamente entre noviembre de 2015 y febrero de 2020. Se recogieron las puntuaciones de las escalas de STESS, mRSTESS, y EMSE (edad/etiología/comorbilidad/electroencefalograma) al ingreso hospitalario, realizándose un análisis teniendo en cuenta si los pacientes requirieron coma inducido con FA, o solo fueron tratados con FAE. Se utilizó el test de DeLong para comparar las áreas bajo la curva (AUROC) en ambos contextos clínicos. Resultados: El 45,9% (50) de los pacientes necesitaron tratamiento con FA. En este grupo existió un predominio de etiología aguda sintomática (p = 0,04), así como de las causas relacionadas con infección del sistema nervioso central, traumatismo craneoencefálico, enfermedades cerebrovasculares, y procesos autoinmunes (p = 0,02). Se apreció una disminución del área bajo la curva en las escalas para predecir mortalidad a los 90 días en los pacientes tratados con FA. Las diferencias en la AUROC para cada modelo fueron de: STESS (0,76 vs. 0,73; p = 0,82), mRSTESS (0,79 vs. 0,75; p = 0,67), EMSEeec (0,87 vs. 0,69; p = 0,04), y EMSEeeceg (0,92 vs. 0,71; p = 0,01). Conclusión: Este resultado sugiere que para pacientes con características similares a las de esta muestra, tratados con FA, y monitoreo electroencefalográfico intermitente pudiese ser más útil las escalas STESS y mRSTESS que EMSE para predecir mortalidad a largo plazo.
Objetivos: Evaluar la capacidad predictiva de mortalidad a los 3 meses de tres escalas pronostica... more Objetivos: Evaluar la capacidad predictiva de mortalidad a los 3 meses de tres escalas pronosticas aplicadas a pacientes con estatus epiléptico (SE). Material y métodos: Se realizó un análisis retrospectivo de los 109 episodios de SE tratados de forma consecutiva entre noviembre de 2015 a febrero de 2020. Todos los pacientes fueron evaluados inicialmente con la escala de gravedad de SE (STESS), STESS modificado por la escala de Rankin (mRSTESS), y la escala de mortalidad basada en factores epidemiológicos (EMSE), calculándose la capacidad predictiva de cada herramienta para identificar los pacientes fallecidos a los 90 días. Los puntos de corte fueron determinados por el índice de Youden, y sus parámetros de validez interna, sensibilidad/especificidad (S/E), y externa, valores predictivos positivos/negativos (VPP/VPN) fueron calculados con el programa estadístico MedCalc 20.218. Resultados: El grado de validez global (área bajo la curva) para identificar los pacientes fallecidos a los 90 días de cada escala fue de: 0,74 (IC95%; 0,65-0,82), 0,77 (IC95%; 0,68-0,85), 0,78 (IC95%; 0,70-0,86), 0,83 (IC95%;0,75-0,90) para STESS, mRSTESS, EMSEeec (edad-etiología-comorbilidad), y EMSEeeceg (edad-etiología-comorbilidad-electroencefalograma) respectivamente. Los puntos de corte que demostraron una mayor validez interna fueron: STESS ≥ 2 (S-61% [IC95% 44-76%], E-72% [IC95% 60-82%]), mRSTESS ≥ 4 (S-76% [IC95% 60-88%], E-68% [IC95% 55-79%]), EMSEeec ≥ 42 (S-80% [IC95% 65-91%], E-68% [IC95%; 55-79%]), EMSEeece ≥72 (S-76% [IC95% 60-88%], E-75% [IC95% 63-85%]). La mayor validez externa fue encontrada en la variante EMSEeeceg con un VPP de 66% (IC95% 55-75%) y VPN de 84% (IC95% 75-90%). Conclusión: Las escalas evaluadas demostraron ser útiles para predecir mortalidad a los tres meses en los pacientes con SE. Los modelos EMSEeec-eeceg mostraron una leve superioridad en comparación al resto de escalas estudiadas.
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Papers by Graham Pluck
In this paper we use the Behavior and Reasoning Descriptive Language (BRDL) to model human memory contents as well as the perceptions that allow humans to input information into STM. By using the Maude rewrite system to provide semantics to BRDL and dynamics to BRDL models, we can explore various cognitive theories about phonological STM maintenance and transfer of information for long-term retention, such as articulatory rehearsal, elaborative rehearsal, and refreshing. This approach has been implemented in a tool that allows cognitive scientists to carry out in silico the simulation of learning processes as well as the replication of experiments conducted with human beings in order to contrast alternative cognitive theories.
RESULTADOS: En una muestra ecuatoriana, el TAP tiene buena consistencia interna y confiabilidad test-retest. La correlación del TAP con los puntajes del WAIS-IV es alta (r=.827), permitiendo el desarrollo de una ecuación de regresión para estimar las puntuaciones de CI. Además, se encontró que una muestra de pacientes con demencia funcionaba normalmente en el TAP en comparación con el grupo de control. Esto sugiere que el rendimiento del TAP se mantiene en la presencia de una enfermedad neurológica con un deterioro cognitivo y puede usarse para valorar inteligencia premórbida.
CONCLUSIONES: El TAP tiene buenas propiedades psicométricas y puede ser utilizado para estimar puntuaciones de pruebas de inteligencia en participantes sanos. También puede valorar puntajes de inteligencia premórbida en pacientes con enfermedades neurológicas o psiquiátricas, permitiendo una interpretación clara de la gravedad del deterioro. Esta evaluación podría utilizarse en contextos clínicos y de investigación.
OBJECTIVES: Premorbid estimation of cognitive function is essential for the interpretation of the presence and severity of actual cognitive impairment. The most reliable method in Spanish speaking countries is with the Word Accentuation Test (WAT) / Test de Acentuación de Palabras (TAP). This is used to predict intelligence test scores by linear regression.
RESULTS:
In an Ecuadorian sample the TAP was found to have good internal consistency and test-retest reliability. The correlation of the TAP with WAIS-IV full IQ scores was high (r= .827), allowing the development of a regression equation to estimate IQ scores from TAP performance. Furthermore, a sample of dementia patients was found to perform normally on the WAT compared to a matched control group. This suggests that WAT performance holds in the presence of neurological illness with associated cognitive impairment.
CONCLUSIONS: The WAT has good psychometric properties and can be used to rapidly estimate actual intelligence test scores in healthy participants. It can also estimate premorbid intelligence scores in patients with neurological or psychiatric illnesses, allowing a clearer interpretation of the severity of impairment. This simple assessment could be used in various research and clinical contexts.
Methods: Retrospective analysis of a prospectively collected dataset of patients treated for SE at a single hospital over 4 years, recording on 107 patients and 109 episodes, including clinical, demographic, and prognosis assessments.
Results: Hospital mortality was 33%, and 38% at 3 months. Glasgow Coma Scale score pretreatment ≤ 12 (odds ratio = 7.7), Charlson Index of comorbidities ≥ 3 (odds ratio = 5.6) and brain lesion (odds ratio = 6.4) predicted high disability. History of epilepsy was associated with favorable outcome in general, and showed a positive impact on survival rates (odds ratio = 0.3), while Glasgow Coma Scale scores pretreatment ≤ 12 (odds ratio = 4.1) and refractory SE (odds ratio = 2.1) were associated with reduced survival rates. Acute symptomatic etiology was the most common cause of SE (58%). Etiologies with structural brain lesion showed a significantly lower survival rate (Log ranks = .04 and .003) compared to other groups.
Conclusion: Mortality rate at 3 months for SE patients was high. Glasgow Coma Scale, Charlson Index, and brain lesions were associated with unfavorable outcome, including mortality. Overall, the results were similar to those reported in more developed countries, but some differences, including overall higher mortality, prevalence of nonconvulsive SE, and lack of association of age with outcome were evident.
Few studies have evaluated the incidence, predisposing factors and impact of healthcare-associated infections (HCAIs) in relation to outcomes among patients with status epilepticus (SE).
Objective:
To investigate the variables associated with development of HCAIs among patients with SE and the impact of factors relating to HCAIs on mortality at three months.
Methods:
This study was a retrospective analysis on our prospectively collected dataset, from November 2015 to January 2019. The sample included all consecutive patients diagnosed with SE who were treated at Hospital Eugenio Espejo during that period. In total, 74 patients were included. Clinical variables such as age, etiology of SE, Charlson comorbidity index (CCI), hospital length of stay, refractory SE (RSE) and outcomes were analyzed.
Results:
HCAIs were diagnosed in 38 patients (51.4%), with a preponderance of respiratory tract infection (19; 25.7%). Prolonged hospital length of stay (OR=1.09; 95%CI 1.03-1.15) and CCI≥2 (OR=5.50; 95%CI 1.37-22.10) were shown to be independent variables relating to HCAIs. HCAIs were associated with an increased risk of mortality at three months, according to Cox regression analysis (OR=2.23; 95%CI 1.08-4.58), and with infection caused by Gram-negative microorganisms (OR=3.17; 95%CI 1.20-8.39). Kaplan-Meier curve analysis demonstrated that HCAIs had a negative impact on the survival rate at three months (log rank=0.025).
Conclusions:
HCAIs are a common complication among Ecuadorian patients with SE and were related to a lower survival rate at three months. Prolonged hospital length of stay, RSE and CCI≥2 were associated with the risk of developing HCAIs.
In this paper we use the Behavior and Reasoning Descriptive Language (BRDL) to model human memory contents as well as the perceptions that allow humans to input information into STM. By using the Maude rewrite system to provide semantics to BRDL and dynamics to BRDL models, we can explore various cognitive theories about phonological STM maintenance and transfer of information for long-term retention, such as articulatory rehearsal, elaborative rehearsal, and refreshing. This approach has been implemented in a tool that allows cognitive scientists to carry out in silico the simulation of learning processes as well as the replication of experiments conducted with human beings in order to contrast alternative cognitive theories.
RESULTADOS: En una muestra ecuatoriana, el TAP tiene buena consistencia interna y confiabilidad test-retest. La correlación del TAP con los puntajes del WAIS-IV es alta (r=.827), permitiendo el desarrollo de una ecuación de regresión para estimar las puntuaciones de CI. Además, se encontró que una muestra de pacientes con demencia funcionaba normalmente en el TAP en comparación con el grupo de control. Esto sugiere que el rendimiento del TAP se mantiene en la presencia de una enfermedad neurológica con un deterioro cognitivo y puede usarse para valorar inteligencia premórbida.
CONCLUSIONES: El TAP tiene buenas propiedades psicométricas y puede ser utilizado para estimar puntuaciones de pruebas de inteligencia en participantes sanos. También puede valorar puntajes de inteligencia premórbida en pacientes con enfermedades neurológicas o psiquiátricas, permitiendo una interpretación clara de la gravedad del deterioro. Esta evaluación podría utilizarse en contextos clínicos y de investigación.
OBJECTIVES: Premorbid estimation of cognitive function is essential for the interpretation of the presence and severity of actual cognitive impairment. The most reliable method in Spanish speaking countries is with the Word Accentuation Test (WAT) / Test de Acentuación de Palabras (TAP). This is used to predict intelligence test scores by linear regression.
RESULTS:
In an Ecuadorian sample the TAP was found to have good internal consistency and test-retest reliability. The correlation of the TAP with WAIS-IV full IQ scores was high (r= .827), allowing the development of a regression equation to estimate IQ scores from TAP performance. Furthermore, a sample of dementia patients was found to perform normally on the WAT compared to a matched control group. This suggests that WAT performance holds in the presence of neurological illness with associated cognitive impairment.
CONCLUSIONS: The WAT has good psychometric properties and can be used to rapidly estimate actual intelligence test scores in healthy participants. It can also estimate premorbid intelligence scores in patients with neurological or psychiatric illnesses, allowing a clearer interpretation of the severity of impairment. This simple assessment could be used in various research and clinical contexts.
Methods: Retrospective analysis of a prospectively collected dataset of patients treated for SE at a single hospital over 4 years, recording on 107 patients and 109 episodes, including clinical, demographic, and prognosis assessments.
Results: Hospital mortality was 33%, and 38% at 3 months. Glasgow Coma Scale score pretreatment ≤ 12 (odds ratio = 7.7), Charlson Index of comorbidities ≥ 3 (odds ratio = 5.6) and brain lesion (odds ratio = 6.4) predicted high disability. History of epilepsy was associated with favorable outcome in general, and showed a positive impact on survival rates (odds ratio = 0.3), while Glasgow Coma Scale scores pretreatment ≤ 12 (odds ratio = 4.1) and refractory SE (odds ratio = 2.1) were associated with reduced survival rates. Acute symptomatic etiology was the most common cause of SE (58%). Etiologies with structural brain lesion showed a significantly lower survival rate (Log ranks = .04 and .003) compared to other groups.
Conclusion: Mortality rate at 3 months for SE patients was high. Glasgow Coma Scale, Charlson Index, and brain lesions were associated with unfavorable outcome, including mortality. Overall, the results were similar to those reported in more developed countries, but some differences, including overall higher mortality, prevalence of nonconvulsive SE, and lack of association of age with outcome were evident.
Few studies have evaluated the incidence, predisposing factors and impact of healthcare-associated infections (HCAIs) in relation to outcomes among patients with status epilepticus (SE).
Objective:
To investigate the variables associated with development of HCAIs among patients with SE and the impact of factors relating to HCAIs on mortality at three months.
Methods:
This study was a retrospective analysis on our prospectively collected dataset, from November 2015 to January 2019. The sample included all consecutive patients diagnosed with SE who were treated at Hospital Eugenio Espejo during that period. In total, 74 patients were included. Clinical variables such as age, etiology of SE, Charlson comorbidity index (CCI), hospital length of stay, refractory SE (RSE) and outcomes were analyzed.
Results:
HCAIs were diagnosed in 38 patients (51.4%), with a preponderance of respiratory tract infection (19; 25.7%). Prolonged hospital length of stay (OR=1.09; 95%CI 1.03-1.15) and CCI≥2 (OR=5.50; 95%CI 1.37-22.10) were shown to be independent variables relating to HCAIs. HCAIs were associated with an increased risk of mortality at three months, according to Cox regression analysis (OR=2.23; 95%CI 1.08-4.58), and with infection caused by Gram-negative microorganisms (OR=3.17; 95%CI 1.20-8.39). Kaplan-Meier curve analysis demonstrated that HCAIs had a negative impact on the survival rate at three months (log rank=0.025).
Conclusions:
HCAIs are a common complication among Ecuadorian patients with SE and were related to a lower survival rate at three months. Prolonged hospital length of stay, RSE and CCI≥2 were associated with the risk of developing HCAIs.
Material y métodos: Se incluyó 109 episodios de SE atendidos consecutivamente entre noviembre de 2015 y febrero de 2020. Se recogieron las puntuaciones de las escalas de STESS, mRSTESS, y EMSE (edad/etiología/comorbilidad/electroencefalograma) al ingreso hospitalario, realizándose un análisis teniendo en cuenta si los pacientes requirieron coma inducido con FA, o solo fueron tratados con FAE. Se utilizó el test de DeLong para comparar las áreas bajo la curva (AUROC) en ambos contextos clínicos.
Resultados: El 45,9% (50) de los pacientes necesitaron tratamiento con FA. En este grupo existió un predominio de etiología aguda sintomática (p = 0,04), así como de las causas relacionadas con infección del sistema nervioso central, traumatismo craneoencefálico, enfermedades cerebrovasculares, y procesos autoinmunes (p = 0,02). Se apreció una disminución del área bajo la curva en las escalas para predecir mortalidad a los 90 días en los pacientes tratados con FA. Las diferencias en la AUROC para cada modelo fueron de: STESS (0,76 vs. 0,73; p = 0,82), mRSTESS (0,79 vs. 0,75; p = 0,67), EMSEeec (0,87 vs. 0,69; p = 0,04), y EMSEeeceg (0,92 vs. 0,71; p = 0,01).
Conclusión: Este resultado sugiere que para pacientes con características similares a las de esta muestra, tratados con FA, y monitoreo electroencefalográfico intermitente pudiese ser más útil las escalas STESS y mRSTESS que EMSE para predecir mortalidad a largo plazo.
Material y métodos: Se realizó un análisis retrospectivo de los 109 episodios de SE tratados de forma consecutiva entre noviembre de 2015 a febrero de 2020. Todos los pacientes fueron evaluados inicialmente con la escala de gravedad de SE (STESS), STESS modificado por la escala de Rankin (mRSTESS), y la escala de mortalidad basada en factores epidemiológicos (EMSE), calculándose la capacidad predictiva de cada herramienta para identificar los pacientes fallecidos a los 90 días. Los puntos de corte fueron determinados por el índice de Youden, y sus parámetros de validez interna, sensibilidad/especificidad (S/E), y externa, valores predictivos positivos/negativos (VPP/VPN) fueron calculados con el programa estadístico MedCalc 20.218.
Resultados: El grado de validez global (área bajo la curva) para identificar los pacientes fallecidos a los 90 días de cada escala fue de: 0,74 (IC95%; 0,65-0,82), 0,77 (IC95%; 0,68-0,85), 0,78 (IC95%; 0,70-0,86), 0,83 (IC95%;0,75-0,90) para STESS, mRSTESS, EMSEeec (edad-etiología-comorbilidad), y EMSEeeceg (edad-etiología-comorbilidad-electroencefalograma) respectivamente. Los puntos de corte que demostraron una mayor validez interna fueron: STESS ≥ 2 (S-61% [IC95% 44-76%], E-72% [IC95% 60-82%]), mRSTESS ≥ 4 (S-76% [IC95% 60-88%], E-68% [IC95% 55-79%]), EMSEeec ≥ 42 (S-80% [IC95% 65-91%], E-68% [IC95%; 55-79%]), EMSEeece ≥72 (S-76% [IC95% 60-88%], E-75% [IC95% 63-85%]). La mayor validez externa fue encontrada en la variante EMSEeeceg con un VPP de 66% (IC95% 55-75%) y VPN de 84% (IC95% 75-90%).
Conclusión: Las escalas evaluadas demostraron ser útiles para predecir mortalidad a los tres meses en los pacientes con SE. Los modelos EMSEeec-eeceg mostraron una leve superioridad en comparación al resto de escalas estudiadas.