Cerebral microbleeds and cognitive decline in a hemodialysis patient: Case report and review of literature

Cerebral microbleeds (CMBs) are small hemosiderin deposits indicative of prior cerebral microscopic hemorrhage and previously thought to be clinically silent. Recent population‐based cross‐sectional studies and prospective longitudinal cohort studies have revealed association between CMB and cognitive dysfunction. In the general population, CMBs are associated with age, hypertension, and cerebral amyloid angiopathy. In the chronic kidney disease (CKD) population, diminished estimated glomerular filtration rate has been found to be an independent risk factor for CMB, raising the possibility that a uremic milieu may predispose to microbleeds. In the end‐stage renal disease (ESRD) population on hemodialysis, the incidence of microbleeds is significantly higher compared with a control group without history of CKD or stroke. We present an ESRD patient on chronic hemodialysis with a history of gradual cognitive decline and progressive CMBs. Through this case and literature review, we illustrate the need to develop detection and prediction models to treat this frequent development in ESRD patients.     

Managing readiness-relevant activities for the organizational dimension of ERP implementation

An organization requires performing readiness-relevant activities to ensure successful implementation of an enterprise resource planning (ERP) system. This paper develops a novel approach to managing these interrelated activities to get ready for implementing an ERP system. The approach enables an organization to evaluate its ERP implementation readiness by assessing the degree to which it can achieve the interrelated readiness relevant activities using fuzzy cognitive maps. Based on the interrelationship degrees among the activities, the approach clusters the activities into manageable groups and prioritizes them. To help work out a readiness improvement plan, scenario analysis is conducted.     

Process issues in treatment: Application to sexual offender programs.

How critical is the therapeutic alliance in the treatment of sexual offenders? To date such process issues have been neglected in the field of sex offender treatment. This article reviews the literature on the influence on behavior change of therapist features, clients' perceptions, and the therapeutic alliance. Among the many therapist features identified as helpful are empathy, warmth, and being directive and rewarding. Therapists who are aggressively confrontational appear not to foster beneficial changes in their clients. These issues are directly related to treatment issues faced by therapists who work with sexual offenders, such as dealing with cognitive distortions, lack of empathy, and lack of motivation to change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The social consequences of expressive suppression.

At times, people keep their emotions from showing during social interactions. The authors' analysis suggests that such expressive suppression should disrupt communication and increase stress levels. To test this hypothesis, the authors conducted 2 studies in which unacquainted pairs of women discussed an upsetting topic. In Study 1, one member of each pair was randomly assigned to (a) suppress her emotional behavior, (b) respond naturally, or (c) cognitively reappraise in a way that reduced emotional responding. Suppression alone disrupted communication and magnified blood pressure responses in the suppressors' partners. In Study 2, suppression had a negative impact on the regulators' emotional experience and increased blood pressure in both regulators and their partners. Suppression also reduced rapport and inhibited relationship formation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drugs, memory, and metamemory: A dose-effect study with lorazepam and scopolamine.

This experiment was designed to use the graded dose-related amnesia produced by the benzodiazepine lorazepam (1.0, 2.0 mg/70 kg, oral) and the anticholinergic scopolamine (0.3, 0.6 mg/70 kg, subcutaneous) as a tool to explore the cognitive and neurochemical mechanisms underlying metamemory in the judgment of learning paradigm, with a placebo-controlled independent groups design in healthy volunteers (n=12/group). Results provide evidence for a pharmacological dissociation between effects on memory versus metamemory (relative accuracy of item-by-item monitoring) across a range of levels of memory performance and suggest that the drugs selectively impair those aspects of metamnemonic monitoring that require participants' awareness of their overall current state of functioning (absolute accuracy of prospective item-by-item monitoring, prospective global monitoring) but not those that rely solely on assessment of individual item characteristics (relative accuracy of item-by-item monitoring). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Obituaries: Roger Todd Davis (1926-2000).

Reports the death of Roger Todd Davis (1926-2002) and how he contributed to the post-WWII development of primatology and primate laboratories, which are important precursors to the study of modern cognition and cognitive neuroscience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working memory in mild Alzheimer's disease and early Parkinson's disease.

Alzheimer's disease (AD) and Parkinson's disease (PD) impair working memory (WM). It is unclear, however, whether the deficits seen early in the course of these diseases are similar. To address this issue, the authors compared the performance of 22 patients with mild AD, 20 patients with early PD and without dementia, and 112 control participants on tests of inhibition, short-term memory, and 2 commonly administered tests of WM. The results suggest that although mild AD and early PD both impair WM, the deficits may be related to the interruption of different processes that contribute to WM performance. Early PD disrupted inhibitory processes, whereas mild AD did not. The WM deficits seen in patients with AD may be secondary to deficits in other cognitive capacities, including semantic memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neural components of social evaluation.

Evaluative responses appear to involve 2 seemingly distinct sets of processes: those that are automatically activated and others that are more consciously controlled. Using functional magnetic resonance imaging, the authors investigated the brain systems associated with automatic and controlled evaluative processing. Participants made either evaluative (good-bad) or nonevaluative (past-present) judgments about famous names. Greater amygdala activity was observed for names rated as "bad" relative to those rated as "good," regardless of whether the task directly involved an evaluative judgment (good-bad) or not (past-present). Good-bad judgments resulted in greater medial and ventrolateral prefrontal cortex (PFC) activity than past-present judgments. Furthermore, there was greater ventrolateral PFC activity in good-bad judgments marked by greater ambivalence. Together, these findings indicate a neural distinction between processes engaged for automatic and controlled evaluation. Whereas automatic processes are sensitive to simple valence, controlled processes are sensitive to attitudinal complexity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are all cognitive therapies alike? A comparison of cognitive and noncognitive therapy process and implications for the application of empirically supported treatments.

The definition of an empirically supported treatment (EST) arguably embodies 2 untested assumptions: (a) that different manualized renditions of the same therapy are functionally equivalent and (b) that therapies can be reliably applied independently of therapist, setting, and format. These assumptions were tested as applied to cognitive therapy (CT), using process data from a large multisite study (N=235) that included 3 cognitive and 6 alternative therapies. Although the non-CTs were more variable than the CTs on 2 of 4 dimensions studied (directiveness and emotional arousal), there was considerable variation among the 3 CTs, even when implemented in the current context of rigorous training, manualization, and adherence checks. Results are discussed as related to the assumptions underlying EST criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)