problems in addition to the signs of the Wernicke-Korsakoff syndrome. Many of the patients were closely examined over long periods and the authors make the point that repeated examinations for as long as ten years in some instances allowed them to describe the natural history of the syndrome. and this they do in their third chapter. Again the description of the pathological findings is precise and comprehensive and the authors stress the periventricular distribution of the lesions and their bilateral symmetry. The authors consider specifically the neuropathological substrate on which are based the defective memory, ocular motor signs, the ataxia, the global confusional state and the occasional disturbance of olfactory and gustatory function. They argue a unity between Wernicke's disease and Korsakoff's psychosis and discuss the relationship between these two and alcoholic cerebellar degeneration, central pontine myelinolysis and other myelinolytic syndromes and interestingly discuss the problem of \"alcoholic dementia\" concluding that the nosological status ofalcoholic dementia is by

https://jnnp.bmj.com/content/jnnp/52/10/1218.2.full.pdf

Neuropsychology Mental Structure

The successful adoption of technology is becoming increasingly important to functional independence. The present article reports findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE) on the use of technology among communitydwelling adults. The sample included 1,204 individuals ranging in age from 18–91 years. All participants completed a battery that included measures of demographic characteristics, self-rated health, experience with technology, attitudes toward computers, and component cognitive abilities. Findings indicate that the older adults were less likely than younger adults to use technology in general, computers, and the World Wide Web. The results also indicate that computer anxiety, fluid intelligence, and crystallized intelligence were important predictors of the use of technology. The relationship between age and adoption of technology was mediated by cognitive abilities, computer self-efficacy, and computer anxiety. These findings are discussed in terms of training strategies to promote technology adoption.

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Factors Predicting the Use of Technology: Findings From the Center for Research and Education on Aging and Technology Enhancement (CREATE)

The Protective Action Decision Model (PADM) is a multistage model that is based on findings from research on people's responses to environmental hazards and disasters. The PADM integrates the processing of information derived from social and environmental cues with messages that social sources transmit through communication channels to those at risk. The PADM identifies three critical predecision processes (reception, attention, and comprehension of warnings or exposure, attention, and interpretation of environmental/social cues)--that precede all further processing. The revised model identifies three core perceptions--threat perceptions, protective action perceptions, and stakeholder perceptions--that form the basis for decisions about how to respond to an imminent or long-term threat. The outcome of the protective action decision-making process, together with situational facilitators and impediments, produces a behavioral response. In addition to describing the revised model and the research on which it is based, this article describes three applications (development of risk communication programs, evacuation modeling, and adoption of long-term hazard adjustments) and identifies some of the research needed to address unresolved issues.

The Protective Action Decision Model: Theoretical Modifications and Additional Evidence

During the past four decades (1960–2000), the United States experienced major transformations in population size, development patterns, economic conditions, and social characteristics. These social, economic, and built-environment changes altered the American hazardscape in profound ways, with more people living in high-hazard areas than ever before. To improve emergency management, it is important to recognize the variability in the vulnerable populations exposed to hazards and to develop place-based emergency plans accordingly. The concept of social vulnerability identifies sensitive populations that may be less likely to respond to, cope with, and recover from a natural disaster. Social vulnerability is complex and dynamic, changing over space and through time. This paper presents empirical evidence on the spatial and temporal patterns in social vulnerability in the United States from 1960 to the present. Using counties as our study unit, we found that those components that consistently increased social vulnerability for all time periods were density (urban), race/ethnicity, and socioeconomic status. The spatial patterning of social vulnerability, although initially concentrated in certain geographic regions, has become more dispersed over time. The national trend shows a steady reduction in social vulnerability, but there is considerable regional variability, with many counties increasing in social vulnerability during the past five decades.

/pdf/temporal-and-spatial-changes-in-social-vulnerability-to-3ioay1stp9.pdf

Temporal and spatial changes in social vulnerability to natural hazards

Prospective memory situations involve forming intentions and then realizing those intentions at some appropriate time in the future. An interesting feature of most prospective remembering is that recollection of the intended action occurs without an explicit request to attempt retrieval, and we present two views on how this type of remembering can be accomplished. One could strategically monitor the environment for the presence of the target event, or one could rely on anticipated environmental conditions more or less automatically reinstating the intended action. We present data supporting both views and argue that people use multiple approaches for solving the problem of retrieving an intention (prospective memory) after a delay. Moreover, we suggest that the extent to which prospective remembering is supported by relatively automatic processes (versus strategic resource-demanding monitoring) and the probability with which prospective memory is likely to be successful when relying on automatic processes varies as a function of the characteristics of the prospective memory task, target cue, ongoing task, and individual. We argue that the complexity of the empirical findings can best be understood by appealing to this multiprocess view of prospective memory. Copyright © 2000 John Wiley & Sons, Ltd.

Strategic and automatic processes in prospective memory retrieval: a multiprocess framework

The magnitude of age differences on event- and time-based prospective memory tasks was investigated in 2 experiments Participants performed a working memory task and were also required to perform either an event- or time-based prospective action Control participants performed either the working memory task only or the prospective memory task only Results yielded age differences on both prospective tasks The age effect was particularly marked on the time-based task Performance of the event-based prospective task, however, had a higher cost to performance on the concurrent working memory task than the time-based task did, suggesting that event-based responding has a substantial attentional requirement The older adults also made a significant number of time-monitoring errors when time monitoring was their sole task This suggests that some time-based prospective memory deficits in older adults are due to a fundamental deficit in time monitoring rather than to prospective memory

Effect of age on event-based and time-based prospective memory.

We conducted a survey to document World Wide Web use patterns in middle-aged (ages 40-59), young-old (ages 60-74), and old-old adults (ages 75-92). We conducted this survey of 550 adults 40 years old and over in southeastern Michigan, and the overall response rate was approximately 71%. The results suggested that (a) there are distinct age and demographic differences in individuals who use the Web; (b) middle-aged and older Web users are similar in their use patterns; (c) the two primary predictors for not using the Web are lack of access to a computer and lack of knowledge about the Web; (d) old-old adults have the least interest in using the Web compared with middle-aged and young-old adults; and (e) the primary content areas in learning how to use the Web are learning how to use electronic mail and accessing health information and information about traveling for pleasure. This research may serve as a preliminary attempt to ascertain the issues that must be faced in order to increase use of the World Wide Web in middle-aged and older adults.

A survey of World Wide Web use in middle-aged and older adults.

Adults over the age of 65 are the fastest growing segment of computer users. Due to this increased demand, effective training programs are essential. Although previous research findings illustrate the importance of older adults’ goals, abilities, and experience levels in learning to use computers, these factors are often neglected in the development of computer training courses. We apply a systems approach to help bridge this gap between research and practice to address the disparity between what older adults would like to learn and the content of computer training courses. We review the literature on training older adults to use computers and report data from a set of structured interviews to illustrate the criticality of each step in the systems approach. Lastly, we provide the means to evaluate existing computer training programs and suggest modifications for improvement. Our purpose is not to evaluate specific programs, but to educate developers about an approach that has proven successful. Specifical...

Older Adults, Computer Training, and the Systems Approach: A Formula for Success.

Objectives. We sought to document the frequency, circumstances, and consequences of prescription medication–sharing behaviors and to use a medication-sharing impact framework to organize the resulting data regarding medication-loaning and -borrowing practices.Methods. One-on-one interviews were conducted in 2006, and participants indicated (1) prescription medicine taken in the past year, (2) whether they had previously loaned or borrowed prescription medicine, (3) scenarios in which they would consider loaning or borrowing prescription medicine, and (4) the types of prescription medicines they had loaned or borrowed.Results. Of the 700 participants, 22.9% reported having loaned their medications to someone else and 26.9% reported having borrowed someone else’s prescription. An even greater proportion of participants reported situations in which medication sharing was acceptable to them.Conclusions. Sharing prescription medication places individuals at risk for diverse consequences, and further research r...

Christopher B. Mayhorn

Papers

Effect of age on event-based and time-based prospective memory.

A survey of World Wide Web use in middle-aged and older adults.

Older Adults, Computer Training, and the Systems Approach: A Formula for Success.

Beyond abuse and exposure: framing the impact of prescription-medication sharing.

Warning the world of extreme events: A global perspective on risk communication for natural and technological disaster