Providing informal care to a person with dementia can substantially affect carers’ quality of life. Existing generic preference-weighted measures (e.g. EQ-5D-5L) may not fully capture the caring experience, while carer-specific measures (e.g. CarerQol), although preference weighted, cannot be used to derive quality-adjusted life-years for cost-utility analysis. The COCOON project aimed to develop a new preference-weighted quality-of-life measure for carers of people living with dementia that is suitable for cost-utility analysis. Development of the descriptive system was informed by: (1) a literature review; (2) qualitative interviews with carers of people with dementia to assess face validity of candidate items; (3) an online survey of carers to evaluate psychometric performance (including missing data, distributions, known-group validity, convergent validity, exploratory factor analysis and item response theory analysis); and (4) consultation with an advisory group. An initial pool of 60 candidate items was reduced to 44 items for qualitative testing. Following interviews, the item set was refined to 35 items. Based on psychometric analyses and final advisory group consultation, the final descriptive system comprised seven items: emotional health, physical health, loss and grief, loss of freedom, loneliness, support and financial burden. Each item is measured using a five-point frequency scale from ‘never’ to ‘always’. The COCOON measure is grounded in the lived experiences of carers of people living with dementia, capturing the multidimensional facets of dementia caregiving and offers a conceptually robust and policy-relevant measure for assessing carers’ quality of life in economic evaluations.

Grounded cognition holds that a word’s semantic representation is grounded in sensory-motor experiences. Much research has supported this account in relation to nouns, but less is known about verbs. The current research was designed to test the effect of grounded cognition with relation to action verbs. Accordingly, we developed a measure labeled potential physical interactions (PPI) aimed at capturing grounded content by measuring the number of physical objects an action verb can interact with. We first collected PPI ratings from 177 university students. Following this, a different group of 40 university students made lexical decisions to the words. The results indicate that words higher in PPI are responded to more rapidly than are those lower in PPI. We replicated this finding with data from the English Lexicon Project. The findings support the claim that the semantic representation of action verbs is grounded in sensory-motor experience.

As the population ages and new therapies become available, general practitioners will have a significant role in the early detection, diagnosis, and management of dementia. However, both in Australia and globally, dementia remains under-recognised and under-diagnosed in primary care. The aim of this study is to develop a complex intervention, informed by behaviour change theory, to improve rates of dementia diagnoses in Australian primary care. Co-design participants included GPs, general practice nurses, practice managers and reception staff. A program logic model was used to describe the essential activities and mechanisms of the intervention. Six behaviour changes—education, training, enablement, modelling, persuasion, and environmental restructuring—were identified to address the identified barriers to dementia diagnosis in primary care. The intervention comprises seven activities—peer-led online dementia education and training, geriatrician ‘drop-in’ online support sessions, quality improvement in dementia care sessions, stand-alone videos, auditing and benchmarking, a dementia risk alert tool and a set of dementia diagnosis and management decision-making resources. Using behaviour change theory can assist in the development of complex interventions aimed at changing clinical practice and may assist in their evaluation.

AIM:To demonstrate the application of the Theoretical Domains Framework (TDF) and behaviour change theory to identify behaviour change techniques for a complex intervention targeting dementia care by general practice nurses (GPNs). BACKGROUND:GPNs have an important role in dementia care but require support to translate evidence-based recommendations into routine practice. Theory-informed implementation strategies may help facilitate this change. METHODS:The target behaviour was derived from a Delphi study identifying national dementia care recommendations relevant to GPNs. Barriers to operationalizing the target behaviour were identified from previous research and then coded independently by two authors using the TDF. Identified domains were then mapped to behaviour change techniques using the Theory and Techniques Tool. FINDINGS:The specified behaviour was: 'the general practice nurse will use language that is accurate, respectful, inclusive, empowering and non-stigmatizing when communicating with people living with dementia within each patient encounter in general practice'. Seven TDF domains were identified, including 'knowledge', 'skills' and 'social influences', mapping to 22 behaviour change techniques, including 'instruction on how to perform the behaviour' and 'social support'. This theory-informed approach identifies practical techniques for developing interventions to improve GPN communication with people living with dementia and provides a method that could be applied to other dementia care behaviours in general practice.

Background Primary care is increasingly tasked with early detection, diagnosis, and management of dementia. Despite policy initiatives, education investments, and development of diagnostic and care pathways in Australia and globally, dementia care in primary care settings remains sub-optimal. This study is part of a bigger project titled Facing Dementia Together, comprising a primary care practice change program and a public help-seeking campaign, aimed at improving timely detection and management of dementia in primary care. A core element of intervention research is understanding the context in which the intervention is to be developed, implemented and evaluated. The aim of this study is to identify current practice and barriers to dementia identification, diagnosis and management in primary care in two regions in Australia. Methods A qualitative design with semi-structured interviews was used. The interview guide was informed by projective techniques using hypothetical scenarios. A convenience sample of 18 key primary care stakeholders were recruited through the Western Victoria and Western Sydney Primary Health Networks located in two different states of Australia. Data analysis Data was thematically analysed following Braun and Clarke's six steps of thematic analysis The socioecological model was used to guide the development of themes. Results Four themes described current primary care practitioner practices in dementia diagnosis and management (1) Family concern triggers dementia investigation (2) GPs delay conversations about dementia (3) Completing routine cognitive assessments in the 75+ health assessment, and (4) Variability in post-diagnostic care. Barriers to identifying, diagnosing, and managing dementia were organised according to the levels of the socioecological framework: 'There is not much we can do' (individual), 'A difficult conversation' (Interpersonal), 'Hierarchy affects team communication' (Organisational), 'It's hard to get services' (Community) and 'If it's not financially viable, it won't be done' (Policy). Conclusion Enhancing care for people living with dementia and their carers requires multifaceted interventions that not only strengthen the capability and motivation of primary care practitioners, but also address intrapersonal, community, organisational, and policy-related challenges. The findings of this study inform the Facing Dementia Together primary care practice change intervention to improve early dementia diagnosis and management in primary care.

Dementia is a leading cause of disability and death worldwide, yet diagnosis in primary care remains substantially lower than expected, delaying access to treatment, support and future care planning. The Facing Dementia Together Practice Change Program was developed as a co-designed, multicomponent intervention to improve dementia diagnosis in Australian general practice. A mixed-methods process evaluation used the RE-AIM framework with the addition of Appropriateness. The intervention included Primary Health Network (PHN) engagement, GP education, clinical resources, audit and benchmarking reports, specialist support, and a dementia risk-alert tool. Data were collected through surveys, stakeholder interviews, website analytics and program documentation. Clinicians who participated reported increased confidence and changes in dementia-related clinical behaviours, while education, resources and benchmarking were perceived as valuable. However, overall reach was limited by competing clinical priorities, workforce pressures, lack of financial incentives, and PHN implementation challenges. The dementia risk-alert tool was feasible but achieved limited uptake because of software compatibility, usability concerns and incomplete electronic medical record data. Although the program was acceptable to participating clinicians, limited reach constrained its potential impact. These findings highlight organizational, workforce, digital infrastructure and policy factors that influenced implementation of multicomponent interventions in routine primary care.

The limited allocation of resources to rural and regional communities is a major contributor to healthcare inequities in Australia. Distribution of health service resources between metropolitan and rural communities commonly sees highly populated areas prioritised over more sparsely populated and geographically vast areas. As such, challenges impacting dementia diagnosis, management, and care in metropolitan areas are experienced more acutely in rural areas. This study aimed to examine equity of access to dementia diagnosis, management, and care services amongst people who experienced the process of dementia diagnosis as a patient or significant other (partner/spouse, adult children, siblings, and friends) throughout rural and metropolitan Australia. This exploratory qualitative study consisted of thirty-three online semi-structured interviews with thirty-seven people with experience of the dementia diagnosis process as a patient and/or significant other. Interviews explored symptoms of dementia, health professionals consulted, tests conducted, and challenges faced throughout the diagnosis and post-diagnosis process. Rurality was defined by the Australian Statistical Geography Standard Remoteness Areas (ASGS-RA) and the Modified Monash Model (MMM). Thematic analysis was conducted, with Russell’s (2013) Dimensions of Access framework (geography, affordability, availability, acceptability, accommodation, awareness, and timeliness) guiding data analysis. Participants were distributed across various regions of Australia: seven interviews from inner regional Australia, five interviews from outer regional Australia, and twenty-one interviews from metropolitan areas. Disparities in access between metropolitan and rural areas emerged in five key dimensions: 1) geography impeding ability to access services; 2) affordability of travel expenses; 3) availability of healthcare and support services; 4) acceptability of available health professionals and services; and 5) awareness of local services and resources. The dimensions of accommodation and timeliness of care were experienced as challenges irrespective of location, with lengthy appointment wait times and difficulty navigating complex systems. However, rurality often compounded the challenges in dementia diagnosis, management, and care. Significant health inequities persist between rural and metropolitan communities that must be prioritised in endeavours to promote equitable dementia diagnosis, management, and care. Targeted action to address disparities is vital to mitigate the impact of rurality, particularly as clinical practice evolves with research advancements.

RationaleLack of knowledge and skills is a barrier to the delivery of best-practice dementia care by nurses working in general practice. To impact clinical practice, education strategies need to be tailored to the target audience and the context in which new knowledge is to be used and should consider research-based theories of how people learn.AimTo explore the value of an animation video as an education strategy and identify if, after viewing the animation, the GPN intends to change their dementia care clinical practice and, if yes, how.MethodsAn animation video, informed by research findings, was developed as a tool to educate general practice nurses to identify and act on cognitive changes in their patients. Study participants were recruited through Australian general practice nursing social media networking sites. Qualitative and quantitative content analyses were used to analyze the responses to an online survey question: after viewing the animation, do you intend to change your clinical practice with regard to the care of people living with dementia? If participants responded "yes," they were asked to describe how.ResultsSixty-one general practice nurses participated. Most nurses reported an intent to change their practice after viewing the animation video. These changes were categorized as "be more alert to change," "find out more information," and "follow up if you notice a change." This suggests that animation may be a useful education tool for knowledge translation aimed at dementia care practice change among general practice nurses.ConclusionThe animation video was associated with an intention to change practice. Further research is needed, however, on the effectiveness of animation videos as an educational tool in supporting the translation of new dementia care knowledge into general practice nurses clinical practice.

Background The increasing prevalence of dementia requires a change in the organisation and delivery of primary care to improve the accessibility of best-practice care for people living with dementia and their carer(s). The aim of this study is to describe potential models of dementia care in the primary care setting whereby the nurse plays a central role, from the perspectives of nurses working in general practice, people living with dementia and carer(s). Methods Data from two qualitative semi-structured interview studies were pooled to explore the views of nurses working in general practice, people living with dementia and carer(s) on potential models for the provision of nurse-delivered dementia care. Data were thematically analysed. Six carers, five people living with dementia and 13 nurses working in general practice took part in the study. The data used in this study have not been previously reported. Results Three themes describing nurse-delivered models of care to meet the healthcare needs of people living with dementia and their carer(s) were identified: nurse-led care, dementia care nurse specialist outreach and nurse-enhanced post-diagnostic care. Conclusions This study describes three potential models of dementia care delivery by the nurse in general practice. These findings can be used to guide the implementation of new models of care that integrate the provision of dementia care by nurses within interdisciplinary primary care teams, to better meet the healthcare needs of people living with dementia and their carer(s).

Cerebrospinal fluid (CSF) biomarkers are currently the only clinically validated biofluid diagnostic test for Alzheimer’s Disease (AD) available in Australia. Testing of CSF biomarkers via lumbar puncture (LP), including quantification of amyloid-β peptide, total tau protein, and phosphorylated tau, can give insight into underlying pathophysiological changes and provide greater certainty in confirming or excluding the presence of Alzheimer’s disease changes compared to standard clinical and radiological assessments. Despite CSF analysis being a safe and cost-effective diagnostic method, the use of CSF biomarkers in the evaluation of potential AD remains limited in Australian clinical practice due to a variety of factors, including regional access challenges, concerns over the perceived invasiveness of LP and a lack of confidence among clinicians in interpreting the results. The advent of disease-modifying therapies as a potential new treatment strategy to reduce the rate of progression in people with AD will drive the demand for early diagnosis of AD. This perspective argues for broader adoption of CSF biomarker testing by providing evidence-based, clinically informed expert guidance on when and why to consider CSF biomarker testing.

INTRODUCTION:With an aging population and a growing prevalence of people living with dementia, the demand for best-practice dementia care in general practice increases. There is an opportunity to better utilise the nurse role within the primary care team to meet this increasing demand in the provision of care for people living with dementia. However, general practice nurses have limited knowledge in the provision of best-practice care for people living with dementia and their carer(s). A number of best-practice dementia care recommendations contained in the Australian Clinical Practice Guidelines and Principles of Care for People with Dementia have been identified as highly relevant to the role of the general practice nurse. AIMS:To explore general practice nurses' perspectives on published best-practice dementia care recommendations relevant to their role and identify barriers and facilitators to their implementation into clinical practice. METHODS:Thirteen Australian general practice nurses took part in this qualitative interview study. The research questions for this study were addressed within a paradigmatic framework of social constructionism. Data were transcribed verbatim and thematically analysed. RESULTS:There was a high level of agreement between general practice nurses that the recommendations were important, reflected best-practice dementia care and were relevant to their role. However the recommendations were perceived as limited in their usefulness to nurses' clinical practice due to being too vague and lacking direction. Four main themes were identified describing barriers and facilitators to operationalising best-practice dementia care.: creating a comfortable environment; changing approach to care; optimising the general practice nurse role and working collaboratively. Nine sub-themes were described: physical environment; social environment; complexity of care; care planning for the family; professional role and identity, funding better dementia care, education, networking and resources; different roles, one team; and interagency communication. CONCLUSION:This study identified several factors that need addressing to support general practice nurses to integrate best-practice dementia care recommendations into daily clinical practice. The development of interventions needs to include strategies to mitigate potential barriers and enhance facilitators that they perceive impact on their delivery of best-practice care for people living with dementia and their carer(s). The knowledge gained in this study could be used to develop multi-faceted interventions informed by theoretical implementation change models to enable the general practice nurse to operationalise best-practice dementia care recommendations.

Background Models that optimise the role of the general practice nurse have the potential to deliver cost-effective best-practice dementia care in the primary care setting. Patient experience is recognised as a vital contribution to the design, provision and evaluation of healthcare services. The aim of this study was to gain insights into the healthcare needs and experiences of people living with dementia and carers as relevant to the provision of dementia care by general practice nurses. Methods A qualitative design with semi-structured interviews was employed. Data were transcribed verbatim and thematically analysed. Six carers and five people living with dementia who received care from a general practice nurse in the previous 12 months took part in the study. Results Five overarching themes were identified: (1) the general practice nurse and dementia care: a golden opportunity, (2) respectful communication: talk to me and hear what I am saying, (3) person-centred information: tell me what I want to know, (4) provide support: more than just information provision, and (5) include the carer: we are a team. Conclusion This study describes the experiences and healthcare needs of people living with dementia and their carer(s) with regard to the general practice nurse role. These findings can inform strategies to support the general practice nurse provision of dementia care that meet the healthcare needs of people living with dementia and carers.

OBJECTIVES:This paper aimed to develop a model to describe help-seeking for dementia diagnosis. The practical model is intended to guide public health interventions to increase help-seeking. METHOD:The model was developed by our multidisciplinary team based on qualitative semi-structured interviews in English (n = 33) and Chinese (n = 8) with older people, people with dementia and carers. The model was also informed by systematic reviews on help-seeking for dementia diagnosis, theories of help-seeking and further iterated based on feedback from a co-design group (n = 10). RESULTS:The model starts with changes which might be symptoms of dementia being observed by the person or family/friends and ends in dementia assessment. Model steps are (1) The person deciding that the changes represent a health problem; (2) obtaining support or confirmation from family/friends that the changes are a health problem; (3) deciding to seek medical help; and (4) persuading the GP to facilitate dementia assessment. The model applies to English and Chinese-speaking Australians, though there were additional barriers for Chinese speakers. There are personal, family, community and health system barriers at each step. CONCLUSION:Interventions to improve diagnosis of dementia might target public knowledge of dementia symptoms and benefits of a diagnosis, and general practice.

Abstract Background Hospitalized older patients with cognitive impairment (CI) experience poor outcomes and high rates of hospital acquired complications (HACs). This study investigated the effectiveness of a multimodal hospital CI identification and education program. Method A prospective stepped-wedge, cross-sectional, continuous-recruitment, hybrid effectiveness-Implementation study was conducted in acute hospitals in four Australian states/territories. The intervention, the Dementia Care in Hospitals Program (DHCP) provided: clinical/ non-clinical hospital staff CI awareness support and education; CI screening for older patients and a bedside alert—the Cognitive Impairment Identifier (CII). The primary outcome was change in the rate of the combined risk of four HACs (urinary tract infection, pneumonia, new onset delirium, pressure injury). Results Participants were patients aged 65 years and over admitted for 24 h or more over a 12-month period between 2015–2017 (n = 16,789). Of the 11,309 (67.4%) screened, 4,277 (37.8%) had CI. HACs occurred in 27.4% of all screened patients and were three times more likely in patients with CI after controlling for age and sex (RR = 3.03; 95%CI:2.74–3.27). There was no significant change in HAC rate for patients with CI (RR = 1.084; 95%CI: 0.93; 1.26). In the intervention period the raw HAC rate for all screened patients was 27.0%, which when adjusted for age and sex suggested a small reduction overall. However, when adjusted for hospital site, this reduction in HAC risk not statistically significant (RR = 0.968; 95%CI:0.865–1.083). There was considerable interhospital variation in intervention implementation and outcomes which explains the final non-significant effect. Conclusion For patient with CI the implementation of the DCHP did not result in a reduction in HAC rates. Education for hospital staff regarding cognitive impairment screening, care support, carer engagement and bedside alerts, using the DCHP, can be feasibly implemented in acute hospitals. Reducing high frequency HACs in older hospital patients with CI, warrants further research. Trial Registration. The trial was registered retrospectively with the Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12615000905561 on 01/09/2015 with 92 patients (0.8% of total sample) recruited in the baseline and none in the intervention before registration submission.

The ability to perform motor actions depends, in part, on the brain’s initial state. We hypothesized that initial state dependence is a more general principle and applies to cognitive control. To test this idea, we examined human single units recorded from the dorsolateral prefrontal (dlPFC) cortex and dorsal anterior cingulate cortex (dACC) during a task that interleaves motor and perceptual conflict trials, the multisource interference task (MSIT). In both brain regions, variability in pre-trial firing rates predicted subsequent reaction time (RT) on conflict trials. In dlPFC, ensemble firing rate patterns suggested the existence of domain-specific initial states, while in dACC, firing patterns were more consistent with a domain-general initial state. The deployment of shared and independent factors that we observe for conflict resolution may allow for flexible and fast responses mediated by cognitive initial states. These results also support hypotheses that place dACC hierarchically earlier than dlPFC in proactive control.

Introduction: In response to COVID-19 and mandated physical distancing, a new digital social connection program was developed and implemented by the local community in a large regional town in western Victoria, Australia. This pilot program, the Digital Inclusion-Social Connections (DI-SC) program, aimed to support people living with dementia to use a digital device to access social connection activities.Objective: The objective of this study is to inform the local community implementing the DI-SC program of key stakeholder experience of DI-SC process and outcomes to support future development and potential translation of digital social connections programs for people living with dementia.Design: Three semi-structured focus groups and two interviews were conducted with a total of fifteen participants. Data was transcribed verbatim and thematically analysed.Findings: Three main themes were identified describing factors as influencing the process and outcomes of the DI-SC program: understanding dementia; personal choice and control; and service planning and coordination. Six sub-themes were identified: matching capability; establishing a relationship; creating opportunities for different interactions; ownership of the device, program coordination and defining the volunteer digital mentor role.Conclusion: Key stakeholders perceived the DI-SC program as an acceptable way of supporting people living with dementia to engage in activities they found enjoyable promoting social connection with care partners and others. DI-SC program outcomes were impacted by inappropriate training and a lack of program coordination. The findings of this study may inform future development and implementation of digital social connection programs for vulnerable populations at risk of social isolation.

Background Patients with cognitive impairment are at greater risk of hospital acquired complications, longer hospital stays, and poor health outcomes compared to patients without cognitive impairment. The Cognitive Impairment Support Program is a multi-disciplinary approach to improve screening rates and awareness of patients with cognitive impairment and guide clinician response and communication during their hospitalisation to improve health outcomes. Objective This study evaluated the impact of implementing the Cognitive Impairment Support Program on patient hospital acquired complications, patient reported quality of life and staff satisfaction in an outer metropolitan hospital. Design A pre-test post-test design was used to collect data in two 6-month time periods between March 2020 and November 2021. Participants Patients aged ≥ 65 years, admitted to a participating ward for > 24 h. Intervention The Cognitive Impairment Support Program consisted of four components: cognitive impairment screening, initiation of a Cognitive Impairment Care Plan, use of a Cognitive Impairment Identifier and associated staff education. Measures The primary outcome was hospital acquired complications experienced by patients with cognitive impairment identified using clinical coding data. Secondary outcomes were patient quality of life and a staff confidence and perceived organisational support to care for patients with cognitive impairment. Results Hospital acquired complication rates did not vary significantly between the two data collection periods for patients experiencing cognitive impairment with a 0.2% (95% confidence interval: -5.7–6.1%) reduction in admissions with at least one hospital acquired complication. Patients in the post intervention period demonstrated statistically significant improvements in many items in two of the Dementia Quality of Life Measure domains: memory and everyday life. The staff survey indicated statistically significant improvement in clinical staff confidence to care for patients with cognitive impairment ( p = 0.003), satisfaction with organisational support for patients ( p = 0.004) and job satisfaction ( p ≤ 0.001). Conclusion This study provides evidence that a multicomponent Cognitive Impairment Support Program had a positive impact on staff confidence and satisfaction and patient quality of life. Broader implementation with further evaluation of the multicomponent cognitive impairment intervention across a range of settings using varied patient outcomes is recommended.

Background Worldwide, responsibility for dementia diagnosis and management is shifting to primary care, in particular to the general practitioner (GP). It has been acknowledged that primary care nurses, working collaboratively with GPs, have a role in dementia care by utilising their unique knowledge and skills. However, there are no best-practice guidelines or care pathways to inform nurses in general practice on what best-practice dementia care comprises and how to implement this into their practice. This study identified the recommendations in the Australian guidelines for dementia management most relevant to the role of the nurse working in general practice. Methods Seventeen experts active in clinical practice and/or research in primary care nursing in general practice participated in an online three-round Delphi study. Results All 17 participants were female with a nursing qualification and experienced in general practice clinical nursing and/or general practice nursing research. Five recommendations were identified as the most relevant to the role of the nurse in general practice. These recommendations all contained elements of person-centred care: the delivery of individualised information, ongoing support, including the carer in decision-making, and they also align with the areas where GPs want support in dementia care provision. Conclusion This novel study identified best-practice dementia care recommendations specific to nurses in general practice. These recommendations will inform a model of care for nurses in the provision of dementia care that supports GPs and better meets the needs of people living with dementia and their carer(s).

Background Previous research has shown that the emotional content of words affects how quickly they are recognised. One recent measure of word emotionality is emotional experience that measures the degree to which reading a word can invoke emotional experiences tied to the word. Words that are higher in emotional experience are recognised more rapidly in the lexical decision task. Methods The current study examines how words' emotional experience and participants' emotionality affect performance on the lexical decision task. To this end, participants were given five emotion measures and completed a lexical decision task with words varying on emotional experience. Results It was found that participants who scored higher on the Positive and Negative Affect Schedule showed a weaker emotional experience effect. No other emotion measures interacted with emotional experience. Conclusions These results are predicted by and interpreted within a framework where the semantic representation of words includes emotion information that is grounded in experience of our internal states.

Intracranial recordings in human subjects provide a unique, fine-grained temporal and spatial resolution inaccessible to conventional non-invasive methods. A prominent signal in these recordings is broadband high-frequency activity (approx. 70-150 Hz), generally considered to reflect neuronal excitation. Here we explored the use of this broadband signal to track, on a single-trial basis, the temporal and spatial distribution of task-engaged areas involved in decision-making. We additionally focused on the alpha rhythm (8-14 Hz), thought to regulate the (dis)engagement of neuronal populations based on task demands. Using these signals, we characterized activity across cortex using intracranial recordings in patients with intractable epilepsy performing the Multi-Source Interference Task, a Stroop-like decision-making paradigm. We analyzed recordings both from grid electrodes placed over cortical areas including frontotemporal and parietal cortex, and depth electrodes in prefrontal regions, including cingulate cortex. We found a widespread negative relationship between alpha power and broadband activity, substantiating the gating role of alpha in regions beyond sensory/motor cortex. Combined, these signals reflect the spatio-temporal pattern of task-engagement, with alpha decrease signifying task-involved regions and broadband increase temporally locking to specific task aspects, distributed over cortical sites. We report sites that only respond to stimulus presentation or to the decision report and, interestingly, sites that reflect the time-on-task. The latter predict the subject's reaction times on a trial-by-trial basis. A smaller subset of sites showed modulation with task condition. Taken together, alpha and broadband signals allow tracking of neuronal population dynamics across cortex on a fine temporal and spatial scale.