Search

The International Conference on Cognitive Modeling brings together researchers from around the world whose main goal is to build computational systems that reflect the internal processes of the mind. In this issue, we present the five best representative papers on this work from our 19th meeting, ICCM 2021, which was held virtually from July 3 to July 9, 2021. Three of these papers provide new techniques for refining computational models, giving better methods for taking empirical data and producing accurate computational models of the cognitive systems that produce them. The other two papers focus on explanation: using models to elucidate the underlying processes affecting cognition in such diverse domains as logical reasoning and the effects of caffeine.

The International League Against Epilepsy (ILAE) presents a revised operational classification of seizure types. The purpose of such a revision is to recognize that some seizure types can have either a focal or generalized onset, to allow classification when the onset is unobserved, to include some missing seizure types, and to adopt more transparent names. Because current knowledge is insufficient to form a scientifically based classification, the 2017 Classification is operational (practical) and based on the 1981 Classification, extended in 2010. Changes include the following: (1) "partial" becomes "focal"; (2) awareness is used as a classifier of focal seizures; (3) the terms dyscognitive, simple partial, complex partial, psychic, and secondarily generalized are eliminated; (4) new focal seizure types include automatisms, behavior arrest, hyperkinetic, autonomic, cognitive, and emotional; (5) atonic, clonic, epileptic spasms, myoclonic, and tonic seizures can be of either focal or generalized onset; (6) focal to bilateral tonic-clonic seizure replaces secondarily generalized seizure; (7) new generalized seizure types are absence with eyelid myoclonia, myoclonic absence, myoclonic-atonic, myoclonic-tonic-clonic; and (8) seizures of unknown onset may have features that can still be classified. The new classification does not represent a fundamental change, but allows greater flexibility and transparency in naming seizure types.

Aim The purpose of this study, using single-event-related near-infrared spectroscopy (NIRS), was to examine the psychophysiological and social function assessment of 30 schizophrenic patients during a modified rock-paper-scissors task. Methods We set up a screen in front of the subjects, on which pictures of hand-gestures for rock, paper, and scissors were randomly presented. Subjects were asked to give verbal answers under the conditions of win, lose, and draw, respectively. Using the 44-channel NIRS system, we evaluated the maximum amplitude of oxygenated hemoglobin, latency, and the area based on the arithmetic mean of resulting values after the task between 30 outpatients with schizophrenia and 30 healthy subjects, and analyzed the frontal pole area, dorsolateral prefrontal region, and parietal association area as regions of interest (ROI). Results In schizophrenic patients, oxygenated hemoglobin changes (Δoxy-Hb) when losing the task showed a significantly lower level of Δoxy-Hb in ROI than controls. In addition, a significant positive correlation was observed between the Global Assessment of Functioning Scale and Δoxy-Hb in ROI, and a significant negative correlation was observed between the Negative Syndrome scale of the Positive and Negative Syndrome Scale and Δoxy-Hb in ROI. Conclusion From these results, we conclude that Δoxy-Hb levels when performing the modified rock-paper-scissors task assessed using NIRS may be a useful psychophysiological marker to evaluate the cognitive and social functions of schizophrenic patients.

The International Conference on Cognitive Modeling brings together researchers from around the world whose main goal is to build computational systems that reflect the internal processes of the mind. In this issue, we present the four best representative papers on this work from our 18th meeting, ICCM 2020, which was also the first meeting to be held virtually. Two of these papers develop novel techniques for building larger and more complex models using Reinforcement Learning and Learning By Instruction, respectively. The other two show how cognitive models connect to neuroscience, drawing on details of the hippocampus and cerebellum to constrain and explain the cognitive processes involved in memory and conditioning.

Scoring systems to recognise the most ill patients, or those at risk of deterioration, are increasingly utilised in hospitals that look after paediatric inpatients. There have been efforts to implement these systems in emergency and urgent care settings, but they have yet unproven value. This is because the child or young person presenting acutely is a different cohort than the 'treated' ward-based group. The majority of children presenting to emergency and urgent care settings are discharged home, and so, scoring systems need to recognise the most unwell but also assist in safe and appropriate discharge as well as highlighting those patients in need of more senior review. This article explores this conundrum, suggesting how cognitive factors have a role to play, and how scoring systems can have wider effects than just individual patient care.

The article focuses on cognitive workload as a key factor which influence paper-based and computer-based assessment of the academic performance of university undergraduates. Cognitive workload has been defined as the interaction between demands of a task that an individual experiences and a person's ability to cope with theses demand. Cognitive workload can be relatively easily measured using subjective, self-report measures. One of the most widely used measures of cognitive workloads is NASA-TLX. It assesses workload on a number of dimensions and has been shown to be more reliable than other subjective workload scales.

Educational technologies such as video cases can improve health professions student learning outcomes, but few studies in dentistry have evaluated video-based technologies. The goal of this study was to compare outcomes associated with video and paper cases used in an introductory public health dentistry course. This was a retrospective cohort study with a historical control group. Based on dual coding theory, the authors tested the hypotheses that dental students who received a video case (n=37) would report better affective, cognitive, and overall learning outcomes than students who received a paper case (n=75). One-way ANOVA was used to test the hypotheses across ten cognitive, two affective, and one general assessment measures (α=0.05). Students in the video group reported a significantly higher overall mean effectiveness score than students in the paper group (4.2 and 3.3, respectively; p

Aims This review aims to locate and summarize the findings of qualitative studies exploring the experience of and adherence to pelvic floor muscle training (PFMT) to recommend future directions for practice and research. Methods Primary qualitative studies were identified through a conventional subject search of electronic databases, reference-list checking, and expert contact. A core eligibility criterion was the inclusion of verbatim quotes from participants about PFMT experiences. Details of study aims, methods, and participants were extracted and tabulated. Data were inductively grouped into categories describing “modifiers” of adherence (verified by a second author) and systematically displayed with supporting illustrative quotes. Results Thirteen studies (14 study reports) were included; eight recruited only or predominantly women with urinary incontinence, three recruited postnatal women, and two included women with pelvic organ prolapse. The quality of methodological reporting varied. Six “modifiers” of adherence were described: knowledge; physical skill; feelings about PFMT; cognitive analysis, planning, and attention; prioritization; and service provision. Conclusions Individuals' experience substantial difficulties with capability (particularly knowledge and skills), motivation (especially associated with the considerable cognitive demands of PFMT), and opportunity (as external factors generate competing priorities) when adopting and maintaining a PFMT program. Expert consensus was that judicious selection and deliberate application of appropriate behavior change strategies directed to the “modifiers” of adherence identified in the review may improve PFMT outcomes. Future research is needed to explore whether the review findings are congruent with the PFMT experiences of antenatal women, men, and adults with fecal incontinence. Neurourol. Urodynam. 34:???–???, 2015. © 2015 Wiley Periodicals, Inc.

Assessing anatomy in a way that tests higher cognitive domains and clinical application is not always straightforward. The old "spotter" examination has been criticized for only testing low level "identify" knowledge, whereas other assessment modalities such as multiple choice questions do not reflect the three dimensional and application nature of clinical anatomy. Medical curricula are frequently integrated and subject specific examinations do not reflect the case based, spiral, integrative nature of the curricula. The integrated anatomy practical paper (IAPP) is a hybrid of the old "spotter" and an objective structured clinical examination but it demonstrates how higher levels of taxonomy can be assessed, together with clinical features and integrates well with other disciplines. Importantly, the IAPP has shown to be reliable and practical to administer. Data gathered from the Bachelor of Medicine five-year program over two academic years for four IAPP examinations, each being 40 minutes with (K = 60 items) based on 440 students revealed consistently strong reliability coefficients (Cronbach alpha) of up to 0.923. Applying Blooms taxonomy to questions has shown a marked shift resulting in an increase in the complexity level being tested; between 2009 and 2013 a reduction of 26% in the number of low level "remember knowledge" domain questions was noted with up to an increase of 15% in "understanding" domain and 12% increase in the "applying" knowledge domain. Our findings highlight that it is possible to test, based in a laboratory, anatomy knowledge and application that is integrated and fit for practice. Anat Sci Educ. © 2014 American Association of Anatomists.

Background Problem solving practice involving paper-and-pencil solutions is a common activity in undergraduate engineering training. This paper addresses three questions: What indicators of problem-solving skill are available in paper-and-pencil solutions, beyond a simple accuracy measure? Can these indicators distinguish between problem solvers in terms of their skill level? How can these indicators be used to improve the effectiveness of instructor feedback to problem-solving exercises? Purpose(Hypothesis) Based on the published literature on cognition and problem solving, several indicators were hypothesized to signal knowledge and skill: an accurate free-body diagram, specification of assumptions, accurate expansion of key principles, strategic (forward) inferences, and checking equations and solutions. Design/Method A mixed experimental methodology was applied that combined qualitative and quantitative analyses. The qualitative data was comprised of paper-and-pencil solutions and video recordings of participants while they solved problems. Frequency counts of skill indicators and grader-assigned scores comprised the quantitative data. Results Statistical tests confirmed that the hypothesized indicators were associated with individuals' level of skill. However, reliable evidence for these indicators was only partially found in the paper-and-pencil solutions and could only be firmly established by including data from the video recordings. Conclusion The results show that paper-and-pencil solutions can be diagnostic of the strengths and weaknesses of problem-solvers. However, to provide useful and reliable feedback to students, these solutions must be supplemented with additional input, possibly through regular structured sampling throughout a course, or through more extensive use of computer resources.

To date researchers have had difficulty establishing reliable conclusions in studies comparing traditional forms of learning (e.g. paper-based or classroom based) vs online learning in relation to student learning outcomes; no consistent results have emerged, and many studies have not been controlled for factors other than lesson mode. This paper compares the effects of presenting two versions of lessons on punctuation that differed only in their mode of presentation. Fifty-nine students completed a pre-lesson questionnaire, and after the lessons completed another questionnaire plus the [National Aeronautics and Space Administration Task Load Index] NASA-TLX which tests subjective cognitive workload stress. The results showed that students who sat the lessons on paper performed 24 per cent better than those who sat the lessons online. Reasons for this difference in learning outcomes are considered, but no clear reason is apparent in the data from this study. The study sounds a note of caution in terms of the move by tertiary institutions to online and/or blended learning, and suggests further studies are required which assess learning outcomes in different modes of learning.

Because of the many advantages, computerized questionnaires are used more often in youth surveys, replacing the more traditional paper-and-pencil (pp Bowling 2005), it is important to determine whether responses to computerized questionnaires are comparable to those obtained by paper-and-pencil method. So far, findings from previous studies among school-aged children and adolescents are inconclusive. Several studies did not find major differences between computerized and paper-and-pencil questionnaires (Truman et al. 2003; Hays and McCallum 2005; Mangunkusumo et al. 2005, 2006; McCabe et al. 2005), whereas other studies showed that adolescents disclose more sensitive information in computerized questionnaires than in paper-and-pencil conditions (Paperny et al. 1990; Turner et al. 1998; Wright, Aquilino, and Supple 1998; Wang et al. 2005) or found (gender-related) differences for some topics (Beebe et al. 1998; Webb et al. 1999; Hallfors et al. 2000; Vereecken and Maes 2006). Of these studies, a few were web-based (Mangunkusumo et al. 2005, 2006; McCabe et al. 2005; Wang et al. 2005). Several factors may be responsible for the differences found in these studies. It is known that the validity of self-reports may be affected by cognitive as well as situational factors. Factors considered especially influential include the presence of others while responding to questions and the respondents’ perceptions of privacy or confidentiality (Brener, Billy, and Grady 2003; Bowling 2005). A perceived lack of privacy or confidentiality could cause response bias because of a fear of reprisal. In particular, behavior that is illegal, stigmatized, or laden with moral implications may be underreported because of this concern (Brener et al. 2003). As the setting of computerized administration of questionnaires at schools is likely to be different from the administration of paper-and-pencil questionnaires, it is important to investigate respondents’ perceived level of privacy and confidentiality as a possible source of response bias. However, little is known about adolescents’ perceived level of privacy and confidentiality in surveys. Because of this and the inconsistent pattern that appears from the literature, the following issues were examined in the present study: (a) (gender-related) differences in perceived level of privacy and confidentiality between web-based and paper-and-pencil questionnaires and (b) (gender-related) differences in the report of indicators of (mental) health and behavior between web-based and paper-and-pencil questionnaires when taking into account pupils’ perceived level of privacy and confidentiality.

OBJECTIVES: To compare the acceptability and feasibility of computerized and pencil-and-paper tests of cognitive function in 85-year-old people. DESIGN: Group comparison of participants randomly allocated to pencil-and-paper (Wechsler Adult Intelligence and Memory Scales) or computerized (Cognitive Drug Research) tests of verbal memory and attention. SETTING: The Newcastle 85+ Pilot Study was the precursor to the Newcastle 85+ Study a United Kingdom Medical Research Council/Biotechnology and Biological Sciences Research Council cohort study of health and aging in the oldest-old age group. PARTICIPANTS: Eighty-one community-dwelling individuals aged 85. MEASUREMENTS: Participant and researcher acceptability, completion rates, time taken, validity as cognitive measures, and psychometric utility. RESULTS: Participants randomized to computerized tests were less likely to rate the cognitive function tests as difficult (odds ratio (OR)=0.16, 95% confidence interval (CI)=0.07–0.39), stressful (OR=0.18, 95% CI=0.07–0.45), or unacceptable (OR=0.18, 95% CI=0.08–0.48) than those randomized to pencil-and-paper tests. Researchers were also less likely to rate participants as being distressed in the computer test group (OR=0.19, 95% CI=0.07–0.46). Pencil-and-paper tasks took participants less time to complete (mean±standard deviation 18±4 minutes vs 26±4 minutes) but had fewer participants who could complete all tasks (91% vs 100%). Both types of task were equally good measures of cognitive function. CONCLUSION: Computerized and pencil-and-paper tests are both feasible and useful means of assessing cognitive function in the oldest-old age group. Computerized tests are more acceptable to participants and administrators.

In this commentary, we summarize some of the main themes of the NRC report and note ways in which the papers by Mislevy and Haertel, Gorin, and Abedi and Gandara address the Panel's recommendations. We then briefly review and offer reflections on each paper. We see much to applaud here and also in the broader effort to build bridges between the cognitive and measurement sciences. However, much work remains, not only in building bridges, be also in educating the next generation of psychometricians about cognition and the next generation of teachers about psychometrics. Until that day, even the best work here will have little impact on the business of large-scale assessment.

The relation of spatial skills to academic success in areas such as math and science has sparked discussion in early education around how spatial thinking skills might be included in early schooling. Planning and evaluating new curricula or interventions requires understanding these skills and having the means to assess them. Prior developmental research focused primarily on one aspect of dynamic spatial transformations (DST), namely mental rotation. This study broadens our knowledge by addressing another important DST, namely mental folding. We devised a new test suitable for young children. Performance of 180 children between 4 and 7 years suggests that mental folding appears at around 5.5 years of age, although there were also marked individual differences. These data on the emergence of DST suggest that educational programs targeting this skill could start in preschool or kindergarten and provide a means to assess the effectiveness of such efforts.

Udgivelsesdato: 2010-Apr BACKGROUND: First-generation H(1)-antihistamines obtained without prescription are the most frequent form of self-medication for allergic diseases, coughs and colds and insomnia even though they have potentially dangerous unwanted effects which are not recognized by the general public. AIMS: To increase consumer protection by bringing to the attention of regulatory authorities, physicians and the general public the potential dangers of the indiscriminate use first-generation H(1)-antihistamines purchased over-the counter in the absence of appropriate medical supervision. METHODS: A GA(2)LEN (Global Allergy and Asthma European Network) task force assessed the unwanted side-effects and potential dangers of first-generation H1-antihistamines by reviewing the literature (Medline and Embase) and performing a media audit of US coverage from 1996 to 2008 of accidents and fatal adverse events in which these drugs were implicated. RESULTS: First-generation H(1)-antihistamines, all of which are sedating, are generally regarded as safe by laypersons and healthcare professionals because of their long-standing use. However, they reduce rapid eye movement (REM)-sleep, impair learning and reduce work efficiency. They are implicated in civil aviation, motor vehicle and boating accidents, deaths as a result of accidental or intentional overdosing in infants and young children and suicide in teenagers and adults. Some exhibit cardiotoxicity in overdose. CONCLUSIONS: This review raises the issue of better consumer protection by recommending that older first-generation H(1)-antihistamines should no longer be available over-the-counter as prescription- free drugs for self-medication of allergic and other diseases now that newer second- generation nonsedating H(1)-antihistamines with superior risk/benefit ratios are widely available at competitive prices.

An English translation of the 1956 paper in which Prader, Labhart and Willi originally described the syndrome which now bears their name is followed by a discussion of the advances in understanding regarding genetic and behavioural aspects which have occurred during the intervening years. Prader-Willi syndrome is associated with an absence of a paternal contribution to a defined area of the long arm of chromosome 15, and with maladaptive behaviours which are more common than among people of the same age and sex, who have equivalent cognitive impairments. The syndrome is associated with an excessive appetite which may lead to the consumption of unusual items (such as frozen or discarded food) and to extreme obesity. The association between genetic and behavioural abnormalities offers an opportunity to explore the mediating effect of environmental variables on specific maladaptive behaviours.

BACKGROUND: The role of modifiable risk factors for patients with dementia and at risk of dementia requires investigation with large population studies. OBJECTIVES: To examine the association between anticholinergic medication use and cognitive decline in the older population DESIGN: A two-year longitudinal study of participants enrolled in the Medical Research Council (MRC) Cognitive Function and Ageing Study (CFAS) between 1991 and 1993. SETTING: Community and institionalized participants. PARTICIPANTS: A sample of 13,004 participants aged 65 years and older. MEASUREMENTS: Baseline use of possible or definite anticholinergics as determined by the Anticholinergic Cognitive Burden (ACB) scale, and cognition as determined by the Mini-Mental State Examination (MMSE). The main outcome measure was decline on the mini-mental state examination at 2 years. RESULTS: At baseline, 47% of the population used a medication with possible anticholinergic properties and 4% used a drug with definite anticholinergic properties. After adjusting for age, sex, educational level, social class, number of non-anticholinergic medications, number of co-morbid health conditions and cognitive performance at baseline, the use of medication with definite anticholinergic effects was associated with an additional reduction in MMSE score of 0.43 points (95% CI 0.11, 0.75; p

Background Existing tools for rapid cognitive assessment in HIV-positive individuals with mild cognitive deficits lack sensitivity or do not meet psychometric requirements for tracking changes in cognitive ability over time. Methods Seventy-five nondemented HIV-positive patients were evaluated with the Montreal Cognitive Assessment (MoCA), a brief battery of standardized neuropsychological tests, and computerized tasks evaluating frontal-executive function and processing speed. Rasch analyses were applied to the MoCA data set and subsequently to the full set of data from all tests. Results The MoCA was found to adequately measure cognitive ability as a single, global construct in this HIV-positive cohort, although it showed poorer precision for measuring patients of higher ability. Combining the additional tests with the MoCA resulted in a battery with better psychometric properties that also better targeted the range of abilities in this cohort. Conclusion This application of modern test development techniques shows a path towards a quick, quantitative, global approach to cognitive assessment with promise both for initial detection and for longitudinal follow-up of cognitive impairment in patients with HIV infection.

This article synthesizes research on resilience theory and its implications for prevention interventions to increase resilience in high-risk children and adolescents. In addition, this response to both the articles by Drs. Greenberg and Dishion summarizes their key points. Their papers discuss the neuroscience substrate behind two major mediators of antisocial behaviors, namely lack of self-regulation and executive function problems. In addition, we present an overall Resilience Framework that will help the reader organize the aspects of resilience discussed by these two researchers into a transactional process model. This article extends prior researchers' suggestion that resilience is the product of the interaction of genetic, biological, and environmental precursors to a further consideration of higher-level cognitive precursors, such as purpose in life and existential meaning. The relevance of resilience to the prevention of negative outcomes in high-risk children of alcoholics (COAs) and substance abusers is covered. Within this third wave of resilience research on prevention interventions, we present data suggesting that family strengthening approaches have the greatest impact on increasing resilience.

The recent growth of pen-based devices, such as the Personal Digital Assistant (PDA), offer mobility and a more natural interface than that of a conventional computer. The feasibility and application of the PDA for mood and cognitive assessment were investigated by examining possible interactions of individual characteristics and administration medium. Previous studies have provided evidence that individual characteristics of 'computer anxiety' and 'private self-consciousness' divergently covaried with mood scores measured by computer and paper methods. To investigate the relationship between individual characteristics and medium effects, 136 paid participants were allocated to and completed mood assessment tasks and a short battery of cognitive tasks by either the computer, PDA or the paper method. Self-ratings of mood measured by these three modalities covaried divergently with measures of computer anxiety and private self-consciousness. In addition, computer anxiety covaried with reaction time on the visual search task obtained on computers, but there was no such relationship when measured by a PDA. These results show that computer anxiety can affect the results of assessments of cognitive function as well as of mood ratings, and suggest that pen-based systems may have advantages over conventional computers in this respect.

William R. Ferrell's paper is a reply to our article “Calibration of sensory and cognitive judgments: Two different accounts”, 1993, 34, 135–148 in this journal. Ferrell's critique centres around three issues: (1) The model of sensory discrimination proposed by Bjorkman et al. (1993) and discussed in Winman and Juslin (1993) is not new, (2) this model does not predict underconfidence, (3) there is no need for separate models of calibration of sensory and cognitive judgments. Below we respond to each of the three issues raised by Ferrell.

The article reviews the book "Researching Language Teacher Cognition and Practice: International Case Studies" edited by Roger Barnard and Anne Burns.

An integrated model of a behavioural and systems approach to family therapy is presented, the main premise being that family interactions are affected by reciprocal determination of cognitions, feelings and behaviours in relation to the environment. Assessment involves a systematic exploration of the interaction and transactional patterns within the family, and the identification of the dysfunctional aspects of such patterns. The main aim of the intervention is to produce change in family behaviour by addressing the important cognitive and affective issues. This entails techniques such as cognitive restructuring, social modelling and operant conditioning which can be used separately, in parallel, or in combination. Whether one or more of these techniques is used depends on the nature of the family's problems and the aims of treatment.

Mind, Culture, and Activity: Seminal Papers from the Laboratory of Comparative Human Cognition. Michael Cole. Yrjo Engestrom. and Olga Vasquez. eds. New York: Cambridge University Press, 1997.502 pp. Handbook of Human Symbolic Evolution. Andrew Lock and Charles R. Peters. eds. New York: Oxford University Press, 1996.906 pp.

Introduction Although the technology used for extracorporeal life support (ECLS) has improved greatly in recent years, the application of these devices to the patient is quite complex and requires extensive training of team members both individually and together. Human factors is an area that addresses the activities, contexts, environments, and tools which interact with human behavior in determining overall system performance. Hypothesis Analyses of the cognitive behavior of ECLS teams and individual members of these teams with respect to the occurrence of human errors may identify additional opportunities to enhance safety in delivery of ECLS. Results The aim of this article is to support health-care practitioners who perform ECLS, or who are starting an ECLS program, by establishing standards for the safe and efficient use of ECLS with a focus on human factor issues. Other key concepts include the importance of ECLS team leadership and management, as well as controlling the environment and the system to optimize patient care. Conclusion Expertise from other industries is extrapolated to improve patient safety through the application of simulation training to reduce error propagation and improve outcomes.

Background Adherence to ADHD medication is a complex phenomenon as the decision to adhere is influenced by a range of factors. To design tailored interventions to promote adherence, it is important to understand the factors that influence adherence in the context of its three phases: initiation, implementation and discontinuation. Objective The objective of this study was to explore the phase‐specific factors that influence adherence to medication in adults who have a diagnosis of ADHD. Methods Three focus groups (FGs) were conducted with twenty adults with ADHD in different metropolitan areas of Sydney, Australia. FGs were transcribed verbatim and thematically analysed. Results Participants’ decision to initiate medication (the initiation phase) was influenced by their perceived needs (desire to improve academic and social functioning) and concerns (fear of side‐effects) about medication following a similar process as defined by the Necessity‐Concerns Framework (NCF). The balance between benefits of medication (needs) and side‐effects (concerns) continued to determine participants’ daily medication‐taking (the implementation phase) and persistence (or discontinuation) with their medication. Forgetfulness and stigma were reported as concerns negatively impacting the implementation phase, while medication cost and dependence influenced the discontinuation phase of adherence. Conclusions Adults’ decision to initiate, continue or discontinue medication is influenced by a range of factors; some are unique to each phase while some are common across the phases. Participants balanced the needs for the medication against their concerns in determining whether to adhere to medication at each phase. It appears that the NCF has applicability when decision making about medication is explored at the three phases of adherence.

The literature on pencil and paper tests and the effects of psychotropic drugs is reviewed. Performance at digit symbol substitution, symbol copying, letter cancellation, arithmetic, logic and cognitive processing with a relatively constant level of triazolam was compared with placebo. Analysis of variance, covariance analysis and principal component analysis were applied to the data. Pencil and paper tests which measure various skills are useful for detecting drug effects. Letter cancellation, arithmetic and DSST appear to be most sensitive, although logic and symbol copying may be useful.

Background\ud Huntington's disease (HD) is a genetic condition resulting in movement, behavioural and cognitive impairments. People with HD have low levels of physical activity which may be compounded by insufficient support from health‐care professionals.\ud \ud Objective\ud To evaluate the initial acceptability of a co‐designed tool used within a HD clinic to promote physical activity.\ud \ud Design\ud Co‐design of a physical activity tool; acceptability evaluation.\ud \ud Setting and participants\ud Co‐design included people with HD and health‐care professionals. Acceptability was evaluated in a HD clinic in the UK.\ud \ud Main variables studied\ud A physical activity tool was co‐designed and used within a HD clinic.\ud \ud Main outcome measure\ud Acceptability as assessed by semi‐structured interviews with members of the HD clinic.\ud \ud Results\ud Forty people visited the HD clinic; 19 were given physical activity advice. Themes around who, where and how promotion of physical activity could take place were identified; concepts of benefits and barriers were threads through each theme.\ud \ud Discussion\ud We describe for the first time the co‐design of a HD specific physical activity tool. Our associated acceptability study emphasizes the importance of individualized planning of physical activities in complex neurodegenerative conditions. Perceived barriers were time and lack of knowledge of local resources.\ud \ud Conclusions\ud A simple tool can support conversations about physical activity with people with HD and is an aid to individualized goal setting. Exploring the use of PAT‐HD within a community setting and development of support systems for health‐care professionals and support workers who are in regular contact with people with HD is required.