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1.
Behav Brain Sci ; 46: e133, 2023 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-37462174

RESUMO

De Neys proposed a "switch" model to address what he argued to be lacuna in dual-process theory, in which he theorized about the processes that initiate and terminate analytic thinking. We will argue that the author neglected to acknowledge the abundant literature on metacognitive functions, specifically, the meta-reasoning framework developed by Ackerman and Thompson (2017), that addresses just those questions.


Assuntos
Metacognição , Pensamento , Humanos , Masculino , Incerteza , Resolução de Problemas , Emoções
2.
BMC Geriatr ; 22(1): 82, 2022 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-35086480

RESUMO

BACKGROUND: Frailty predicts adverse post-kidney transplant (KT) outcomes, yet the impact of frailty assessment on center-level outcomes remains unclear. We sought to test whether transplant centers assessing frailty as part of clinical practice have better pre- and post-KT outcomes in all adult patients (≥18 years) and older patients (≥65 years). METHODS: In a survey of US transplant centers (11/2017-4/2018), 132 (response rate = 65.3%) centers reported their frailty assessment practices (frequency and specific tool) at KT evaluation and admission. Assessment frequency was categorized as never, sometime, and always; type of assessment tool was categorized as none, validated (for post-KT risk prediction), and any other tool. Center characteristics and clinical outcomes for adult patients during 2017-2019 were gleaned from the transplant national registry (Scientific Registry of Transplant Recipients). Poisson regression was used to estimate incidence rate ratios (IRRs) of waitlist outcomes (waitlist mortality, transplantation) in candidates and IRRs of post-KT outcomes (all-cause mortality, death-censored graft loss) in recipients by frailty assessment frequency. We also estimated IRRs of waitlist outcomes by type of assessment tool at evaluation. All models were adjusted for case mix and center characteristics. RESULTS: Assessing frailty at evaluation was associated with lower waitlist mortality rate (always IRR = 0.91,95%CI:0.84-0.99; sometimes = 0.89,95%CI:0.83-0.96) and KT rate (always = 0.94,95%CI:0.91-0.97; sometimes = 0.88,95%CI:0.85-0.90); the associations with waitlist mortality rate (always = 0.86,95%CI:0.74-0.99; sometimes = 0.83,95%CI:0.73-0.94) and KT rate (always = 0.82,95%CI:0.77-0.88; sometimes = 0.92,95%CI:0.87-0.98) were stronger in older patients. Furthermore, using validated (IRR = 0.90,95%CI:0.88-0.92) or any other tool (IRR = 0.90,95%CI:0.87-0.93) at evaluation was associated lower KT rate, while only using a validated tool was associated with lower waitlist mortality rate (IRR = 0.89,95%CI:0.83-0.96), especially in older patients (IRR = 0.82,95%CI:0.72-0.93). At admission for KT, always assessing frailty was associated with a lower graft loss rate (IRR = 0.71,95%CI:0.54-0.92) but not with mortality (IRR = 0.93,95%CI:0.76-1.13). CONCLUSIONS: Assessing frailty at evaluation is associated with lower KT rate, while only using a validated frailty assessment tool is associated with better survival, particularly in older candidates. Centers always assessing frailty at admission are likely to have better graft survival rates. Transplant centers may utilize validated frailty assessment tools to secure KT access for appropriate candidates and to better allocate health care resources for patients identified as frail, particularly for older patients.


Assuntos
Fragilidade , Falência Renal Crônica , Transplante de Rim , Idoso , Fragilidade/complicações , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Humanos , Transplante de Rim/efeitos adversos , Estudos Prospectivos , Fatores de Risco
3.
Mem Cognit ; 49(3): 532-543, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33057905

RESUMO

The dual strategy model proposes that people use one of two potential ways of processing information when making inferences. The statistical strategy generates a rapid probabilistic estimate based on associative access to a wide array of information, while the counterexample strategy uses a more focused representation, allowing for a search for potential counterexamples. In the following studies, we explore the hypothesis that individual differences in strategy use are related to the ability to make rapid intuitive logical judgments. In Study 1, we show that this is the case for rapid judgments requiring a distinction between simple logical form and for a novel form of judgment, the ability to identify inferences that are not linked to their premises (non sequiturs). In Study 2, we show that strategy use is related to the ability to make the kinds of rapid logical judgments previously examined over and above contributions of working memory capacity. Study 3 shows that strategy use explains individual variability in rapid logical responding with belief-biased inferences over and above the contribution of IQ. The results of Studies 2 and 3 indicate that under severe time constraint cognitive capacity is a very poor predictor of reasoning, while strategy use becomes a stronger predictor. These results extend the notion that people can make rapid intuitive "logical" judgments while highlighting the importance of strategy use as a key individual difference variable.


Assuntos
Lógica , Resolução de Problemas , Pensamento , Cognição , Humanos , Julgamento
4.
Mem Cognit ; 48(4): 655-671, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31792857

RESUMO

A common explanation for individual differences in the ability to draw rule-based inferences, when a putative conclusion suggests a competing belief-based inference, is that the ability to do so depends on working memory capacity. In the following studies, we examined the hypothesis that the ability to draw rule-based inferences in belief bias tasks can also be explained by individual differences in reasoning strategies and in the related attentional focus. The dual-strategy model differentiates counterexample and statistical strategies that involve different information-processing styles. In the first study (N = 139), participants completed a working memory task (operation span), a strategy diagnostic questionnaire, and a belief bias task. The results showed that individual differences in strategy use predicted performance in the belief bias problems over and above any effects of working memory capacity, with counterexample reasoners producing rule-based inferences more often than statistical reasoners. In the second study (N = 196), an eye-tracking methodology was used as a process-tracing technique to investigate attentional differences between the two strategies. On problems showing a conflict between rule-based and belief-based information, counterexample reasoners demonstrated longer fixation times on the premises than did statistical reasoners, thus providing direct evidence that individual differences in strategy use reflect different processing styles. These results clearly indicate that individual differences in strategy use are an important determinant of the way that people make inferences when rule-based and belief-based cues are both present.


Assuntos
Individualidade , Memória de Curto Prazo , Atenção , Cognição , Humanos , Resolução de Problemas
5.
Mem Cognit ; 45(7): 1182-1192, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28608194

RESUMO

The dual strategy model of reasoning proposed by Verschueren, Schaeken, and d'Ydewalle (Thinking & Reasoning, 11(3), 239-278, 2005a; Memory & Cognition, 33(1), 107-119, 2005b) suggests that people can use either a statistical or a counterexample-based strategy to make deductive inferences. Subsequent studies have supported this distinction and investigated some properties of the two strategies. In the following, we examine the further hypothesis that reasoners using statistical strategies should be more vulnerable to the effects of conclusion belief. In each of three studies, participants were given abstract problems used to determine strategy use and three different forms of syllogism with believable and unbelievable conclusions. Responses, response times, and feeling of rightness (FOR) measures were taken. The results show that participants using a statistical strategy were more prone to the effects of conclusion belief across all three forms of reasoning. In addition, statistical reasoners took less time to make inferences than did counterexample reasoners. Patterns of variation in response times and FOR ratings between believable and unbelievable conclusions were very similar for both strategies, indicating that both statistical and counterexample reasoners were aware of conflict between conclusion belief and premise-based reasoning.


Assuntos
Pensamento/fisiologia , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
6.
Mem Cognit ; 45(4): 539-552, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28028779

RESUMO

Two experiments pitted the default-interventionist account of belief bias against a parallel-processing model. According to the former, belief bias occurs because a fast, belief-based evaluation of the conclusion pre-empts a working-memory demanding logical analysis. In contrast, according to the latter both belief-based and logic-based responding occur in parallel. Participants were given deductive reasoning problems of variable complexity and instructed to decide whether the conclusion was valid on half the trials or to decide whether the conclusion was believable on the other half. When belief and logic conflict, the default-interventionist view predicts that it should take less time to respond on the basis of belief than logic, and that the believability of a conclusion should interfere with judgments of validity, but not the reverse. The parallel-processing view predicts that beliefs should interfere with logic judgments only if the processing required to evaluate the logical structure exceeds that required to evaluate the knowledge necessary to make a belief-based judgment, and vice versa otherwise. Consistent with this latter view, for the simplest reasoning problems (modus ponens), judgments of belief resulted in lower accuracy than judgments of validity, and believability interfered more with judgments of validity than the converse. For problems of moderate complexity (modus tollens and single-model syllogisms), the interference was symmetrical, in that validity interfered with belief judgments to the same degree that believability interfered with validity judgments. For the most complex (three-term multiple-model syllogisms), conclusion believability interfered more with judgments of validity than vice versa, in spite of the significant interference from conclusion validity on judgments of belief.


Assuntos
Lógica , Modelos Psicológicos , Pensamento , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
7.
Brain ; 138(Pt 10): 2987-3002, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26220941

RESUMO

Abnormal dopamine neurotransmission is associated with many different genetic and acquired dystonic disorders. For instance, mutations in genes critical for the synthesis of dopamine, including GCH1 and TH cause l-DOPA-responsive dystonia. Despite evidence that implicates abnormal dopamine neurotransmission in dystonia, the precise nature of the pre- and postsynaptic defects that result in dystonia are not known. To better understand these defects, we generated a knock-in mouse model of l-DOPA-responsive dystonia (DRD) mice that recapitulates the human p.381Q>K TH mutation (c.1141C>A). Mice homozygous for this mutation displayed the core features of the human disorder, including reduced TH activity, dystonia that worsened throughout the course of the active phase, and improvement in the dystonia in response to both l-DOPA and trihexyphenidyl. Although the gross anatomy of the nigrostriatal dopaminergic neurons was normal in DRD mice, the microstructure of striatal synapses was affected whereby the ratio of axo-spinous to axo-dendritic corticostriatal synaptic contacts was reduced. Microinjection of l-DOPA directly into the striatum ameliorated the dystonic movements but cerebellar microinjections of l-DOPA had no effect. Surprisingly, the striatal dopamine concentration was reduced to ∼1% of normal, a concentration more typically associated with akinesia, suggesting that (mal)adaptive postsynaptic responses may also play a role in the development of dystonia. Administration of D1- or D2-like dopamine receptor agonists to enhance dopamine signalling reduced the dystonic movements, whereas administration of D1- or D2-like dopamine receptor antagonists to further reduce dopamine signalling worsened the dystonia, suggesting that both receptors mediate the abnormal movements. Further, D1-dopamine receptors were supersensitive; adenylate cyclase activity, locomotor activity and stereotypy were exaggerated in DRD mice in response to the D1-dopamine receptor agonist SKF 81297. D2-dopamine receptors exhibited a change in the valence in DRD mice with an increase in adenylate cyclase activity and blunted behavioural responses after challenge with the D2-dopamine receptor agonist quinpirole. Together, our findings suggest that the development of dystonia may depend on a reduction in dopamine in combination with specific abnormal receptor responses.


Assuntos
Dopaminérgicos/uso terapêutico , Distonia/tratamento farmacológico , Levodopa/uso terapêutico , Mutação/genética , Tirosina 3-Mono-Oxigenase/genética , Animais , Benzazepinas/farmacocinética , Encéfalo/metabolismo , Encéfalo/patologia , Encéfalo/ultraestrutura , Catecolaminas/metabolismo , Modelos Animais de Doenças , Antagonistas de Dopamina/farmacocinética , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Distonia/diagnóstico por imagem , Distonia/genética , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Atividade Motora/efeitos dos fármacos , Atividade Motora/genética , Cintilografia , Comportamento Estereotipado/fisiologia , Trítio/farmacocinética , Tirosina 3-Mono-Oxigenase/metabolismo
8.
Mem Cognit ; 43(4): 681-93, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25416026

RESUMO

The nature of people's meta-representations of deductive reasoning is critical to understanding how people control their own reasoning processes. We conducted two studies to examine whether people have a metacognitive representation of abstract validity and whether familiarity alone acts as a separate metacognitive cue. In Study 1, participants were asked to make a series of (1) abstract conditional inferences, (2) concrete conditional inferences with premises having many potential alternative antecedents and thus specifically conducive to the production of responses consistent with conditional logic, or (3) concrete problems with premises having relatively few potential alternative antecedents. Participants gave confidence ratings after each inference. Results show that confidence ratings were positively correlated with logical performance on abstract problems and concrete problems with many potential alternatives, but not with concrete problems with content less conducive to normative responses. Confidence ratings were higher with few alternatives than for abstract content. Study 2 used a generation of contrary-to-fact alternatives task to improve levels of abstract logical performance. The resulting increase in logical performance was mirrored by increases in mean confidence ratings. Results provide evidence for a metacognitive representation based on logical validity, and show that familiarity acts as a separate metacognitive cue.


Assuntos
Metacognição/fisiologia , Pensamento/fisiologia , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-37466327

RESUMO

BACKGROUND: Frailty is associated with poor outcomes in surgical patients including kidney transplant (KT) recipients. Transplant centers that measure frailty have better pre- and postoperative outcomes. However, clinical utility of existing tools is low due to time constraints. To address this major barrier to implementation in the preoperative evaluation of patients, we developed an abridged frailty phenotype. METHODS: The abridged frailty phenotype was developed by simplifying the 5 physical frailty phenotype (PFP) components in a two-center prospective cohort of 3 220 KT candidates and tested for efficiency (time to completion) in 20 candidates evaluation (January 2009 to March 2020). We examined area under curve (AUC) and Cohen's kappa agreement to compare the abridged assessment with the PFP. We compared waitlist mortality risk (competing risks models) by frailty using the PFP and abridged assessment, respectively. Model discrimination was assessed using Harrell's C-statistic. RESULTS: Of 3 220 candidates, the PFP and abridged assessment identified 23.8% and 27.4% candidates as frail, respectively. The abridged frailty phenotype had substantial agreement (kappa = 0.69, 95% CI: 0.66-0.71) and excellent discrimination (AUC = 0.861). Among 20 patients at evaluation, abridged assessment took 5-7 minutes to complete. The PFP and abridged assessment had similar associations with waitlist mortality (subdistribution hazard ratio [SHR] = 1.62, 95% CI: 1.26-2.08 vs SHR = 1.70, 95% CI: 1.33-2.16) and comparable mortality discrimination (p = .51). CONCLUSIONS: The abridged assessment is an efficient and valid way to identify frailty. It predicts waitlist mortality without sacrificing discrimination. Surgical departments should consider utilizing the abridged assessment to evaluate frailty in patients when time is limited.


Assuntos
Fragilidade , Transplante de Rim , Humanos , Fragilidade/diagnóstico , Fragilidade/etiologia , Estudos de Coortes , Estudos Prospectivos , Transplante de Rim/efeitos adversos , Fenótipo
10.
JAMA Intern Med ; 184(4): 402-413, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38372985

RESUMO

Importance: Identifying the mechanisms of structural racism, such as racial and ethnic segregation, is a crucial first step in addressing the persistent disparities in access to live donor kidney transplantation (LDKT). Objective: To assess whether segregation at the candidate's residential neighborhood and transplant center neighborhood is associated with access to LDKT. Design, Setting, and Participants: In this cohort study spanning January 1995 to December 2021, participants included non-Hispanic Black or White adult candidates for first-time LDKT reported in the US national transplant registry. The median (IQR) follow-up time for each participant was 1.9 (0.6-3.0) years. Main Outcome and Measures: Segregation, measured using the Theil H method to calculate segregation tertiles in zip code tabulation areas based on the American Community Survey 5-year estimates, reflects the heterogeneity in neighborhood racial and ethnic composition. To quantify the likelihood of LDKT by neighborhood segregation, cause-specific hazard models were adjusted for individual-level and neighborhood-level factors and included an interaction between segregation tertiles and race. Results: Among 162 587 candidates for kidney transplant, the mean (SD) age was 51.6 (13.2) years, 65 141 (40.1%) were female, 80 023 (49.2%) were Black, and 82 564 (50.8%) were White. Among Black candidates, living in a high-segregation neighborhood was associated with 10% (adjusted hazard ratio [AHR], 0.90 [95% CI, 0.84-0.97]) lower access to LDKT relative to residence in low-segregation neighborhoods; no such association was observed among White candidates (P for interaction = .01). Both Black candidates (AHR, 0.94 [95% CI, 0.89-1.00]) and White candidates (AHR, 0.92 [95% CI, 0.88-0.97]) listed at transplant centers in high-segregation neighborhoods had lower access to LDKT relative to their counterparts listed at centers in low-segregation neighborhoods (P for interaction = .64). Within high-segregation transplant center neighborhoods, candidates listed at predominantly minority neighborhoods had 17% lower access to LDKT relative to candidates listed at predominantly White neighborhoods (AHR, 0.83 [95% CI, 0.75-0.92]). Black candidates residing in or listed at transplant centers in predominantly minority neighborhoods had significantly lower likelihood of LDKT relative to White candidates residing in or listed at transplant centers located in predominantly White neighborhoods (65% and 64%, respectively). Conclusions: Segregated residential and transplant center neighborhoods likely serve as a mechanism of structural racism, contributing to persistent racial disparities in access to LDKT. To promote equitable access, studies should assess targeted interventions (eg, community outreach clinics) to improve support for potential candidates and donors and ultimately mitigate the effects of segregation.


Assuntos
Transplante de Rim , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Negro ou Afro-Americano , Estudos de Coortes , Doadores Vivos , Grupos Minoritários , Brancos , Estados Unidos
11.
Transplantation ; 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38771099

RESUMO

BACKGROUND: Recent data suggest patients with graft failure had better access to repeat kidney transplantation (re-KT) than transplant-naive dialysis accessing first KT. This was postulated to be because of better familiarity with the transplant process and healthcare system; whether this advantage is equitably distributed is not known. We compared the magnitude of racial/ethnic disparities in access to re-KT versus first KT. METHODS: Using United States Renal Data System, we identified 104 454 White, Black, and Hispanic patients with a history of graft failure from 1995 to 2018, and 2 357 753 transplant-naive dialysis patients. We used adjusted Cox regression to estimate disparities in access to first and re-KT and whether the magnitude of these disparities differed between first and re-KT using a Wald test. RESULTS: Black patients had inferior access to both waitlisting and receiving first KT and re-KT. However, the racial/ethnic disparities in waitlisting for (adjusted hazard ratio [aHR] = 0.77; 95% confidence interval [CI], 0.74-0.80) and receiving re-KT (aHR = 0.61; 95% CI, 0.58-0.64) was greater than the racial/ethnic disparities in first KT (waitlisting: aHR = 0.91; 95% CI, 0.90-0.93; Pinteraction = 0.001; KT: aHR = 0.68; 95% CI, 0.64-0.72; Pinteraction < 0.001). For Hispanic patients, ethnic disparities in waitlisting for re-KT (aHR = 0.83; 95% CI, 0.79-0.88) were greater than for first KT (aHR = 1.14; 95% CI, 1.11-1.16; Pinteraction < 0.001). However, the disparity in receiving re-KT (aHR = 0.76; 95% CI, 0.72-0.80) was similar to that for first KT (aHR = 0.73; 95% CI, 0.68-0.79; Pinteraction = 0.55). Inferences were similar when restricting the cohorts to the Kidney Allocation System era. CONCLUSIONS: Unlike White patients, Black and Hispanic patients with graft failure do not experience improved access to re-KT. This suggests that structural and systemic barriers likely persist for racialized patients accessing re-KT, and systemic changes are needed to achieve transplant equity.

12.
Mol Ther ; 20(3): 544-54, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22008908

RESUMO

Neurotrophic factors are integrally involved in the development of the nigrostriatal system and in combination with gene therapy, possess great therapeutic potential for Parkinson's disease (PD). Pleiotrophin (PTN) is involved in the development, maintenance, and repair of the nigrostriatal dopamine (DA) system. The present study examined the ability of striatal PTN overexpression, delivered via psueudotyped recombinant adeno-associated virus type 2/1 (rAAV2/1), to provide neuroprotection and functional restoration from 6-hydroxydopamine (6-OHDA). Striatal PTN overexpression led to significant neuroprotection of tyrosine hydroxylase immunoreactive (THir) neurons in the substantia nigra pars compacta (SNpc) and THir neurite density in the striatum, with long-term PTN overexpression producing recovery from 6-OHDA-induced deficits in contralateral forelimb use. Transduced striatal PTN levels were increased threefold compared to adult striatal PTN expression and approximated peak endogenous developmental levels (P1). rAAV2/1 vector exclusively transduced neurons within the striatum and SNpc with approximately half the total striatal volume routinely transduced using our injection parameters. Our results indicate that striatal PTN overexpression can provide neuroprotection for the 6-OHDA lesioned nigrostriatal system based upon morphological and functional measures and that striatal PTN levels similar in magnitude to those expressed in the striatum during development are sufficient to provide neuroprotection from Parkinsonian insult.


Assuntos
Proteínas de Transporte/genética , Corpo Estriado/metabolismo , Citocinas/genética , Transtornos Parkinsonianos/terapia , Animais , Proteínas de Transporte/metabolismo , Citocinas/metabolismo , Dependovirus/genética , Modelos Animais de Doenças , Expressão Gênica , Ordem dos Genes , Terapia Genética , Vetores Genéticos/administração & dosagem , Vetores Genéticos/genética , Masculino , Oxidopamina , Transtornos Parkinsonianos/induzido quimicamente , Transtornos Parkinsonianos/genética , Transporte Proteico , Ratos , Ratos Sprague-Dawley , Transdução Genética
13.
Aust N Z J Obstet Gynaecol ; 53(6): 571-3, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24289063

RESUMO

OBJECTIVE: The purpose of this study was to review outcomes from LLETZ (large loop excision of the transformation zone) procedures carried out for high-grade cervical intraepithelial neoplasia (CIN), in particular findings at colposcopy, cytology and HR-HPV(high-risk human papilloma virus) result to assess whether colposcopy provides any additional information in the management of women at 12 months. METHODS: We retrospectively analysed 252 patients who had a LLETZ procedure for a HSIL (high-grade squamous intraepithelial lesion) between January 2005 and December 2010. RESULTS: Eighty per cent of women who had a LLETZ procedure for HSIL were reviewed in our colposcopy clinic at 12 months after the procedure. Colposcopy at 12 months after LLETZ was documented as unsatisfactory for 30% of these women. The sensitivity of colposcopy at 12 months after LLETZ was 0.47, and the specificity was 0.95. CONCLUSION: Colposcopy examination is an insensitive tool for detection of persisting HPV-related change after excision of high-grade CIN. Its usefulness to investigate persistent or recurrent HSIL is further reduced by the high rate of unsatisfactory colposcopy examinations after a LLETZ procedure. Papanicolaou smear and HRHPV tests may be adequate follow-up at 12 months after LLETZ for women at low risk of recurrence of HSIL.


Assuntos
Colposcopia , Recidiva Local de Neoplasia/diagnóstico , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Adulto , Feminino , Humanos , Auditoria Médica , Pessoa de Meia-Idade , Neoplasia Residual , Teste de Papanicolaou , Estudos Retrospectivos , Sensibilidade e Especificidade , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal , Displasia do Colo do Útero/cirurgia , Displasia do Colo do Útero/virologia
14.
Science ; 382(6673): 890, 2023 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-37995224

RESUMO

An optimistic game proves that solving hard problems can be serious fun.

15.
J Exp Psychol Learn Mem Cogn ; 49(11): 1773-1785, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37883048

RESUMO

Mental model (Johnson-Laird, 2001) and probabilistic theories (Oaksford & Chater, 2009) claim to provide distinct explanations of human reasoning. However, the dual strategy model of reasoning suggests that this distinction corresponds to different reasoning strategies, termed counterexample and statistical, respectively. There is clear evidence that most people have a preference for a given strategy, and that this predicts performance on a variety of forms of reasoning and judgment (Thompson & Markovits, 2021). To date, however, the evidence for this conclusion has been correlational in nature; in the current studies, we manipulated strategy use. To this end, we gave people (N = 885) explicit instructions to reason either using a counterexample strategy or a probabilistic strategy. In two studies, we observed that the ability to follow these instructions was constrained by people's spontaneous strategy use, and that the effect of instructions carried over to two subsequent forms of reasoning (a) belief-biased inferences and (b) base-rate judgments. Finally, the ability to follow instructions was correlated with reasoning accuracy on both tasks. These results provide strong evidence for the underlying reality of the dual strategy model and show that explicit instructions to reason differently can modify performance on different forms of reasoning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Julgamento , Resolução de Problemas , Humanos , Bases de Dados Factuais
16.
Surgery ; 173(1): 111-116, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36195501

RESUMO

BACKGROUND: Prior studies have demonstrated racial disparities in the severity of secondary hyperparathyroidism among dialysis patients. Our primary objective was to study the racial and socioeconomic differences in the timing and likelihood of parathyroidectomy in patients with secondary hyperparathyroidism. METHODS: We used the United States Renal Data System to identify 634,428 adult (age ≥18) patients who were on maintenance dialysis between 2006 and 2016 with Medicare as their primary payor. Adjusted multivariable Cox regression was performed to quantify the differences in parathyroidectomy by race. RESULTS: Of this cohort, 27.3% (173,267) were of Black race. Compared to 15.4% of White patients, 23.1% of Black patients lived in a neighborhood that was below a predefined poverty level (P < .001). The cumulative incidence of parathyroidectomy at 10 years after dialysis initiation was 8.8% among Black patients compared to 4.3% among White patients (P < .001). On univariable analysis, Black patients were more likely to undergo parathyroidectomy (adjusted hazard ratio = 1.83; 95% confidence interval, 1.74-1.93). This association persisted after adjusting for age, sex, cause of end-stage renal disease, body mass index, comorbidities, dialysis modality, and poverty level (adjusted hazard ratio = 1.35; 95% confidence interval, 1.27-1.43). Therefore, patient characteristics and socioeconomic status explained 26% of the association between race and likelihood of parathyroidectomy. CONCLUSION: Black patients with secondary hyperparathyroidism due to end-stage renal disease are more likely to undergo parathyroidectomy with shorter intervals between dialysis initiation and parathyroidectomy. This association is only partially explained by patient characteristics and socioeconomic factors.


Assuntos
Hiperparatireoidismo Secundário , Falência Renal Crônica , Idoso , Adulto , Humanos , Estados Unidos/epidemiologia , Fatores de Risco , Medicare , Hiperparatireoidismo Secundário/epidemiologia , Hiperparatireoidismo Secundário/etiologia , Hiperparatireoidismo Secundário/cirurgia , Paratireoidectomia/efeitos adversos , Falência Renal Crônica/terapia , Falência Renal Crônica/cirurgia
17.
Ethn Dis ; 33(4): 180-193, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38854414

RESUMO

Introduction: Black and Hispanic adults are disproportionately burdened by cardiometabolic disorders. The aim of this systematic review was to examine the effectiveness of mobile health technologies to promote disease prevention and self-management among US adults in diverse communities. Methods: Potential studies were identified using a comprehensive search of the PubMed and EMBASE databases for recent studies published from December 2018 through 2021. Keywords and search strategies were established to focus on health disparity populations and the application of mobile health technology for cardiovascular disease risk reduction. Titles and abstracts were assessed and, if a study was eligible, 2 independent reviewers completed a full-length review with extraction in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 13 studies met our inclusion criteria. Study sample sizes ranged from 8 to 533 baseline participants. Studies were conducted in diverse communities (eg, North Carolina and California). Most studies used mobile applications (n=11) and a majority used accelerometers or similar technologies (eg, smartwatches) to assess changes in dietary behavior, blood pressure control, and physical activity. Overall, studies reported positive associations between mobile technology use and risk factor reduction actions and behaviors. Long-term adherence varied across studies. Those that prioritized culturally tailored approaches reported more significant impacts than those that did not. Conclusions: Evidence suggests that mobile technology may be useful in promoting disease self-management and risk reduction among populations at higher risk of cardiometabolic diseases. The use of mobile health technologies, particularly when tailored to target populations, may be a practical approach to advancing population health equity.


Assuntos
Doenças Cardiovasculares , Telemedicina , Humanos , Estados Unidos , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/etnologia , Aplicativos Móveis , Hispânico ou Latino/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Negro ou Afro-Americano
18.
Behav Res Methods ; 44(4): 1255-65, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22437511

RESUMO

MorePower 6.0 is a flexible freeware statistical calculator that computes sample size, effect size, and power statistics for factorial ANOVA designs. It also calculates relational confidence intervals for ANOVA effects based on formulas from Jarmasz and Hollands (Canadian Journal of Experimental Psychology 63:124-138, 2009), as well as Bayesian posterior probabilities for the null and alternative hypotheses based on formulas in Masson (Behavior Research Methods 43:679-690, 2011). The program is unique in affording direct comparison of these three approaches to the interpretation of ANOVA tests. Its high numerical precision and ability to work with complex ANOVA designs could facilitate researchers' attention to issues of statistical power, Bayesian analysis, and the use of confidence intervals for data interpretation. MorePower 6.0 is available at https://wiki.usask.ca/pages/viewpageattachments.action?pageId=420413544 .


Assuntos
Análise de Variância , Teorema de Bayes , Intervalos de Confiança , Modelos Estatísticos , Software , Interpretação Estatística de Dados , Probabilidade , Psicologia Experimental/métodos , Projetos de Pesquisa , Tamanho da Amostra
19.
J Exp Psychol Gen ; 151(9): 2009-2028, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35130014

RESUMO

Recent research suggests that reasoners are able to draw simple logical or probabilistic inferences relatively intuitively and automatically, a capacity that has been termed "logical intuition" (see, e.g., De Neys & Pennycook, 2019). A key finding in support of this interpretation is that conclusion validity consistently interferes with judgments of conclusion believability, suggesting that information about logical validity is available quickly enough to interfere with belief judgments. In this study, we examined whether logical intuitions arise because reasoners are sensitive to the logical features of a problem or another structural feature that just happens to align with logical validity. In three experiments (N = 113, 137, and 254), we presented participants with logical (determinate) and pseudological (indeterminate) arguments and asked them to judge the validity or believability of the conclusion. Logical arguments had determinately valid or invalid conclusions, whereas pseudological arguments were all logically indeterminate, but some were pseudovalid (possible strong arguments) and others pseudoinvalid (possible weak arguments). Experiments 1 and 2 used simple modus ponens and affirming the consequent structures; Experiment 3 used more complex denying the antecedent and modus tollens structures. In all three experiments, we found that pseudovalidity interfered with belief judgments to the same extent as real validity. Altogether, these findings suggest that while people are able to draw inferences intuitively, and these inferences impact belief judgments, they are not logical intuitions. Rather, the intuitive inferences are driven by the processing of more superficial structural features that happen to align with logical validity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Intuição , Pensamento , Humanos , Julgamento , Lógica , Resolução de Problemas
20.
J Intell ; 10(4)2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36412789

RESUMO

Research on dual-process theories of judgment makes abundant use of reasoning problems that present a conflict between Type 1 intuitive responses and Type 2 rule-based responses. However, in many of these reasoning tasks, there is no way to discriminate between the adequate and inadequate use of rules based on logical or probabilistic principles. To experimentally discriminate between the two, we developed a new set of problems: rule-inadequate versions of standard base-rate problems (where base rates are made irrelevant). Across four experiments, we observed conflict sensitivity (measured in terms of response latencies and response confidence) in responses to standard base-rate problems but also in responses to rule-inadequate versions of these problems. This failure to discriminate between real and merely apparent (or spurious) conflict suggests that participants often misuse statistical information and draw conclusions based on irrelevant base rates. We conclude that inferring the sound use of statistical rules from normatively correct responses to standard conflict problems may be unwarranted when this kind of reasoning bias is not controlled for.

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