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19 Oral Versus Written Trail Making Test Scores in Patients with Movement Disorders
- Joshua T Fox-Fuller, Kayci L Vickers, Jessica L Saurman, Rachel Wechsler, Amanda Eakin, Felicia C Goldstein
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 536-537
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Objective:
During the COVID-19 pandemic the Oral Trail Making Test (O-TMT) was frequently used as a telehealth-compatible substitute for the written version of the Trail Making Test (W-TMT). There is significant debate among neuropsychologists about the degree to which the O-TMT measures the same cognitive abilities as the W-TMT (i.e., processing speed for part A and set-shifting for part B). Given the continued use of the O-TMT - especially for patients with fine-motor or visual impairments -we examined how O-TMT and W-TMT scores were correlated in patients with movement disorders.
Participants and Methods:Between April 2021 and July 2022 thirty individuals with movement disorders (n=27 idiopathic Parkinson’s disease [PD]; n=1 drug-induced PD; n=1 progressive supranuclear palsy [PSP]; n=1 possible PSP) completed in-person neuropsychological evaluations at the Emory Brain Health Center in Atlanta, GA. The patients were on average 71.3 years old (SD=7.5 years), had 16 years of education (SD=2.8 years), and the majority were non-Hispanic White (n=27 White; n=3 African American) and male (n=17). In addition to other neuropsychological measures, these patients completed both the O-TMT and the W-TMT. O-TMT and W-TMT administration was counterbalanced across patients and took place thirty-minutes apart. Raw scores (i.e., time in seconds) to complete O-TMT and W-TMT part A and part B, as well as discrepancy scores (part B - part A), were used for statistical analysis; a raw score of 300 seconds was assigned when a participant could not complete that section of the O-TMT or W-TMT. Given the non-normal distribution of the data, Spearman correlations were performed between O-TMT and W-TMT scores.
Results:Ten patients were unable to perform W-TMT part B. Of these, seven patients could also not perform O-TMT part B. Part A scores on O-TMT and W-TMT were not significantly correlated (rs = 0.27, p = .15). In contrast, part B scores were strongly correlated, such that slower performances on O-TMT part B corresponded with slower performances on W-TMT part B (rs = 0.82, p < .001). Discrepancy scores for the O-TMT and W-TMT were also significantly correlated, such that larger part A and part B discrepancy scores on O-TMT corresponded with larger discrepancy scores on W-TMT (rs = 0.78, p <.001). The pattern of results was replicated when examining these correlations only in patients who could complete all parts of O-TMT and W-TMT (n=19); part A scores of the O-TMT and W-TMT were again not correlated (rs = -0.20, p = .41), whereas the part B scores (rs = 0.54, p = .02) and discrepancy scores (rs = 0.59, p = .008) were significantly correlated.
Conclusions:Results suggest that an oral version of the Trail Making Test shows promise as an alternative to the written version for assessing set shifting abilities. These findings are limited to patients with movement disorders, and future research with diverse patient populations could help determine whether O-TMT can be generalized to other patient groups. Additionally, future research should examine whether O-TMT scores obtained via virtual testing correspond with W-TMT scores obtained in-person.
A Review of Unmet Needs – Making a Case for a High Dependency Rehabilitation Service
- Amanda Fuller, Moustafa Abdelkader, Meenaxi McGill, Denzil Robinson, Joanne Smith, Alice Sigfid, Mo Eyeoyibo
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S147
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Aims
The Kent and Medway Partnership Trust (KMPT) Rehabilitation service strategy 2020-2025 in line with NICE guidance for Complex Psychosis 2020, sets out to deliver a complete mental health rehabilitation pathway with local provision of high dependency rehabilitation units (HDRU), open rehabilitation units and community rehabilitation provision across the county. There is a lack of HDRU provision in Kent and Medway in its rehabilitation pathway. All HDRU provision is by external providers, often out of area, dislocating people from family support and local resources essential for their recovery and integration. Kent has a relatively high number of out of area (OAT) placements based on national benchmark data (GIRFT). The proposal to develop a HDRU locally led to a review of local population needs for HDRU. The review with the existing OAT data provided information on the number of HDRU beds required in Kent and Medway.
MethodsWe identified 564 patients who had had 5 or more Mental Health Act assessments, in cluster 16 and 17, more than 3 admissions to psychiatric inpatient units and with CTO recalls. Two senior clinicians reviewed these patients against the HDRU eligibility criteria. Demographics, diagnosis and comorbidities were also recorded.
Results119/564 patients met the threshold for HDRU assessment. Using our conversation rate from referral to admission in our open rehab, it means about 20% (24) of this cohort would require treatment in a HDRU. Demographics, diagnosis and comorbidities were reviewed which gave important information about service provision requirements. This was compared with NICE guidance recommendations of 1 high dependency unit per 600,000 - 1,000,000. Therefore, based on this, we would be expected to have between 23 and 38 patients requiring HDRU treatment.
ConclusionA high level of unmet need for HDRU exists in Kent and there is a need for further recognition of the relevance within the rehabilitation pathway. Lack of local provision of HDRUs means the use of longer, expensive and variable quality out of area or private placements. These can be not only detrimental for patients due to a loss of connection to an area and social network but a drain on resources. These results support the case for x2 12 bedded HDRUs. The lack of provision of HDRU impacts on the wider system and patient's timely access to appropriate treatment pathways.
A first absolute chronology for Late Neolithic to Early Bronze Age Myanmar: new AMS 14C dates from Nyaung'gan and Oakaie
- Thomas Oliver Pryce, Aung Aung Kyaw, Myo Min Kyaw, Tin Tin Win, Thu Thu Win, Khin Htwe Win, May Myat Mon, Mar Mar Aye, Su Hlaing Htay, Aye Aye Mar, Bérénice Bellina, R. Alexander Bentley, Louis Champion, Camille Colonna, Amanda J. Cook, Aude Favereau, Dorian Q Fuller, Cloé Georjon, Charles Higham, Kalayar Myat Myat Htwe, Yoshiyuki Iizuka, Jitlada Innanchai, Clémence Le Meur, Xavier Peixoto, Peter Petchey, Ron Pinhasi, Baptiste Pradier, Frédérique Valentin, Anna Willis, Antoine Zazzo
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Late prehistoric archaeological research in Myanmar is in a phase of rapid expansion. Recent work by the Mission Archéologique Française au Myanmar aims to establish a reliable Neolithic to Iron Age culture-historical sequence, which can then be compared to surrounding regions of Southeast Asia. Excavations at Nyaung'gan and Oakaie in central Myanmar have provided 52 new AMS dates, which allow the creation of Myanmar's first reliable prehistoric radiometric chronology. They have also identified the Neolithic to Bronze Age transition in central Myanmar, which is of critical importance in understanding long-range interactions at the national, regional and inter-regional level. This research provides the first significant step towards placing late prehistoric Myanmar in its global context.
16 - Inspiration and the creative process1
- from Part V - Creativity and mental health
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- By Todd M. Thrash, University of Rochester, Emil G. Moldovan, Ohio State University, Amanda K. Fuller, Vanderbilt University, John T. Dombrowski, College of William and Mary
- Edited by James C. Kaufman, University of Connecticut
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- Book:
- Creativity and Mental Illness
- Published online:
- 05 August 2014
- Print publication:
- 07 August 2014, pp 343-362
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Summary
During his self-narrated journey through Purgatory in Part II of Divine comedy, Dante encounters a fellow poet, Donati Ferese, who ingratiates Dante with the following greeting: “[T]ell me if I see here the one who drew forth the new rhymes, beginning, ‘Ladies who have intellect of Love’?” Dante replies, “I in myself am one who, when Love breathes within me, takes note, and to that measure which he dictates within, I go signifying.” Ferese continues, “O my brother, now I see the knot that held Notary and Guittone and me back on this side of the sweet new style I hear. I see well how your pens follow close behind him who dictates, which with ours certainly did not happen” (Alighieri, 2003, Canto 24, p. 403).
It would be difficult to find in the literary canon a pithier portrayal of the role of inspiration in the creative process. Dante’s description of inspiration conveys its hallmark features – passive evocation (“when Love breathes within me”), transcendent awakening (“I…take note”), and motivation to express the content of the new awareness in concrete form (“I go signifying”). This passage also puts forth a provocative thesis: without inspiration, the writer produces a work of inferior quality. Although not universal, the belief that inspiration plays an important role in the creative process is widely held among writers and other creators (Fehrman, 1980; Harding, 1948). However, scientists traditionally have not invoked the inspiration concept in their theories or investigations of the creative process. In fact, some scientists (e.g., Sawyer, 2006) have portrayed inspiration as an outmoded explanation of creativity, a supernatural account that originated in ancient times and that has been perpetuated by Romantic poets and other creators.