Cognitive Domains Research Articles

Convergent Validity of Experimental Cognitive Tests in a Large Community Sample

Experimental cognitive tests are designed to measure particular cognitive domains, although evidence supporting test validity is often limited. The Consortium for Neuropsychiatric Phenomics test battery administered 23 experimental and traditional neuropsychological tests to a large sample of community volunteers ( n = 1,059) and patients with psychiatric diagnoses ( n = 137), providing a unique opportunity to examine convergent validity with factor analysis. Traditional tests included subtests from the Wechsler and Delis–Kaplan batteries, while experimental tests included the Attention Networks Test, Balloon Analogue Risk Task, Delay Discounting Task, Remember–Know, Reversal Learning Task, Scene Recognition, Spatial and Verbal Capacity and Manipulation Tasks, Stop-Signal Task, and Task Switching. Several experimental cognitive measures were insufficiently related to other tests and were excluded from factor analyses. In the remaining 18 tests, exploratory factor analysis and subsequent multigroup confirmatory factor analysis supported a three-factor structure broadly corresponding to domains of verbal/working memory, inhibitory control, and memory. In sum, several experimental measures of inhibitory control had weak relationships with all other tests, while the convergent validity of most tests of working memory and memory was supported.

Measurement Invariance for Multilingual Learners Using Item Response and Response Time in PISA 2018

AbstractThis study examines potential assessment bias based on students' primary language status in PISA 2018. Specifically, multilingual (MLs) and nonmultilingual (non‐MLs) students in the United States are compared with regard to their response time as well as scored responses across three cognitive domains (reading, mathematics, and science). Differential item functioning (DIF) analysis reveals that 7–14% of items exhibit DIF‐related problems in scored responses between the two groups, aligning with PISA technical report results. While MLs generally spend more time on the test than non‐MLs across cognitive levels, differential response time (DRT) functioning identifies significant time differences in 7–10% of items for students with similar cognitive levels. It was noticeable that items with DIF and DRT issues show limited overlap, suggesting diverse reasons for student struggles in the assessment. A deeper examination of item characteristics is recommended for test developers and teachers to gain a better understanding of these nuances.

Anti‐saccade can be used as a screening tool for early cognitive impairment: a correlation study based on anti‐saccade parameters and cognitive function

AbstractBackgroundEye movement tasks, especially anti‐saccade tasks, have been used to assess cognitive function in patients with neuropsychiatric disorders. Although it has been shown that individuals with cognitive impairment perform worse on anti‐saccades tasks, there is a lack of systematic evaluation of the sensitivity of parameters of anti‐saccades to assess different subtypes of cognitive impairment.MethodsA total of 158 participants were enrolled in this study, consisting of 66 men and 92 women, with an average age of 50.2 ± 10 years. The comparison of pro‐saccade reaction time, anti‐saccade reaction time, and error rates in the saccade task between individuals with cognitive impairments and a normal group was conducted. Furthermore, we systematically analyzed the correlations between the performance in neurological function tests (Mini‐Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Stroop) and these anti‐saccade parameters. Especially, the correlation between these parameters and cognitive function in different domains of the MoCA task were also evaluated.ResultsThe pro‐saccade reaction time, anti‐saccade reaction time and error rate were negatively correlated with the MMSE and MoCA scores (P < 0.001), and positively correlated with the time used in Stroop tasks. Among them, the error rate had the strongest correlation with the performance of MMSE, MoCA and Stroop tasks (MoCA: P < 0.0001, r2 = −0.608; MMSE: P < 0.0001, r2 = −0.344; Stroop: P < 0.0001, r2 = 0.455). Among the seven cognitive domains examined by the MoCA task, error rates had relatively high correlations with visuospatial/executive (P < 0.0001, r2 = −0.4660) and delayed recall (P < 0.0001, r2 = −0.4228) compared to naming, language (P = 0.0004, r2 = −0.0788), attention (P = 0.0004, r2 = −0.0780), abstraction (P < 0.0001, r2 = −0.1515), orientation (P < 0.0001, r2 = −0.1075). Moreover, pro‐saccade reaction time, anti‐saccade reaction time and error rate of people with high MoCA scores were significantly higher than those of people with low MoCA scores, which can be used to identify people with mild cognitive impairment.ConclusionsOur study's results provide valuable clinical evidence supporting the effectiveness of anti‐saccades in assessing cognitive impairment, which is beneficial for screening and timely clinical intervention in individuals with specific cognitive impairment.

Addressing treatment hurdles in adults with late-onset attention-deficit/hyperactivity disorder: a detailed case report

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children, characterized by inattention, hyperactivity, and impulsivity. This neurobehavioral disorder often persists into adulthood, presenting significant challenges when undiagnosed and untreated, due to potential long-term implications and comorbidities, including anxiety, mood instability, and mixed symptoms along the bipolar spectrum.Case presentationA 49-year-old married male patient presented with anxiety and recurrent depressive episodes, initially diagnosed as major depressive disorder. His mood symptoms fluctuated between depressive lows, irritability, and impulsivity. His diagnosis was revised to ADHD with comorbid bipolar spectrum disorder. The patient exhibited lifelong ADHD symptoms affecting academic performance, relationships, and job responsibilities. Cognitive-behavioral therapy (CBT) was employed to manage symptoms and enhance coping strategies. Despite progress in controlling anger and impulsivity, challenges persisted in inhibitory control and negative triggers, causing impulsive decisions. The patient reported a restless mind, depressive mood, and a sense of inadequacy. Improvements were noted in anxiety regulation, concentration, and sleep quality, though deficits in cognitive and behavioral domains remained. The patient faced challenges in academic performance, information processing speed, attention, and executive functions.ConclusionThis case underscores the importance of accurately diagnosing ADHD and its comorbidities in adults to ensure effective treatment. Delayed diagnosis can have lasting impacts, emphasizing the need for further research and personalized therapeutic approaches. The insights from this case serve as a valuable resource for healthcare professionals enhancing their understanding of the diverse manifestations of ADHD, aiding in better diagnosis and management strategies.

How do you target cognitive training? Bridging the gap between standard and technological rehabilitation of cognitive domains

How do you target cognitive training? Bridging the gap between standard and technological rehabilitation of cognitive domains

A multi-objective optimal control approach to motor strategy changes in older people with mild cognitive impairment during obstacle crossing.

Mild cognitive impairment (MCI) may lead to difficulty maintaining postural stability and balance during locomotion. This heightened susceptibility to falls is particularly evident during tasks such as obstacle negotiation, which demands efficient motor planning and reallocation of attentional resources. This study proposed a multi-objective optimal control (MOOC) technique to assess the changes in motor control strategies during obstacle negotiation in older people affected by amnestic MCI. Motion data from 12 older adults with MCI and 12 controls when crossing obstacles were measured using a motion capture system, and used to obtain the control strategy of obstacle-crossing as the best compromise between the conflicting objectives of the MOOC problem, i.e., minimising mechanical energy expenditure and maximising foot-obstacle clearance. Comparisons of the weighting sets between groups and obstacle heights were performed using a two-way analysis of variance with a significance level of 0.05. Compared to the controls, the MCI group showed significantly lower best-compromise weightings for mechanical energy expenditure but greater best-compromise weightings for both heel- and toe-obstacle clearances. This altered strategy involved a trade-off, prioritising maximising foot-obstacle clearance at the expense of increased mechanical energy expenditure. The MCI group could successfully navigate obstacles with a normal foot-obstacle clearance but at the cost of higher mechanical energy expenditure. MCI alters the best-compromise strategy between minimising mechanical energy expenditure and maximising foot-obstacle clearances for obstacle-crossing in older people. These findings provide valuable insights into how MCI impacts motor tasks and offer potential strategies for mitigating fall risks in individuals with MCI. Moreover, this approach could serve as an assessment tool for early diagnosis and a more precise evaluation of disease progression. It may also have applications for individuals with impairments in other cognitive domains.

A meta-analysis of data-driven cognitive subgroups in bipolar disorder

The delineation of cognitive subgroups of bipolar disorder (BD) might be helpful for identifying biologically valid subtypes of this disorder. This meta-analysis identified peer-reviewed literature on studies investigating cognitive subgroups of BD with data-driven clustering methods. Relevant studies were searched in PubMed, Scopus, and Web of Science. Random-effects meta-analysis was performed using R software. A total of 14 cross-sectional studies including euthymic or mildly symptomatic patients with BD were included in the current meta-analysis. The available studies have consistently supported a 3-cluster solution. The pooled prevalence of the severe-impairment, moderate-impairment, and major good-functioning groups were 23.1 % (95%CI, 18.5 %–27.7 %), 42.5 % (95%CI, 36.3 %–48.8 %), and 33.5 % (95%CI, 25.9 %–41.1 %) respectively. Compared to healthy controls, both the severe-impairment (g=−1.40 to −1.73) and moderate-impairment groups (g=−0.59 to −0.96) had significant deficits in all six cognitive domains (verbal memory, visual memory, executive functions, working memory, attention and processing speed). The good-performance subgroup had a small increase in the performance of executive functions (g=0.23) and normal functioning in all other domains. Compared to the good-performance subgroup, the severe-impairment subgroup was characterized by more severe functional impairment, more hospital admissions, a higher percentage of type I BD and antipsychotic use. The characteristics of the moderate-impairment subgroup were lying between the other two subgroups for most of the measures. The current findings support the existence of 3 cognitive subgroups in BD including severe-impairment and moderate-impairment groups which are associated with a more severe course of illness.

Analysis of First Professional Written Short-Answer Questions of Four Public Universities of Bangladesh in Regional Anatomy

Background: Analysis of written question papers may reveal the assessment pattern and teaching- learning method of the undergraduate curriculum. Written examination is the most essential assessment tool in the MBBS curriculum and the subjective knowledge of the undergraduates’ can be well assessed by the written assessment. Therefore, analyses of written question papers may reveal the assessment pattern and teaching learning method of undergraduate curriculum. The present study has assessed the weightage given to the different components of cognitive domain in SAQs in the First Professional MBBS Examination in Regional Anatomy under four public universities of Bangladesh. Objective: To determine the frequencies of question-segments addressing different levels of cognitive domain in the First Professional MBBS written examination in Regional Anatomy of five years (2014-2018) of four public universities of Bangladesh. Methods: This descriptive type of research was conducted in the Department of Anatomy, BSMMU, Dhaka. Anatomy written short-answer questions (SAQs) both paper I and paper II from 2014 to 2018 of four public universities of Bangladesh were analyzed to determine the frequency of ‘question-segment’s addressing different levels of cognitive domain according to undergraduate medical curriculum. Results: On analysis it was found that 91.42% ‘question-segments’ were remember-level and 8.58% were understand-level. No ‘question-segment’ was found that have addressed apply-, analyze-, evaluate- or create-levels of cognitive domain. Conclusion: The research revealed that higher levels of cognitive domain was not addressed properly in the undergraduate written question papers, so, goals of undergraduate curriculum were poorly achieved. Mediscope 2024;11(2): 52-57

Family income and polygenic scores are independently but not interactively associated with cognitive performance among youth genetically similar to European reference populations.

Cognitive abilities are heritable and influenced by socioeconomic status (SES). It is critical to understand the association between SES and cognition beyond genetic propensity to inform potential benefits of SES-based interventions and to determine if such associations vary across (i) cognitive domains, (ii) facets of SES, and/or (iii) genetic propensity for different aspects of cognition. We examined the contributions of neighborhood socioeconomic advantage, family income, and polygenic scores (PGS) for domains of cognition (i.e., general cognitive ability, executive function, learning and memory, fluid reasoning) in a sample of children (ages 9-10; n = 5549) most genetically similar to reference populations from Europe. With some variability across cognitive outcomes, family income and PGS were independently significantly associated with cognitive performance. Within-sibling analyses revealed that cognitive PGS associations were predominantly driven by between-family effects suggestive of non-direct genetic mechanisms. These findings provide evidence that SES and genetic propensity to cognition have unique associations with cognitive performance in middle childhood. These results underscore the importance of environmental factors and genetic influences in the development of cognitive abilities and caution against overinterpreting associations with PGS of cognitive and educational outcomes as predominantly direct genetic effects.

Recent advances in laboratory education research

Abstract This review synthesizes recent advancements in laboratory education research in university chemistry over the past decade, from 2014 to 2024. It focuses on three key areas: evidence-oriented teaching practices, student learning outcomes and processes, and progressive curriculum development. The paper highlights the growing emphasis on evidence-based approaches to laboratory instruction, the multifaceted nature of student learning in the laboratory, and the importance of designing laboratory curricula that ensure progression and congruence across study programs. The review instantiates how evidence-oriented teaching practices have led to a shift in focus from theory to practical techniques. It explores the diverse learning outcomes associated with laboratory work, including experimental competencies, conceptual understanding, and affective aspects such as identity development and self-efficacy. The paper also introduces a comprehensive framework for assessing student learning in laboratories, integrating cognitive, conative, affective, psychomotor, social, and epistemic domains. Furthermore, the review examines approaches to curriculum development that emphasize scaffolding, progression, and alignment between various curricular elements. It presents models for developing experimental design competence and ensuring congruence in laboratory curriculum development. The paper concludes by acknowledging the persistent gap between research and practice in laboratory education and calling for continued efforts to bridge this divide.

The effect of cognitive emotion regulation on direct-acting antivirals adherence in patients with hepatitis C

IntroductionAdherence to direct-acting antivirals (DAAs) could be a predictor of chronic viral hepatitis C (HCV) therapeutic failure. We examined the perceptions of patients receiving DAAs to determine how cognitive factors influence their decision to maintain adherence. Also, we explored the threshold of DAAs adherence for obtaining sustained virologic response (SVR) among patients with HCV, in order to better implement a strategy that improves the DAAs adherence in the future clinical practice.MethodsA single-arm prospective study was performed. Patients with HCV that started and completed DAAs treatment in the County Hospital of Craiova, Dolj, Romania, were enrolled. Patients’ medication adherence was assessed using the HCV-AD10 questionnaire, and the cognitive emotion regulation was measured with CERQ questionnaire (five positive/adaptive cognitive emotion-regulation domains and four negative/maladaptive domains). Spearman correlation analysis was conducted to explore the relationships between adherence and different factors. ROC-curves were used to evaluate the adherence threshold to achieve SVR. A linear regression model was performed to analyze the primary outcome (DAAs adherence) to be the target variable based on given independent variables (age, treatment duration, severity of HCV, the nine adaptive and maladaptive strategies).Results368 patients (mean age: 61 years) with HCV diagnosed 4.05 ± 6.38 (average) years ago were enrolled. Mean (±SD) adherence via HCV-AD10 was 91.51 ± 8.34, and the proportion of the participants achieving SVR was 96%. Patients with an adherence less than 84% (5 patients, 1.36%) was considered nonadherent and they have a high probability of not achieving response (sensitivity and specificity of 83% and 80%, respectively). We obtained significantly higher values of three adaptive strategies between adherent and nonadherent patients following DAAs treatment: in positive refocusing (p-value = 0.044), refocus on planning (p-value = 0.037), and positive reappraisal (p-value = 0.047).DiscussionThe interplay between the three adaptive strategies of the cognitive emotion regulation and the enhancement of DAAs adherence contributes to a more holistic comprehension of patient behavior in the context of HCV treatment. Increasing refocusing and planning using goal setting and assisting patients in establishing specific, achievable goals can be crucial strategies for clinicians aiming to improve adherence among their patients.

Early onset and increasing disparities in neurodevelopmental delays from birth to age 6 in children from low socioeconomic backgrounds.

To analyze the complex relationship between socioeconomic status (SES) and neurodevelopmental achievements by investigating the temporal dynamics of these associations from birth to age 6. This retrospective cohort study was conducted over 6 years using population-based data from the National Health Insurance Service and integrated data from the National Health Screening Program for Infants and Children. Participants were children born between 2009 and 2011 in Korea without neurodevelopmental delays with potential developmental implications. We analyzed results from the Korean Developmental Screening Test, administered at age 6, which covered overall assessment and six domains of gross and fine motor function, cognition, language, sociality, and self-care. The secondary outcome was to determine when neurodevelopmental outcomes began after birth and how these differences changed over time. Of 276,167 individuals (49.2% males), 66,325, 138,980, and 60,862 had low, intermediate, and high SES, respectively. Neurodevelopmental delays observed across all developmental domains were more prevalent in the low-SES group than in the high-SES group. Disparities in neurodevelopment according to these statuses were apparent as early as age 2 and tended to increase over time (interaction, P < 0.001). The cognition and language domains exhibited the most substantial disparities between SES levels. These disparities persisted in subgroup analyses of sex, birthweight, head circumference, birth data, and breastfeeding variables. Low SES was significantly associated with an increased risk of adverse neurodevelopmental outcomes in preschool children, particularly those affecting cognitive and language domains. These differences manifested in early childhood and widened over time.

Distinct brain and neurocognitive transformations after bariatric surgery: a pilot study

BackgroundObese patients have worse outcomes after surgery and are at increased risk for perioperative neurocognitive disorders (PND). Our aim was to detail the cognitive trajectories of patients undergoing bariatric surgery (BS) and map distinct structural brain changes using magnetic resonance imaging (MRI) to better understand the association between the vulnerable brain, surgery, and the arc of PND.MethodsProspective pilot study with longitudinal comprehensive cognitive assessments and MRI were performed on obese patients scheduled for BS. We analyzed baseline cognitive function and high-resolution T1-/T2-weighted brain images on 19 obese patients [age, 54 (9) years, BMI, 40 (36, 42) kg m−2] and compared with 50 healthy control subjects [age, 52 (6) years; BMI, 25 (24, 27) kg m−2]. Patients were evaluated within five days of BS (baseline), immediately after (within 48h), and follow up at six months.ResultsAt baseline, obese patients had significant brain tissue changes seen in MRI and decreased cognitive scores compared to controls (MoCA 26 vs 28, P = 0.017). Surgery induced further gray matter volume and brain tissue changes along with reduced cognitive scores within the immediate postoperative period (MoCA 26 vs 24, P &amp;lt; 0.001). At six months, we observed reversal of brain alterations for most patients and a concomitant rebound of cognitive scores to patient’s baseline status.ConclusionsBariatric surgery resulted in worsening of preexisting brain structural integrity and lower cognitive function for obese patients compared to baseline. These distinct brain lesions are consistent with specific domains of cognition. Most of these changes reverted to patient’s baseline condition within six months after surgery.

Formal Thought Disorders and Neurocognition in Treatment-Resistant Schizophrenia: Trouble du cours de la pensée et neurocognition dans la schizophrénie réfractaire.

Formal thought disorders (FTDs), a core feature of schizophrenia, have been subdivided into positive and negative types, and are clinically assessed by examining speech (objective) or patient introspection (subjective). Despite being associated with poorer treatment response and worse outcomes, FTDs have been understudied in patients with schizophrenia, in particular treatment-resistant schizophrenia (TRS) or schizoaffective disorder. We aimed to explore the relationship between the severity of positive and negative FTDs and neurocognition as well as social/occupational functioning in this clinical subgroup. This was a retrospective chart review conducted at the Clozapine Clinic at the Centre for Addiction and Mental Health, Toronto, Canada. We reviewed charted standardized assessment of FTDs using the Thought and Language Disorder (TALD) scale, neurocognition using the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS), and functioning using the Social and Occupational Functioning Assessment Scale (SOFAS) between October 2022 and June 2023. Following the original factor structure of the TALD, we computed 4- factor scores that combined positive or negative and objective or subjective FTDs. We then explored the correlation between the scores from each TALD factor and the neurocognition and functioning scores. We analysed data for 23 outpatients on clozapine. After the Bonferroni adjustment, total TALD scores, indicating overall severity of FTDs, were strongly and inversely correlated with SOFAS scores (p < 0.001). A strong inverse correlation was found between the objective positive TALD factor and Letter-Number Span verbal working memory scores, r(21) = -0.63, p < 0.001. Our results demonstrate the strong relationship between FTDs, neurocognition, and social/occupational functioning in a sample of TRS outpatients. Within the cognitive domains assessed, verbal working memory impairment had the strongest correlation with positive FTDs, such as derailment or tangentiality. These findings highlight the value of employing standardized psychopathological scales for FTDs in clinical practice.

The operationalization of bilingual linguistic experience and its relationship with executive function

Research of the relation between linguistic experiences and the executive function have been a hot topic in the field of psycholinguistics for over two decades. Considerable body of studies have provided both supporting and challenging evidence for the existence of such relation. The final answer about the relation between the linguistic experiences and the executive function has not been obtained yet, due to reconsiderations of the established methodological approaches and new theories still being developed, which challenge the validity of earlier findings. This article is an attempt to summarize and explain current trends in this line of studies, specifically focusing on the issue of operationalization of linguistic experiences. Bilingualism and multilingualism are complex constructs, composed of multiple elements that can have unique, independent effects on cognition, including language proficiency, manner and duration of language acquisition, current tendencies of language use. Earlier studies had a tendency to focus on a single element of language experience for categorical distinction between monolinguals and bilinguals, converging the great variability in the latter under a single category. Each element of linguistic experience has to be accounted for and carefully operationalized in a way that would allow reasonable comparison between different research on the topic. In addition to exploring the effects of various elements of linguistic experiences on cognitive control, interactions between those experiences also demand attention, which have been largely overlooked. Finally, each study has to be backed up by a solid theoretical background, which was argued to be a problem for the research of the relation between the linguistic experiences and the executive function, but has great potential for resolving the inconsistencies in research findings. Not all experiences with languages require effortful cognitive processing and adaptations, and even if some might, a comprehensive theory is required to explain how cognitive adaptations for language use can be generalized for other domains of cognition.

Employing Verbal Divergent Thinking to Mitigate Cognitive Decline: Current State of Research and Reasons to Support Its Use

Background/Objectives: Divergent thinking (DT), the ability to generate alternative responses to open-ended problems, has become an increasingly relevant topic in aging research due to its inverse relationship with cognitive decline. Methods: In this narrative review, we explore the latest evidence supporting DT training as a potential strategy for dementia prevention. Results: We identify two pathways through which DT may protect against cognitive decline: (1) by fostering creative cognition and (2) by stimulating DT-related domains. Our findings suggest that verbal DT remains relatively well preserved in older adults, although there is limited empirical evidence to support the idea that DT training enhances creative cognition or DT-related domains in this population. Conclusions: Therefore, while tools designed to enhance DT in older individuals seem promising, it is crucial to rigorously test their effects on the target population to maximize their impact on both the cognitive and psychological domains.

Effects of thematic art programs on cognitive function and depressive symptoms in older adults

ABSTRACT The rapid aging of the global population underscores the need to employ innovative strategies, such as creative aging, to address the accompanying opportunities and challenges. This study investigated the effects of a thematic art program on cognitive abilities and depressive symptoms in older adults. An 8-week art program was developed. Participants attended weekly 2-hour sessions that focuses on connections with life experiences and the link between music and color. The study recruited 40 older adults aged between 60 and 90 years. Among the recruited older adults, 31 completed the entire program. The adults were recruited from community care centers in Northern Taiwan. The Montreal Cognitive Assessment, Stroop Color and Word Test, and Geriatric Depression Scale were used to assess cognitive and depressive symptoms. Participatory program observations and follow-up interviews were conducted to cross-check the results. Significantly improved cognitive abilities (in the overall cognitive function, visuospatial/executive, and orientation domains), executive function, and selective attention were observed. Additionally, the participants reported significantly reduced depressive symptoms. The intervention maintained and improved the physical and mental health of the participants. The empirical results provide a practical reference for developing art programs for older adults.

Penerapan Model Pembelajaran Kooperatif Tipe Two Stay Two Stray Untuk Meningkatkan Aktivitas dan Hasil Belajar Siswa

In this research, there were problems that showed a low level of learning activity and also in the initial ability test of students showed that the learning outcomes of the cognitive domain of students on the material of the adjusting journal were still low. The purpose of this research was to determine the increase in students' accounting activities and learning outcomes in class XII IPS 2 at SMA Swasta Dharmawangsa Medan through the application of the Two Stay Two Stray type cooperative learning model on the material of the trading company's adjustment journal. This type of research is Classroom Action Research (PTK) which is carried out in two cycles. The subjects in this study were 27 students of class XII IPS 2. The instruments in this study consisted of knowledge tests and activity observation sheets. The results of the observation of student activity in cycle I there were 9 students (34%) who fell into the active and very active categories. In cycle II students who were included in the active and very active categories increased to 27 students (100%) and had met the success indicator &gt;85%. And from the results of data analysis, the first cycle knowledge test was obtained with an average value of 62.2 with 15 students (56%) and an increase in the second cycle knowledge test with an average value of 84.1 with 26 students (96%) and has met the success indicator &gt;85%. Based on these data, the indicators of this study have been met. So, it can be concluded that the application of the Two Stay Two Stray type cooperative learning model can improve student learning activities and outcomes at SMA Swasta Dharmawangsa Medan.

The effect of cognitive rehabilitation on motor function and balance in individuals with multiple sclerosis: a systematic review.

Balance and motor functions are associated with a complex sensory-cognitive-motor system that is not reliant on a single component. In people with Multiple Sclerosis (pwMS), deficits in cognitive domains may cause abnormal gait and balance disorders. Therefore, the impact of cognitive rehabilitation (CR) on motor and balance functions in pwMS was investigated. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review was registered in the Prospero system. A systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library until April 2024. Articles meeting the eligibility criteria were assessed and included in the review, those that evaluated the impact of CR on balance and motor functions. Bias in the studies was assessed by using the Risk of Bias-2 tool for randomized controlled trials. The articles' evidence level was evaluated using the Modified Bakker Scale. After searching four databases, eight studies were included in the review, comprising a total of 668 participants. The bias risks of the studies were categorized as low in two studies, unclear in five studies, and high in one study. The evidence levels of the studies showed high levels of evidence for balance and motor skills. This review suggests that CR may have a positive impact on motor and balance performance in pwMS, underscoring the relationship between cognition and motor function. Further research is required to enhance this evidence base, particularly given the limited number of studies in this area.

The investigation of visuospatial memory and visual attention in children with intellectual disability and Down syndrome

Within cognitive domains, memory and attention are among the most studied processes in people with intellectual disabilities, and studies have documented difficulties or even heterogeneities in their functioning. This study investigates the differences and similarities in the development of visuospatial memory and visual attention between children with typical development and intellectual disabilities of various etiologies. The study involved 106 children: 42 with typical development, 41 with intellectual disabilities, and 23 with Down syndrome. The sex ratio was 1:1, and the mean chronological age across groups was 8.81 years. Tools used included the Visual Information Recall Scale and Scales for Sustained Visual Attention and Visual Attention Span. Findings revealed that children with typical development outperformed the others, with statistically significant differences between groups. Notably, children with intellectual disabilities and Down syndrome also showed significant differences, highlighting the cognitive heterogeneity in intellectual disabilities.