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[Video matching as intraoperative navigation aid in operations to improve the facial profile].

Planning and simulation of individual interventions are not yet the common standard treatment in general surgery. Improvements in planning and simulation of individual orthognatic and craniofacial interventions have led to the need to transfer the results of preoperative planning to the location. Videomatching offers a new approach to the surgeon so that simulation output can be used in a highly intuitive way. Congruent video superimposition of the real site and a view of the simulation give the surgeon a unified view of both domains. Visual merging is immediately accepted by the surgeon who prefers the intuitive, non-tactile nature of this highly informative navigational aid. Application and positioning of anatomical markers and time-consuming calibration procedures can be reduced to a minimum. Alternative plans can be discussed among several surgeons preoperatively, and different therapeutic concepts solidified in various simulation models can be selected intraoperatively. We concentrate on the application of this new method in craniomaxillofacial surgery, but it is applicable in other disciplines as well.

Calibration↗

Heeding warnings ... from the canary, the whale, and the Jnuit, Part Two.

There is a tension between traditional and modern definitions of reproductive risk and normalcy. These experts describe that tension as it plays out among the Inuit of Northern Canada from the perspective of a community midwife who has worked with the Inuit. She presents an analytical framework which classifies and illuminates the types of logic that compete in most birth settings around the world--a framework useful for showing how some types of logic can be supervalued while others, such as cultural or intuitive logic, are devalued or simply ignored, often at great cost. Part One presented political, scientific, clinical and cultural logic, and the influence of time. We now go on to look at professionalization and training and describe legal, personal, intuitive and economic logic. The author describes how the Inuit settlement of Povungnituk (POV) attempts to re-integrate the authoritative knowledge of the community by allowing Inuit midwives at The Maternity to choose their own criteria for balancing the imperatives of each kind of logic in decision-making for birth.

Canada↗

[Information model of systemic organization of human mental functions: new approach to the problem of artificial intelligence].

The information model of systemic functions of the human brain reproduces important features of human intelligence: goal planning, prediction of needed results, behavior correction by feedback from the parameters of the results obtained and their comparison with the acceptor of action results. Human behavior imitation in the model is statistically proved by testing the model on a computer. An Adaptron apparatus based on the model quantitatively estimates the parameters of an important mechanism of the brain, namely human intuitive learning. With the Adaptron, the ade-dependent properties and some human intellectual dysfunctions are estimated, which reflect the mechanisms of prediction of future results, the building of memory traces in intuitive learning when the findings coincide with the planned results and the restructure of memory and respective behavior changes when the findings do not coincide with the planned ones.

Artificial Intelligence↗

Evidence-based practice in home healthcare. A springboard for discussion.

Nursing has an increasing interest in EBP, and home healthcare nurses cannot afford to be left out of the loop. A variety of sources exist for home healthcare nurses to use in determining whether there is sufficient information for EBP. There are also various methods that can be used to develop EBP guidelines in home healthcare. Finally, home healthcare nurses have an ethical obligation to provide patient care that is effective and most likely to result in positive outcomes. Relying on tradition, intuition, and experimentation is no longer enough. It is hoped that this article will serve as a springboard, not the final word, for the development of EBP initiatives for home healthcare nurses. It is important also to "share the wealth" so that nurses and their patients can benefit. One way of doing this is to convene a group to evaluate current practice and publish the group consensus on the clinical issue of interest to home healthcare nurses. For example, Janet Steele, concerned about EBP, convenes a group of interested nurses from the agency to decide how the AHCRP guidelines can be incorporated into operations. This group rewrites the policies and procedures based on the CPGs, retrains the nursing and home care aide staff, and uses the patient information from AHCPR as the handouts for patients. Aside from the initial confusion relative to operational changes, EBP has enabled the nursing staff to be more consistent from patient to patient, and there is less confusion regarding what works for specific patient conditions. Evaluation of care 6 months after the change to EBP shows that patients have shorter times for healing, and fewer nursing visits are needed. This information is used by the agency administration in negotiations with payers on the quality of the care provided by the agency and is published in a peer reviewed journal such as Home Healthcare Nurse. Best of all, patient care no longer relies on tradition, intuition, and experimentation as colleagues throughout the country use these findings in their own agencies.

Community Health Nursing↗

[Cognition and emotion in the evaluation of accidents: modelling and empirical studies].

Lay people's evaluation of environmental risks is often based on mass media descriptions of single disastrous events. This article analyzes the cognitive and emotional reactions towards those reports. We assume that characteristic features of the events determine the cognitive evaluation and the rise of the emotions anger and sadness. An intuitive, spontaneous, and schema-based evaluation process is postulated that entails a coherent perception and appraisal of an event. The theoretical assumptions are formally specified and implemented in the computer model ITERA (Intuitive Thinking in Environmental Risk Appraisal). In three experimental studies, we presented manipulated descriptions about negative environmental events. The effects of three experimental variables (knowledge about the riskiness of an action, higher goal of the actor, voluntarity of the actor) were compared with the model's predictions. For anger we found a good correspondence between the empirical results and the model's data. The predicted coherence effects of the cognitive appraisal were confirmed to a great extent. Results for sadness did not conform with model predictions.

Adult↗

The use of aesthetic knowledge in the management of brain injury patients.

A patient's recovery from a brain injury (BI) is unpredictable and requires flexible nursing strategies for each stage of recovery. Empirical knowledge provides a framework for delivering nursing care based on scientific principles. Aesthetic knowledge, including intuition, provides a further opportunity to know and understand BI patients and their responses as they progress along the trajectory of recovery. Incorporating both empirical and aesthetic knowledge into the nursing plan of care for this population affords on opportunity for nurses to help patients and their families negotiate the course of recovery with greater success.

Art↗

The ethical implications of Paul Meehl's work on comparing clinical versus actuarial prediction methods.

Paul E. Meehl's work comparing statistical versus actuarial prediction-and the large body of research that followed by others on the same topic-was mainly theoretical and empirical. Meehl also suggested that this work led to a "practical" conclusion, which was quite strong. The author argues that, in addition, it leads to an ethical conclusion, equally strong. Whether the scientific findings are combined with an overarching ethical principle that the best predictions possible should be made for clients, or whether these findings are framed as delineating what can be done for clients-and that clinicians ought not to attempt to do what they cannot-the conclusion is the same. Whenever statistical prediction rules (SPR's) are available for making a relevant prediction, they should be used in preference to intuition. Any modification of these rules should be systematic and subject to the same type of evaluation originally used to assess the SPR's themselves. It is even possible to develop near-optimal rules in new situations. Providing service that assumes that clinicians "can do better" simply based on self-confidence or plausibility in the absence of evidence that they can actually do so is simply unethical.

Actuarial Analysis↗

Gender differences in advanced mathematical problem solving.

Strategy flexibility in mathematical problem solving was investigated. In Studies 1 and 2, high school juniors and seniors solved Scholastic Assessment Test-Mathematics (SAT-M) problems classified as conventional or unconventional. Algorithmic solution strategies were students' default choice for both types of problems across conditions that manipulated item format and solution time. Use of intuitive strategies on unconventional problems was evident only for high-ability students. Male students were more likely than female students to successfully match strategies to problem characteristics. In Study 3, a revised taxonomy of problems based on cognitive solution demands was predictive of gender differences on Graduate Record Examination-Quantitative (GRE-Q) items. Men outperformed women overall, but the difference was greater on items requiring spatial skills, shortcuts, or multiple solution paths than on problems requiring verbal skills or mastery of classroom-based content. Results suggest that strategy flexibility is a source of gender differences in mathematical ability assessed by SAT-M and GRE-Q problem solving.

Adolescent↗

Paradoxical effects of education on the Iowa Gambling Task.

Suitable normative information on the Iowa Gambling Task (IGT) is not currently available, though it is clear that there is great individual variability in performance on this assessment tool. Given that the task is presumed to measure the emotion-based learning systems that are thought to form the biological basis of 'intuition,' there is some reason to think that education (especially tertiary education) might explicitly de-emphasise the role of emotion-based learning in decision-making. This suggests the paradoxical finding that better-educated participants should show poorer performance on the IGT. We recruited 30 participants (all female, all aged 18-25) to participate in a 'real money' version of the IGT. There was no significant difference in performance in blocks 1-3 of the task (trials 1-60). However, there was a substantial effect of education on the final two blocks (trials 61-100), such that the less-well-educated participants produced twice as much of an improvement over baseline as did their university-educated colleagues. A range of possible explanations for this remarkable finding are discussed. The most likely appears to be that tertiary education specifically discourages the use of emotion-based learning systems in decision-making. These findings bear on the extent to which education has a role to play in our reliance on cognition and emotion in decision-making, including the likely role of education in the generation and maintenance of false beliefs.

Adolescent↗

Theory-based Bayesian models of inductive learning and reasoning.

Inductive inference allows humans to make powerful generalizations from sparse data when learning about word meanings, unobserved properties, causal relationships, and many other aspects of the world. Traditional accounts of induction emphasize either the power of statistical learning, or the importance of strong constraints from structured domain knowledge, intuitive theories or schemas. We argue that both components are necessary to explain the nature, use and acquisition of human knowledge, and we introduce a theory-based Bayesian framework for modeling inductive learning and reasoning as statistical inferences over structured knowledge representations.

Association Learning↗

Neuroscientific challenges to free will and responsibility.

Recent developments in neuroscience raise the worry that understanding how brains cause behavior will undermine our views about free will and, consequently, about moral responsibility. The potential ethical consequences of such a result are sweeping. I provide three reasons to think that these worries seemingly inspired by neuroscience are misplaced. First, problems for common-sense notions of freedom exist independently of neuroscientific advances. Second, neuroscience is not in a position to undermine our intuitive notions. Third, recent empirical studies suggest that even if people do misconstrue neuroscientific results as relevant to our notion of freedom, our judgments of moral responsibility will remain largely unaffected. These considerations suggest that neuroethical concerns about challenges to our conception of freedom are misguided.

Brain↗

Why we do the things we do: applying clinical decision-making frameworks to triage practice.

This paper discusses major themes presented in the published literature concerning clinical decision making and links these to the practice of emergency department nurse triage. Themes discussed include: approaches to decision research in nursing and medicine; decision autonomy in nursing practice and clinical decision making under conditions of uncertainty. Some assumptions underpinning clinical decision-making frameworks are explored and the use of triage scales, algorithms and intuitive thought processes are discussed in terms of clinical practice. In addition, the strengths and limitations of each approach are outlined. It is argued that naturalistic research methods are necessary in order to describe the often uncertain and frequently chaotic environment in which triage decisions are made. This research must occur in order to evaluate and improve both the triage process and the outcomes of these decisions in practice.

Algorithms↗

Decision-making phenomena described by expert nurses working in urban community health settings.

Decision making by expert community health nurses was explored using qualitative research methods. Each subject described a crucial incident, a clinical situation where their independent decision making made a positive difference in a client's outcome. Subjects were given instructions to record a crucial incident in writing. After completing each written incident, subjects were asked five interview questions related to the incident. Subject's verbal responses to questions were audiotaped. Content analysis methods were used to analyze data. Findings suggest that decision making in clinical practice in both a rational and intuitive process. Themes emergent from data describing decision making included the following: focus, type, and purpose of the decision making; characteristics of the decision maker; sequencing of events; data collection methods; facilitators and barriers to decision making; and nursing roles in the decision-making process. Conclusions of the study include recommendations for continued research of decision making using qualitative methods allowing flexibility necessary to explore phenomena representing the essence of nursing practice. A clearer understanding of decision making is essential now and in the next century as nurses increase independent practice roles in community health settings.

Community Health Nursing↗

Religion's evolutionary landscape: counterintuition, commitment, compassion, communion.

Religion is not an evolutionary adaptation per se, but a recurring cultural by-product of the complex evolutionary landscape that sets cognitive, emotional, and material conditions for ordinary human interactions. Religion exploits only ordinary cognitive processes to passionately display costly devotion to counterintuitive worlds governed by supernatural agents. The conceptual foundations of religion are intuitively given by task-specific panhuman cognitive domains, including folkmechanics, folkbiology, and folkpsychology. Core religious beliefs minimally violate ordinary notions about how the world is, with all of its inescapable problems, thus enabling people to imagine minimally impossible supernatural worlds that solve existential problems, including death and deception. Here the focus is on folkpsychology and agency. A key feature of the supernatural agent concepts common to all religions is the triggering of an "Innate Releasing Mechanism," or "agency detector," whose proper (naturally selected) domain encompasses animate objects relevant to hominid survival--such as predators, protectors, and prey--but which actually extends to moving dots on computer screens, voices in wind, and faces on clouds. Folkpsychology also crucially involves metarepresentation, which makes deception possible and threatens any social order. However, these same metacognitive capacities provide the hope and promise of open-ended solutions through representations of counterfactual supernatural worlds that cannot be logically or empirically verified or falsified. Because religious beliefs cannot be deductively or inductively validated, validation occurs only by ritually addressing the very emotions motivating religion. Cross-cultural experimental evidence encourages these claims.

Anxiety↗

Personality types of dental school applicants.

A questionnaire-based prospective study was carried out to measure the personality styles of students being interviewed for a place on the 1997/98 dental undergraduate course in Leeds, England. A total of 334 applicants attended for interview between November 1997 and March 1998, of which 311 anonymously and voluntarily completed a personality questionnaire. The Keirsey Temperament Sorter was used to measure the strength and nature of preferences along four dimensions: extroversion-introversion (E-I), sensing-intuition (S-N), thinking-feeling (T-F) and judging-perceiving (J-P). 4 personality types accounted for 79% of the students, 21% were divided among nine personality types with no type comprising more than 6.7% of the students. The remaining 3 possible personality types were not represented in this student population. Further comparisons revealed significant differences between this student sample and the general population in the judging-perceiving preference and also an intra-group gender difference with regard to the thinking-feeling (T-F) preference. A predominance of the S-J (sensing with judging) temperament type was also confirmed. Personality questionnaires may be a useful adjunct in the selection process of dental school applicants. The identification of a student's working and learning style preference has implications for both the dental undergraduate curriculum and the teaching methods employed by dental school staff.

Adolescent↗

Depressive realism from the perspective of cognitive-experiential self-theory.

To explain why the depressive realism effect has been found in trivial, artificial laboratory but not in more realistic or emotionally engaging situations, the authors hypothesized that depressed people overcompensate for a tendency toward maladaptive experiential (intuitive) processing by exercising excessive rational control in trivial situations. In more consequential situations, they are unable to control their maladaptive experiential processing because it is excessive, or their rational control is insufficient, or both. As predicted, a subclinically depressed group (n = 39) made more optimal decisions than a nondepressed control group (n = 36) under trivial conditions, and the groups converged under more consequential conditions, with the depressed group responding less and the control group more optimally. Also, the depressed group reported engaging in less rational processing and in more maladaptive experiential processing in everyday life than did the control group.

Analysis of Variance↗

Interindividual-intergroup discontinuity reduction through the anticipation of future interaction.

Consistent with the role of a long-term perspective in reducing the tendency of intergroup relations to be more competitive than interindividual relations in the context of noncorrespondent outcomes, an experiment demonstrated that anticipated future interaction reduced intergroup but not interindividual competitiveness. Further results indicated that the effect was present only for groups composed of members high in abstractness (Openness-Intellect on the Big 5 Inventory and Intuition on the Myers-Briggs Type Inventory) who trusted their opponents.

Adult↗

The emotional dog and its rational tail: a social intuitionist approach to moral judgment.

Research on moral judgment has been dominated by rationalist models, in which moral judgment is thought to be caused by moral reasoning. The author gives 4 reasons for considering the hypothesis that moral reasoning does not cause moral judgment; rather, moral reasoning is usually a post hoc construction, generated after a judgment has been reached. The social intuitionist model is presented as an alternative to rationalist models. The model is a social model in that it deemphasizes the private reasoning done by individuals and emphasizes instead the importance of social and cultural influences. The model is an intuitionist model in that it states that moral judgment is generally the result of quick, automatic evaluations (intuitions). The model is more consistent that rationalist models with recent findings in social, cultural, evolutionary, and biological psychology, as well as in anthropology and primatology.

Emotions↗