The effect of object state-changes on event processing: do objects compete with themselves?

When an object is described as changing state during an event, do the representations of those states compete? The distinct states they represent cannot coexist at any one moment in time, yet each representation must be retrievable at the cost of suppressing the other possible object states. We used functional magnetic resonance imaging of human participants to test whether such competition does occur, and whether this competition between object states recruits brain areas sensitive to other forms of conflict. In Experiment 1, the same object was changed either substantially or minimally by one of two actions. In Experiment 2, the same action either substantially or minimally changed one of two objects. On a subject-specific basis, we identified voxels most responsive to conflict in a Stroop color-word interference task. Voxels in left posterior ventrolateral prefrontal cortex most responsive to Stroop conflict were also responsive to our object state-change manipulation, and were not responsive to the imageability of the described action. In contrast, voxels in left middle frontal gyrus responsive to Stroop conflict were not responsive even to language, and voxels in left middle temporal gyrus that were responsive to language and imageability were not responsive to object state-change. Results suggest that, when representing object state-change, multiple incompatible representations of an object compete, and the greater the difference between the initial state and the end state of an object, the greater the conflict.     

Theory of mind in children with traumatic brain injury

Theory of mind (ToM) involves thinking about mental states and intentions to understand what other people know and to predict how they will act. We studied ToM in children with traumatic brain injury (TBI) and age- and gender-matched children with orthopedic injuries (OI), using a new three-frame Jack and Jill cartoon task that measures intentional thinking separate from contingent task demands. In the key ToM trials, which required intentional thinking, Jack switched a black ball from one hat to another of a different color, but Jill did not witness the switch; in the otherwise identical non-ToM trials, the switch was witnessed. Overall accuracy was higher in children with OI than in those with TBI. Children with severe TBI showed a larger decline in accuracy on ToM trials, suggesting a specific deficit in ToM among children with severe TBI. Accuracy was significantly higher on trials following errors than on trials following correct responses, suggesting that all groups monitored performance and responded to errors with increased vigilance. TBI is associated with poorer intentional processing in school-age children and adolescents relative to peers with OI; furthermore, children with TBI are challenged specifically by intentional demands, especially when their injury is severe. (JINS, 2012, 19, 1-9).     

Design and rationale of the MR-INFORM study: stress perfusion cardiovascular magnetic resonance imaging to guide the management of patients with stable coronary artery disease

Background

In patients with stable coronary artery disease (CAD), decisions regarding revascularisation are primarily driven by the severity and extent of coronary luminal stenoses as determined by invasive coronary angiography. More recently, revascularisation decisions based on invasive fractional flow reserve (FFR) have shown improved event free survival. Cardiovascular magnetic resonance (CMR) perfusion imaging has been shown to be non-inferior to nuclear perfusion imaging in a multi-centre setting and superior in a single centre trial. In addition, it is similar to invasively determined FFR and therefore has the potential to become the non-invasive test of choice to determine need for revascularisation.

Trial design

The MR-INFORM study is a prospective, multi-centre, randomised controlled non-inferiority, outcome trial. The objective is to compare the efficacy of two investigative strategies for the management of patients with suspected CAD. Patients presenting with stable angina are randomised into two groups: 1) The FFR-INFORMED group has subsequent management decisions guided by coronary angiography and fractional flow reserve measurements. 2) The MR-INFORMED group has decisions guided by stress perfusion CMR. The primary end-point will be the occurrence of major adverse cardiac events (death, myocardial infarction and repeat revascularisation) at one year. Clinical trials.gov identifier {"type":"clinical-trial","attrs":{"text":"NCT01236807","term_id":"NCT01236807"}}NCT01236807.

Conclusion

MR INFORM will assess whether an initial strategy of CMR perfusion is non-inferior to invasive angiography supplemented by FFR measurements to guide the management of patients with stable coronary artery disease. Non-inferiority of CMR perfusion imaging to the current invasive reference standard (FFR) would establish CMR perfusion imaging as an attractive non-invasive alternative to current diagnostic pathways.     

A survey of pedagogical approaches and quality mechanisms used in education programs for mental health professionals

The provision of high-quality education and training that is responsive, relevant, accessible and evidence based is critical if the vision for quality mental health services presented in recent policy initiatives in Ireland is to be fulfilled. This paper reports the findings related to pedagogical approaches and quality assurance mechanisms utilized within mental health education. The study involved canvassing all Higher Education Institutions in Ireland. A total of 227 courses in 31 educational institutes were identified and 149 questionnaires were returned from 129 Course Coordinators. Various quality processes were identified in existing programs; however, formal feedback from service providers, service users and carers was seldom reported. Ongoing evaluation and quality assurance strategies are a key element of governance and there is a need to develop strategies that explore the impact of education programs on mental health education and health outcomes. Recommendations are made in terms of future interprofessional mental health education and practice.     

Involvement of the endocannabinoid system in reward processing in the human brain

Rationale  

Disturbed reward processing in humans has been associated with a number of disorders, such as depression, addiction, and attention-deficit hyperactivity disorder. The endocannabinoid (eCB) system has been implicated in reward processing in animals, but in humans, the relation between eCB functioning and reward is less clear.     

Student perceptions of incivility in nursing education: implications for educators

This study explored the phenomenon of incivility in nursing education from the perspective of undergraduate nursing students and compared it to perspectives of educators as found in the literature. The sample consisted of 24 undergraduate junior and senior nursing students from four universities in the mid-Atlantic states. Data from four focus groups were transcribed and content analyzed to reveal themes and subthemes. Students perceived that incivility in nursing education exists. They shared a common view with findings in the literature regarding incivility from the faculty perspective. Notably, an emerging student view was that faculty may contribute to the escalating incivility in nursing education, and that student incivility is justified when faculty are seen as uncivil. The implications for educators, consistent with the literature, are that students want professors to maintain classroom decorum and set the example for civility.     

Systematic assessment in child protection: improving outcomes

As part of the multidisciplinary safeguarding team, children's nurses should have a clear understanding of child protection processes and how they have sometimes lacked a systematic approach. Methods of detecting threats to patient safety in high-risk clinical care can also be employed to analyse child protection processes. This article outlines one tool, known as failure mode and effects analysis, which can be used in a framework that takes into account human factors that can influence an individual's performance. It discusses how this tool can be used to identify and reduce the potential for failure in the serious case review process, in particular by not attributing blame.