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PubMed2006

Safety communications: warnings.

This paper has two objectives: to identify and review factors that research has shown to be most significant in determining the effectiveness of warnings; and, to offer suggestions regarding challenges and opportunities for future research on warnings. In order for warnings to be effective, they must accomplish two objectives: they must be noticed and encoded; and they must provide understandable information needed for recipients to make informed decisions regarding compliance. A number of variables or factors have emerged as being especially significant in determining whether or not a warning achieves these objectives. These factors include both warning system design variables as well as characteristics of the target audience and the situation in which the warning is presented. While there has been significant progress in understanding the factors that influence warning effectiveness, there are also remaining challenges and opportunities. Challenges include issues associated with growing international trade such as language barriers, literacy and cultural values. Innovative approaches and opportunities are offered by developing communication technologies.

Accidents, Occupational↗
PubMed2004

Development of orbitofrontal function: current themes and future directions.

In recent years, an exciting thrust in the developmental research literature has been the focus on "executive" functions (EF). However, the emphasis has been on the more purely cognitive aspects of EF operative in abstract reasoning and problem solving-aspects associated mainly with dorsolateral frontal regions. Although the literature on adult neuropsychology has seen an emerging and growing interest in the study of processes more related to orbitofrontal cortex (OFC), including emotion and personality, research on the development of EF has lagged behind. This special issue of Brain and Cognition is intended to redress this imbalance by bringing together researchers who are studying the nature and development of orbitofrontal function from a wide variety of perspectives.

Affect↗
PubMed2006

The mismatch negativity in cognitive and clinical neuroscience: theoretical and methodological considerations.

Mismatch negativity (MMN) component of the event-related brain potentials has become popular in cognitive and clinical brain research during the recent years. It is an early response to a violation of an auditory rule such as an infrequent change in the physical feature of a repetitive sound. There is a lot of evidence on the association of the MMN parameters and behavioral discrimination ability, although this relationship is not always straight-forward. Since the MMN reflects sound discrimination accuracy, it can be used for probing how well different groups of individuals perceive sound differences, and how training or remediation affects this ability. In the present review, we first introduce some of the essential MMN findings in probing sound discrimination, memory, and their deficits. Thereafter, issues which need to be taken into account in MMN investigations as well as new improved recording paradigms are discussed.

Auditory Perception↗
PubMed2005

Prospect theory on the brain? Toward a cognitive neuroscience of decision under risk.

Most decisions must be made without advance knowledge of their consequences. Economists and psychologists have devoted much attention to modeling decisions made under conditions of risk in which options can be characterized by a known probability distribution over possible outcomes. The descriptive shortcomings of classical economic models motivated the development of prospect theory (D. Kahneman, A. Tversky, Prospect theory: An analysis of decision under risk. Econometrica, 4 (1979) 263-291; A. Tversky, D. Kahneman, Advances in prospect theory: Cumulative representation of uncertainty. Journal of Risk and Uncertainty, 5 (4) (1992) 297-323) the most successful behavioral model of decision under risk. In the prospect theory, subjective value is modeled by a value function that is concave for gains, convex for losses, and steeper for losses than for gains; the impact of probabilities are characterized by a weighting function that overweights low probabilities and underweights moderate to high probabilities. We outline the possible neural bases of the components of prospect theory, surveying evidence from human imaging, lesion, and neuropharmacology studies as well as animal neurophysiology studies. These results provide preliminary suggestions concerning the neural bases of prospect theory that include a broad set of brain regions and neuromodulatory systems. These data suggest that focused studies of decision making in the context of quantitative models may provide substantial leverage towards a fuller understanding of the cognitive neuroscience of decision making.

Animals↗
PubMed2005

Multi-stage mental process for economic choice in capuchins.

We studied economic choice behavior in capuchin monkeys by offering them to choose between two different foods available in variable amounts. When monkeys selected between familiar foods, their choice patterns were well-described in terms of relative value of the two foods. A leading view in economics and biology is that such behavior results from stimulus-response associations acquired through experience. According to this view, values are not psychologically real; they can only be defined a posteriori. One prediction of this associative model is that animals faced for the first time with a new pair of foods learn to choose between them gradually. We tested this prediction. Surprisingly, we find that monkeys choose as effectively between new pairs of foods as they choose between familiar pairs of foods. We therefore, propose a cognitive model in which economic choice results from a two-stage mental process of value-assignment and decision-making. In a follow-up experiment, we find that the relative value assigned to three foods in sessions in which we tested them against each other combine according to transitivity.

Analysis of Variance↗
PubMed2006

Varieties of musical experience.

In this paper, we argue that music cognition involves the use of acoustic and auditory codes to evoke a variety of conscious experiences. The variety of domains that are encompassed by music is so diverse that it is unclear whether a single domain of structure or experience is defining. Music is best understood as a form of communication in which formal codes (acoustic patterns and their auditory representations) are employed to elicit a variety of conscious experiences. After proposing our theoretical perspective we offer three prominent examples of conscious experiences elicited by the code of music: the recognition of structure itself, affect, and the experience of motion.

Auditory Perception↗
PubMed2006

Generalist genes and cognitive neuroscience.

Multivariate genetic research suggests that a single set of genes affects most cognitive abilities and disabilities. This finding already has far-reaching implications for cognitive neuroscience, and will become even more revealing when this - presumably large - set of generalist genes is identified. Similar to other complex disorders and dimensions, molecular genetic research on cognitive abilities and disabilities is adopting genome-wide association strategies. These strategies involve very large samples to detect DNA associations of small effect size using microarrays that simultaneously assess hundreds of thousands of DNA markers. When this set of generalist genes is identified, it can be used to provide solid footholds in the climb towards a systems-level understanding of how genetically driven brain processes work together to affect diverse cognitive abilities and disabilities.

Chromosome Mapping↗
PubMed2006

Cognitive neuroscience and the law.

Advances in cognitive neuroscience now allow us to use physiological techniques to measure and assess mental states under a growing set of circumstances. The implication of this growing ability has not been lost on the western legal community. If biologists can accurately measure mental state, then legal conflicts that turn on the true mental states of individuals might well be resolvable with techniques ranging from electroencephalography to functional magnetic resonance imaging. Therefore, legal practitioners have increasingly sought to employ cognitive neuroscientific methods and data as evidence to influence legal proceedings. This poses a risk, because these scientific methodologies have largely been designed and validated for experimental use only. Their subsequent use in legal proceedings is an application for which they were not intended, and for which those methods are inadequately tested. We propose that neurobiologists, who might inadvertently contribute to this situation, should be aware of how their papers will be read by the legal community and should play a more active role in educating and engaging with that community.

Cognitive Science↗
PubMed2006

The cognitive neuroscience of remote episodic, semantic and spatial memory.

The processes and mechanisms implicated in retention and retrieval of memories as they age is an enduring problem in cognitive neuroscience. Research from lesion and functional neuroimaging studies on remote episodic, semantic and spatial memory in humans is crucial for evaluating three theories of hippocampal and/or medial temporal lobe-neocortical interaction in memory retention and retrieval: cognitive map theory, standard consolidation theory and multiple trace theory. Each theory makes different predictions regarding first, the severity and extent of retrograde amnesia following lesions to some or all of the structures mentioned; second, the extent of activation of these structures to retrieval of memory across time; and third, the type of memory being retrieved. Each of these theories has strengths and weaknesses, and there are various unresolved issues. We propose a unified account based on multiple trace theory. This theory states that the hippocampus is needed for re-experiencing detailed episodic and spatial memories no matter how old they are, and that it contributes to the formation and assimilation of semantic memories and schematic spatial maps.

Amnesia, Retrograde↗
PubMed2006

Cognitive assessment of musculoskeletal pain with a newly validated Greek version of the Fear-Avoidance Beliefs Questionnaire (FABQ).

Fear of pain and avoidance are psychological factors of primary importance when assessing chronic musculoskeletal pain, which are often measured with the Fear-Avoidance Beliefs Questionnaire (FABQ). Both two- and three-subscale versions have been described. The aims of this study were: to assess the cognitive traits of musculoskeletal pain patients using a newly validated Greek version of the FABQ, and to further examine the construct validity and responsiveness of the measure. Factor analysis yielded three factors that accounted for 65% of the total variance. Physical activity explained 12.3% of the variance and was identical to the original version, unlike the work subscale which split into two: the FABQ work1 related to "work as cause" (15.2% of the variance) and the FABQ work2 related to "work as prognosis" (37.5% of the variance). Internal consistency was good (0.72-0.90). Test-retest reliability was satisfactory and close to the original version both for individual items and the subscales. Responsiveness of the 3-factor model was satisfactorily assessed as the ability to detect: (A) change in general - (paired t test, effect size); (B) clinically important change (paired t test, standardised effect size), and (C) real change in the concept being measured (ROC analysis). Construct validity of the FABQ was shown through the interaction with anxiety and depression, pain control and responsibility, psychological distress and pain intensity, and criterion-related validity through the association with another fear-avoidance measure (TSK). New aspects of responsiveness and construct validity were demonstrated for the FABQ, using a three-subscale validated Greek version.

Adolescent↗
PubMed2006

Models and theories of brain function in cognition within a framework of behavioral cognitive psychology.

The present article presents a nonexhaustive collection of contemporary models and theories on brain function and discusses these models and theories within a framework of explanatory formulations in behavioral cognitive psychology. Such a mission was accomplished by evaluating the cognitive implications in the explanatory formulations with respect to established laws/principles and models/theories of behavioral cognitive psychology. The article also points to problem areas of behavioral cognitive psychology for which the explanatory formulations have solutions to offer. The article shows that the cinematographic hypothesis, the new visual model, the synergetic model, and the theory of whole-brain-work emphasize various aspects of perception. The formulations on P300 theory emphasize attention and also working memory. The theory on cognits is a comprehensive account of memory. Characteristic to all of these explanatory formulations and also to that on the complexity and its evolution and that on neurocognitive networks is the emphasis on selective distribution, integration to the point of supersynergy, and dynamicity. Such a viewpoint was not only applied to the operations of the brain but also of cognition. With such a conceptualization, the explanatory formulations could account for cognitive processes other than the ones emphasized. A common aspect in a majority of the formulations is the utilization of the oscillatory activity as the valid activity of the brain. The article points out that a frontier in cognitive psychophysiology would be the study of the genetics of brain oscillations.

Brain↗
PubMed2004

A cognitive taxonomy of medical errors.

OBJECTIVE: Propose a cognitive taxonomy of medical errors at the level of individuals and their interactions with technology. DESIGN: Use cognitive theories of human error and human action to develop the theoretical foundations of the taxonomy, develop the structure of the taxonomy, populate the taxonomy with examples of medical error cases, identify cognitive mechanisms for each category of medical error under the taxonomy, and apply the taxonomy to practical problems. MEASUREMENTS: Four criteria were used to evaluate the cognitive taxonomy. The taxonomy should be able (1) to categorize major types of errors at the individual level along cognitive dimensions, (2) to associate each type of error with a specific underlying cognitive mechanism, (3) to describe how and explain why a specific error occurs, and (4) to generate intervention strategies for each type of error. RESULTS: The proposed cognitive taxonomy largely satisfies the four criteria at a theoretical and conceptual level. CONCLUSION: Theoretically, the proposed cognitive taxonomy provides a method to systematically categorize medical errors at the individual level along cognitive dimensions, leads to a better understanding of the underlying cognitive mechanisms of medical errors, and provides a framework that can guide future studies on medical errors. Practically, it provides guidelines for the development of cognitive interventions to decrease medical errors and foundation for the development of medical error reporting system that not only categorizes errors but also identifies problems and helps to generate solutions. To validate this model empirically, we will next be performing systematic experimental studies.

Cognition↗
PubMed2005

Designing the design phase of critical care devices: a cognitive approach.

In this study, we show how medical devices used for patient care can be made safer if various cognitive factors involved in patient management are taken into consideration during the design phase. The objective of this paper is to describe a methodology for obtaining insights into patient safety features--derived from investigations of institutional decision making--that could be incorporated into medical devices by their designers. The design cycle of a product, be it a medical device, software, or any kind of equipment, is similar in concept, and course. Through a series of steps we obtained information related to medical errors and patient safety. These were then utilized to customize the generic device design cycle in ways that would improve the production of critical care devices. First, we provided individuals with different levels of expertise in the clinical, administrative, and engineering domains of a large hospital setting with hypothetical clinical scenarios, each of which described a medical error event involving health professionals and medical devices. Then, we asked our subjects to "think-aloud" as they read through each scenario. Using a set of questions as probes, we then asked our subjects to identify key errors and attribute them to various players. We recorded and transcribed the responses and conducted a cognitive task analysis of each scenario to identify different entities as "constant," "partially modifiable," or "modifiable." We compared our subjects' responses to the results of the task analysis and then mapped them to the modifiable entities. Lastly, we coded the relationships of these entities to the errors in medical devices. We propose that the incorporation of these modifiable entities into the device design cycle could improve the device end product for better patient safety management.

Cognitive Science↗
PubMed2005

Interpreting procedures from descriptive guidelines.

Errors in clinical practice guidelines may translate into errors in real-world clinical practice. The best way to eliminate these errors is to understand how they are generated, thus enabling the future development of methods to catch errors made in creating the guideline before publication. We examined the process by which a medical expert from the American College of Physicians (ACP) created clinical algorithms from narrative guidelines, as a case study. We studied this process by looking at intermediate versions produced during the algorithm creation. We identified and analyzed errors that were generated at each stage, categorized them using Knuth's classification scheme, and studied patterns of errors that were made over the set of algorithm versions that were created. We then assessed possible explanations for the sources of these errors and provided recommendations for reducing the number of errors, based on cognitive theory and on experience drawn from software engineering methodologies.

Artificial Intelligence↗
PubMed2004

The Lowbury lecture: behaviour in infection control.

The majority of healthcare-associated infections result from cross-transmission related to inappropriate patient-care practices. Improving practices frequently implies modifying healthcare workers' behaviour, a key challenge of today's infection control. To improve healthcare workers' compliance with practices, infection control should learn from the behavioural sciences. Social cognitive models can help to improve our understanding of human behaviour. Cognitive determinants that shape behaviour are acquired through the socialization process and are susceptible to change. Some models have been applied to evaluate predictors of health behaviour but, so far, none have been successfully applied to explain behaviour in the field of infection control. Successful strategies to improve infection control practices result from their multidimensional aspect. Similarly, social models that include several levels of cognitive determinants have more chance of success to explain change in behaviour. Concrete examples applied to infection control issues are presented, including special references to hand hygiene behaviour. The theory of ecological perspective, based on the idea that behaviour is viewed as being affected by and affecting multiple levels of influence, and that it both influences and is influenced by the social environment, seems promising to explain behaviour modification. Studies are needed to assess the key determinants of infection control practices and behaviour promotion among the different populations of healthcare workers, and to implement and evaluate the impact of the different components of multimodal programmes to promote optimal infection control practices.

Behavior↗
PubMed2005

Why revelations have occurred on mountains? Linking mystical experiences and cognitive neuroscience.

The fundamental revelations to the founders of the three monotheistic religions, among many other revelation experiences, had occurred on a mountain. These three revelation experiences share many phenomenological components like feeling and hearing a presence, seeing a figure, seeing lights, and feeling of fear. In addition, similar experiences have been reported by non-mystic contemporary mountaineers. The similarities between these revelations on mountains and their appearance in contemporary mountaineers suggest that exposure to altitude might affect functional and neural mechanisms, thus facilitating the experience of a revelation. Different functions relying on brain areas such as the temporo-parietal junction and the prefrontal cortex have been suggested to be altered in altitude. Moreover, acute and chronic hypoxia significantly affect the temporo-parietal junction and the prefrontal cortex and both areas have also been linked to altered own body perceptions and mystical experiences. Prolonged stay at high altitudes, especially in social deprivation, may also lead to prefrontal lobe dysfunctions such as low resistance to stress and loss of inhibition. Based on these phenomenological, functional, and neural findings we suggest that exposure to altitudes might contribute to the induction of revelation experiences and might further our understanding of the mountain metaphor in religion. Mystical and religious experiences are important not only to the mystic himself, but also to many followers, as it was indeed with respect to the leaders of the three monotheistic religions. Yet, concerning its subjective character, mystical experiences are almost never accessible to the scholars interested in examining them. The tools of cognitive neuroscience make it possible to approach religious and mystical experiences not only by the semantical analysis of texts, but also by approaching similar experiences in healthy subjects during prolonged stays at high altitude and/or in cognitive paradigms. Cognitive neurosciences, in turn, might profit from the research of mysticism in their endeavor to further our understanding of mechanisms of corporeal awareness and self consciousness.

Acclimatization↗