Enhancing free-recall rates of individuals with mental retardation.

Generative encoding contexts promote activation of multiple retrieval routes and have been shown to enhance free-recall rates of individuals without mental retardation. The present extension to individuals with mental retardation involved a comparison of two encoding conditions: (a) fade-in, initially presenting pictures out of focus then slowly fading them into focus, and (b) fade-out, presenting pictures clearly then slowly blurring them. Results indicated that free-recall rates were greater for the fade-in items for the individuals with mental retardation and CA-matched comparisons, but not for the MA-matched group. These findings demonstrate the utility of a generative encoding context that does not involve verbal instruction for individuals with and without mental retardation.

"Aha" effects in the generation of pictures.

An "aha" effect in memory was first reported by Auble, Franks, and Soraci (1979). They demonstrated that recall was greater for sentences that were initially incomprehensible but which were eventually comprehended, as compared with sentences that were understood from the outset. The present studies extend this "aha" effect to memory for pictorial stimuli. In Experiment 1, a recall advantage for pictures encoded by connecting the dots as compared with those encoded by tracing or visual scanning occurred only in the absence of foreknowledge of the picture (i.e., an "aha" effect). In Experiment 2, we replicated this finding and obtained evidence that conceptually based, verbal foreknowledge does not function in a similar manner as does pictorial foreknowledge in suppressing the "aha" recall advantage. These results place important constraints on previous research on generation effects for visual stimuli and attest to the cross-modal generalizability of the "aha" effect.

Study of thrombinic activation indexes, in patients with lower limb critic ischaemia, before and after prostaglandin E1 therapy.

BACKGROUND: In this study the action of a prostaglandin, PGE1, was studied in a group of patients with peripheral arterial occlusive disease (PAOD). METHODS: In 16 patients (14 men and 2 women, aged 47-70 years, mean 57 +/- 7) with PAOD, Fontaine stage IIb and III in critical ischemia, the effects on two indexes of thrombin generation and action of the endovenous administration (2 hours) of 60 micrograms of Alprostadil-PGE1 for four weeks were evaluated. In all artheriopathic patients, before and after pharmacological treatment, the following haemostatic parameters were evaluated: the prothrombin fragment 1 + 2 (F1 + 2) and the fibrinopeptide A(FPA). RESULTS: The patients showed plasma levels of FPA significantly decreased at the end of the treatment. On the other hand, no significant difference in plasma F1 + 2 levels was observed after treatment. CONCLUSIONS: These results seem to indicate that plasma F1 + 2 levels are significantly elevated, as a marker of thrombosis status, in patients with PAOD before and after treatment with PGE1.

Clinical and haemostatic effects of intravenous prostaglandin E1 therapy in patients with peripheral arterial occlusive disease.

BACKGROUND: In this study the action of an antiaggregatory prostaglandin, PGE1, was studied in a group of patients with peripheral arterial occlusive disease (PAOD). METHODS: In 16 patients with PAOD Fontaine stage IIb and III the clinical and haemostatic effects of the endovenous administration of 60 micrograms/die of alprostadil-PGE1 for four weeks, were evaluated. Before and after pharmacological treatment, were evaluated the clinical symptoms (claudicatio intermittens and rest pain) and the following haemostatic parameters: plasma thrombomodulin (TM), beta-thromboglobulin (beta-TG), D-dimer (DD), tissue-type plasminogen activator (t-PA) and plasminogen activator-inhibitor (PAI-1). RESULTS: No significant difference in plasma TM, t-PA and PAI-1 levels was observed after the treatment. On the other hand the patients showed plasma levels of beta-TG and DD significantly decreased at the end of the treatment. From the clinical point of view both claudicatio intermittens and rest pain satisfactorily improved in all patients. CONCLUSIONS: This data confirmed the therapeutic efficacy of PGE1 in the treatment of PAOD patients.

Haemostatic effects of iloprost in patients with lower limb ischemia.

The aim of this study was to investigate the haemostatic effects of iloprost, a stable analogue of prostacyclin, in patients with peripheral arterial disease. In a group of 13 patients with obliterative arteriopathies of the lower limbs the plasma levels of thrombomodulin (TM), betathromboglobulin (beta-TG), D-dimer (DD) and plasminogen activator-inhibitor (pAI-1) were measured, and compared to the values obtained from 10 healthy volunteers. All the parameters were found to be significantly higher in vasculopathic patients. These haemostatic evaluations were carried out after 4 weeks of treatment with iloprost up to 2 ng/kg/min, 6 hours infusion per day. During and at the end of treatment a clinical improvement was recorded. The patients also showed a significant decrease in plasma beta-TG and DD at the end of treatment. These data suggest that iloprost exerts clinical improvement, in who may have a part the decrease of platelet activation and of fibrin turnover.

Haemostatic parameters in patients with primitive venous hypertension.

In twenty patients with primitive venous hypertension and in ten healthy subjects we have determined the plasmatic levels of: Thrombomodulin (TM), beta-Thromboglobulin (beta-TG), D-Dimer (DD), the tissue activator of the plasminogen (t-PA) and the inhibitor of the activator of the plasminogen (PAI-1). The levels of the parameter we studied have shown in the patients a significant difference of beta-TG (p < 0.01) and PAI-1 (p < 0.01) compared to the controls, whereas there was no significant difference in the other parameters we studied. Our data underline, in patients with primitive venous hypertension, the importance that the activation of the platelets and the reduction of the potential fibrinolytic can assume, together with the stasis, regarding the onset of thrombotic complications.

Haemostatic changes in patients with deep vein thrombosis.

Thrombomodulin (TM), beta-thromboglobulin (beta-TG), D-dimer (DD), tissue-type plasminogen-activator (t-PA), plasminogen activator-inhibitor (PAI-1) and quantitative determination of functional protein S (PS) were measured using ELISA procedures in the plasma of 16 untreated patients with newly-diagnosed deep vein thrombosis in the leg and in 10 healthy volunteers. No significant difference in plasma TM, t-PA and PS levels was observed among the controls and patients with deep vein thrombosis. These patients, on the other hand, showed plasma DD, beta-TG and PAI-1 levels significantly higher than the control subjects. These data show that in patients with deep vein thrombosis a hypercoagulable state is a common occurrence.

Protein S in normal subjects and patients with peripheral arterial disease.

The aim of the present study was to investigate if alterations in protein S levels occur in peripheral arterial disease. In a group of 33 patients with peripheral arterial disease and in a group of 10 healthy volunteers we have the quantitative determination of functional protein S. The observer values show non significant difference in protein S levels among vasculopathic patients and controls (only five out of 33 patients showed low protein S levels). These data seem to suggest that low protein S levels do not play an important role in the development of peripheral arterial disease.

Hemostatic disorders associated with arterial hypertension and peripheral arterial disease.

To study a possible hypercoagulability in vascular disease, in 22 patients with essential hypertension and in 13 patients with obliterative arteriopathies of the lower limbs we measured the levels of plasma thrombomodulin (TM), plasma and urine beta-thromboglobulin (beta-TG), plasma D-dimer (DD) and plasminogen activator-inhibitor (PAI-1) and compared to the values obtained from 10 healthy volunteers. The values observed in hypertensive patients show only PAI-1 levels significantly higher. All the parameters were found to be significantly increased in vasculopathic patients. These data confirm that in vasculopathic patients endothelium damage, platelet activation, impaired fibrinolytic potential and increase of fibrin turnover, occur. On the other hand, in the hypertensive patients, at first stages of the disease, we have found only an increase of PAI-1 plasma levels documenting impaired fibrinolytic potential.

Haemostatic variables in arterial hypertension.

In 22 untreated patients with uncomplicated essential hypertension and in 10 normotensive subjects the plasma levels of thrombomodulin (TM), beta-thromboglobulin (beta-TG), D-dimer (DD), tissue-type plasminogen activator (t-PA) and plasminogen activator-inhibitor (PAI-1) were evaluated. The observed values show no significant difference in plasma TM, plasma and urine beta-TG concentration and plasma DD among hypertensive patients and controls. On the other hand, the levels of t-PA and PAI-1 in hypertensive patients were significantly higher than the values detected in normotensive control subjects. These data seem to indicate that, at initial stages of essential hypertension, the t-PA and PAI-1 levels increase.

Incongruous item generation effects: a multiple-cue perspective.

In a series of studies, generation effects were obtained under encoding conditions designed to induce incongruous, unrelated item generation. Experiments 1 and 2, using free- and cued-recall measures, respectively, provided evidence that this unrelated generation effect was due to response-specific processing. Experiment 3 demonstrated a lack of relation between free recall and indices of clustering. A preliminary protocol study suggested that Ss generate multiple items in their search for appropriate unrelated responses. In Experiments 4 and 5, conditions designed to produce more extensive multiple generations demonstrated enhanced free recall. These results supported a multiple-cue account of facilitated recall for incongruous item generation. The multiple-cue perspective is consistent with traditional conceptualizations of memory, such as the principle of congruity, and contemporary distinctions between cue-target relational and item-specific processing.

Similarities in the detection of stimulus symmetry by individuals with and without mental retardation.

Intelligence-related differences in the detection of stimulus organization previously identified by Soraci, Carlin, Deckner, and Baumeister (1990) were examined further to determine whether they would (a) extend to similar checkerboard stimuli varying solely with respect to symmetry and (b) generalize to form-like polygon stimuli. Detection performances of 10 individuals with mild mental retardation, 10 CA-matched, and 10 MA-matched individuals were assessed on a rapid presentation a two-choice match-to-sample task. The organizations of the target and distractor stimuli were varied across four levels of symmetry: double, vertical, horizontal, and asymmetrical. Results indicated that detection rates for each group were highest when the target stimulus was vertically symmetrical or when target-distractor structural disparity was maximal. However, no significant main effects of subject group or stimulus type (i.e., checkerboard vs. polygon) were found, thereby arguing for the robustness of the symmetry effect across groups differing in intelligence and physically dissimilar stimulus types.

Motivational orientation and span of apprehension in children with mental retardation.

Children diagnosed as mildly mentally retarded were examined with respect to performance on Estes's (1965) span-of-apprehension task. Based on their scores on the Simplified Version of the Intellectual Achievement Responsibility scale, we divided subjects into a "learned-helpless" group and a "mastery-oriented" group. Motivational orientation had a significant effect on performance, with the mastery-oriented subjects demonstrating higher detection accuracies than the learned-helpless subjects. These results have implications regarding not only centrally mediated attentional functioning in children with mental retardation, but also interpretation of certain previous findings with the span-of-apprehension task.

Span of apprehension in mentally retarded children: an initial investigation.

The present investigation is the first to apply Estes' (1965) span of apprehension task to the study of attentional functioning in mentally retarded persons. Detection accuracies of 25 children diagnosed as mildly mentally retarded and 25 non-retarded children were compared under conditions of 100-ms exposure duration, and either two, four, six or eight distractor letters. Significant main effects of subject group and distractor number were found, with no interaction. These results provide converging evidence in support of previous positions that posit a structural deficit in mentally retarded individuals with respect to centrally mediated processing.

Generalized oddity performance in preschool children: a bimodal training procedure.

Oddity performance requires relational discriminative responding, which typically is difficult to establish in children with MAs below five. In Experiment 1, a combination intrasubject reversal and multiple baseline across subjects design was used to establish the internal validity of a bimodal intervention in establishing generalized oddity performance. Six of seven children demonstrated oddity responding when presented with stimuli that instantiated the oddity relation in the visual and auditory modalities simultaneously. Oddity performance was evaluated with both reversal assessments and assessments with new sets of stimuli. The newly acquired oddity performance was durable; the six children continued to respond discriminatively when returned to a visual-only task on which they previously had been unsuccessful. Utilizing a reversal assessment more stringent than that of Experiment 1, Experiment 2 replicated this effect. The present studies are the first to demonstrate the utility of bimodal training in establishing oddity performance. The bimodal procedure is discussed with respect to the theoretical positions of Gibson, Dinsmoor, and Dixon.

Attentional functioning and relational learning.

Stimulus properties such as similarity-dissimilarity and novelty-familiarity are inherently relational and are embedded in ubiquitous stimulus contexts. Children with mental retardation and young children without mental retardation are particularly prone to failure on relational tasks such as oddity and match-to-sample (Greenfield, 1985; Soraci et al., in press). Converging evidence from a number of studies suggest that a critical factor in the performance discrepancies between these and other children is a differential sensitivity to relational information. In these studies relational characteristics of stimulus arrays were enhanced in order to facilitate performances on such relational tasks. Findings indicate the theoretical and practical significance of perceptually based interventions that induce rapid discrimination learning.

Oddity learning in developmentally delayed children: facilitation by means of familiar stimuli.

Four of 8 low-functioning, developmentally delayed children initially failed to demonstrate oddity responding under conditions in which ostensibly similar children did show oddity responding (e.g., Soraci et al., 1987). In the context of a multiple baseline across-subjects design, each of the 4 previously unsuccessful children demonstrated statistically significant increases in the percentage of correct oddity responses immediately upon introduction of familiar stimuli. These results indicate that perceptual differentiation enhances relational learning of the type required by the oddity task.

Oddity performance in preschool children at risk for mental retardation: transfer and maintenance.

The oddity performance of five preschool children at risk for mental retardation was facilitated by increasing the number of nonodd elements in a visual array. A combination intrasubject reversal and multiple baseline across subjects design indicated the internal validity of interventions designed to enhance the perceptual salience and consequent stimulus control of the odd stimulus. Results demonstrate that transfer and maintenance of oddity learning can be obtained even with individuals for whom correct oddity responding is uncommon. The typically poor performance of young and developmentally delayed children as compared to nondelayed children on tasks such as the oddity task may be attributable to a lower sensitivity to relational information.

Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire.

Patient satisfaction in performing activities of daily living (ADL) was assessed by using a self-administered questionnaire modified from the Stanford Health Assessment Questionnaire (HAQ). The HAQ includes questions to determine a patient's degree of difficulty and need for help and assistive devices in ADL. A modification of the HAQ (MHAQ) was developed to include questions concerning perceived patient satisfaction regarding the same ADL, along with perceived change in degree of difficulty. In order to add additional questions while maintaining the length of the questionnaire in a format suitable in routine care, the number of ADL included in the MHAQ was reduced from 20 to 8. Information regarding degree of difficulty derived from 8 questions in the MHAQ is comparable with that derived from 20 questions in the HAQ. The response of a patient that a specific activity is associated with difficulty in functional capacity was not inevitably associated with the absence of patient satisfaction; 43.7% of patients responding "with some difficulty" and 19.1% of patients responding "with much difficulty" expressed satisfaction with their functional capacity. A major determinant of expression of patient satisfaction was perceived change in difficulty: 81.4% of patients noting that their function was "less difficult now," in contrast to 16.9% of patients responding "more difficult now," expressed satisfaction. These studies suggest that data regarding patient satisfaction and perceived change in difficulty can be assessed to more completely characterize patients' functional status in ADL.