Is regret for inaction relatively self-enhancing?

Previous accounts of regret suggest that people report greater regret for inaction than for action because the former is longer lasting and more painful than the latter. We suggest instead that the tendency for people's greatest regrets to concern inaction more than action may be due to the relatively self-enhancing nature of regrets for inaction. In Study I we asked people to think about their greatest recent regret and to code it as being due to action or inaction. In Study 2 participants described their greatest regret from across their entire life. In both studies we observed an inaction effect only amongst individuals high in self-esteem (HSE). In Study 2 we found that the inaction effect was confined to HSE people whose greatest regret was personal in nature. These results support the claim that regret for inaction is relatively self-enhancing and suggest that the inaction effect found in real-life regrets may be due, in part at least, to the self-enhancement goals of HSE individuals. Copyright (c) 2005 John Wiley & Sons, Ltd.

Ultra-fast processing of gigapixel Tissue MicroArray images using high performance computing.

BACKGROUND:
tissue MicroArrays (TMAs) are a valuable platform for tissue based translational research and the discovery of tissue biomarkers. The digitised TMA slides or TMA Virtual Slides, are ultra-large digital images, and can contain several hundred samples. The processing of such slides is time-consuming, bottlenecking a potentially high throughput platform.
METHODS:
a High Performance Computing (HPC) platform for the rapid analysis of TMA virtual slides is presented in this study. Using an HP high performance cluster and a centralised dynamic load balancing approach, the simultaneous analysis of multiple tissue-cores were established. This was evaluated on Non-Small Cell Lung Cancer TMAs for complex analysis of tissue pattern and immunohistochemical positivity.
RESULTS:
the automated processing of a single TMA virtual slide containing 230 patient samples can be significantly speeded up by a factor of circa 22, bringing the analysis time to one minute. Over 90 TMAs could also be analysed simultaneously, speeding up multiplex biomarker experiments enormously.
CONCLUSIONS:
the methodologies developed in this paper provide for the first time a genuine high throughput analysis platform for TMA biomarker discovery that will significantly enhance the reliability and speed for biomarker research. This will have widespread implications in translational tissue based research.

The Equiprobability Bias from a Mathematical and Psychological Perspective

The equiprobability bias (EB) is a tendency to believe that every process in which randomness is involved corresponds to a fair distribution, with equal probabilities for any possible outcome. The EB is known to affect both children and adults, and to increase with probability education. Because it results in probability errors resistant to pedagogical interventions, it has been described as a deep misconception about randomness: the erroneous belief that randomness implies uniformity. In the present paper, we show that the EB is actually not the result of a conceptual error about the definition of randomness. On the contrary, the mathematical theory of randomness does imply uniformity. However, the EB is still a bias, because people tend to assume uniformity even in the case of events that are not random. The pervasiveness of the EB reveals a paradox: The combination of random processes is not necessarily random. The link between the EB and this paradox is discussed, and suggestions are made regarding educational design to overcome difficulties encountered by students as a consequence of the EB.

General practitioners perceptions on advance care planning for patients living with dementia

BACKGROUND: Advance care planning (ACP) facilitates communication and understanding of preferences, nevertheless the use of ACPs in primary care is low. The uncertain course of dementia and the inability to communicate with the patient living with dementia are significant challenges for GPs to initiate discussions on goals of care.

METHODS: A cross-sectional survey, using a purposive, cluster sample of GPs across Northern Ireland with registered dementia patients was used. GPs at selected practices received the survey instrument and up to four mail contacts was implemented.

RESULTS: One hundred and thirty-three GPs (40.6%) participated in the survey, representing 60.9% of surveyed practices. While most respondents regarded dementia as a terminal disease (96.2%) only 37.6% felt that palliative care applied equally from the time of diagnosis to severe dementia. While most respondents thought that early discussions would facilitate decision-making during advanced dementia (61%), respondents were divided on whether ACP should be initiated at the time of diagnoses. While most respondents felt that GPs should take the initiative to introduce and encourage ACP, most survey participants acknowledged the need for improved knowledge to involve families in caring for patients with dementia at the end of life and that a standard format for ACP documentation was needed.

CONCLUSION: Optimal timing of ACP discussions should be determined by the readiness of the patient and family carer to face to face end of life. ACP discussions can be enhanced by educational strategies directed towards the patient and family carer that enable shared decision-making with their GP when considering options in future care.

The views of general practitioners on advance care planning for patients living with dementia

Background Advance care planning (ACP) facilitates communication
and understanding of preferences, nevertheless the use of
ACPs in primary care for patients with dementia is low. The disease’s
uncertain course and the inability to communicate with
the patient living with dementia are significant challenges for
GPs.
Aim The purpose of this study was to describe the attitudes and
practice preferences of GPs working within the UK’s National
Health System (NHS) regarding communication, and decisionmaking
for patients with dementia and their families
Methods A cross-sectional survey, using a purposive, cluster sample
of GPs across Northern Ireland with registered dementia
patients was used.
Results One hundred and thirty-three GPs (40.6%) participated
in the survey, representing 60.9% of surveyed practices. While
most respondents regarded dementia as a terminal disease
(96.2%) only 37.6% felt that palliative care applied equally from
the time of diagnosis to severe dementia. While most respondents
thought that early discussions would facilitate decision-making
during advanced dementia (61%), respondents were divided
on whether ACP should be initiated at the time of diagnoses
(39.8% in favour vs 45.8% disagreed). Interestingly, GPs who
were longer in practice placed greater importance on the presence
of an advance directive (F (2, 124) = 3.38, p = 0.037).
Discussion The timing of initiating ACP varies across individuals
requiring GPs to carefully consider strategies and receptiveness
of the patient and family carer.
Conclusion The findings promote both ongoing training in communication
and dementia management for GPs to meet the
needs of their patients living with dementia.

Learning about probability from text and tables: Do color coding and labeling through an interactive-user interface help?

Learning from visual representations is enhanced when learners appropriately integrate corresponding visual and verbal information. This study examined the effects of two methods of promoting integration, color coding and labeling, on learning about probabilistic reasoning from a table and text. Undergraduate students (N = 98) were randomly assigned to learn about probabilistic reasoning from one of 4 computer-based lessons generated from a 2 (color coding/no color coding) by 2 (labeling/no labeling) between-subjects design. Learners added the labels or color coding at their own pace by clicking buttons in a computer-based lesson. Participants' eye movements were recorded while viewing the lesson. Labeling was beneficial for learning, but color coding was not. In addition, labeling, but not color coding, increased attention to important information in the table and time with the lesson. Both labeling and color coding increased looks between the text and corresponding information in the table. The findings provide support for the multimedia principle, and they suggest that providing labeling enhances learning about probabilistic reasoning from text and tables

Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

Background
In dementia, advance care planning (ACP) of end-of-life issues may start as early as possible in view of the patient’s decreasing ability to participate in decision making. We aimed to assess whether practicing physicians in the Netherlands and the United Kingdom who provide most of the end-of-life care, differ in finding that ACP in dementia should start at diagnosis.

Methods
In a cross-sectional study, we surveyed 188 Dutch elderly care physicians who are on the staff of nursing homes and 133 general practitioners from Northern Ireland. We compared difference by country in the outcome (perception of ACP timing), rated on a 1–5 agreement scale. Regression analyses examined whether a country difference can be explained by contrasts in demographics, presence, exposure and role perceptions.

Results
There was wide variability in agreement with the initiation of ACP at dementia diagnosis, in particular in the UK but also in the Netherlands (60.8% agreed, 25.3% disagreed and 14.0% neither agreed, nor disagreed). Large differences in physician characteristics (Dutch physicians being more present, exposed and adopting a stronger role perception) hardly explained the modest country difference. The perception that the physician should take the initiative was independently associated with agreeing with ACP at diagnosis.

Conclusions
There is considerable ambiguity about initiating ACP in dementia at diagnosis among physicians practicing in two different European health care systems and caring for different patient populations. ACP strategies should accommodate not only variations in readiness to engage in ACP early among patient and families, but also among physicians.