Predicting the attention of others.

As social animals, people are highly sensitive to the attention of others. Seeing someone else gaze at an object automatically draws one's own attention to that object. Monitoring the attention of others aids in reconstructing their emotions, beliefs, and intentions and may play a crucial role in social alignment. Recently, however, it has been suggested that the human brain constructs a predictive model of other people's attention that is far more involved than a moment-by-moment monitoring of gaze direction. The hypothesized model learns the statistical patterns in other people's attention and extrapolates how attention is likely to move. Here, we tested the hypothesis of a predictive model of attention. Subjects saw movies of attention displayed as a bright spot shifting around a scene. Subjects were able to correctly distinguish natural attention sequences (based on eye tracking of prior participants) from altered sequences (e.g., played backward or in a scrambled order). Even when the attention spot moved around a blank background, subjects could distinguish natural from scrambled sequences, suggesting a sensitivity to the spatial-temporal statistics of attention. Subjects also showed an ability to recognize the attention patterns of different individuals. These results suggest that people possess a sophisticated model of the normal statistics of attention and can identify deviations from the model. Monitoring attention is therefore more than simply registering where someone else's eyes are pointing. It involves predictive modeling, which may contribute to our remarkable social ability to predict the mind states and behavior of others.

Improving Patient Safety: Using Bruner's Theory of Constructivism to Develop an Innovative Root Cause Analysis Virtual Simulation for Graduate Nursing Students.

ABSTRACT: Medical errors and near-miss events continue to impact hundreds of thousands of people annually. Given this fact, it is imperative that graduate students entering a career in patient safety are confident and competent in conducting root cause analyses so that they can fix broken systems and improve patient outcomes. Using Bruner's theory of constructivism as a framework, a virtual simulation was developed to provide online graduate nursing students an opportunity to apply classroom knowledge of root cause analyses in a virtual real-world online simulation.

Decreasing Falls With Injury Rates: Development of a Support Staff Falls Advocate Program.

Falls with injury are a persistent patient safety challenge in the acute care setting. This article describes the creation and implementation of a Certified Falls Prevention Advocate (CFPA) program on a medical-surgical unit. The program created standardization of nursing support staff involvement in falls prevention and engaged them as members of the interdisciplinary team. The CFPA program was an important element in the unit's improvement in falls with injury rates. The mean falls with injury rate decreased from 1.115 to 0.178 per 1000 patient-days over a 1-year period.

Childhood outcomes following discharge from a referral bronchopulmonary dysplasia program.

OBJECTIVES: The primary objective of this study was to profile the childhood health, development, and health-related quality of life (HR QoL) for children with the most severe bronchopulmonary dysplasia (BPD), those discharged from a quaternary referral program. STUDY DESIGN: We collected cross-sectional data through telephone interviews with 282 families of children ages 18 months to 11 years who had been discharged from a BPD referral program. RESULTS: Respiratory morbidities were near universal, with 42% of children ever having required a tracheostomy and severity of these morbidities correlated with parent-reported health and QoL. Developmental morbidities were also marked: 97% required an individualized educational plan. While respiratory morbidities and overall health improved over time, developmental morbidities were increasingly prominent, resulting in lower quality of life. CONCLUSIONS: Among children referred to a quaternary BPD program, respiratory and developmental morbidities are on numerous counts more severe than any reported in the literature.

Comparison of video laryngoscopy and direct laryngoscopy in a critical care transport service.

OBJECTIVE: We evaluated video laryngoscopy (VL) (C-MAC, Karl Storz, Tuttlingen, Germany) for use in a critical care transport system. We hypothesized that the total number of airway attempts would decrease when using a video laryngoscope versus use of direct laryngoscopy (DL). METHODS: We performed a nonrandomized group-controlled trial where six aircraft were outfitted with VL and the remainder utilized DL responding to a mix of scene runs and interfacility transports. Our primary outcome measure was the number of intubation attempts. We also compared the first-pass success (FPS) rates, laryngoscopic grades, and frequencies of rescue device use (including utilization of surgical airways) between VL and DL. RESULTS: Crews intubated 348 patients with VL and 510 with DL. Successful endotracheal intubation within three attempts occurred 97.6% (confidence interval [CI] 96.5-98.6) of the time. The FPS rate was 85.8% (CI 83.4-88.1). In this cohort of patients, VL did not differ from DL with respect to total number of airway attempts (1.17 [CI 1.11-1.22] vs. 1.16 [CI 1.12-1.20]), FPS rate (85.6% [CI 82-89%] vs. 86.1% [CI 83-89]), or use of rescue airways (2.6% vs. 2.2%). The laryngoscopic view was superior in the VL group relative to the DL group (median Cormack-Lehane grade 1 [interquartile range (IQR) 1, 2] vs. 2 [IQR 1, 2]). CONCLUSION: VL using the C-MAC video laryngoscope did not reduce the total number of airway attempts or improve intubation compared with DL in a system of highly trained providers.