No abstract

We administered measures of fluid and crystallized intelligence to Morning-and Evening-type adolescents who were tested either during a morning session or an afternoon session, at times chosen to reflect the limits of the average school day schedule. For the fluid intelligence measures, there was a synchrony effect, with better performance at times that matched individuals' preferences. A composite measure of the subtests used (block design, digit span, and vocabulary) computed to a 6 point difference in IQ estimates. We also assessed the behavioral adjustment of these participants and found heightened levels of maladaptive behavior for Evening-type adolescents. Adolescents tested at their nonoptimal times of day and adolescents who are Evening-types appear to be at risk for poor academic performance and Evening-types appear to be at risk for behavioral adjustment problems.

In many countries timely access to care is a growing problem. As medical costs escalate health care resources must be prioritized. In this context there is an increasing need for benchmarks and best practices in wait-time management. The Canadian Pain Society struck a Task Force in December 2005 to identify benchmarks for acceptable wait-times for treatment of chronic pain. As part of the mandate a systematic review of the literature regarding the relationship between waiting times, health status and health outcomes for patients awaiting treatment for chronic pain was undertaken. Twenty-four studies met the inclusion criteria for the review. The current review supports that patients experience a significant deterioration in health related quality of life and psychological well being while waiting for treatment for chronic pain during the 6 months from the time of referral to treatment. It is unknown at what point this deterioration begins as results from the 14 trials involving wait-times of 10 weeks or less yielded mixed results with wait-times amounting to as little as 5 weeks, associated with deterioration. It was concluded that wait-times for chronic pain treatment of 6 months or longer are medically unacceptable. Further study is necessary to determine at what stage the deterioration begins from the onset of pain to treatment and the impact of waiting on treatment outcomes. Most important is the need to improve access to appropriate care for patients with chronic pain, an escalating public health care problem with significant human and economic costs.

A growing literature on decision making in older adults suggests that they are more likely to use heuristic processing than are younger adults. We assessed this tendency in the context of a framing effect, a decision-making phenomenon whereby the language used to describe options greatly influences the decision maker's choice. We compared decision making under a standard ("heuristic") condition and also under a "justification" condition known to reduce reliance on heuristics. In the standard condition, older adults were more susceptible than younger adults to framing but the two groups did not differ when participants were asked to provide a justification. Thus, although older adults may spontaneously rely more on heuristic processing than younger adults, they can be induced to take a more systematic approach to decision making.

These results support the findings that good obturator function is associated with a better quality of life.