Detecting cognitive fatigue in multiple sclerosis: method matters.

BACKGROUND: Fatigue is a frequently reported and debilitating symptom in multiple sclerosis (MS). Cognitive fatigue (CF) can be defined as decreased performance with sustained cognitive effort. The effectiveness of the Paced Auditory Serial Addition Task (PASAT) and the Computerized Test of Information Processing (CTIP) at detecting CF was examined, as was the impact of methodology. Subjective fatigue was measured using the Fatigue Impact Scale (FIS). The relationship between objective and subjective fatigue was examined. METHODS: 70 MS and 72 healthy controls (HC) completed the PASAT (3″ and 2″), CTIP, and FIS as part of a larger battery. RESULTS: The MS and HCs performed worse on cognitively demanding tasks. Depending on methodology, PASAT performance varied between groups at the 3″ inter-stimulus interval (ISI) and the MS group showed greater susceptibility to CF as their ability to meet task demands declined as the task progressed. CTIP performance for both groups varied differently over time depending on task. The relationship between subjective and objective measures of fatigue varied depending on methodology, with PASAT generally correlating well with the Cognitive Dimension of the FIS. CONCLUSIONS: The PASAT is a sensitive measure of CF in MS. Additional information is obtained with different scoring methods, with percent dyad scoring method being most sensitive to CF. The ability to detect a relationship between objective and subjective measures varied with methodology.

Assessing the efficacy of HME filters at preventing contamination of breathing systems.

Breathing system filters are intended to prevent cross-infection during anaesthesia. However, there is a lack of information on whether filters prevent contamination of the breathing system by the patient. We measured the contamination of 235 used filters of four different types obtained from operating theatres: two pleated hydrophobic (BB25M and BB22/15M, Pall Medical, Portsmouth, UK) used for adult patients and two electrostatic (355/5430 Hygroboy and 355/5427 Hygrobaby, Tyco Healthcare, Gosport, UK) used for paediatric patients. The filters were swabbed over their internal surfaces on both the patient and the machine sides and these were assessed with the use of adenosine triphosphate bioluminescence. Contamination was present on the machine side of 20 (9%) filters. Current standards for testing of filters has no set "pass" level and is performed in the laboratory setting. Bioluminescence may be used in the clinical setting to elucidate factors that might increase the chance of cross-contamination between patients.

Depression and the Test of Memory Malingering.

Research on the Test of Memory Malingering (TOMM) [Tombaugh, T. N., 1996. The Test of Memory Malingering. Toronto, Canada: Multi-Health Systems], has consistently shown that it is sensitive to exaggerated or deliberate faking of memory impairment, but it is relatively unaffected by a wide variety of neurological impairments causing genuine memory dysfunction. However, there is little research on the effects that affective disorders have on the TOMM. The current study examined how inpatients diagnosed with major depression performed on the TOMM. Results show that the TOMM is unaffected by affective state. These results, combined with those from previous research, provide converging evidence that performance on the TOMM below a cutoff score of 45 cannot be attributable to depression, neurological impairment, age or education.

Do attitudes towards persons with handicaps really shift over time? Comparison between 1975 and 1988.

A replication of a study by Spreen (1977) was conducted to assess whether a positive shift in attitudes towards persons with mental retardation has occurred. Undergraduate students (N = 191) were tested. Results compared to those of Spreen (1977) showed a positive shift over the 13-year period. We also tested the hypothesis that exposure to a course on developmental disabilities and contact with individuals with mental retardation would improve students' attitudes. Findings support this hypothesis, although results suggest the influence of a third variable, namely, public awareness.