Cognitive Processes Research Articles

Associations of Microbiota and Nutrition with Cognitive Impairment in Diseases

Background/Objectives: Recent research highlights the growing interest in the impact of nutrition on cognitive health and function in disease, as dietary habits are increasingly recognized as crucial factors in relation to brain function. This focus is especially important given the rising prevalence of neurodegenerative diseases and the cognitive decline associated with poor dietary choices. Links are now being sought between brain function and the microbiota and gut–brain axis. Mechanisms are proposed that include low-grade chronic neuroinflammation, the influence of short-chain fatty acids, or the disruption of glial cells and transmitters in the brain. Methods: We reviewed the articles on pubmed. This is not a systematic review, but of the narrative type. We wanted to outline the issue and summarise the latest information. Results: The axis in question has its foundation in nutrition. It has been reported that diet, particularly the components and the timing of food intake, has an impact on cognitive processes. The Mediterranean diet is most often cited in the literature as being beneficial to health. In order to obtain a more complete view, it is worth considering other dietary patterns, even those that impair our health. Conclusions: Determining what is beneficial and what is not will allow us to develop a speronized strategy for the prevention of, and fight against, cognitive impairment. Appropriately selected supplements, the functions of which we have also discussed, may prove supportive.

Mechanisms of brain self-regulation: psychological factors, mechanistic models and neural substrates.

While neurofeedback represents a promising tool for neuroscience and a brain self-regulation approach to psychological rehabilitation, the field faces several problems and challenges. Current research has shown great variability and even failure among human participants in learning to self-regulate target features of brain activity with neurofeedback. A better understanding of cognitive mechanisms, psychological factors and neural substrates underlying self-regulation might help improve neurofeedback's scientific and clinical practices. This article reviews the current understanding of the neural mechanisms of brain self-regulation by drawing on findings from human and animal studies in neurofeedback, brain-computer/machine interfaces and neuroprosthetics. In this article, we look closer at the following topics: cognitive processes and psychophysiological factors affecting self-regulation, theoretical models and neural substrates underlying self-regulation, and finally, we provide an outlook on the outstanding gaps in knowledge and technical challenges. This article is part of the theme issue 'Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation'.

Cultural, Cognitive, and Ecological Dynamics of Individual Religiosity

In the following, I consider how to better link the study of cognition and behavior to the evolutionary origins of cognitive mechanisms, within the framework of embodied cognition theory. Specifically, I attempt to show this by examining the topic of individual commitment, its origins, and its relationship to beliefs and identity. I then go on to point out that the way we talk about cognition and cognitive processes can be misleading, and although we cannot dispense with the use of metaphorical language, it might be worth considering some of the shortcomings of the metaphors in order to rid ourselves of misconceptions.

Cortex level connectivity between ACT-R modules during EEG-based n-back task

AbstractFinding the synchronization between Electroencephalography (EEG) and human cognition is an essential aspect of cognitive neuroscience. Adaptive Control of Thought-Rational (ACT-R) is a widely used cognitive architecture that defines the cognitive and perceptual operations of the human mind. This study combines the ACT-R and EEG-based cortex-level connectivity to highlight the relationship between ACT-R modules during the EEG-based n-back task (for validating working memory performance). Initially, the source localization method is performed on the EEG signal, and the mapping between ACT-R modules and corresponding brain scouts (on the cortex surface) is performed. Once the brain scouts are identified for ACT-R modules, then those scouts are called ACT-R scouts. The linear (Granger Causality: GC) and non-linear effective connectivity (Multivariate Transfer Entropy: MTE) methods are applied over the scouts’ time series data. From the GC and MTE analysis, for all n-back tasks, information flow is observed from the visual-to-imaginal ACT-R scout for storing the visual stimuli (i.e., input letter) in short-term memory. For 2 and 3-back tasks, causal flow exists from imaginal to retrieval ACT-R scout and vice-versa. Causal flow from procedural to the imaginal ACT-R scout is also observed for all workload levels to execute the set of productions. Identifying the relationship among ACT-R modules through scout-level connectivity in the cortical surface facilitates the effects of human cognition in terms of brain dynamics.

What's in a treatment name? How people with posttraumatic stress disorder (PTSD) symptoms interpret and react to PTSD treatment names.

Prior research has rarely examined how people understand or react to the names of psychological treatments. In the case of evidence-based psychotherapies for posttraumatic stress disorder (PTSD), such reactions may be relevant to the low rates of uptake of such treatments. Participants who screened positive for PTSD (n = 887) completed questions assessing their initial reactions to PTSD treatment names as well as how a different name would affect their openness to treatment. In addition, they gave brief responses to open-ended questions about the reason for their initial reactions, and content analysis was used to better understand these reasons. The results indicated that among the treatment name options, cognitive processing therapy (CPT) and present-centered therapy (PCT) were viewed most positively. Approximately 40% of the sample preferred plain language alternatives for treatment names. Content analyses focused on descriptions of the treatments-which could be accurate or inaccurate-as well as whether respondents evaluated a treatment name itself as positive or negative. Some names conveyed treatments more accurately (e.g., CPT and written exposure therapy) than others (e.g., eye movement desensitization and reprocessing and prolonged exposure [PE]). Some names were also evaluated more positively (e.g., PCT) than others (e.g., PE). The general term "trauma-focused therapy" was seen as positive and clear. Addressing the ways patients react to psychological terms and treatment names could help clarify misperceptions about evidence-based psychotherapies and promote more widespread uptake of effective treatments for PTSD.

DISSOCIATION, SPLITTING AND COMPARTMENTALIZATION IN TRAUMA-RELATED DISORDERS

The article is devoted to the analysis of actual scientific views and theoretical research on the participation of the phenomena of dissociation, splitting, and compartmentalization in disorders associated with mental trauma, in particular, PTSD and addictions. It is shown that the understanding of the concepts of dissociation and splitting developed in parallel and that both concepts emerged from research on trauma. Empirical studies show a clear correlation between dissociation, splitting, and compartmentalization with trauma-related disorders. However, there is considerable confusion in the differentiation of these concepts: some authors use them as synonyms, other authors consider dissociation to be a more basic process underlying splitting, and some distinguish two separate types of dissociation - separation, and compartmentalization. In this article, the concept of dissociation and splitting into separate independent phenomena is chosen, where dissociation is defined as the separation of mental processes or mental systems from consciousness, and splitting is defined as the division of consciousness itself into several independent centers of self-consciousness, with the phenomenon of compartmentalization referring to a shallow level of splitting. Both dissociation and splitting can exist in the spectrum from normal to deep pathology of the (sub)psychotic level. The article analyzes how dissociation and splitting can participate in the formation of trauma-related disorders such as PTSD and addiction. In the formation of PTSD, a part of the human psyche system associated with traumatic experiences is detached from consciousness as a result of protection from unbearable experiences (dissociation). Further, due to unsuccessful attempts to integrate the trauma, a negative self-concept with feelings of shame/guilt is formed, which splits off from the core self (splitting). As a result, a triadic structure is formed: the normative Ego-state, the split traumatic Ego-state, and the dissociated traumatic Self-state. When addiction is formed based on early trauma, a dissociated self-state exists since childhood, but while using psychoactive substances, it is integrated with a state of altered consciousness, which is why a person is experiencing a state of high, similar to a miracle. In this case, a system is formed of a normative Ego state, a dissociated traumatic Self-state, and a detached addictive Ego state, which is activated exclusively in a state of altered consciousness, and during activation, integration with the dissociated Self-state occurs. This addictive integration is the real motive for the use of this group of addictive drugs. The proposed concept can be used in the psychotherapy of trauma-related disorders as a conceptualization of cases and conceptualization of loci of therapeutic contact. Keywords: dissociation, splitting, compartmentalization, mental trauma, PTSD, addiction

Using fMRI to examine nonlinear mixed selectivity tuning to task and category in the human brain

Abstract Recent experimental and theoretical work has shown that nonlinear mixed selectivity, where neurons exhibit interaction effects in their tuning to multiple variables (e.g., stimulus and task) plays a key role in enabling the primate brain to form representations that can adapt to changing task contexts. Thus far all such studies have relied on invasive neural recording techniques. In this study, we demonstrate the feasibility of measuring nonlinear mixed selectivity tuning in the human brain noninvasively using fMRI pattern decoding. To do so, we examined the joint representation of object category and task information across human early, ventral stream, and dorsal stream areas while participants performed either an oddball detection task or a one-back repetition detection task on the same stimuli. These tasks were chosen to equate spatial, object-based, and feature-based attention, in order to test whether task modulations of visual representations still occur when the inputs to visual processing are kept constant between the two tasks, with only the subsequent cognitive operations varying. We found moderate but significant evidence for nonlinear mixed selectivity tuning to object category and task in fMRI response patterns in both human ventral and dorsal areas, suggesting that neurons exhibiting nonlinear mixed selectivity for category and task not only exist in these regions, but cluster at a scale visible to fMRI. Importantly, while such coding in ventral areas corresponds to a rotation or shift in the object representational geometry without changing the representational content (i.e., with the relative similarity among the categories preserved), nonlinear mixed selectivity coding in dorsal areas corresponds to a reshaping of representational geometry, indicative of a change in representational content.

Parametric resonance brain model

The paper introduces a parametric resonance model for characterizing some features of the brain’s electrical activity. This activity is assumed to be a fundamental aspect of brain functionality underpinning functions from basic sensory processing to complex cognitive operations such as memory, reasoning, and emotion. A pivotal element of the proposed parametric model is neuron synchronization which is crucial for generating detectable brain waves. The analysis of the frequency content of brain waves, categorized as delta (0÷4 Hz), theta (4÷7 Hz), alpha (8÷12 Hz), beta (13÷30 Hz), and gamma (30÷100 Hz) reveals, notably, that the mean frequency of each of these brain wave classes is, in sequence, approximately the double of that of the previous one. Based on this observation, the proposed parametric resonance model suggests a cascade of amplification effects. Following the proposed model, in the transition from wakefulness to sleep, the brain wave bands are energized at double frequency by higher frequency neighboring bands; on the contrary, in the sleep to awake transition, brain waves are energized at a half frequency by their lower frequency neighbor waves. Finally, the trend of increasing amplitude values from higher to lower frequencies lends empirical support to the parametric resonant brain model validity.

When Gestures also Argue: Multimodal Viewpoint Shift as a Rhetorical Strategy in American Political Talk Shows

Drawing on Mental Spaces Theory and Conceptual Blending Theory in Cognitive Linguistics, we examine the interaction between speech and co-speech gestures in The Daily Show with Trevor Noah. Statistical analysis shows that viewpoint shift in the self-built multimodal corpus, generally following the pattern: Base Space->News Narrative Space(->Base space)->Source Viewpoint Space(+)(->Base space), is significantly related to the use of verbal markers and gestural types. Moreover, multimodal viewpoint shift in political talk shows can achieve such rhetorical functions as enhancing ironic effects, solidifying and highlighting opposing positions, and simplifying political issues. Since verbal markers and gestures can mobilize the audience’s embodied experience by primarily activating mental images and motor programs, we claim that mental simulation and perspective taking play a pivotal role in the cognitive processing of multimodal viewpoint shifts by promoting viewpoint alignment between the audience and the host.

Cognitive functions explain discrete parameters of normal walking and dual-task walking, but not postural sway in quiet stance among physically active older people.

Postural control is dependent on the central nervous system's accurate interpretation of sensory information to formulate and execute adequate motor actions. Research has shown that cognitive functions are associated with both postural control and fall risk, but specific associations are not established. The aim of this study was to explore how specific components of everyday postural control tasks are associated with both general and specific cognitive functions. Forty-six community-dwelling older adults reported their age, sex, physical activity level, falls and fall-related concerns. The following cognitive aspects were assessed: global cognition, executive functions, processing speed and intraindividual variability. Postural control was quantified by measuring postural sway in quiet stance, walking at a self-selected pace, and walking while performing a concurrent arithmetical task. Separate orthogonal projections of latent structures models were generated for each postural control outcome using descriptive and cognitive variables as explanatory variables. Longer step length and faster gait speed were related to faster processing speed and less intraindividual variability in the choice reaction test. Moreover, longer step length was also related to less fall-related concerns and less severe fall-related injuries, while faster gait speed was also related to female sex and poorer global cognition. Lower dual-task cost for gait speed was explained by the executive function inhibition and faster processing speed. Postural sway in quiet stance was not explained by cognitive functions. Cognitive functions explained gait speed and step length during normal walking, as well as the decrease of gait speed while performing a concurrent cognitive task. The results suggest that different cognitive processes are important for different postural control aspects. Postural sway in quiet stance, step time and gait variability seem to depend more on physical and automatic processes rather than higher cognitive functions among physically active older people. The relationships between cognitive functions and postural control likely vary depending on the specific tasks and the characteristics of different populations.

How Perceived Child-Friendly Communities Alleviate Adolescents' Psychological Reactance.

When children enter adolescence, their personality traits easily give rise to psychological reactance (PR). PR involves a desire for autonomy and independence, as well as an aversion to parental and social rules and restrictions. Factors that influence PR include physiological, familial, and social aspects. However, most studies on adolescent noncompliance have primarily focused on rebellious behavior. Little research has examined motivational state reactance, although its interaction with environmental perception can significantly affect adolescents' lives. This study aimed to explore the relationship between the perceived friendliness of the community environment and cognitive processing at different quality of life (QoL) levels in relation to PR among adolescents. Propensity score matching was performed on a sample of 3546 adolescents, collected in Sanya, China. The results show that child-friendly communities (CFCs) had a significantly negative impact on adolescents' PR levels. Additionally, QoL had a moderating effect, meaning that the higher the QoL, the stronger the role of a CFC in alleviating PR. In contrast to claims that PR is determined by temperament or character profiles, this study reveals the importance of environmental shaping through triadic reciprocal determinism and a focus on the key role of the community environment.

An Analysis of the Conceptual Function of Facing the Sea with Spring Blossoms

Since Facing the Sea with Spring Blossoms has attracted widespread attention, many scholars have formed four interpretations from various perspectives, namely: the poem conveys the love of life and the pursuit of happiness; the poem is a deathbed poem, expressing the poet's despair of earthly life; the poet is a sad and bitter soul in pursuit of happiness; the poem is the poet's choice between “existence or destruction.” Poetry is the poet's choice between "existence or destruction," and he finally chooses to give up earthly happiness. Systemic functional grammar was founded by Halliday, who believed that language has three meta-functions: conceptual function, communicative function, and textual function, which are linked to the transitivity system, mood system, and thematic system. Since its inception, Systemic Functional Grammar has been applied to many text analyses, demonstrating its powerful interpretative power. Guided by this theory, the author conducted a conceptual-functional analysis of Facing the Sea with Spring Blossoms and found that there are 25 processes in the poem, including nine material processes, five mental processes, six relational processes, three verbal processes, and two existential processes. The author analyzed the three types of processes that are more typical in this poem and drew the following conclusions: first, happiness is an important theme for the poet; second, the poem is opened by me (the poet) choosing between two kinds of happiness; third, the poet finally chooses non-earthly happiness, i.e., “I only wish to face the sea, with spring blossoms.”

Unleashing think-aloud data to investigate self-assessment: Quantitative and qualitative approaches

BackgroundThink-aloud is a process data method that provides detailed insights into students’ cognitive, emotional, and motivational processes. This makes it an ideal method for investigating self-assessment as, the vast majority of times, it occurs internally without obvious external cues. In this paper, we present a methodological overview based on three previous empirical studies, utilizing both quantitative and qualitative methods to analyze think-aloud data and explore the ‘black box’ of self-assessment. MethodsA total of 67 secondary education students and 126 university students participated concurrently thinking-aloud while self-assessing academic tasks they had previously completed. ResultsWe compare our two methodological approaches to analyzing think-aloud data, highlighting the coding schemes, data analysis techniques, and the critical decisions made during the think-aloud process. ConclusionsOur findings demonstrate how think-aloud can be effectively employed through complementary quantitative and qualitative methods, providing a comprehensive understanding of the self-assessment phenomena.

Psychometric characteristics of the decision‐making ability scale among high school students

AbstractThe process of decision‐making is a multifaceted cognitive endeavor encompassing various cognitive, emotional, psychological, and social processes. It empowers individuals to select from a range of alternatives. Its significance spans across age groups, impacting both adults and children, and the relevance of which goes beyond aiding learners in choosing their educational or professional paths; it also pertains to preparing them to navigate the diverse situations they will encounter throughout their lives. To approach this ability, we developed a scale comprising 20 items, assessing five distinct decision‐making factors. This scale was administered to a sample of 303 learners in the first and second years of the baccalaureate course (pre‐final and final years of secondary education), representing both genders, and studying in four high schools. The participants’ ages ranged between 16 and 20 years. The results of this study revealed positive psychometric properties of the scale after its apparent validity was verified. Additionally, principal component analysis, using a latent root criterion greater than one (Eigenvalue > 1), and performing Varimax rotation, resulted in five factors that represent decision‐making styles (dependent, avoidant, confident, rational, intuitive) that explain 53.67% of the total variance. Through the application of confirmatory factor analysis (CFA), the outcomes showcased favorable conformity indicators. The ratio of chi‐square value to degrees of freedom was recorded at less than 5 (x²/df = 1.531). The RMSEA index, at 0.041, remained below the accepted threshold of 0.08. The metrics (CFI, TLI, GFI, IFI) all surpassed 0.90, falling within acceptable ranges. Strong internal consistency between item scores and their respective factors was established by Pearson coefficients. The correlation coefficients between each factor's score and the total scale score were robust, ranging from 0.483 to 0.727. The Cronbach's alpha coefficient for the scale's factors ranged from 0.788 (highest) to 0.723 (lowest), with an overall scale stability coefficient of 0.748. These high coefficients collectively confirm the scale's validity, reliability, and appropriateness for implementation within the Middle East and North Africa (MENA) region.

Self-determination and perceived learning in online learning communities

This study explores the interplay between Self-Determination (SDT), relatedness, and teaching presence and CoI’s presence (teaching, cognitive, and social) in the context of online educational settings within China. Specifically, the study employs the Partial Least Squares Structural Equation Modeling (PLS-SEM) to investigate the interaction between SDT (Self-Determination, relatedness, and competence) and the perceived learning outcomes (autonomy, competence, and perceived learning). The underlying structure of the study’s conceptual framework was analyzed through the measurement model and the discriminant validity assessment. The results show that cognitive presence, social presence, and teaching presence are significantly associated with autonomy, competence, relevance, and perceived learning. Moreover, cognitive presence and social presence can potentially augment cognitive processes, amplifying the mediating role of relatedness between cognitive presence and learning outcomes.

Does vibrotactile biofeedback for postural control interfere with cognitive processes?

BackgroundDirectional vibrotactile biofeedback for balance control can be instructed in the form of Repulsive (to move in the opposite direction of vibrations) or Attractive (to move in the direction of vibrations) stimulus encodings. However, which of these encodings is less cognitively demanding and poses less interference with high-level cognitive processes of conflict resolution remains unresolved.MethodsIn two between-subject studies with 30 (16 females) and 35 (23 females) healthy young adults, respectively, we investigated the cognitive load of Attractive and Repulsive vibrotactile biofeedback on 1) working memory (Study I) and 2) cognitive conflict resolution (Study II). Both studies also examined the effectiveness of both feedback stimulus encodings on balance control during quiet standing with eyes closed.ResultsBoth Attractive and Repulsive vibrotactile biofeedback increased balance stability (reduced trunk sway variability) in both the working memory and the conflict resolution study (Study I and II, respectively) with a greater increase of stability for the Repulsive encoding during multitasking demanding cognitive conflict resolution (Study II). Cognitive costs, measured in terms of the Linear Integrated Speed-Accuracy Score (LISAS), were greater for the Attractive encoding during multitasking with working memory demands. When cognitive conflict resolution was required as a secondary cognitive task, both stimulus encodings increased cognitive costs equally.ConclusionsThe effects of instructed Repulsive and Attractive stimulus encodings for the response-related interpretation of vibrotactile biofeedback of body sway were contrasted with respect to cognitive processing demands and balance stabilisation benefits. Both encodings improved balance stability but at certain cognitive costs. Regarding interference with specific high-level cognitive processes, however, a distinction has to be made between both encodings. Repulsive feedback encoding seems to cause less cognitive costs on working memory load and slightly greater stabilisation when cognitive conflict resolution is required. These results are discussed in the context of the known benefits of avoidance actions on cognitive control.

A new variant of the electromagnetic field theory of consciousness: approaches to empirical confirmation.

There are various electromagnetic (EM) field theories of consciousness. They postulate an epineural EM field which, due to its binding properties, unifies the different neuronal information differences originating from various sensory and cognitive processes. Only through a real physical integration in space within this field could phenomenal consciousness arise. This would solve the binding problem mentioned in the philosophy of mind. On closer inspection, the electromagnetic interaction not only provides an explanation for the integrative property of the EM field, but also for the necessary differentiating contrasts of information. This article will take a closer look at the physical properties of a postulated EM field. It will also show how the problem of qualia in connection with emergentism could be solved by a new variant of EM field theory. If it can be clearly demonstrated that the postulated epineural EM field plays a decisive role in the origin of consciousness in addition to neuronal "wired" information processing, this also leaves less room for metaphysical assumptions that attempt to solve the binding problem. In experiments to prove the postulated epineural EM field by means of external electromagnetic manipulations, it can never be ruled out that these also have a direct effect on the "wired" neuronal signal processing. Therefore, on the way to proving the EM field theory of consciousness, an experimental method is needed that must ensure that external manipulations only affect the extensions of the EM field without directly influencing the neuronal network. A method will be discussed here that works with the shielding of EM fields instead of external electromagnetic stimuli.

Unskilled and unaware? Differences in metacognitive awareness between high and low-ability students in STEM

IntroductionMetacognition, or the ability to monitor and control one's cognitive processes, is critical for learning in self-regulated contexts, particularly in introductory STEM courses. The ability to accurately make predictions about one's ability and performance can determine the effectiveness in which students effectively prepare for exams and employ good study strategies. The Dunning-Kruger pattern, where low-performing individuals are more overconfident and less accurate at the ability to predict their performance than high-performing individuals, is robustly found in studies examining metacognitive monitoring. The extent to which the Dunning-Kruger pattern can be explained by the lack of metacognitive awareness is not yet established in the literature. In other words, it is unclear from prior work whether low-performing students are “unskilled and unaware” or simply “unskilled but subjectively aware.” In addition, arguments about whether this pattern is a psychological phenomenon or a statistical artifact of the measurement of metacognition can be found in the literature.MethodsStudents enrolled in three different physics courses made predictions about their exam scores immediately before and after taking each of the three exams in the course. Student predictions were compared to their exam scores to exam metacognitive accuracy. A new method for examining the cause of the Dunning-Kruger effect was tested by examining how students adjust their metacognitive predictions after taking exams.ResultsIn all contexts low-performing students were more overconfident and less accurate at making metacognitive predictions than high-performing students. In addition, these students were less able to efficiently adjust their metacognitive predictions after taking an exam.DiscussionThe results of the study provide evidence for the Dunning-Kruger effect being a psychological phenomenon. In addition, findings from this study align with the position that the skills needed to accurately monitor one's performance are the same as those needed for accurate performance in the first place, thus providing support for the “unskilled and unaware” hypothesis.

Effects of Social Roles Rotation on the Cognitive Learning Process in Online Collaborative Conversation

Effects of Social Roles Rotation on the Cognitive Learning Process in Online Collaborative Conversation

Feasibility and Acceptability of Providing Cognitive Remediation in a Large USA System of Coordinated Specialty Care for Early Psychosis.

Multinational treatment guidelines support providing cognitive remediation to people recently diagnosed with schizophrenia, but the feasibility of implementing the treatment on a large scale is less well understood. This study took place between 2019 and 2023 at 14 clinics within a large network of programs providing early intervention services to people aged 16-30 experiencing nonaffective psychosis. Clinics were randomly assigned to deliver cognitive remediation as twice-weekly clinician-led groups (N = 5), cognitive remediation as once-weekly clinician-led groups with homework (N = 6), or treatment as usual (N = 3). All clinics screened for cognitive health need to guide treatment planning. Clinical teams (N = 11) received training to provide cognitive remediation. Program evaluation data were analysed for feasibility and acceptability. Screening for cognitive health needs was completed on 77% of the 1193 participants enrolled at the 11 clinics offering cognitive remediation. Clinicians identified cognitive difficulties in 53.9% (n = 496) of screened participants and referred 27% (n = 134) of these participants to cognitive remediation. Of referred participants, 77.6% (n = 104) initiated treatment, and n = 41 completed the treatment. The rate of referral was nearly double, and treatment initiation was significantly higher at programs delivering once-weekly (84.3%) than twice-weekly (64.4%) treatment but the difference in the rate of treatment completion was statistically nonsignificant. Satisfaction among treatment completers was high. Referrals to cognitive remediation required systemic support of a feasible cognitive health screening process. About a quarter of people with clinician-identified cognitive health needs were referred to cognitive remediation. Feasibility data suggest a flexible model of treatment delivery may facilitate implementation in this service setting.