Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales

Background: Online technology could potentially revolutionise how patients are cognitively assessed and monitored. However, it remains unclear whether assessments conducted remotely can match established pen-and-paper neuropsychological tests in terms of sensitivity and specificity. Methods: This observational study aimed to optimise an online cognitive assessment for use in traumatic brain injury (TBI) clinics. The tertiary referral clinic in which this tool has been clinically implemented typically sees patients a minimum of 6 months post-injury in the chronic phase. Between March and August 2019, we conducted a cross-group, cross-device and factor analyses at the St. Mary's Hospital TBI clinic and major trauma wards at Imperial College NHS trust and St. George's Hospital in London (UK), to identify a battery of tasks that assess aspects of cognition affected by TBI. Between September 2019 and February 2020, we evaluated the online battery against standard face-to-face neuropsychological tests at the Imperial College London research centre. Canonical Correlation Analysis (CCA) determined the shared variance between the online battery and standard neuropsychological tests. Finally, between October 2020 and December 2021, the tests were integrated into a framework that automatically generates a results report where patients’ performance is compared to a large normative dataset. We piloted this as a practical tool to be used under supervised and unsupervised conditions at the St. Mary's Hospital TBI clinic in London (UK). Findings: The online assessment discriminated processing-speed, visual-attention, working-memory, and executive-function deficits in TBI. CCA identified two significant modes indicating shared variance with standard neuropsychological tests (r = 0.86, p < 0.001 and r = 0.81, p = 0.02). Sensitivity to cognitive deficits after TBI was evident in the TBI clinic setting under supervised and unsupervised conditions (F (15,555) = 3.99; p < 0.001). Interpretation: Online cognitive assessment of TBI patients is feasible, sensitive, and efficient. When combined with normative sociodemographic models and autogenerated reports, it has the potential to transform cognitive assessment in the healthcare setting. Funding: This work was funded by a National Institute for Health Research (NIHR) Invention for Innovation (i4i) grant awarded to DJS and AH ( II-LB-0715-20006)

Academic Dishonesty, Bullying, Incivility, and Violence: Difficult Challenges Facing Nurse Educators

Prior to the NLN Education Summit 2005, the authors took part in a conference call to discuss some of the difficulties and challenges faced by faculty in schools of nursing. Familiar with the growing body of published work on troublesome behaviors in American schools and the workplace, we determined to use a panel discussion format to explore the nature of these difficulties and capture the meanings these experiences have for the individuals involved. By sharing personal experiences and presenting a review of the literature, we hoped to give voice to troublesome and sometimes painful aspects of our roles as educators. In our vision for the panel discussion and this article, our desire was to be part of the solution. Our goal is to explore these experiences in a way that encourages self-reflection, teaches acceptable behavior, and supports positive change in the educational environment. We hope to promote opportunities for all involved in nursing education — students, faculty, and administrators — to grow and flourish. This article follows the sequence of the panel presentation, which began with a comprehensive review of the literature on academic dishonesty, followed by a discussion of low-and high-tech forms of cheating used by students.We addressed the need to process social information correctly and develop positive and acceptable social skills needed for professional development, and we discussed bullying, issues of incivility among faculty members, and the troublesome practice known as “mean girl games.” Our names are presented alongside our contributions, but all of us answered questions and participated in the lively discussion that took place at the Summit

The effect of sodium nitroprusside on psychotic symptoms and spatial working memory in patients with schizophrenia:a randomized, double-blind, placebo-controlled trial

Sodium nitroprusside (SNP) has been reported to rapidly reduce psychotic symptoms in patients with schizophrenia. This has the potential to revolutionize treatment for schizophrenia. In this study, we tested the hypothesis that SNP leads to a reduction in psychotic symptoms and an improvement in spatial working memory (SWM) performance in patients with schizophrenia.This was a single-centre, randomized, double-blind, placebo-controlled trial performed from 27 August 2014 to 10 February 2016 (clinicaltrials.gov identifier: NCT02176044). Twenty patients with schizophrenia aged 18-60 years with a diagnosis of schizophrenia or schizoaffective disorder were recruited from psychiatric outpatient clinics in the South London and Maudsley NHS Trust, London, UK. Baseline symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) and the 18-item Brief Psychiatric Rating Scale (BPRS-18), and SWM was assessed using the CANTAB computerized test. Participants received either an infusion of SNP (0.5 μg/kg per min for 4 h) or placebo and were re-assessed for symptoms and SWM performance immediately after the infusion, and 4 weeks later.SNP did not lead to any reduction in psychotic symptoms or improvement in SWM performance compared to placebo.Although this study was negative, it is possible that the beneficial effects of SNP may occur in patients with a shorter history of illness, or with more acute exacerbation of symptoms

Electrolysis of Water in the Secondary School Science Laboratory with Inexpensive Microfluidics

This activity allows students to visualize the electrolysis of water in a microfluidic device in under 1 min. Instructional materials are provided to demonstrate how the activity meets West Virginia content standards and objectives. Electrolysis of water is a standard chemistry experiment, but the typical laboratory apparatus (e.g., Hoffman cell) is best suited for group presentations. With microfluidics, the cell volume is reduced from 100 mL to 100 μL, making the electrolysis safer and easier to view by an individual. A single device is reusable and assembled for $5. This report describes the development of a microfluidic learning module that was implemented and assessed in the eighth-grade chemistry classroom