A Model of Contributors to Academic Achievement Deficits in Childhood Cancer Survivors

Long-term survivors of childhood cancer often experience a myriad of late effects of their treatment. Among these are academic and learning problems that often do not appear until the child has been off treatment for years. The purpose of this study was to examine the contributors to academic achievement deficits in children who are long-term survivors of acute lymphocytic leukemia (ALL) or a brain tumor (BT), and who have received central nervous system directed treatment. The present study analyzed a hypothesized developmental model of contributors to academic achievement deficits in a sample of 302 long-term survivors. These children participated in a larger study of cognitive late effects and data from that study used in this analysis included: the treatment variables of length of time since completion of treatment, treatment intensity and age when treatment began; demographic variables of gender and age at testing; family education variables; a measure of intelligence; and academic achievement measures in the areas of reading comprehension, basic reading skills, mathematics calculation, mathematics reasoning and spelling. Also included in the analyses were selected items from the Conners’ Teacher Rating Scale-Revised: Short form (CTRS-R:S) and the Conners’ Continuous Performance Test. Data were submitted to a structural equation modeling analysis. Results of the analyses were generally consistent with the hypothesized model of the causal effects of the treatment-related factors of treatment intensity and age at treatment on academic achievement deficits, however indicated that attention, as measured by the Conners’ CPT is not a contributor to these deficits. Length of time off treatment was not found to be a significant contributing variable in the model. Attention and classroom performance problems, as observed by teachers, are significant contributors to academic achievement deficits in this model. The findings also indicated that Intelligence is an important mediating variable in academic achievement outcomes in this sample. Implications of these results for understanding the nature of academic achievement deficits in long-term survivors of childhood cancer, and future assessment and remediation practices are discussed

Cognitive function and mood at high altitude following acclimatization and use of supplemental oxygen and adaptive servoventilation sleep treatments.

Impairments in cognitive function, mood, and sleep quality occur following ascent to high altitude. Low oxygen (hypoxia) and poor sleep quality are both linked to impaired cognitive performance, but their independent contributions at high altitude remain unknown. Adaptive servoventilation (ASV) improves sleep quality by stabilizing breathing and preventing central apneas without supplemental oxygen. We compared the efficacy of ASV and supplemental oxygen sleep treatments for improving daytime cognitive function and mood in high-altitude visitors (N = 18) during acclimatization to 3,800 m. Each night, subjects were randomly provided with ASV, supplemental oxygen (SpO2 > 95%), or no treatment. Each morning subjects completed a series of cognitive function tests and questionnaires to assess mood and multiple aspects of cognitive performance. We found that both ASV and supplemental oxygen (O2) improved daytime feelings of confusion (ASV: p < 0.01; O2: p < 0.05) and fatigue (ASV: p < 0.01; O2: p < 0.01) but did not improve other measures of cognitive performance at high altitude. However, performance improved on the trail making tests (TMT) A and B (p < 0.001), the balloon analog risk test (p < 0.0001), and the psychomotor vigilance test (p < 0.01) over the course of three days at altitude after controlling for effects of sleep treatments. Compared to sea level, subjects reported higher levels of confusion (p < 0.01) and performed worse on the TMT A (p < 0.05) and the emotion recognition test (p < 0.05) on nights when they received no treatment at high altitude. These results suggest that stabilizing breathing (ASV) or increasing oxygenation (supplemental oxygen) during sleep can reduce feelings of fatigue and confusion, but that daytime hypoxia may play a larger role in other cognitive impairments reported at high altitude. Furthermore, this study provides evidence that some aspects of cognition (executive control, risk inhibition, sustained attention) improve with acclimatization

The effects of intrinsic motivation on mental fatigue

There have been many studies attempting to disentangle the relation between motivation and mental fatigue. Mental fatigue occurs after performing a demanding task for a prolonged time, and many studies have suggested that motivation can counteract the negative effects of mental fatigue on task performance. To complicate matters, most mental fatigue studies looked exclusively at the effects of extrinsic motivation but not intrinsic motivation. Individuals are said to be extrinsically motivated when they perform a task to attain rewards and avoid punishments, while they are said to be intrinsically motivated when they do for the pleasure of doing the activity. To assess whether intrinsic motivation has similar effects as extrinsic motivation, we conducted an experiment using subjective, performance, and physiological measures (heart rate variability and pupillometry). In this experiment, 28 participants solved Sudoku puzzles on a computer for three hours, with a cat video playing in the corner of the screen. The experiment consisted of 14 blocks with two alternating conditions: low intrinsic motivation and high intrinsic motivation. The main results showed that irrespective of condition, participants reported becoming fatigued over time. They performed better, invested more mental effort physiologically, and were less distracted in high-level than in low-level motivation blocks. The results suggest that similarly to extrinsic motivation, time-on-task effects are modulated by the level of intrinsic motivation: With high intrinsic motivation, people can maintain their performance over time as they seem willing to invest more effort as time progresses than in low intrinsic motivation

Draining your Brain: The Effects of Four Fatiguing Task Domains on Executive Function and Prefrontal Cortex

The present study empirically examined the effects of four fatiguing task domains on executive function through participants\u27 reaction time, accuracy, and brain activity in prefrontal cortex (PFC). Forty college-age participants were collected (16 males and 24 females), of which eleven were examined using a functional near-infrared spectroscopy (fNIRS) imaging system. The present study used a 4×2 mixed factorial design consisting of fatiguing task (arm contractions task, vigilance task, distance-manipulated Fitts\u27 task, size-manipulated Fitts\u27 task) as a between-participant variable and n-back testing period (pre-test versus post-test 3-back task) as a within-participant variable. Results indicated significant increases in 3-back performance after the fatiguing tasks, and significant increases in 3-back compensatory brain activity in dorsomedial and dorsolateral prefrontal cortex (dmPFC and dlPFC) after the fatiguing tasks. Furthermore, results showed an interaction between 3-back target type and fatiguing task on standardized changes in reaction time, and an interaction between fatiguing task and testing period on brain activity in dmPFC. Theoretical and practical implications are discussed. Findings from this study may be used to help draw the boundaries on different domains of fatigue and their effects on the brain and body

Does Video Game Use Exacerbate the Relation Between Neurophysiological Deficits and ADHD Symptoms in Children and Adolescents?

Attention-deficit/hyperactivity disorder (ADHD) is diagnosed based on behavioral symptoms but is thought to have a significant heritable neurological basis, and several brain structures have been implicated. Recent research has focused on the role of environmental factors that may influence the behavioral expression of inattention and hyperactivity-impulsivity in children and teens, particularly when a biological predisposition exists. This study sought to broaden the literature base by examining the extent to which one environmental factor—video game use—moderated the relation between neuropsychological deficits in attention and inhibition and the behavioral symptoms of ADHD. It was hypothesized that gaming frequency and duration as well as deficits in neuropsychological functioning would relate positively to ADHD symptoms. Twenty-five participants (age 10 to 17 years) recruited from the community were administered four neuropsychological tests of attention and behavioral disinhibition and reported on gaming habits while parents completed measures of ADHD symptoms and also reported on the child’s video gaming habits. Moderated multiple regression analyses were used to examine the moderating effects of gaming frequency and gaming duration on the association between neuropsychological deficits and ADHD symptom domains beyond control variables (i.e., age, gender, race/ethnicity, family income, IQ). Gaming duration was significantly related to symptoms of inattention. Neuropsychological deficits were not significantly related to symptoms of inattention or hyperactivity-impulsivity. However, the interaction of gaming frequency and sustained attention deficits predicted significant variability in inattention, and the interaction of gaming frequency and set shifting deficits significantly predicted symptoms of hyperactivity-impulsivity. These findings underscore the importance of continued research on environmental factors, such as video game use, that may exacerbate a biological predisposition for ADHD symptoms in children. Masters thesis: http://aquila.usm.edu/masters_theses/238

Sleep difficulties and sustained attention following traumatic brain injury and research portfolio

Objectives: The audit sought to investigate and characterise general practitioner referrals to the Riverside locality Direct Access Clinical Psychology Service, in the West of Scotland. The audit aimed to describe any variations in general practice referral rates, and to consider why such variation might be occurring in terms of practice characteristics (primary care CPN support and single-handed practices) and referral characteristics (demographic and referral problem of patients). Design: A retrospective analysis of general practice referrals to the Riverside Direct Access Clinical Psychology Service was conducted. Setting: An out-patient Direct Access Clinical Psychology Department in the West Sector of Glasgow, which covers three localities. One of these localities, Riverside, was the focus of this audit. Cases: Four hundred and eighty patients consecutively referred from GPs to the Riverside locality Direct Access Clinical Psychology Department between the 1st of January 2004 - 31st of December 2004. Results: Four hundred and eighty referrals were received by the psychology department from 51 general practices. Of these practices, 23 were members of the two locality LHCCs and accounted for 79.3% (n=381) of referrals. There was a high degree of variation in the number and rate of referrals by individual practices. There were no significant differences between practice characteristics in groups of practices that referred more or less frequently. Fifty five percent (n=266) of all general practice referrals were female, and forty five percent (n=214) were male. The median age of referrals was 35 years (the mean age was 36.1). According to Carstairs deprivation categories clients most frequently fell into category four (n= 126, 29.4%) which is an area of no deprivation and band six (n=119, 27.7%) which is an area of medium deprivation (McLoone, 2001). The referral reasons most frequently used in GPs letters were the general categories of anxiety (n=143, 29.8%), and depression / low mood (n=143, 29.8%). Where more specific categories were described, the most frequent primary problems were stress/ coping difficulties (n=23, 4.8%) and panic (n= 20, 4.2%). There were no obvious differences in these referral characteristics between groups of practices that referred higher and lower than the median referral rate. Conclusions: The majority of referrals came from practices within the Riverside locality. There was a wide variation of referral rates. This variation in referral rates was not explained by the presence of the practice characteristics examined in this audit. In line with the results of other audits the broad referral categories of anxiety and depression/low mood were utilised most frequently by referring GPs. However, looking at more specific problems that were frequently referred may be more useful in terms of future service provision. Implications for future service delivery, allocation of resources and staff training, which take account of and meet the needs of general practice referrals, were discussed. Limitations of this study and ideas for further investigation were also discussed along with a dissemination strategy for these data