Evaluación de la pertinencia en la solicitud del electroencefalograma en la Fundación Cardio Infantil IC

Introducción: En este estudio se realiza un análisis sobre la pertinencia en la solicitud del electroencefalograma (EEG), por parte de las diferentes especialidades médicas en la Fundación Cardio-Infantil-IC. Objetivos: Determinar la pertinencia de la solicitud de electroencefalogramas en la Fundación Cardio-Infantil IC, en el período de tiempo comprendido entre enero de 2008 a septiembre de 2008. Cuantificar que cantidad de médicos se adhiere a las guías basadas en la evidencia para la solicitud del electroencefalograma Metodología: Estudio retrospectivo, descriptivo de corte transversal, toma como muestra los electroencefalogramas realizados en el período comprendido entre enero de 2008 a septiembre de 2008, en la Fundación Cardio Infantil- IC. Se analizaron 1211 electroencefalogramas. Resultados: Se encontró que la pertinencia en la solicitud de electroencefalogramas es mayor en el servicio de neurología, con un 95.2%, seguido de las especialidades médicas con una pertinencia del 90.5%, neuropediatría 90.2%, especialidades quirúrgicas 77.2% y medicina general con un 55.4% de solicitudes pertinentes. Discusión: El uso racional de las pruebas diagnósticas es un tema bien documentado en la literatura, con este estudio se observó que la solicitud de EEG en la institución tiene un sustento apropiado, siguiendo las indicaciones de las guías médicas basadas en la evidencia; Sin embargo, es necesario continuar con la realización de estudios y estrategias que garanticen una formación continúa de los diferentes profesionales, para mejorar la adherencia a las recomendaciones de la literatura no sólo para la solicitud de electroencefalogramas, sino también de otras pruebas diagnósticas, garantizando una atención más segura, pertinente y costo efectiva.

Is prospective memory enhanced by cue-action semantic relatedness and enactment at encoding?

Benefits and costs on prospective memory performance, of enactment at encoding and a semantic association between a cue-action word pair, were investigated in two experiments. Findings revealed superior performance for both younger and older adults following enactment, in contrast to verbal encoding, and when cue-action semantic relatedness was high. Although younger adults outperformed older adults, age did not moderate benefits of cue-action relatedness or enactment. Findings from a second experiment revealed that the inclusion of an instruction to perform a prospective memory task led to increments in response latency to items from the ongoing activity in which that task was embedded, relative to latencies when the ongoing task only was performed. However, this task interference ‘cost’ did not differ as a function of either cue-action relatedness or enactment. We argue that the high number of cue-action pairs employed here influenced meta-cognitive consciousness, hence determining attention allocation, in all experimental conditions.

Beyond arousal and valence: the importance of the biological versus social relevance of emotional stimuli

The present study addressed the hypothesis that emotional stimuli relevant to survival or reproduction (biologically emotional stimuli) automatically affect cognitive processing (e.g., attention, memory), while those relevant to social life (socially emotional stimuli) require elaborative processing to modulate attention and memory. Results of our behavioral studies showed that (1) biologically emotional images hold attention more strongly than do socially emotional images, (2) memory for biologically emotional images was enhanced even with limited cognitive resources, but (3) memory for socially emotional images was enhanced only when people had sufficient cognitive resources at encoding. Neither images’ subjective arousal nor their valence modulated these patterns. A subsequent functional magnetic resonance imaging study revealed that biologically emotional images induced stronger activity in the visual cortex and greater functional connectivity between the amygdala and visual cortex than did socially emotional images. These results suggest that the interconnection between the amygdala and visual cortex supports enhanced attention allocation to biological stimuli. In contrast, socially emotional images evoked greater activity in the medial prefrontal cortex (MPFC) and yielded stronger functional connectivity between the amygdala and MPFC than did biological images. Thus, it appears that emotional processing of social stimuli involves elaborative processing requiring frontal lobe activity.

Emotional engagement and orienting: the effects of picture size on affective response

For their survival, humans and animals can rely on motivational systems which are specialized in assessing the valence and imminence of dangers and appetitive cues. The Orienting Response (OR) is a fundamental response pattern that an organism executes whenever a novel or significant stimulus is detected, and has been shown to be consistently modulated by the affective value of a stimulus. However, detecting threatening stimuli and appetitive affordances while they are far away compared to when they are within reach constitutes an obvious evolutionary advantage. Building on the linear relationship between stimulus distance and retinal size, the present research was aimed at investigating the extent to which emotional modulation of distinct processes (action preparation, attentional capture, and subjective emotional state) is affected when reducing the retinal size of a picture. Studies 1-3 examined the effects of picture size on emotional response. Subjective feeling of engagement, as well as sympathetic activation, were modulated by picture size, suggesting that action preparation and subjective experience reflect the combined effects of detecting an arousing stimulus and assessing its imminence. On the other hand, physiological responses which are thought to reflect the amount of attentional resources invested in stimulus processing did not vary with picture size. Studies 4-6 were conducted to substantiate and extend the results of studies 1-3. In particular, it was noted that a decrease in picture size is associated with a loss in the low spatial frequencies of a picture, which might confound the interpretation of the results of studies 1-3. Therefore, emotional and neutral images which were either low-pass filtered or reduced in size were presented, and affective responses were measured. Most effects which were observed when manipulating image size were replicated by blurring pictures. However, pictures depicting highly arousing unpleasant contents were associated with a more pronounced decrease in affective modulation when pictures were reduced in size compared to when they were blurred. The present results provide important information for the study of processes involved in picture perception and in the genesis and expression of an emotional response. In particular, the availability of high spatial frequencies might affect the degree of activation of an internal representation of an affectively charged scene, and might modulate subjective emotional state and preparation for action. Moreover, the manipulation of stimulus imminence revealed important effects of stimulus engagement on specific components of the emotional response, and the implications of the present data for some models of emotions have been discussed. In particular, within the framework of a staged model of emotional response, the tactic and strategic role of response preparation and attention allocation to stimuli varying in engaging power has been discussed, considering the adaptive advantages that each might represent in an evolutionary view. Finally, the identification of perceptual parameters that allow affective processing to be carried out has important methodological applications in future studies examining emotional response in basic research or clinical contexts.

Sediment yield reduction in an agricultural watershed

With proper application of Best Management Practices (BMPs), the impact from the sediment to the water bodies could be minimized. However, finding the optimal allocation of BMP can be difficult, since there are numerous possible options. Also, economics plays an important role in BMP affordability and, therefore, the number of BMPs able to be placed in a given budget year. In this study, two methodologies are presented to determine the optimal cost-effective BMP allocation, by coupling a watershed-level model, Soil and Water Assessment Tool (SWAT), with two different methods, targeting and a multi-objective genetic algorithm (Non-dominated Sorting Genetic Algorithm II, NSGA-II). For demonstration, these two methodologies were applied to an agriculture-dominant watershed located in Lower Michigan to find the optimal allocation of filter strips and grassed waterways. For targeting, three different criteria were investigated for sediment yield minimization, during the process of which it was found that the grassed waterways near the watershed outlet reduced the watershed outlet sediment yield the most under this study condition, and cost minimization was also included as a second objective during the cost-effective BMP allocation selection. NSGA-II was used to find the optimal BMP allocation for both sediment yield reduction and cost minimization. By comparing the results and computational time of both methodologies, targeting was determined to be a better method for finding optimal cost-effective BMP allocation under this study condition, since it provided more than 13 times the amount of solutions with better fitness for the objective functions while using less than one eighth of the SWAT computational time than the NSGA-II with 150 generations did.

Decoding Delay Minimization in Inter-Session Network Coding

Intra-session network coding has been shown to offer significant gains in terms of achievable throughput and delay in settings where one source multicasts data to several clients. In this paper, we consider a more general scenario where multiple sources transmit data to sets of clients over a wireline overlay network. We propose a novel framework for efficient rate allocation in networks where intermediate network nodes have the opportunity to combine packets from different sources using randomized network coding. We formulate the problem as the minimization of the average decoding delay in the client population and solve it with a gradient-based stochastic algorithm. Our optimized inter-session network coding solution is evaluated in different network topologies and is compared with basic intra-session network coding solutions. Our results show the benefits of proper coding decisions and effective rate allocation for lowering the decoding delay when the network is used by concurrent multicast sessions.

A Process Model of the Formation of Spatial Presence Experiences

In order to bridge interdisciplinary differences in Presence research and to establish connections between Presence and “older” concepts of psychology and communication, a theoretical model of the formation of Spatial Presence is proposed. It is applicable to the exposure to different media and intended to unify the existing efforts to develop a theory of Presence. The model includes assumptions about attention allocation, mental models, and involvement, and considers the role of media factors and user characteristics as well, thus incorporating much previous work. It is argued that a commonly accepted model of Spatial Presence is the only solution to secure further progress within the international, interdisciplinary and multiple-paradigm community of Presence research.

Pupillometry: the eyes shed fresh light on the mind

Recent studies provide promising methodological advances in the use of pupillometry as on-line measurement of cognitive processes and show that visual attention allocation, mind-wandering, mental imagery, and even rhyme expectations can influence the size of the human pupil.

Measuring Spatial Presence: Introducing and Validating the Pictorial Presence SAM

The aim of the present study was to develop a pictorial presence scale using selfassessment- manikins (SAM). The instrument assesses presence sub-dimensions (selflocation and possible actions) as well as presence determinants (attention allocation, spatial situation model, higher cognitive involvement, and suspension of disbelief). To qualitatively validate the scale, think-aloud protocols and interviews (n = 12) were conducted. The results reveal that the SAM items are quickly filled out as well as easily, intuitively, and unambiguously understood. Furthermore, the instrument’s validity and sensitivity was quantitatively examined in a two-factorial design (n = 317). Factors were medium (written story, audio book, video, and computer game) and distraction (non-distraction vs. distraction). Factor analyses reveal that the SAM presence dimensions and determinants closely correspond to those of the MEC Spatial Presence Questionnaire, which was used as a comparison measure. The findings of the qualitative and quantitative validation procedures show that the Pictorial Presence SAM successfully assesses spatial presence. In contrast to the verbal questionnaire data (MEC), the significant distraction effect suggests that the new scale is even more sensitive. This points out that the scale can be a useful alternative to existing verbal presence selfreport measures.

Raising the bar for systematic conservation planning

Mathematical methods in systematic conservation planning (SCP) represent a significant step toward cost-effective, transparent allocation of resources for biodiversity conservation. However, research demonstrates important consequences of uncertainties in SCP. Current research often relies on simplified case studies with unknown forms and amounts of uncertainty and low statistical power for generalizing results. Consequently, conservation managers have little evidence for the true performance of conservation planning methods in their own complex, uncertain applications. SCP needs to build evidence for predictive models of error and robustness to multiple, simultaneous uncertainties across a wide range of problems of known complexity. Only then can we determine true performance rather than how a method appears to perform on data with unknown uncertainty.

An experimental study of the effects of noise upon short term memory

The overall aim of this study was to examine experimentally the effects of noise upon short-term memory tasks in the hope of shedding further light upon the apparently inconsistent results of previous research in the area. Seven experiments are presented. The first chapter of the thesis comprised a comprehensive review of the literature on noise and human performance while in the second chapter some theoretical questions concerning the effects of noise were considered in more detail follovred by a more detailed examination of the effects of noise upon memory. Chapter 3 described an experiment which examined the effects of noise on attention allocation in short-term memory as a function of list length. The results provided only weak evidence of increased selectivity in noise. In further chapters no~effects Here investigated in conjunction vrith various parameters of short-term memory tasks e.g. the retention interval, presentation rate. The results suggested that noise effects were significantly affected by the length of the retention interval but not by the rate of presentation. Later chapters examined the possibility of differential noise effects on the mode of recall (recall v. recognition) and the type of presentation (sequential v. simultaneous) as well as an investigation of the effect of varying the point of introduction of the noise and the importance of individual differences in noise research. The results of this study were consistent with the hypothesis that noise at presentation facilitates phonemic coding. However, noise during recall appeared to affect the retrieval strategy adopted by the subject.

Behavioral Perspectives on Organizational Change: Practice Adoption, Product Culling, and Technological Search

This dissertation explores the complex process of organizational change, applying a behavioral lens to understand change in processes, products, and search behaviors. Chapter 1 examines new practice adoption, exploring factors that predict the extent to which routines are adopted “as designed” within the organization. Using medical record data obtained from the hospital’s Electronic Health Record (EHR) system I develop a novel measure of the “gap” between routine “as designed” and routine “as realized.” I link this to a survey administered to the hospital’s professional staff following the adoption of a new EHR system and find that beliefs about the expected impact of the change shape fidelity of the adopted practice to its design. This relationship is more pronounced in care units with experienced professionals and less pronounced when the care unit includes departmental leadership. This research offers new insights into the determinants of routine change in organizations, in particular suggesting the beliefs held by rank-and-file members of an organization are critical in new routine adoption. Chapter 2 explores changes to products, specifically examining culling behaviors in the mobile device industry. Using a panel of quarterly mobile device sales in Germany from 2004-2009, this chapter suggests that the organization’s response to performance feedback is conditional upon the degree to which decisions are centralized. While much of the research on product exit has pointed to economic drivers or prior experience, these central finding of this chapter—that performance below aspirations decreases the rate of phase-out—suggests that firms seek local solutions when doing poorly, which is consistent with behavioral explanations of organizational action. Chapter 3 uses a novel text analysis approach to examine how the allocation of attention within organizational subunits shapes adaptation in the form of search behaviors in Motorola from 1974-1997. It develops a theory that links organizational attention to search, and the results suggest a trade-off between both attentional specialization and coupling on search scope and depth. Specifically, specialized unit attention to a more narrow set of problems increases search scope but reduces search depth; increased attentional coupling also increases search scope at the cost of depth. This novel approach and these findings help clarify extant research on the behavioral outcomes of attention allocation, which have offered mixed results.

Los estilos de enseñanza: construyendo puentes para transitar las diferencias individuales del alumnado

Para progresar en el camino hacia una efectiva atención a la diversidad, es inevitable desarrollar un estilo de enseñanza que tenga en cuenta las diferencias individuales que presenta el alumnado, muy vinculadas a intereses, necesidades, aptitudes, potencialidades y estilos de aprendizaje particulares del educando. Rasgos, todos ellos, que los hace únicos y diferenciados. Así, desde el estudio de la variabilidad intersujeto y partiendo de un marco teórico multidimensional, se describen y analizan las diferencias interindividuales e intergrupales de 555 estudiantes de la Facultades de Ciencias de la Educación de Galicia pertenecientes a las Universidades de Coruña, Santiago de Compostela y Vigo, bajo el prisma de los siguientes estilos de enseñanza: reflexivo, cooperador, individualizador, innovador, indagador y académico. Los resultados obtenidos revelan la existencia de diferencias significativas en las preferencias sobre estilos de enseñanza en función de las variables propuestas: Universidad, especialidad, sexo y edad.

Allocation of spatial attention to emotional stimuli depends upon arousal and not valence

Attentional allocation to emotional stimuli is often proposed to be driven by valence and in particular by negativity. However, many negative stimuli are also arousing leaving the question whether valence or arousal accounts for this effect. The authors examined whether the valence or the arousal level of emotional stimuli influences the allocation of spatial attention using a modified spatial cueing task. Participants responded to targets that were preceded by cues consisting of emotional pictures varying on arousal and valence. Response latencies showed that disengagement of spatial attention was slower for stimuli high in arousal than for stimuli low in arousal. The effect was independent of the valence of the pictures and not gender-specific. The findings support the idea that arousal affects the allocation of attention.