Thesis (Ph.D.)--Ohio University, August, 2009. / Release of full electronic text on OhioLINK has been delayed until September 1, 2012. Includes bibliographical references (leaves 185-254)

Thesis (Ph.D.)--Ohio University, August, 2009. / Title from PDF t.p. Release of full electronic text on OhioLINK has been delayed until September 1, 2012. Includes bibliographical references (leaves 185-254)

The purpose of this study was to determine whether and to what extent free association following exposure to written material would affect the memory of that material, and whether the effect upon memory would vary with age of the subject. A test of learning (immediate retention) resulted in a significant difference in performance between young and old women--the older learning less. Free association was not found to be significant as a mnemonic aid to either age group, and was compared with characteristics of other more common mnemonics. Suggestions for additional research are discussed.

Yes / Background: Involving patients and the public in all stages of research has been the focus of the SHARED study. Patient and public involvement (PPI) is an important strategic priority for the Department of Health and funders such as the National Institute for Health Research. The aim of this paper is to describe the benefits, challenges and costs involved in setting up the research study with lay members as part of the research team. The study focused on developing service user-led recommendations for people with memory loss and their carers, on discharge from acute hospital to the community. Methods: This began with a discussion of an initial research idea with a lay group of carers and people living with dementia. Once funded, approval was sought from the Research Ethics Committee and NHS Trusts to conduct the research including the active involvement of lay co-researchers. Finally, to recruit, train and pay lay co-researchers in their role. Results: The benefits of PPI have included developing ideas which are important to people living with memory loss; support for PPI received from the funders and research ethics committee, high levels of interest from volunteer groups, and lasting enthusiasm from many of the co-researchers. Organisational challenges were met in the requirement for research passports and with payment methods for the co-researchers. Training was beneficial but incurred extra costs for repeated training days. Discussion: Overall the benefits outweighed the challenges which were overcome to varying degrees. The lay co-researchers gained membership of a study group and a beneficial partnership developed with the third sector. The biggest challenge was in overcoming the differences in approach to lay co-researchers between NHS Trusts. Organisational culture has been slow to incorporate PPI and this has not yet been fully addressed. It has the potential to delay the start of projects, affect recruitment time, incur extra research costs and disadvantage PPI.

Yes / Background Health and social care services are under strain providing care in the community particularly at hospital discharge. Patient and carer experiences can inform and shape services. Objective To develop service user-led recommendations enabling smooth transition for people living with memory loss from acute hospital to community. Design Lead and co-researchers conducted semi-structured interviews with 15 pairs of carers and patients with memory loss at discharge, 6 and 12 weeks post-discharge and one semi-structured interview with health and social care professionals and Admiral Nurses. Framework analysis was guided by co-researchers. Two focus groups of study participants, facilitated by co-researchers, met to shape and finalize recommendations. Setting and participants Recruitment took place in acute hospitals in two National Health Service (NHS) Trusts in England. Patients were aged 65 and over, with memory loss, an in-patient for at least 1 week returning to the community, who had a carer consenting to be in the study. Results Poor delivery of services caused considerable stress to some study families living with memory loss. Three key recommendations included a need for a written, mutually agreed discharge plan, a named coordinator of services, and improved domiciliary care services. Discussion and conclusions Vulnerable patients with memory loss find coming out of hospital after an extended period a stressful experience. The SHARED study contributes to understanding the hospital discharge process through the eyes of the patient and carer living with memory loss and has the potential to contribute to more efficient use of resources and to improving health outcomes in communities. / National Institute for Health Research. Grant Number: PB-PG-1112-29064

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Memory monitoring, or the ability to accurately assess one’s memory retrieval success, is known to be declined for older adults. The behavioral decline has been well explored, and is specific to tasks of source monitoring; tasks involving item memory monitoring do not show age-related deficits. This study attempts to further characterize the decline by exploring neuroanatomical contributions to the decline, and genetic influences that may explain performance variability in older adults. Older adults were genotyped for the serotonin transporter (5-HTTLPR) gene, and those that are carriers of the low-expressing allele demonstrate the expected age-related decline of source monitoring performance when compared to younger adults. Interestingly, older adults who lack this allele did not display any decline in performance when compared to younger adults. Neuroanatomical correlates of task performance indicate that prefrontal regions in the inferior and lateral cortices support accurate source memory monitoring, likely through their role in the proper selection of memory cues and inhibition of irrelevant information. This relationship suggests that age-related atrophy occurring in these structures could be responsible for the performance deficits on source memory monitoring tasks. There was no direct relationship seen between genotype for the 5-HTTLPR gene and cortical volumes, however diffusion tensor imaging shows that older adults who carry this allele have altered connections between the medial temporal lobe, responsible for memory retrieval, and prefrontal cortex, which monitors the retrieval process. Through stronger connections of critical networks, older adults who lack the 5-HTTLPR short allele may be able to compensate for the age-related atrophy seen in the prefrontal cortex. Functional results further indicate that the older adult non-carriers recruit inferior and lateral frontal regions to a greater extent than the older adult carriers during accurate memory monitoring. These results begin to suggest a neuroprotective mechanism for the 5-HTTLPR genotype, wherein some older adults may be able to postpone the expected decline of memory monitoring by retaining the ability to recruit essential inferior frontal structures through more organized white matter pathways. / text

Det är vanligt att gränssnitt utformas med komplexa interaktioner och större mängder information, där användare förväntas besitta typisk fysisk, psykisk och intellektuell förmåga. Designas gränssnitt utifrån dessa förväntningar kan resultatet bli att icke normtypiska användargrupper exkluderas, däribland individer med kognitiv nedsättning. Kognitiv nedsättning har i denna studie begränsats till de tre symptomen minnesbortfall, hjärntrötthet samt överstimulans. För att inkludera individer med kognitiv nedsättning i användning samt stödja minnesbortfall ämnar denna studie att genom en designorienterad ansats besvara frågeställningen “Hur kan en aktiv påminnelsefunktion designas för att stödja individer med kognitiv nedsättning”. Designriktlinjer har framtagits utifrån litteratur och utvärderats genom en prototyp med nio testpersoner som erfarit symptomen. Studien resulterar i kunskapsbidraget att en aktiv påminnelsefunktion bör designas med hänsyn till att dela upp information med minimalt krav på beslutstagande, kommunicera brådska, använda igenkänningsbara element samt ge användare kontroll och stöd för besluttagande. / It is common to design interfaces with complex interactions as well as large amounts of information, where users are expected to have typical physical, psychological and intellectual abilities. If interfaces are designed based on these expectations, the result may be that non-normative user groups are excluded, including individuals with cognitive limitations. In this study, cognitive limitations have been restricted to the three symptoms: memory loss, fatigue and overstimulation. To include people with cognitive limitations in use and to support memory loss, this study aims to answer the question "How can an active reminder be designed to support individuals with cognitive limitation" through a design-oriented approach. Design guidelines have been developed based on literature and evaluated through a prototype with nine participants who have experienced the symptoms. The study results in the knowledge contribution that an active reminder should be designed with divided information including minimal decision-making, communicate urgency, use recognizable elements and give users control as well as support for decision-making.

This study aims to highlight patients´ experiences about and thoughts of side effects fromelectroconvulsive therapy (ECT), a therapeutic method commonly used when having severedepressions. The framing of questions were how the respondents of this study describe theirlife before, during and after ECT-treatment, how the treatment has affected their daily life andhow these experiences may contribute to the awareness of power in professional relations.The study is based on three semi-structured narrative interviews and the main result showedthat, according to my interpretation, ECT as a treatment obliterated memories, quality of lifeand daily structure for all participants. Unfortunately they have all become subjects ofpsychiatric power and have faced considerable difficulty in getting professional recognitionaccording to their severe memory issues. The respondents have lost the ability to relate totheir past which clearly makes them struggle in their present context. A point in commonamong them is that neither of them wanted ECT but, because of the lack of communicationbetween them as patients and the health care in general, they all ended up getting it.