The metabolic and cognitive energy costs of stabilising a high-energy interlimb coordination task

Kinematic (relative phase error), metabolic (oxygen consumption, heart rate) and attentional (baseline and cycling reaction times) variables were measured while participants practised a high energy-demanding, intrinsically unstable 90° relative phase coordination pattern on independent bicycle ergometers. The variables were found to be strongly inter-correlated, suggesting a link between emerging performance stability with practice and minimal metabolic and attentional cost. The effects of practice of 90° relative phase coordination on the performance of in-phase (0°-phase) and antiphase (180°-phase) coordination were investigated by measuring the relative phase attractor layouts and recording the metabolic and attentional cost of the three coordination patterns before and after practice. The attentional variables did not differ significantly between coordination patterns and did not change with practice. Before practice, the coordination performance was most accurate and stable for in-phase cycling, with antiphase next and 90°-phase the poorest. However, metabolic cost was lower for antiphase than either in-phase or 90°-phase cycling, and the pre-practice attractor layout deviated from that predicted on the basis of dynamic stability as an attractor state, revealing an attraction to antiphase cycling. After practice of 90°-phase cycling, in-phase cycling remained the most accurate and stable, with 90°-phase next and antiphase the poorest, but antiphase retained the lowest metabolic energy cost. The attractor layout had changed, with new attractors formed at the practised 90°-phase pattern and its symmetrical partner of 270°-phase. Considering both the pre- and post-practice results, attractors were formed at either a low metabolic energy cost but less stable (antiphase) pattern or at a more stable but higher metabolic energy cost (90°-phase) pattern, but in neither case at the most stable and accurate (in-phase) pattern. The results suggest that energetic factors affect coordination dynamics and that coordination modes lower in metabolic energy expenditure may compete with dynamically stable modes.

Aging effects on the metabolic and cognitive energy cost of interlimb coordination

Many everyday motor tasks have high metabolic energy demands, and some require extended practice to learn the required coordination between limbs. Eight older (73.1 6 4.4 years) and 8 younger (23.3 6 5.9) men practiced a  high-energy two-hand coordination task with both 1808 and 908 target  relative phase. The older group showed greater performance error in both conditions, and performance at 908 was strongly attracted to antiphase coordination (1808). In a retention test one week following the acquisition trials, the older group had learned the 1808 condition but did not learn the 908 condition. Metabolic energy cost was not different between groups, but the older men showed higher heart rate and both conditions imposed  greater cognitive demands as revealed in auditory probe reaction time. Older adults’ motor learning may be inhibited by elevated heart rate at the same  oxygen cost, increased cognitive cost, and an attraction toward more  established low-energy in-phase or antiphase coordination.

Assessment of cognitive function in heart failure patients

Background
Research on the cognitive capacity of heart failure patients is limited, with a paucity of benchmark information available for this population. It is highly likely that cognitive deficits affect patients' understanding of disease and treatment requirements, as well as limiting their functional capacity and ability to implement treatment plans, and undertake self-care.

Aims
The purpose of this study was to establish a comprehensive neurocognitive profile of the heart failure patient through systematic neurocognitive assessment and to determine whether an association existed between severity of heart failure and cognitive abilities.

Methods
Thirty-eight patients were recruited from the heart failure patient databases of two metropolitan hospitals in Melbourne, Australia. Participants were individually assessed using four standardised, internationally recognised neuropsychological tests that examined current and premorbid intelligence, memory and executive functioning.

Results
Although there was no significant decline from premorbid general intellectual function, other specific areas of deficit, including impaired memory and executive functioning, were identified. There were no significant correlations between heart failure severity and the neurocognitive measures used.

Conclusion
The results support the need to recognise cognitive impairment in people with heart failure and to develop an abbreviated method of assessing cognitive function that can be easily implemented in the clinical setting. Identifying cognitive deficits in this population will be useful in guiding the content and nature of treatment plans to maximise adherence and minimise worsening of heart failure symptoms.

Truth is God harm minimization through the practice of ecologically sustainable design and buddhism

The emergence of the global ecological crisis is presenting unique opportunities for the coordination of ethical thinking across cultural boundaries. Harm minimization as an ethical imperative operates as the ‘modus operandi’ behind both Ecologically Sustainable Design (ESD) and Buddhist practice. The architectural response to ESD is founded upon the ‘Declaration of Interdependence for a Sustainable Future’ adopted in 1993 by the International Union of Architects, of which the RAIA is a member.

Buddhism is a response to existential concerns universal to humanity. It developed as a set of principles for personal transformation known as the Four Noble Truths elucidated two and a half thousand years ago. Buddhist meditation practise ‘interrupts automatic patterns of conditioned behaviour’ recognised as the major obstacle to be overcome in any programme for change. Unsustainable egocentric behaviour is considered fundamental to our global ecological crisis and calls for radical behavioural change are increasingly being heard at the professional as well as the personal level. Emerging synergies between the Western cognitive sciences and Buddhist study of the mind increasingly validate the Tibetan Buddhist mind development phenomenon. Buddhists argue that their programme for enhancing ethical behaviour through mind development is a step-by step process of observation and analysis built upon empirical observation – a fundamental pre-requisite of any ‘scientific’ enquiry. Collaborative research programmes currently underway are an attempt to re-interpret Buddhist meditation techniques within a framework acceptable to Western scientific understanding. A truly holistic approach to harm minimization requires its consideration.

Assessing financial competence in older adults with cognitive impairment

One common problem brought before Courts and Tribunals in Australia is whether or not someone is able to manage his or her own financial affairs. The problem is that currently in Australia there are no universally agreed upon standards for assessing financial competence. The aim of this study was to examine the reliability and validity of a new measure of financial competence, The Financial Competence Assessment Inventory (FCAI), in assessing financial competency of older adults with a cognitive impairment. The sample comprised 18 older adults with acquired brain injury, 10 adults with schizophrenia, 21 adults with dementia and 27 older adults without cognitive impairment. Ages ranged from 55 to 91. Each participant was individually interviewed using the FCAI. The findings revealed that the FCAI is a reliable and valid assessment tool for assessing financial competence of older adults with different types and levels of cognitive impairment. In particular, the FCAI was able to distinguish between older adults with global brain impairment and older adults with specific brain impairment; and older adults who had a legal administrator and older adults who did not. In addition, using the FCAI it was possible to obtain a profile of participants’ strengths and weaknesses across six domains of financial competence including; everyday financial abilities, financial judgment, estate management, cognitive based financial tasks, debt management, and support resources. The FCAI has the potential to assist clinicians and legal decision-makers regarding ‘least restrictive alternatives’ when financial competence is in question.

Empirical generalisation as an inadequate cognitive scaffold to theoretical generalisation of a more complex concept

The impact of prior learning on new learning is highlighted by the case of Dean, a Year 8 student who developed his own method to find the sum of the interior angles of a polygon without knowing why his method worked. Enriched transcripts and visual displays of the cognitive, social (Dreyfus, Hershkowitz, & Schwarz, 2001) and affective elements (Williams, 2002) of Dean's interrupted abstraction process informed the identification of factors that inhibited Dean's constructing process. It was found Dean possessed an empirical, not theoretical, generalization (Davydov, 1990) about sums of interior angles of triangles that was an inadequate cognitive artifact for constructing the new more complex theoretical generalization. The study suggests use of tasks designed with the opportunity develop assumed knowledge in conjunction with new concepts.

Applications of cognitive theories to children's fire safety education

Children under five have the highest rate of fire-related accidents (Australian Institute of Health and Welfare, 2001). It is therefore essential to develop effective fire safety education programs to prevent casualties due to a fire. At present, there are fire education programs conducted across Australia for primary school children. However, it is vital that these programs get their message across to the children in the most efficient manner to help children retain the information. The present study evaluated the effectiveness of the 'Fire Ed' program conducted in Victoria and assessed the retention of fire safety information in children in preparatory and Grade five levels. The findings suggest that the information is not retained over long periods of time. Suggestions are made to provide fire safety education in line with
theories of cognitive development to make it more effective.

Cost-effectiveness of cognitive-behavioural therapy and drug interventions for major depression

Objective: Antidepressant drugs and cognitive–behavioural therapy (CBT) are effective treatment options for depression and are recommended by clinical practice guidelines. As part of the Assessing Cost-effectiveness – Mental Health project we evaluate the available evidence on costs and benefits of CBT and drugs in the episodic and maintenance treatment of major depression.

Method: The cost-effectiveness is modelled from a health-care perspective as the cost per disability-adjusted life year. Interventions are targeted at people with major depression who currently seek care but receive non-evidence based treatment. Uncertainty in model inputs is tested using Monte Carlo simulation methods.

Results: All interventions for major depression examined have a favourable incremental cost-effectiveness ratio under Australian health service conditions. Bibliotherapy, group CBT, individual CBT by a psychologist on a public salary and tricyclic antidepressants (TCAs) are very cost-effective treatment options falling below $A10 000 per disability-adjusted life year (DALY) even when taking the upper limit of the uncertainty interval into account. Maintenance treatment with selective serotonin re-uptake inhibitors (SSRIs) is the most expensive option (ranging from $A17 000 to $A20 000 per DALY) but still well below $A50 000, which is considered the affordable threshold.

Conclusions: A range of cost-effective interventions for episodes of major depression exists and is currently underutilized. Maintenance treatment strategies are required to significantly reduce the burden of depression, but the cost of long-term drug treatment for the large number of depressed people is high if SSRIs are the drug of choice. Key policy issues with regard to expanded provision of CBT concern the availability of suitably trained providers and the funding mechanisms for therapy in primary care.

Subjective wellbeing as an affective-cognitive construct

The affective content of Subjective Wellbeing (SWB) was investigated in two separate studies. Study 1 involved a representative sample of 478 participants from across Australia aged between 18 and 72 years. This study tested the circumplex model of affect and then determined the minimum set of affects that explain variance in SWB. The model was supported, with most affects congregated around the valence axis. Overall, 64% of the variance in SWB was explained by six Core Affects, indicating that SWB is a highly affective construct. Study 2 tested the relative strength of Core Affect (content, happy and excited), in three separate models of SWB incorporating cognition (seven discrepancies)
and all five factors of personality. Using a sample of 854 participants aged been 18 – 86 years, structural equation modeling was used to compare an affective-cognitive driven model of SWB, with a personality driven model of SWB and a discrepancy driven model of SWB. The results provide support for an affective-cognitive model which explained 90 percent of the variance in SWB. All models confirm that the relationship between SWB, Core Affect and Discrepancies is far stronger than the relationship between personality and SWB. It is proposed that Core Affect and Discrepancies comprise the essence of SWB. Moreover, Core Affect is the driving force behind individual set-point levels in SWB homeostasis.

The prevalence and recognition of major depression among low-level aged care residents with and without cognitive impairment

Previous research has demonstrated a high level of depression in nursing homes. The current study was designed to determine the prevalence of depression, using a structured diagnostic interview, among older people with and without mild-moderate cognitive impairment residing in low-level care facilities. The results demonstrated that, consistent with previous research in nursing homes, 16.9% of older people were diagnosed with major depressive disorder. Less than half of these cases had been detected or treated. Individuals with moderate cognitive impairment were more likely to be depressed, but cognitive impairment did not appear to act as a strong impediment to the detection of depression by general practitioners. A low awareness of their use of antidepressant medications was demonstrated among older people prescribed this treatment, including those with normal cognitive function. Reasons for the poor recognition of depression among older people are discussed.

Understanding informations systems outsourcing success and risks through the lens of cognitive biases

Because outsourcing of information systems (IS) is now widespread, it is generally assumed to be successful. It is also often assumed that outsourcing risks are easily managed. In this paper we adopt an “evidence based management” approach to first test these assumptions through a qualitative metaanalysis of academic studies into IS outsourcing outcomes. Our research reveals a shortage of reliable and valid evidence for outsourcing’s benefits, and for the level of risk involved. We then use data from a series of focus groups to explain the paradox of widespread adoption of a strategy with limited empirical support. These focus groups were interpreted through the lens of research on a
range of cognitive mechanisms and biases that are known to affect decision makers. We conclude that cognitive mechanisms that are likely to affect sourcing decisions include framing biases, cognitive dissonance, attribution error, and the “optimism”, “confirmation”, “disconfirmation” and “overconfidence” biases. Given the shortage of supporting evidence, and the potential for these biases to operate, we argue that researchers need to be more critical in their analysis of reports of the success and risks of IS outsourcing.

The cognitive contexts of beliefs about the healthiness of meat

Objective: The overall aim of this study was to examine a variety of belief and demographic factors that are associated with the perception that meat is intrinsically unhealthy.

Design: State-wide survey (written questionnaire) that included questions on meat and nutrition beliefs, perceived barriers and benefits of vegetarian diets, personal values, number of vegetarian friends and family members, and use and trust of health/nutrition/food information sources.

Setting: South Australia.

Subjects: Six hundred and one randomly selected South Australians and 106 non-randomly selected vegetarians and semi-vegetarians.

Results: For all respondents considered as a group, the most important predictors of the belief that meat is intrinsically unhealthy were the perceived benefits of vegetarian diets (all positive predictors). These included: (1) the perceived links between vegetarianism, peace and increased contentment; (2) animal welfare and environmental benefits; and (3) health benefits. There were differences between different dietary groups however. For non-vegetarians, social concerns about vegetarianism (positive) were most important, followed by health and non-health benefits (positive) of vegetarianism. Red meat appreciation was the strongest (positive) predictor for vegetarians, with health benefits of vegetarianism (positive) and education (negative predictor) also important.

Conclusions: The implications of the findings for health and other issues are discussed. Judgements about the healthiness of meat are likely to be related to moral and environmental beliefs and, for non-vegetarians, to social concerns about vegetarianism, in addition to health beliefs. These need to be considered if any attempts are made to influence meat consumption.