Computer-based Program Research Articles

Protocol for a Systematic Review: Targeted School‐Based Interventions for Improving Reading and Mathematics for Students With or At‐Risk of Academic Difficulties in Grade 7 to 12: A Systematic Review

Protocol for a Systematic Review: Targeted School‐Based Interventions for Improving Reading and Mathematics for Students With or At‐Risk of Academic Difficulties in Grade 7 to 12: A Systematic Review

Enhancing Decision-Making in STSE Education by Inducing Reflection and Self-Regulated Learning

Thoughtful decision-making to resolve socioscientific issues is central to science, technology, society, and environment (STSE) education. One approach for attaining this goal involves fostering students’ decision-making processes. Thus, the present study explores whether the application of decision-making strategies, combined with reflections on the decision-making processes of others, enhances decision-making competence. In addition, this study examines whether this process is supported by elements of self-regulated learning, i.e., self-reflection regarding one’s own performance and the setting of goals for subsequent tasks. A computer-based training program which involves the resolution of socioscientific issues related to sustainable development was developed in two versions: with and without elements of self-regulated learning. Its effects on decision-making competence were analyzed using a pre test-post test follow-up control-group design (N = 242 high school students). Decision-making competence was assessed using an open-ended questionnaire that focused on three facets: consideration of advantages and disadvantages, metadecision aspects, and reflection on the decision-making processes of others. The findings suggest that students in both training groups incorporated aspects of metadecision into their statements more often than students in the control group. Furthermore, both training groups were more successful in reflecting on the decision-making processes of others. The students who received additional training in self-regulated learning showed greater benefits in terms of metadecision aspects and reflection, and these effects remained significant two months later. Overall, our findings demonstrate that the application of decision-making strategies, combined with reflections on the decision-making process and elements of self-regulated learning, is a fruitful approach in STSE education.

A Pilot Study of Assessing Cognition in Children with Sickle Cell Disease Using a New Software Package the Cogstate Battery

Introduction17% of children with sickle cell disease (SCD) between the ages of 6 and 16 could have silent infarcts1. Depending on the area of the brain affected silent infarcts can cause problems with attention, coordination, visual-motor speed and executive function. Children with SCD in the UK do not receive routine MRI scans. Subtle defects in cognition can be assessed with neuropsychometric testing which involves multiple tests assessing many areas of cognition. However, testing is limited to those with known neurological deficits due to lack of funding and shortage of specialist staff. There is a need for a robust screening tool for assessment of cognition, which could identify children for further specialist testing.The Cogstate battery is computer-based program that assesses cognition and has been used in several clinical settings, both adult and paediatric2-3. The Cogstate battery is reported to be culturally neutral and is available in several languages. Additionally the Cogstate battery is free from practice effects and so could be used as an annual assessment tool in order to identify any declines as early as possible. The Cogstate battery has not yet been used to assess cognition in children with SCD.Research ObjectivesThe aim of this study was to assess the feasibility of using the Cogstate Battery as a tool for the assessment of cognition in children with SCD. It was hypothesised that the Cogstate battery would be easy to use within this setting and would be acceptable to patients, parents and assessors.MethodsEight clinically well children, aged 10-17 with SCD were recruited through St Mary's Hospital paediatric haematology outpatient clinics. The Cogstate software was downloaded onto a Windows laptop computer and an anonymous profile was created for each child before testing. A battery of 6 tests (Table 1) was created aiming to assess a range of cognitive domains within a reasonable amount of time. Every child completed the battery of tests once, which included a short practice before each test. After testing each patient was asked to give an opinion of how they found the tests. Upon completion of the test the patients' results were uploaded to the Cogstate website which generated a test report and a case report form. A mark was given for each test and a score of over 90 represents normal cognition in the area tested, 81-90 represents mild impairment and below 81 represents impairment. Table 1Tests used in the Cogstate battery and corresponding cognitive domains assessedTest NameCognitive Domain TestedContinuous paired associate learning (CPAL)Paired associate learningDetection (DET)Psychomotor functionGroton maze learning test (ME)Executive functionGroton maze learning test-delayed recall (ME)Delayed recallIdentification (IDN)AttentionOne card learning (OCL)LearningOne-back memory (ONBA)Working memoryResults8 patients completed the battery, taking on average 29 minutes (Table 2). The battery was easy to carry out and although some children reported it as boring, they all finished the tests without distress. The test report generated by the Cogstate website allowed results to be analysed quickly and with ease. An overall score from each test is clearly indicated. The Continuous Paired Associate Learning test was not displayed as part of the test report as there was insufficient normal data to draw conclusions from the results within the age group tested.Table 2Summary Report of 8 patients testedPatientIDDET(Psychomotor function)IDN(Attention)OCL(Learning)ONBS(Processing speed)ONBA(Working memory)ME(Executive function & delayed recall)00018775827883990002106105949011799000396101959511798000476769481949300058684988189890006981049797941110007949091831018600089188108909695ConclusionThe Cogstate battery is a feasible tool for paediatric SCD patients and can be undertaken in a clinic setting. This feasibility study will help design a prospective, comparative study of cognition in children with SCD using the Cogstate battery and conventional neuropsychometric assessment and once validated, would be a useful tool to assess cognition and institute timely educational and medical intervention.

The Impact of Multimedia Graphic and Text with Autistic Learners in Reading

Autism Spectrum Disorder (ASD) refers to a groups of developmental disabilities that can cause significant social, communication and behavioral challenges .This pauses several characteristics that subject a child to problems such social communication, difficulty relating to people, things and events, and repetitive body movements or behaviors .In the academic setting as well, the learners who suffer from (ASD) encounter various problems. As an instance of academic skill reading, Reading is required to be learn but not on the way it done in traditional classroom. An intervention which yielded better results in learning reading skill, based on (Iman and Fouad, 2010) (1) organizing the memory lead to paying attention to relevant information ,Thus this research, attempts to use utilize multimedia elements aimed to find out the impact of multimedia elements (graphic and text) in reading comprehension. And to ascertain how multimedia, especially graphic helps children with autism in reading comprehension. This systematic review attempts to address three specific research questions: the teaching reading comprehension to children with autism (1) can graphic with the texts help young children to improve their reading skills? (2) Can colors lead to better attention with autistic learners? (3) Does the computer-based intervention program increase and improve autistic learner's abilities to read? Results indicate that children with autism can benefit from the strategies of reading comprehension when they used graphic and text together.

SRT-Joy - computer-assisted self-regulation training for obese children and adolescents: study protocol for a randomized controlled trial.

BackgroundObesity is not only a highly prevalent disease but also poses a considerable burden on children and their families. Evidence is increasing that a lack of self-regulation skills may play a role in the etiology and maintenance of obesity. Our goal with this currently ongoing trial is to examine whether training that focuses on the enhancement of self-regulation skills may increase the sustainability of a complex lifestyle intervention.Methods/DesignIn a multicenter, prospective, parallel group, randomized controlled superiority trial, 226 obese children and adolescents aged 8 to 16 years will be allocated either to a newly developed computer-training program to improve their self-regulation abilities or to a placebo control group. Randomization occurs centrally and blockwise at a 1:1 allocation ratio for each center. This study is performed in pediatric inpatient rehabilitation facilities specialized in the treatment of obesity. Observer-blind assessments of outcome variables take place at four times: at the beginning of the rehabilitation (pre), at the end of the training in the rehabilitation (post), and 6 and 12 months post-rehabilitation intervention. The primary outcome is the course of BMI-SDS over 1 year after the end of the inpatient rehabilitation. Secondary endpoints are the self-regulation skills. In addition, health-related quality of life, and snack intake will be analyzed.DiscussionThe computer-based training programs might be a feasible and attractive tool to increase the sustainability of the weight loss reached during inpatient rehabilitation.Trial registrationThe present study protocol was registered on 13 July 2015 at German Clinical Trials Register: DRKS00007879.

A prospective case-control study to investigate retinal microvascular changes in acute dengue infection

Dengue infection can affect the microcirculation by direct viral infection or activation of inflammation. We aimed to determine whether measured retinal vascular parameters were associated with acute dengue infection. Patients with acute dengue were recruited from Communicable Diseases Center, Singapore and age-gender-ethnicity matched healthy controls were selected from a population-based study. Retinal photographs were taken on recruitment and convalescence. A spectrum of quantitative retinal microvascular parameters (retinal vascular caliber, fractal dimension, tortuosity and branching angle) was measured using a semi-automated computer-based program. (Singapore I Vessel Assessment, version 3.0). We included 62 dengue patients and 127 controls. Dengue cases were more likely to have wider retinal arteriolar and venular calibers (158.3 μm vs 144.3 μm, p < 0.001; 227.7 μm vs 212.8 μm, p < 0.001; respectively), higher arteriolar and venular fractal dimensions (1.271 vs 1.249, p = 0.002; 1.268 vs. 1.230, p < 0.001, respectively), higher arteriolar and venular tortuosity (0.730 vs 0.546 [x104], p < 0.001; 0.849 vs 0.658 [x104], p < 0.001; respectively), compared to controls. Resolution of acute dengue coincided with decrease in retinal vascular calibers and venular fractal dimension. Dengue patients have altered microvascular network in the retina; these changes may reflect pathophysiological processes in the immune system.

Implementation of Health Information Technology in Routine Care for Fibromyalgia: Pilot Study

Fibromyalgia management remains complicated and challenging. Health information technology is an evidence-based, nonpharmacological self and symptom management strategy, but few studies have evaluated its feasibility for managing fibromyalgia patients in clinical practice. FibroGuide is an example of an evidence-based, interactive, and computer-based program comprised of 10 educational modules on fibromyalgia. Study aims were to: (1) develop a process for implementing FibroGuide into the routine care of patients with fibromyalgia, (2) evaluate the overall impact on fibromyalgia before and after a 12-week implementation, and (3) assess patient perspectives on using FibroGuide health information technology to assist in self-management. In this pilot study, 35 participants with fibromyalgia were recruited from an Advanced Practice Registered Nurse's outpatient clinic. Using a descriptive design, quantitative data analysis was employed to address study aims. Based on data collection pre- and post-intervention using paired samples testing, a statistically significant change (p = .017) was observed in overall fibromyalgia impact (improved symptom severity, activity, and function). Majority felt that FibroGuide was helpful as part of their routine care, and nearly half reported that it assisted in their self-management. Although 65% noted that technology was an effective and efficient way to receive education for fibromyalgia management, 57% preferred talking to healthcare providers. Larger longitudinal studies are needed on the use of health information technology in fibromyalgia, evaluating both statistical and clinical significance, while decreasing barriers to participant use for this promising adjunct to clinical management. Providers need to be well educated on supporting self-management strategies and health information technology.

A programme for future audit professionals: using action research to nurture student engagement

Professionals require decision-making skills as well as technical knowledge. One might assume that their university education prepares them for this role yet, and least for future audit professionals, traditional text – and lecture – methods dominate teaching practice. This Participation Action Research study develops with auditing students a practice-informed, computer-based and judgement-orientated learning programme. We seek to identify ways in which student engagement in such decision-making dilemmas can be created and improved. Logs, student-surveys and notes from an independent observer document the longitudinal process. Findings identify features that improve student engagement and a contribution of the project is in revealing the value of removing technical and in-class social barriers. Implications for nurturing higher-level learning and for serving professional curriculums generally conclude the study.

Health communication research in the digital age: A systematic review

There has been an increased interest in the use of information technology for health and health care delivery. This systematic review examines patterns and trends of research pertaining to the intersection between technology and health communication, determines where gaps exist within the current body of literature, and provides future directions for researchers and practitioners. Drawn from three major databases, a sample of peer-reviewed journal articles (n = 348) published from 2008 to 2012 was coded in terms of research focus, health concern, technology, research method, and research agenda development. The most investigated subject in the literature was online health information, including search, dissemination, and evaluation, followed by telemedicine/electronic medical records, social support, provider–patient relationship, and health intervention. Health literacy, technology access, public health emergency preparedness/response, and health policy advocacy were examined less often. The most studied health concerns were cancer and mental health, followed by HIV/AIDS/STD, general nutrition, diet, exercise/obesity, physical disability, diabetes, and substance/alcohol/tobacco use. Some critical health issues such as heart disease/stroke were not emphasized. The most discussed technology was the Web, including website for health information, web or computer-based intervention program, traditional online forum/support group, email/listserv, and Web 2.0 social media. Newer technologies such as mobile phone and 3D virtual world/virtual reality/video game were not paid equivalent attention. Studies with quantitative methods tripled those that were non-quantitative. In terms of the development of the research agenda, half of the articles focused on how people use technologies for health and health care, while one-quarter investigated the impact of technologies.

Assessment of a six-week computer-based remediation program for social cognition in chronic schizophrenia.

BackgroundPrograms to remediate cognitive deficits have shown promising results in schizophrenia, but remediation of social cognition deficits is less well understood. Social cognitive deficits may cause more disability than the widely recognized neurocognitive deficits, suggesting that this is an area worthy of further investigation.AimImplement and evaluate a brief computerized cognitive remediation program designed to improve memory, attention, and facial affect recognition (FAR) in outpatients with chronic schizophrenia.MethodsBaseline assessments of FAR and of clinical, cognitive, and psychosocial functioning were completed on 20 males with schizophrenia enrolled in an outpatient rehabilitation program at the Shanghai Mental Health Center (the intervention group) and on 20 males with schizophrenia recruited from among regular outpatients at the Center (the control group). Both groups received treatment as usual, but the intervention group also completed an average of 12.7 sessions of a computer-based remediation program for neurocognitive, social, and FAR functioning over a 6-week period. The baseline measures were repeated in both groups at the end of the 6-week trial.ResultsThere were no statistically significant differences in the changes in clinical symptoms (assessed by the Positive and Negative Syndrome Scale, PANSS) or cognitive measures (assessed using the Hong Kong List Learning Test and the Letter-Number Sequencing Task) between the intervention and control groups over the 6-week trial, but there were modest improvements on the PANSS for the intervention group between baseline and after the intervention. There was a significantly greater improvement in the social functioning measure (the Personal and Social Performance scale, PSP) in the intervention group than in the control group. The pre-post change in the total facial recognition score in the intervention group was statistically significant (paired t-test=-2.60, p=0.018), and there was a statistical trend of a greater improvement in facial recognition in the intervention group than in the control group (F(1,37)=2.93; p=0.092).ConclusionIntegration of FAR training with a short, computer-administrated cognitive remediation program may improve recognition of facial emotions by individuals with schizophrenia, and, thus, improve their social functioning. But more work on developing the FAR training modules and on testing them in larger, more diverse samples will be needed before this can be recommended as a standard part of cognitive remediation programs.

A Computerized Lifestyle Application to Promote Multiple Health Behaviors at the Workplace: Testing Its Behavioral and Psychological Effects.

BackgroundPreventive health behaviors, such as regular physical activity and healthy nutrition, are recommended to maintain employability and to facilitate the health of employees. Theory-based workplace health promotion needs to include psychological constructs and consider the motivational readiness (so-called stages of change) of employees. According to the stages, people can be grouped as nonintenders (not motivated to change and not performing the goal behavior), intenders (decided to adopt the goal behavior but not started yet), or actors (performing the goal behavior already). The tailoring to these stages can be done computer based and should make workplace health promotion more effective.ObjectiveIt was tested whether a parsimonious computer-based health promotion program implemented at the workplace was effective in terms of lifestyle changes and psychological outcomes as well as body weight. We hypothesized that the stage-matched intervention would outperform the one-size-fits-all active control condition (standard care intervention).MethodsIn a randomized controlled trial, a total of 1269 employees were recruited by a trained research assistant at their workplace during a routine medical examination. After excluding noneligible employees, 560 completed Time 1 (T1), and 384 also completed Time 2 (T2), achieving a retention rate of 68.6%. Two fully automated computer-based treatments were adopted: (1) an active control condition with information about benefits of exercise and healthy nutrition (n=52), or (2) a stage-matched multiple-behavior intervention that provided different psychological treatments to 9 subgroups, addressing stages of change (nonintenders, intenders, and actors per behavior; n=332). Baseline assessments (T1) on behavior, psychological constructs, and body weight were repeated after 4 weeks (T2).ResultsThe stage-matched intervention outperformed the active control condition for lifestyle changes containing physical activity and nutrition (χ2 1=3.5; P=.04, for N=384) as well as psychological variables (physical activity intention, P=.04; nutrition intention, P=.03; nutrition planning, P=.02; and general social support to live healthily, P=.01). When predicting a healthy lifestyle at follow-up, baseline lifestyle (odds ratio, OR, 2.25, 95% CI 1.73-2.92; P<.01) and the intervention (OR 1.96, 95% CI 1.00-3.82; P=.05) were found to be significant predictors. Physical activity planning mediated the effect of the intervention on the adoption of an overall healthy lifestyle (consisting of activity and nutrition, R 2 adj=.08; P<.01), indicating that if the stage-matched intervention increased planning, the adoption of a healthy lifestyle was more likely.ConclusionsMatching an intervention to the motivational readiness of employees can make a health promotion program effective. Employees’ motivation, planning, social support, and lifestyle can be supported by a stage-matched intervention that focuses on both physical activity and healthy nutrition. Occupational settings provide a potential to implement parsimonious computer-based health promotion programs and to facilitate multiple behavior change.

Using a computer-based precision teaching program to facilitate learning of complex material: The case of the model of hierarchical complexity.

Using a computer-based precision teaching program to facilitate learning of complex material: The case of the model of hierarchical complexity.

Motivational Interviewing to Increase Cognitive Rehabilitation Adherence in Schizophrenia.

Adherence to treatment in psychiatric populations is notoriously low. In this randomized, controlled, proof-of-concept study, we sought to examine whether motivational interviewing (MI) could be used to enhance motivation for, adherence to, and benefit obtained from cognitive rehabilitation. Dual diagnosis MI, developed specifically for individuals with psychotic symptoms and disorganization, was further adapted to focus on cognitive impairments and their impact. Sixty-four outpatients diagnosed with schizophrenia spectrum disorders completed baseline assessments and were randomized to receive either the 2-session MI focused on cognitive functioning or a 2-session sham control interview focused on assessment and feedback about preferred learning styles. Next, all participants were given 4 weeks during which they could attend up to 10 sessions of a computer-based math training program, which served as a brief analog for a full course of cognitive rehabilitation. As hypothesized, MI condition was associated with greater increases in task-specific motivation along with greater training program session attendance. Moreover, postinterview motivation level predicted session attendance. There were no significant differences in improvement on a measure of cognitive training content, which may have been due to the abbreviated nature of the training. While the literature on the efficacy of MI for individuals with psychosis has been mixed, we speculate that our positive findings may have been influenced by the adaptations made to MI as well as the focus on a nonpharmacological intervention.

A Systematic Review of Digital and Computer-Based Alcohol Intervention Programs in Primary Care.

Alcohol misuse is a significant public health issue resulting in substantial morbidity, premature mortality and costs to the healthcare system. Although face-to-face interventions offered by health practitioners have been shown to be effective, they are not routinely offered due to lack of time, training and resources, and potential damage to rapport. Computerbased interventions may help overcome these implementation barriers. Suitable research databases were searched and studies were selected if they described digital or computer-based alcohol interventions used by primary care patients. Studies which did not report patient alcohol outcomes were excluded. Fifteen trials were identified, eleven of which trialled brief interventions only while the remaining four trialled both brief and extended interventions. Nine trials were associated with a reduction in alcohol use at followup. This is the first systematic review of digital or computer-based alcohol intervention programs used by primary care patients. Although the number of trials in this area of research is relatively small, their findings indicate effectiveness in reducing alcohol consumption as well as drinking related consequences. Extended interventions which offer additional opportunities to monitor drinking over time appear no more effective than single occasion brief interventions. These findings suggest that digital and computer-based interventions in primary care may have the potential to increase alcohol intervention activities in the general population at a relatively low cost and low burden on practitioners.

Disease Profiling for Computerized Peer Support of Ménière's Disease.

BackgroundPeer support is an emerging form of person-driven active health care. Chronic conditions such as Ménière’s disease (a disorder of the inner ear) need continuing rehabilitation and support that is beyond the scope of routine clinical medical practice. Hence, peer-support programs can be helpful in supplementing some of the rehabilitation aspects.ObjectiveThe aim of this study was to design a computerized data collection system for the peer support of Menière’s disease that is capable in profiling the subject for diagnosis and in assisting with problem solving.MethodsThe expert program comprises several data entries focusing on symptoms, activity limitations, participation restrictions, quality of life, attitude and personality trait, and an evaluation of disease-specific impact. Data was collected from 740 members of the Finnish Ménière’s Federation and utilized in the construction and evaluation of the program.ResultsThe program verifies the diagnosis of a person by using an expert system, and the inference engine selects 50 cases with matched symptom severity by using a nearest neighbor algorithm. These cases are then used as a reference group to compare with the person’s attitude, sense of coherence, and anxiety. The program provides feedback for the person and uses this information to guide the person through the problem-solving process.ConclusionsThis computer-based peer-support program is the first example of an advanced computer-oriented approach using artificial intelligence, both in the profiling of the disease and in profiling the person’s complaints for hearing loss, tinnitus, and vertigo.

A preliminary report of music-based training for adult cochlear implant users: Rationales and development

ObjectiveThis paper provides a preliminary report of a music-based training program for adult cochlear implant (CI) recipients. Included in this report are descriptions of the rationale for music-based training, factors influencing program development, and the resulting program components.MethodsPrior studies describing experience-based plasticity in response to music training, auditory training for persons with hearing impairment, and music training for CI recipients were reviewed. These sources revealed rationales for using music to enhance speech, factors associated with successful auditory training, relevant aspects of electric hearing and music perception, and extant evidence regarding limitations and advantages associated with parameters for music training with CI users. This informed the development of a computer-based music training program designed specifically for adult CI users.ResultsPrinciples and parameters for perceptual training of music, such as stimulus choice, rehabilitation approach, and motivational concerns were developed in relation to the unique auditory characteristics of adults with electric hearing. An outline of the resulting program components and the outcome measures for evaluating program effectiveness are presented.ConclusionsMusic training can enhance the perceptual accuracy of music, but is also hypothesized to enhance several features of speech with similar processing requirements as music (e.g., pitch and timbre). However, additional evaluation of specific training parameters and the impact of music-based training on speech perception of CI users is required.

Remotely-delivered cognitive remediation in multiple sclerosis (MS): protocol and results from a pilot study.

BackgroundCognitive impairment represents a critical unmet treatment need in multiple sclerosis (MS). Cognitive remediation is promising but traditionally requires multiple clinic visits to access treatment. Computer-based programs provide remote access to intensive and individually-adapted training.ObjectiveOur goal was to develop a protocol for remotely-supervised cognitive remediation that enables individuals with MS to participate from home while maintaining the standards for clinical study.MethodsMS participants (n = 20) were randomized to either an active cognitive remediation program (n = 11) or a control condition of ordinary computer games (n = 9). Participants were provided study laptops to complete training for five days per week over 12 weeks, targeting a total of 30 hours. Treatment effects were measured with composite change via scores of a repeated neuropsychological battery.ResultsCompliance was high with an average of 25.0 hours of program use (80% of the target) and did not differ between conditions (25.7 vs. 24.2 mean hours, p = 0.80). The active vs. control participants significantly improved in both the cognitive measures (mean composite z-score change of 0.46 ± 0.59 improvement vs. −0.14 ± 0.48 decline, p = 0.02) and motor tasks (mean composite z-score change of 0.40 ± 0.71improvement vs. −0.64 ± 0.73 decline, p = 0.005).ConclusionsRemotely-supervised cognitive remediation is feasible for clinical study with potential for meaningful benefit in MS.

The effectiveness of the correction of cognitive impairment using computer-based stimulation programs for patients with coronary heart disease after coronary bypass surgery

We evaluated effectiveness of using copyrighted computer-based stimulation programs in the correction of cognitive function in patients with coronary heart disease after coronary bypass surgery.A total of 74 patients were examined, all the patients underwent a course of drug therapy, 37 patients underwent a course of rehabilitation in addition to medical therapy using computer-based stimulation programs (1 time per day for 20min within 10days). A course of rehabilitation using computer-based stimulation programs in patients with coronary heart disease after coronary bypass surgery was proved to be an effective way of correcting cognitive function.

Changes in retinal vessels related to varicocele: a pilot investigation.

The aim of this study was to investigate whether retinal vasculature changes had occurred (retinal artery diameter, retinal vein diameter and artery/vein ratio) in patients with varicocele. This pilot study included 50 healthy subjects with any eye disease apart from slight refractive errors and 55 patients with varicocele. Retinal arteriolar and venular diameters were measured and summarised as central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE). Retinal microvascular diameters and the arteriolar-to-venular ratio (AVR) were assessed with a digital retinal camera. All measurements and calculations were performed using a computer-based program. The mean CRAE value was 151.8±3.6μm in the study group and 150.4±4.5μm in the control group. Mean CRVE value was 209.4±5.9μm in the study group and 200.1±8.7μm in the control group. AVR was found 0.72±0.02 in the study group and 0.75±0.03 in the control group. There were significant differences between groups in terms of CRVE and AVR. There were no significant differences between groups in terms of CRAE. The results of this study showed that the patients with varicocele showed significant changes on retinal vascular diameter.

Improving spatial-simultaneous working memory in Down syndrome: effect of a training program led by parents instead of an expert.

Recent studies have suggested that the visuospatial component of working memory (WM) is selectively impaired in individuals with Down syndrome (DS), the deficit relating specifically to the spatial-simultaneous component, which is involved when stimuli are presented simultaneously. The present study aimed to analyze the effects of a computer-based program for training the spatial-simultaneous component of WM in terms of: specific effects (on spatial-simultaneous WM tasks); near and far transfer effects (on spatial-sequential and visuospatial abilities, and everyday memory tasks); and maintenance effects (1 month after the training). A comparison was drawn between the results obtained when the training was led by parents at home as opposed to an expert in psychology. Thirty-nine children and adolescents with DS were allocated to one of two groups: the training was administered by an expert in one, and by appropriately instructed parents in the other. The training was administered individually twice a week for a month, in eight sessions lasting approximately 30 min each. Our participants’ performance improved after the training, and these results were maintained a month later in both groups. Overall, our findings suggest that spatial-simultaneous WM performance can be improved, obtaining specific and transfer gains; above all, it seems that, with adequate support, parents could effectively administer a WM training to their child.