Performance on the Boston Naming Test in English-Spanish Bilingual Older Adults: Some Considerations

Gollan, Fennema-Notestine, Montoya, and Jernigan (this issue) present a timely and clinically relevant study that examines the impact of bilingualism on the performance on the Boston Naming Test in older adults. In light of the methodology employed, we weigh different potential interpretations of the findings and make recommendations for future studies. (JINS, 2007, 13, 212–214.

Importancia de la implementación de recursos didácticos y tecnológicos enfocados en la enseñanza de la fonética del idioma inglés en el nivel superior.

Este trabajo está enfocado en la importancia de la implementación de recursos didácticos y tecnológicos en la enseñanza de la fonética en inglés; ya que actualmente en el Centro Regional Universitario de Los Santos los estudiantes enfrentan problemas en el aprendizaje de la pronunciación. Existen muchos recursos didácticos, tales como libros, láminas, diccionarios, posters, murales, juegos, canciones, entre otros, que son beneficiosos para el aprendizaje de la fonética, al igual que recursos tecnológicos, tales como: videos, tableros inteligentes, data shows , audios, aplicaciones, cursos online, plataformas, entre otros que son muy esenciales para emplearlos en las aulas de clases. La metodología utilizada para la recolección de los datos es la aplicación de encuestas, entrevista y sondeo. Los resultados estarán plasmados en las respectivas gráficas que se presentan en el IV capítulo. Con este trabajo se busca verificar qué tan valiosos son los recursos didácticos y tecnológicos en la enseñanza de la fonética en inglés

Is the cloze procedure appropriate to evaluate health literacy in older individuals? Age effects in the test of functional health literacy in adults.

Health literacy has received increasing attention because of its importance for older individuals\u27 health, as studies have shown a close relation between older individuals\u27 health literacy and their health. Research also suggests that older individuals have low levels of health literacy, but this finding is variable and may depend on which health literacy test is used. Older individuals assessed with the Test of Functional Health Literacy (TOFHLA) score lower than younger individuals, but a previous study suggested that this may result from age-related differential item functioning (DIF) on the TOFHLA. The study reported here assessed age-related DIF in a sample of community-dwelling volunteers. Twenty-two percent of items were differentially more difficult for older individuals independent of their overall ability, and when these items were eliminated from the total score, age differences were no longer found. Performance on a working memory task predicted older but not younger individuals\u27 performance on the age-related items. At least part of older individuals\u27 apparent deficits in health literacy when assessed by the TOFHLA may be related to DIF on its items. The TOFHLA, and any measure that employs the cloze procedure to evaluate reading comprehension, should be used cautiously in older individuals

Cost effectiveness of a computer-delivered intervention to improve HIV medication adherence.

BACKGROUND: High levels of adherence to medications for HIV infection are essential for optimal clinical outcomes and to reduce viral transmission, but many patients do not achieve required levels. Clinician-delivered interventions can improve patients\u27 adherence, but usually require substantial effort by trained individuals and may not be widely available. Computer-delivered interventions can address this problem by reducing required staff time for delivery and by making the interventions widely available via the Internet. We previously developed a computer-delivered intervention designed to improve patients\u27 level of health literacy as a strategy to improve their HIV medication adherence. The intervention was shown to increase patients\u27 adherence, but it was not clear that the benefits resulting from the increase in adherence could justify the costs of developing and deploying the intervention. The purpose of this study was to evaluate the relation of development and deployment costs to the effectiveness of the intervention. METHODS: Costs of intervention development were drawn from accounting reports for the grant under which its development was supported, adjusted for costs primarily resulting from the project\u27s research purpose. Effectiveness of the intervention was drawn from results of the parent study. The relation of the intervention\u27s effects to changes in health status, expressed as utilities, was also evaluated in order to assess the net cost of the intervention in terms of quality adjusted life years (QALYs). Sensitivity analyses evaluated ranges of possible intervention effectiveness and durations of its effects, and costs were evaluated over several deployment scenarios. RESULTS: The intervention\u27s cost effectiveness depends largely on the number of persons using it and the duration of its effectiveness. Even with modest effects for a small number of patients the intervention was associated with net cost savings in some scenarios and for durations greater than three months and longer it was usually associated with a favorable cost per QALY. For intermediate and larger assumed effects and longer durations of intervention effectiveness, the intervention was associated with net cost savings. CONCLUSIONS: Computer-delivered adherence interventions may be a cost-effective strategy to improve adherence in persons treated for HIV. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT01304186

Semantic Interference Deficits and the Detection of Mild Alzheimer’s Disease and Mild Cognitive Impairment Without Dementia

Impairment in delayed recall has traditionally been considered a hallmark feature of Alzheimer’s disease (AD). However, vulnerability to semantic interference may reflect early manifestations of the disorder. In this study, 26 mildly demented AD patients (mild AD), 53 patients with mild cognitive impairment without dementia (MCI), and 53 normal community-dwelling elders were first presented 10 common objects that were recalled over 3 learning trials. Subjects were then presented 10 new semantically related objects followed by recall for the original targets. After controlling for the degree of overall memory impairment, mild AD patients demonstrated greater proactive but equivalent retroactive interference relative to MCI patients. Normal elderly subjects exhibited the least amount of proactive and retroactive interference effects. Recall for targets susceptible to proactive interference correctly classified 81.3% of MCI patients and 81.3% of normal elderly subjects, outperforming measures of delayed recall and rate of forgetting. Adding recognition memory scores to the model enhanced both sensitivity (84.6%) and specificity (88.5%). A combination of proactive and retroactive interference measures yielded sensitivity of 84.6% and specificity of 96.2% in differentiating mild AD patients from normal older adults. Susceptibility to proactive semantic interference may be an early cognitive feature of MCI and AD patients presenting for clinical evaluation. (JINS, 2004, 10, 91–100.

Category Fluency Test: Normative Data for English- and Spanish-Speaking Elderly

Category fluency tasks are an important component of neuropsychological assessment, especially when evaluating for dementia syndromes. The growth in the number of Spanish-speaking elderly in the United States has increased the need for appropriate neuropsychological measures and normative data for this population. This study provides norms for English and Spanish speakers, over the age of 50, on 3 frequently used measures of category fluency: animals, vegetables, and fruits. In addition, it examines the impact of age, education, gender, language, and depressed mood on total fluency scores and on scores on each of these fluency measures. A sample of 702 cognitively intact elderly, 424 English speakers, and 278 Spanish speakers, participated in the study. Normative data are provided stratified by language, age, education, and gender. Results evidence that regardless of the primary language of the examinee, age, education, and gender are the strongest predictors of total category fluency scores, with gender being the best predictor of performance after adjusting for age and education. English and Spanish speakers obtained similar scores on animal and fruit fluency, but English speakers generated more vegetable exemplars than Spanish speakers. Results also indicate that different fluency measures are affected by various factors to different degrees. (JINS, 2000, 6, 760–769.

Development and initial validation of a computer-administered health literacy assessment in Spanish and English: FLIGHT/VIDAS.

Current measures of health literacy have been criticized on a number of grounds, including use of a limited range of content, development on small and atypical patient groups, and poor psychometric characteristics. In this paper, we report the development and preliminary validation of a new computer-administered and -scored health literacy measure addressing these limitations. Items in the measure reflect a wide range of content related to health promotion and maintenance as well as care for diseases. The development process has focused on creating a measure that will be useful in both Spanish and English, while not requiring substantial time for clinician training and individual administration and scoring. The items incorporate several formats, including questions based on brief videos, which allow for the assessment of listening comprehension and the skills related to obtaining information on the Internet. In this paper, we report the interim analyses detailing the initial development and pilot testing of the items (phase 1 of the project) in groups of Spanish and English speakers. We then describe phase 2, which included a second round of testing of the items, in new groups of Spanish and English speakers, and evaluation of the new measure\u27s reliability and validity in relation to other measures. Data are presented that show that four scales (general health literacy, numeracy, conceptual knowledge, and listening comprehension), developed through a process of item and factor analyses, have significant relations to existing measures of health literacy