The Preservation of Cued Recall in the Acute Mentally Fatigued State: A Randomised Crossover Study.

The objective of this study is to investigate the impact of acute mental fatigue on the recall of clinical information in the non-sleep-deprived state. Acute mental fatigue in the non-sleep-deprived subject is rarely studied in the medical workforce. Patient handover has been highlighted as an area of high risk especially in fatigued subjects. This study evaluates the deterioration in recall of clinical information over 2 h with cognitively demanding work in non-sleep-deprived subjects.A randomised crossover study involving twenty medical students assessed free (presentation) and cued (MCQ) recall of clinical case histories at 0 and 2 h under low and high cognitive load using the N-Back task. Acute mental fatigue was assessed through the Visual Analogue Scale, Stanford Scale and NASA-TLX Mental Workload Rating Scale.Free recall is significantly impaired by increased cognitive load (p < 0.05) with subjects demonstrating perceived mental fatigue during the high cognitive load assessment. There was no significant difference in the amount of information retrieved by cued recall under high and low cognitive load conditions (p = 1).This study demonstrates the loss of clinical information over a short time period involving a mentally fatiguing, high cognitive load task. Free recall for the handover of clinical information is unreliable. Memory cues maintain recall of clinical information. This study provides evidence towards the requirement for standardisation of a structured patient handover. The use of memory cues (involving recognition memory and cued recall methodology) would be beneficial in a handover checklist to aid recall of clinical information and supports evidence for their adoption into clinical practice

Economic Analysis of Law: Some Realism About Nominalism

With the publication of Richard A. Posner\u27s Economic Analysisof Law, that field of learning known as Law and Economics has reached a stage of extended explicitness that requires and permits extendedand explicit comment

Unconscionability and the Code: The Emperor\u27s New Clause

This paper is devoted wholly to section 2-302 of the UniformCommercial Code, the so-called unconscionability clause

The Cultural and Social Impact of Society on American Advertising

Professor Leff, a noted expert on consumer protection, was askedto analyze and comment on the preceding Article by CommissionerMary Gardiner Jones. In his response, he challenges several of theCommissioner\u27s basic premises concerning the nature and effect ofbroadcast advertising and the role of the advertising industry in thesocietal context. He examines the necessity and potential for successof the Commissioner\u27s exhortations to the industry that its messagesand techniques be reevaluated in order better to serve the publicinterest

Information erasure without an energy cost

Landauer argued that the process of erasing the information stored in a memory device incurs an energy cost in the form of a minimum amount of mechanical work. We find, however, that this energy cost can be reduced to zero by paying a cost in angular momentum or any other conserved quantity. Erasing the memory of Maxwell's demon in this way implies that work can be extracted from a single thermal reservoir at a cost of angular momentum and an increase in total entropy. The implications of this for the second law of thermodynamics are assessed.Comment: 8 pages with 1 figure. Final published versio

Rethinking damaged cognition: an expert opinion on cognitive rehabilitation

Cognition is frequently damaged by acquired brain injury (ABI). Impaired thinking is both a symptom in its own right and also a barrier to recovery by impacting their insight and awareness and their engagement with rehabilitation. Here we consider the aims, mechanisms and contexts when the goal is to improve cognitive function in patients with ABI

An expert opinion in speech and language therapy: The Queen Square Intensive Comprehensive Aphasia Programme

Less is more, right? Wrong: more is more. Here we make the case that the total dose of speech and language therapy (SLT) is a key factor in improving persons with aphasia’s (PWA) outcomes. The challenge is: how can we deliver high-dose therapy when resources are stretched? We review the recent evidence for dose and timing of SLT and then describe one solution to the problem of dose that we are trialing at Queen Square, an Intensive Comprehensive Aphasia Programme (ICAP)

Abundance of Planktonic Virus-Like Particles in Lake Erie Subsurface Waters

Author Institution: Department of Biological Sciences, Kent State University - Trumbull Campus ; Department of Biological Sciences and Water Resources Research Institute, Kent State UniversityAbundance of virus-like particles (VLP) was determined in Lake Erie subsurface water. The relationship between VLP and the bacterial and phytoplankton communities were investigated. Viral and bacterial numbers were determined using nucleic acid stains and epifluorescent microscopy. Phytoplankton abundance was estimated by chlorophylls extraction. Viral abundance averaged 1.05 x 106 VLP/ml and the ratio of viral to bacterial number was less than 1.0 across most sampling sites and dates. Viral abundance was not correlated with either bacterial abundance or chlorophyll a concentration. Viral abundance was found to be most similar to other Great Lakes and marine systems and dissimilar to other freshwater systems