Event‐related potentials in response to cheating and cooperation in a social dilemma game

A sequential prisoner's dilemma game was combined with psychophysiological measures to examine the cognitive underpinnings of reciprocal exchange. Participants played four rounds of the game with partners who either cooperated or cheated. In a control condition, the partners’ faces were shown, but no interaction took place. The partners’ behaviors were consistent in the first three rounds of the game, but in the last round some of the partners unexpectedly changed strategies. In the first round of the game, the feedback about a partner's decision elicited a feedback P300, which was more pronounced for cooperation and cheating in comparison to the control condition, but did not vary as a function of feedback valence. In the last round, both the feedback negativity and the feedback P300 were sensitive to expectancy violations. There was no consistent evidence for a negativity bias, that is, enhanced allocation of attention to feedback about another person's cheating in comparison to feedback about another person's cooperation. Instead, participants focused on both positive and negative information, and flexibly adjusted their processing biases to the diagnosticity of the information. This conclusion was corroborated by the ERP correlates of memory retrieval. Successful retrieval of a partner's reputation was associated with an anterior positivity between 400 and 600 ms after face onset. This anterior positivity was more pronounced for both cooperator and cheater faces in comparison to control faces. The results suggest that it is not the negativity of social information, but rather its motivational and behavioral relevance that determines its processing.     

Unfashionable tales: narratives about what is (still) great in NHS general practice

Background

There is clear evidence that general practice has become a less popular career choice and among GPs there are high levels of dissatisfaction and demotivation. Little empirical evidence has emerged to indicate which factors contribute intrinsic value to the working lives of GPs and sustain their ongoing commitment.

Aim

To understand which aspects of work continue to motivate and engage senior GPs by exploring their narrative accounts.

Design and setting

This was part of a qualitative study in which senior GPs and hospital specialists contributed narratives in which they reflected on their working lives.

Method

Individual, open interviews were conducted with eight GPs who had graduated in the early 1980s. Thematic analysis and situational analysis mapping were used to identify and connect related themes.

Results

During interviews in which doctors drew on a wide range of encounters and experiences, they revealed which aspects of work were associated with greater intrinsic rewards and contributed to their continuing motivation. Having chosen careers that suited their preferred settings and working practices, they recounted adjustments made in response to new challenges and confirmed experiencing greater enjoyment when performing roles affirming their sense of providing valued health care.

Conclusion

This study’s findings offer an alternative angle from which to consider the current unpopularity of general practice careers. The article proposes that long-term engagement of practitioners may be achieved through provision of adequate supportive resources to allow them to enact a sense of medical identity that matches with their acquired expectations of their role in the NHS.     

Surveillance of resistance in bacteria causing community-acquired respiratory tract infections

Bacterial resistance to antibiotics in community-acquired respiratory tract infections is a serious problem and is increasing in prevalence world-wide at an alarming rate. Streptococcus pneumoniae , one of the main organisms implicated in respiratory tract infections, has developed multiple resistance mechanisms to combat the effects of most commonly used classes of antibiotics, particularly the β -lactams (penicillin, aminopenicillins and cephalosporins) and macrolides. Furthermore, multidrug-resistant strains of S. pneumoniae have spread to all regions of the world, often via resistant genetic clones. A similar spread of resistance has been reported for other major respiratory tract pathogens, including Haemophilus influenzae , Moraxella catarrhalis and Streptococcus pyogenes . To develop and support resistance control strategies it is imperative to obtain accurate data on the prevalence, geographic distribution and antibiotic susceptibility of respiratory tract pathogens and how this relates to antibiotic prescribing patterns. In recent years, significant progress has been made in developing longitudinal national and international surveillance programs to monitor antibiotic resistance, such that the prevalence of resistance and underlying trends over time are now well documented for most parts of Europe, and many parts of Asia and the Americas. However, resistance surveillance data from parts of the developing world (regions of Central America, Africa, Asia and Central/Eastern Europe) remain poor. The quantity and quality of surveillance data is very heterogeneous; thus there is a clear need to standardize or validate the data collection, analysis and interpretative criteria used across studies. If disseminated effectively these data can be used to guide empiric antibiotic therapy, and to support—and monitor the impact of—interventions on antibiotic resistance.     

不同拒绝敏感性大学生对社交情绪词记忆的偏好

目的:探究不同拒绝敏感性大学生对社交情境中情绪性词语的记忆偏好。方法:本实验采用2(拒绝敏感性:高分组,低分组)×2(情绪词效价:积极,消极)×2(回忆倾向:自我,他人)混合实验设计。结果:1与低拒绝敏感性大学生相比,高拒绝敏感性大学生更倾向于记忆描述不同情绪效价的句子[F(1,52)=9.59,P0.01];2所有大学生在记忆描述自我情绪的句子时比记忆描述他人情绪的句子时的成绩更好[F(1,52)=4.45,P0.05];3与拒绝敏感性低分组大学生相比,拒绝敏感性高分组大学生在记忆描述他人消极情绪的句子时的成绩更好[F(1,52)=4.21,P0.05],而且也更倾向于记忆描述自我的积极情绪的句子[F(1,52)=12.65,P0.001]。结论:高拒绝敏感性大学生更倾向于记忆他人的消极情绪,并且会过度的关注此社交情境中自我产生的积极情绪。     

大学生社会适应性现状调查

目的:研究在校大学生的社会适应性现状。方法:采用大学生社会适应性问卷对大学生进行调查。结果:1大学生的社会适应性在自我调节、自我评价、就业准备、人际交往和角色适应等维度上存在显著的性别差异(t=-3.996,3.614;P0.001;t=3.016,P0.01;t=6.843,3.639;P0.001),在学习管理维度上性别差异不显著;2大学生的社会适应性在自我调节、学习管理、就业准备和角色适应等维度上存在显著的毕业班与非毕业班差异(t=-3.626,4.040;P0.001;t=2.954,P0.01;t=4.056,P0.001),在自我评价和人际交往等维度上毕业班与非毕业班差异不显著。结论:高校应当采取切实措施,把社会适应能力培养列入人才培养方案,构建科学的社会适应能力培养的课程体系,改革社会适应能力培养课程的内容和方法,创设模拟情境训练大学生的社会适应能力。     

An architecture for a continuous,user-driven,and data-driven application of clinical guidelines and its evaluation

ObjectivesDesign, implement, and evaluate a new architecture for realistic continuous guideline (GL)-based decision support, based on a series of requirements that we have identified, such as support for continuous care, for multiple task types, and for data-driven and user-driven modes.MethodsWe designed and implemented a new continuous GL-based support architecture, PICARD, which accesses a temporal reasoning engine, and provides several different types of application interfaces. We present the new architecture in detail in the current paper. To evaluate the architecture, we first performed a technical evaluation of the PICARD architecture, using 19 simulated scenarios in the preeclampsia/toxemia domain. We then performed a functional evaluation with the help of two domain experts, by generating patient records that simulate 60 decision points from six clinical guideline-based scenarios, lasting from two days to four weeks. Finally, 36 clinicians made manual decisions in half of the scenarios, and had access to the automated GL-based support in the other half. The measures used in all three experiments were correctness and completeness of the decisions relative to the GL.ResultsMean correctness and completeness in the technical evaluation were 1 ± 0.0 and 0.96 ± 0.03 respectively. The functional evaluation produced only several minor comments from the two experts, mostly regarding the output’s style; otherwise the system’s recommendations were validated. In the clinically oriented evaluation, the 36 clinicians applied manually approximately 41% of the GL’s recommended actions. Completeness increased to approximately 93% when using PICARD. Manual correctness was approximately 94.5%, and remained similar when using PICARD; but while 68% of the manual decisions included correct but redundant actions, only 3% of the actions included in decisions made when using PICARD were redundant.ConclusionsThe PICARD architecture is technically feasible and is functionally valid, and addresses the realistic continuous GL-based application requirements that we have defined; in particular, the requirement for care over significant time frames. The use of the PICARD architecture in the domain we examined resulted in enhanced completeness and in reduction of redundancies, and is potentially beneficial for general GL-based management of chronic patients.     

The influence of social environmental condition on the production of stress-induced 22 kHz calls in adult male Wistar rats

Adult rats emit 22 kHz ultrasonic vocalizations (USVs) in response to aversive stimuli, and these sounds are suggested to have communicative information among conspecifics. It is conceivable that social environment during development of rats has relevance to the emission of 22 kHz USVs. To examine the effects of social environment after weaning on production of stress-induced USVs, we compared the amount of emission of USVs among three groups of rats reared under different conditions after weaning. One group of rats was housed individually, and the other two groups were housed in pairs, in which social hierarchy of the pair was determined by social dominance-subordination relationships. The USVs were induced by acute mild somatic stimuli on the back and neck. Individually reared rats emitted much fewer USVs than pair-reared rats. In addition, socially subordinate rats emitted more USVs compared with socially dominant ones. These results suggest that not only social interaction but also the status in social hierarchy may play an important role in the process of the development of USVs induced by somatic stimuli.     

Involving the patient: a prospective study on use, appreciation and effectiveness of an information system in head and neck cancer care

OBJECTIVE: To determine use, appreciation and effectiveness of an electronic health information support system in head and neck (H&N) cancer care. DESIGN: A prospective evaluation study. The evaluated system has four different functions: (1) communication amongst health care providers and between health care providers and patients, (2) information for health care providers and patients, (3) contact with fellow sufferers and (4) monitoring of discharged patients by means of electronic questionnaires. Evaluation of the system was done both objectively using automatically created log files and stored messages, and subjectively by using paper questionnaires from patients and general practitioners (GPs). SETTING: Department of Otorhinolaryngology and Head and Neck Surgery of a tertiary health care centre in the Netherlands. The system was put at patients' disposal for a period of 6 weeks following discharge from the hospital after surgery for H&N cancer, and was additional to standard care. PARTICIPANTS: Head and neck cancer patients, hospital physicians, members of a hospital-based support team, GPs, district nurses and speech therapists. MAIN OUTCOME MEASURES: Actual use of the system by patients and health care providers. Patients' appreciation for each of the system's four different functions. GPs' appreciation for the system. Capability to detect potential patient problems with the system. RESULTS: The system was used by 36 H&N cancer patients, 10 hospital physicians, 2 members of the support team, 8 GPs, 2 district nurses and 2 speech therapists. The total number of patient-sessions was 982: an average of 27.3 sessions per patient during the 6 weeks study period. In total, 456 monitoring questionnaires were completed. The support team in hospital responded with 231 actions. In 16 cases, an extra appointment was made for a patient with the hospital physician. Out of these cases, immediate action was considered necessary eight times. Patients appreciated the system highly, rating it with an average score of 8.0 on a 10-point scale. All patients used the monitoring function, and rated 'monitoring' with a mean score of 8.0 on a 10-point scale. Least used and appreciated was the 'contact with fellow sufferers' function. Only 8 out of possible 36 GPs used the system, rating it with an average of 5.6 on a 10-point scale. CONCLUSIONS: The electronic health information support system was used intensively and highly appreciated by H&N cancer patients. The system enabled the early detection of occurring health problems that required direct intervention. ICT can play an additional role in the management of patients, also in a relatively elderly and computer illiterate patient population.