Which Factor Is More Relevant to the Effectiveness of the Cognitive Intervention? A Meta-Analysis of Randomized Controlled Trials of Cognitive Training on Symptoms and Executive Function Behaviors of Children With Attention Deficit Hyperactivity Disorder

Objective: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate inattention, hyperactivity, and impulsivity. Multiple cognitive training appeared to be more effective than working memory training, but the evidence remains insufficient, particularly for the subgroup symptoms and executive function behaviors at home. Further analysis of the impact of factors on the effectiveness would facilitate the development of cognitive training.Methods: We searched PubMed, Cochrane Library, Psyche, Embase, Chinese Biomedical Literature Database, CNKI, and Weifang Database, and included randomized controlled trials (RCTs) of children with ADHD undergoing cognitive intervention. Metaanalysis and univariate metaregression were performed by STATE. The risk of bias was assessed with the Cochrane risk of bias tool 2.0 by the two investigators separately. This study was registered with INPLASY, number INPLASY202140065.Results: We included 17 RCTs in the systematic review, with a combined 1,075 participants. For metaanalyses of both subgroups of ADHD symptoms and the executive function behaviors, the test of published bias failed to reach the p < 0.05 level. When all of the training are considered together, cognitive training can improve the presentation of inattention symptoms [SMD = −0.390, 95%CI (−0.675, −0.104)] and executive function behaviors (SMD = −0.319, 95%CI (−0.527, −0.111)]. In the subgroup analysis, the effects of working memory training on both presentations were not statistically significant. In contrast, the multiple cognitive training had significant effects on the presentation of inattention symptoms [SMD = −0.507, 95% CI (−0.722, −0.292)], hyperactivity/impulsivity [SMD = −0.305, 95% CI (−0.518, −0.09)], and the executive function behaviors [SMD = −0.499, 95%CI (−0.707, −0.290)]. In addition, metaregression analysis showed that only training frequency did significantly impact the symptoms of ADHD and the executive function behaviors.Conclusion: This study showed that improvements in symptoms and executive function behaviors were related to the domains of cognitive intervention. The findings suggest that multiple domains of cognitive training and moderate training frequency may have wider clinical benefits. All the above results highlight further research in refining the executive functions of children with ADHD and developing individually tailored cognitive intervention on homes based for children with vulnerable executive functions.Systematic Review Registration: [http://inplasy.com/], [INPLASY202140065].

COGNITIVE INTERVENTION TO THE WOMEN WHO ATTEND THE "BREASTFEEDING SUPPORT GROUP"

Introduction: Breast milk is the best food to meet the nutritional needs of the child, exclusively for the first 6 months and up to two years of age, favoring the establishment of the mother-child bond. Objective: To carry out a cognitive intervention to the women who attend the “breastfeeding support group”. Method: Quantitative research, with a quasi-experimental design, in a census sample made up of 11 pregnant women and 19 breastfeeding women. The Iowa Infant Feeding Attitudes Scale (IIFAS) was used. Results: 33.30% (10) are between 33-35 years old, 63% (19) in the puerperium, 56% (17) with primary education, 60% (18) carry out agricultural / cattle raising activities, 53% (16) in free union. In the pre-intervention, the women had a positive attitude with a score of 17-48 towards artificial breastfeeding 83% (25), in the post-intervention the positive attitude towards breastfeeding changed 87% (26), with a significant difference of p <0.01, in the items of the IIFAS instrument in the pre-intervention a mean and standard deviation of 2.07 ± 1.16, with an increase in the post-intervention of 4.48±0.65, a significance difference <0.05 in the total of questions in the pre-intervention from 35.23, increased after the intervention to 76.13, their attitude changed to exclusive breastfeeding. Conclusions: the cognitive intervention increased the positive attitude towards exclusive breastfeeding, highlighting that a timely educational intervention of promotion, support and accompaniment during pregnancy and postpartum guarantees the duration and exclusivity of breastfeeding. Keywords: breastfeeding, breastfeeding behavior, breastfeeding, knowledge, attitudes and health practice

A cognitive model for understanding fraudulent behavior in construction industry

PurposePrevious fraud studies focused on the influence of external environmental factors rather than the actor's own cognition or psychological factors. This paper aims to explore the influence of cognitive factors on people's intention to commit fraud in the construction industry.Design/methodology/approachA scenario-based questionnaire survey was conducted with 248 Chinese construction practitioners. Partial least squares structural equation modeling (PLS-SEM) was used to analyze the data.FindingsThe findings showed that perceived threat possibility and perceived threat severity positively affected people's attitudes towards fraud. The reward for compliance and response cost had adverse effects on people's attitudes. Attitude towards fraud and response efficacy directly influenced people's intentions to commit fraud.Research limitations/implicationsThe limitations of this study are that only behavioral intention data were collected, and a single scenario was designed. Despite these limitations, this study proposed a cognitive model to understand fraud in the construction industry and provided an empirical analysis using data from Chinese construction practitioners.Originality/valueThis study reveals the impact of cognitive factors on fraud in the construction industry. The results expand the understanding of fraud and propose a cognitive intervention framework to reduce fraud.

The Impact of Cognitive, Physical, and Psychological Stressors on Subsequent Cognitive Performance

Objective To quantify the impact of performing challenging cognitive, physical and psychological tasks on subsequent cognitive performance, and whether differences in performance are predicted by psychological variables. Background Successful performance in many occupations depends on resilient cognition: the degree to which cognitive functions can withstand, or are resilient to, the effects of stress. Several studies have examined the effect of individual stressors on cognition; however, the capacity to compare different types of stress across studies is limited. Method Fifty-eight participants completed cognitive, physical, psychological and control interventions, immediately preceded, and followed, by a battery of cognitive tasks. Self-efficacy and cognitive appraisal were reported at baseline. Perceived stress was recorded post-intervention. Subjective workload was recorded for each cognitive battery and intervention. Results Cognitive performance was impaired by the cognitive, physical and psychological interventions, with the greatest effect following the cognitive intervention. The subjective workload reported for the post-intervention cognitive battery was higher following the cognitive and physical interventions. Neither self-efficacy, cognitive appraisal, perceived stress nor subjective workload of the intervention strongly predicted post-intervention performance. Conclusion Given the differences among interventions and cognitive domains, it appears that challenges to resilient cognition are broad and varied, and the mechanism(s) by which impairment occurs is complex. Application Considering the increase in subjective workload for the post-intervention cognitive battery, a combination of subjective and objective measures of cognitive performance monitoring should be considered.

Global trends on studies with cognitive training: Mapping and bibliometric analysis using CiteSpace

The widespread utility of cognitive training has gained its value in maintaining cognitive performance, reducing neuropsychiatric illnesses, restoring their abilities, and preventing cognitive decline. The objective of this article is to explore the global trends in cognitive training studies. Publication records were obtained from the Web of Science (WoS) core collection for the period of 25 years from 1996 to 2020. CiteSpace 5.7.R5 (64-bit) W version software was used for mapping and bibliometric analysis. Overall, 4,575 records were retrieved and analyzed using bibliometric approaches such as dual-overlay analysis, author co-citation analysis (ACA), document co-citation analysis (DCA), and keyword analysis. It was found that the publication records were increased steadily in the recent five years (2016-2020). The US academic institutions and journals played the dominant role in the field of cognitive training. However, University College London (UCL) had contributed for the highest publication records (128) with a centrality value of 0.12. Few studies were contributed by the developing countries/territories. Author Spector, A had the highest number of publications (47). However, Author Simons, DT as the top-author based on citation burst value (35.15) focused on brain-training interventions. Through the DCA, it was found that working memory training has to be the predominant trend in this domain. The most recent burst keywords such as ‘cognitive intervention,’ ‘plasticity,’ ‘group cognitive intervention,’ ‘virtual reality,’ and ‘prevention’ were considered to be the indicators of emerging trends.

PERMA model vs. integrative-behavioral couple therapy for fertility problems: A randomized clinical trial protocol

Background: Psychological interventions may reduce fertility problems. Positive emotion, engagement, meaning, positive relationship and accomplishment (PERMA) is a cognitive intervention and integrative-behavioral couple therapy (IBCT) is a behavioral intervention. Appropriate mental interventions are important in infertility treatment. Objective: To investigate the effect of the PERMA model vs. IBCT in reducing the fertility problems of couples. Materials and Methods: The content of the interventions was developed and adjusted based on a literature review and the opinions of experts. In this three-arm parallel randomized clinical trial, 42 couples undergoing infertility treatment will be allocated randomly into three groups (n = 14 couples/each). Group 1 will receive the PERMA intervention, group 2 will receive the IBCT intervention, and group 3 as the control group will receive an infertility treatment training program intervention. The primary outcome will be the fertility problems, which will be measured by completing a fertility problem inventory at baseline, as well as in the 5th and 9th wk as a follow-up. Another primary outcome, satisfaction with the intervention, will also be assessed in the 5th and 9th wk. The secondry outcome will be a positive pregnancy test at wk 12. The interventions will be conducted through a combination of face-to-face and online via WhatsApp. Conclusion: This study will assess social, sexual, and parenthood concerns. A combination of online and face-to-face interventions will be appropriate given the COVID-19 pandemic. Couple’s counseling may provide better counseling outcomes for fertility problems in comparison with group counseling. This study will try to optimize resilience during infertility treatment through learning better relationship and problem-solving skills, and may have an indirect impact on pregnancy rate, burden of infertility, and costs of treatment due to increased effectiveness. Key words: Online, Face-to-face, Infertility, Integrative-behavioral couple therapy, PERMA model, RCT, Positive psychology, Protocol study, COVID-19.

HomeCoRe for Telerehabilitation in Mild or Major Neurocognitive Disorders: A Study Protocol for a Randomized Controlled Trial

Background: Given the limited effectiveness of pharmacological treatments for cognitive decline, non-pharmacological interventions have gained increasing attention. Evidence exists on the effectiveness of cognitive rehabilitation in preventing elderly subjects at risk of cognitive decline and in reducing the progression of functional disability in cognitively impaired individuals. In recent years, telerehabilitation has enabled a broader application of cognitive rehabilitation programs. The purpose of this study is to test a computer-based intervention administered according to two different modalities (at the hospital and at home) using the tools CoRe and HomeCoRe, respectively, in participants with Mild or Major Neurocognitive Disorders.Methods: Non-inferiority, single-blind randomized controlled trial where 40 participants with Mild or Major Neurocognitive Disorders will be assigned to the intervention group who will receive cognitive telerehabilitation through HomeCoRe or to the control group who will receive in-person cognitive intervention through CoRe, with the therapist administering the same computer-based exercises. The rehabilitative program will last 6 weeks, with 3 sessions/week, each lasting ~45 min. All the participants will be evaluated on an exhaustive neuropsychological battery before (T0) and after (T1) the intervention; follow-up visits will be scheduled after 6 (T2) and 12 months (T3).Discussion: The results of this study will inform about the comparability (non-inferiority trial) of HomeCoRe with CoRe. Their equivalence would support the use of HomeCoRe for at distance treatment, favoring the continuity of care.Ethics and Dissemination: This study has been approved by the Local Ethics Committee and registered in https://clinicaltrials.gov (NCT04889560). The dissemination plan includes the scientific community through publication in open-access peer-reviewed scientific journals and presentations at national and international conferences.Trial Registration:Clinicaltrials.govhttps://clinicaltrials.gov/ct2/show/NCT04889560 (registration date: May 17, 2021).

Changes in Brain Volume Resulting from Cognitive Intervention by Means of the Feuerstein Instrumental Enrichment Program in Older Adults with Mild Cognitive Impairment (MCI): A Pilot Study

There is increasing interest in identifying biological and imaging markers for the early detection of neurocognitive decline. In addition, non-pharmacological strategies, including physical exercise and cognitive interventions, may be beneficial for those developing cognitive impairment. The Feuerstein Instrumental Enrichment (FIE) Program is a cognitive intervention based on structural cognitive modifiability and the mediated learning experience (MLE) and aims to promote problem-solving strategies and metacognitive abilities. The FIE program uses a variety of instruments to enhance the cognitive capacity of the individual as a result of mediation. A specific version of the FIE program was developed for the cognitive enhancement of older adults, focusing on strengthening orientation skills, categorization skills, deductive reasoning, and memory. We performed a prospective interventional pilot observational study on older subjects with MCI who participated in 30 mediated FIE sessions (two sessions weekly for 15 weeks). Of the 23 subjects who completed the study, there was a significant improvement in memory on the NeuroTrax cognitive assessment battery. Complete sets of anatomical MRI data for voxel-based morphometry, taken at the beginning and the end of the study, were obtained from 16 participants (mean age 83.5 years). Voxel-based morphometry showed an interesting and unexpected increase in grey matter (GM) in the anterolateral occipital border and the middle cingulate cortex. These initial findings of our pilot study support the design of randomized trials to evaluate the effect of cognitive training using the FIE program on brain volumes and cognitive function.

The Development of a Smart Reminder System to Promote Adherence to Technology-Based Intervention and Assessment

The overarching aim of the National Institute on Aging funded Adherence Promotion with Person-centered Technology (APPT) Project is to promote adherence to technology-based solutions designed to enhance the early detection and treatment of cognitive decline. The goal is to build and evaluate adaptive, tailored, and integrated technology-based adherence support systems for mobile software platforms that assess and train cognitive skill. The symposium describes the various steps of the development process of the APPT smart adherence support system. N. Charness will present an overview of the APPT project, its aims, and the clinical trials designed to assess the effectiveness of the APPT smart reminder system compared to typical reminder systems. S. Chakraborty will present detailed analyses of past cognitive intervention data to inform understanding of who is likely at risk for poor adherence and how adherence lapses might be predicted in advance to provide just-in-time adherence support. D. Carr will present an exploration of motivating factors for participants to engage in research, and these motivations will be tapped to help develop motivational messages for the APPT adherence support system to be used in the two planned clinical trials. M. Dieciuc will provide additional insights into motivations for engaging in home-based cognitive assessment and training derived from a focus group study. Finally, S. Zhang will describe the results of an initial pilot study examining the effectiveness of motivational reminder messages that match vs. mismatch participants’ own motivations. All results inform the design of the APPT system to maximize adherence.