Medical maximization: The effect of personality on triage decision-making.

Mass Casualty Incidents (MCIs) rapidly overwhelm the ability of local medical resources to deliver comprehensive and definitive medical care and they have been occurring more frequently in recent decades and affect countries of all socioeconomic backgrounds (Hart et al., 2018). As such, it is important to understand how individuals make such decisions in these events and what factors can hinder or help the process. In this study we focused on the critical role of maximization within MCI triage. Triaging an MCI requires juggling the demand and supply of resources, time, and focus, likely leading to various decisions involving compromise/sacrifice. In a vignette study, hosted on Amazon Mturk (n = 235, Mean age = 38.05, 51.49% self-identified as male), which involved triaging over 100 patients we found that trait differences maximization impacted the willingness to use a "black tag". Furthermore, maximization also impacted how much information an individual needed about the patient before being willing to use a black tag. Overall, this research demonstrates the importance of understanding factors that create individual differences in how people make decisions during MCI events, especially those decisions that involve the use of potentially lifesaving treatments.

Network analysis of 16S rRNA sequences suggests microbial keystone taxa contribute to marine N2O cycling.

The mechanisms by which large-scale microbial community function emerges from complex ecological interactions between individual taxa and functional groups remain obscure. We leveraged network analyses of 16S rRNA amplicon sequences obtained over a seven-month timeseries in seasonally anoxic Saanich Inlet (Vancouver Island, Canada) to investigate relationships between microbial community structure and water column N2O cycling. Taxa separately broadly into three discrete subnetworks with contrasting environmental distributions. Oxycline subnetworks were structured around keystone aerobic heterotrophs that correlated with nitrification rates and N2O supersaturations, linking N2O production and accumulation to taxa involved in organic matter remineralization. Keystone taxa implicated in anaerobic carbon, nitrogen, and sulfur cycling in anoxic environments clustered together in a low-oxygen subnetwork that correlated positively with nitrification N2O yields and N2O production from denitrification. Close coupling between N2O producers and consumers in the anoxic basin is indicated by strong correlations between the low-oxygen subnetwork, PICRUSt2-predicted nitrous oxide reductase (nosZ) gene abundances, and N2O undersaturation. This study implicates keystone taxa affiliated with common ODZ groups as a potential control on water column N2O cycling and provides a theoretical basis for further investigations into marine microbial interaction networks.

Measuring engagement among older adults using a multidimensional approach to communication.

Characterizing older adult engagement is important to determine the effectiveness of interventions. Engagement refers to the occupying of oneself in external stimuli and is observable across multiple dimensions of behavior. Engagement of older adults is commonly investigated using a single behavioral dimension. There is a dearth of analytical methods that can simultaneously quantify both verbal and non-verbal forms of communication as proxies for engagement. In this article, we present a multidimensional technique to measure engagement of older adults using techniques appropriate for people with varying degrees of dementia. The new analytical approach measures facial movement, lexical use, and prosodic patterns of speech as indices of affective and behavioral outcomes of engagement. Contexts for engagement included a dyadic reminiscence therapy interview and a 12-week technology-driven group reminiscence therapy. Illustrative examples of the technique are described by two participants from two different groups in a naturalistic setting. Application of these analytical techniques can enhance measurement precision and further develop the science and evidence base, especially for, but not confined to, non-pharmacological interventions.

The Impact of a Home Respiratory Therapist to Reduce 30-Day Readmission Rates for Exacerbation of COPD.

BACKGROUND: In 2015, the Centers for Medicare and Medicaid Services limited payments to hospitals with high readmission rates for patients admitted with COPD exacerbation. Decreasing readmissions in this patient population improves patient health and decreases health care utilization of resources. We hypothesized a COPD disease management program delivered by a respiratory therapist (RT) in the patient's home may reduce readmission rates for COPD exacerbation. METHODS: We performed a pre/post interventional study comparing hospital readmissions for subjects with COPD exacerbation that received standard of care in the home versus an RT-led home COPD disease management program. Subjects discharged home from Atlantic Health System with COPD exacerbation were enrolled in the pre-intervention group. Subsequently, an evidence-based home COPD disease management program was implemented by an RT from At Home Medical in the home. The home COPD Disease Management Program was implemented from April 2017-September 2019, and this served as the post-intervention group. The primary end point was readmission rates at 30 d. Secondary end points included 60-d and 90-d readmission rates. RESULTS: A total of 1,093 participants were included in the study, 658 in the pre-intervention cohort and 435 participants in the post-intervention group. Approximately 22.3% (n = 147) of subjects in the pre-intervention group was readmitted within 30 d of discharge compared to 12.2% (n = 53) in the post-intervention group (P < .001). A reduction in 60-d (33.9% vs 12.0%, P < .001) and 90-d all-cause readmissions (43.5% vs 13.1%, P < .001) was also seen. Participation in the COPD Disease Management Program was significantly associated with decreased 30-, 60-, and 90-d readmission rates adjusting for age, gender, race, ethnicity, and smoking status (odds ratio 0.48 [95% CI 0.33-0.70]; odds ratio 0.26 [95% CI 0.18-0.38]; odds ratio 0.20 [95% CI 0.14-0.27];P < .001, for all 3 readmission rates). CONCLUSIONS: The COPD Disease Management Program is significantly associated with decreased readmission adjusting for demographics and smoking status.

Avoidant authority: The effect of organizational power on decision-making in high-uncertainty situations.

Individuals in positions of power are often required to make high-stakes decisions. The approach-inhibition theory of social power holds that elevated power activates approach-related tendencies, leading to decisiveness and action orientation. However, naturalistic decision-making research has often reported that increased power often has the opposite effect and causes more avoidant decision-making. To investigate the potential activation of avoidance-related tendencies in response to elevated power, this study employed an immersive scenario-based battery of least-worst decisions (the Least-Worst Uncertain Choice Inventory for Emergency Responses; LUCIFER) with members of the United States Armed Forces. In line with previous naturalistic decision-making research on the effect of power, this research found that in conditions of higher power, individuals found decisions more difficult and were more likely to make an avoidant choice. Furthermore, this effect was more pronounced in domain-specific decisions for which the individual had experience. These findings expand our understanding of when, and in what contexts, power leads to approach vs. avoidant tendencies, as well as demonstrate the benefits of bridging methodological divides that exist between "in the lab" and "in the field" when studying high-uncertainty decision-making.

The Effect of a 3-Minute Mindfulness Intervention, and the Mediating Role of Maximization, on Critical Incident Decision-Making.

OBJECTIVE: In this study, we extend the impact of mindfulness to the concept of least-worst decision-making. Least-worst decisions involve high-uncertainty and require the individual to choose between a number of potentially negative courses of action. Research is increasingly exploring least-worst decisions, and real-world events (such as the COVID-19 pandemic) show the need for individuals to overcome uncertainty and commit to a least-worst course of action. From sports to business, researchers are increasingly showing that "being mindful" has a range of positive performance-related benefits. We hypothesized that mindfulness would improve least-worst decision-making because it would increase self-reflection and value identification. However, we also hypothesized that trait maximization (the tendency to attempt to choose the "best" course of action) would negatively interact with mindfulness. METHODS: Three hundred and ninety-eight participants were recruited using Amazon MTurk and exposed to a brief mindfulness intervention or a control intervention (listening to an audiobook). After this intervention, participants completed the Least-Worst Uncertain Choice Inventory for Emergency Responders (LUCIFER). RESULTS: As hypothesized, mindfulness increased decision-making speed and approach-tendencies. Conversely, for high-maximizers, increased mindfulness caused a slowing of the decision-making process and led to more avoidant choices. CONCLUSIONS: This study shows the potential positive and negative consequences of mindfulness for least-worst decision-making, emphasizing the critical importance of individual differences when considering both the effect of mindfulness and interventions aimed at improving decision-making.

Amplified inversion effects for moving biological stimuli remain largest for faces and bodies.

Turning an object upside-down disrupts our ability to perceive it accurately, and this inversion effect is disproportionately larger for faces and whole bodies than most other objects. This disproportionate inversion effect is taken as an indicator of holistic processing for these stimuli. Large inversion effects are also found when viewing motion-only information from faces and bodies; however, these have not been compared to other moving objects in an identity task so it is unclear whether inversion effects remain disproportionately larger for faces and bodies when they are engaged in motion. The current study investigated the effect of inversion on static and moving unfamiliar faces, human bodies, and German Shepherd dogs in an old-new recognition memory task. Sensitivity and baseline corrected reaction time (RT) results revealed that inversion effects for faces and whole-bodies remained disproportionately larger than those for German Shepherd dogs, regardless of presentation type, suggesting that both static and moving faces and bodies are processed holistically.

Music playlists for people with dementia: Qualitative evaluation of a guide for caregivers.

This study aimed to evaluate a set of guidelines for music use with people with dementia. A secondary aim was to identify challenges and barriers to implementation of music interventions by caregivers. Caregivers (n = 16) were interviewed after implementing a music listening programme based on the guidelines with 29 people with dementia in home-care and aged care facilities. Caregivers found the guidelines informative, easy to understand and use. Positive effects on mood, reduced agitation and reduced challenges to care were reported. Difficulties with technology and finding time to implement the music programme were identified. Results highlight the need for more research around appropriate technology and the streamlining of processes and procedures for aged care staff. Further iterations of the guidelines will need to address these issues and consider the differing needs of home-based carers and aged care providers separately.

Music Playlists for People with Dementia: Trialing A Guide for Caregivers.

BACKGROUND: Music programs have the potential to provide an effective non-pharmacological tool for caregivers to reduce depression and agitation and increase quality of life in people with dementia. However, where such programs are not facilitated by a trained music therapist, caregivers need greater access to information about how to use music most effectively in response to key challenges to care, and how to pre-empt and manage adverse responses. OBJECTIVE: This study reports on the trial of a Guide for use of music with 45 people with dementia and their caregivers in residential care facilities and home-based care. METHODS: The study used a pre-post experimental design in which participants were randomly allocated to a treatment group or a waitlist control group. RESULTS: Improvements to quality of life were found in the experimental group over the 6-week period. Significant increases in Interest, Responsiveness, Initiation, Involvement, and Enjoyment were reported for individual listening sessions. CONCLUSION: The Guide can provide an effective protocol for caregivers to follow in selecting music to manage particular challenges to care, confirming the need for caregivers to be prepared to monitor and manage potential negative responses.

Adaptation aftereffects influence the perception of specific emotions from walking gait.

We investigated the existence and nature of adaptation aftereffects on the visual perception of basic emotions displayed through walking gait. Stimuli were previously validated gender-ambiguous point-light walker models displaying various basic emotions (happy, sad, anger and fear). Results indicated that both facilitative and inhibitive aftereffects influenced the perception of all displayed emotions. Facilitative aftereffects were found between theoretically opposite emotions (i.e. happy/sad and anger/fear). Evidence suggested that low-level and high-level visual processes contributed to both stimulus aftereffect and conceptual aftereffect mechanisms. Significant aftereffects were more frequently evident for the time required to identify the displayed emotion than for emotion identification rates. The perception of basic emotions from walking gait is influenced by a number of different perceptual mechanisms which shift the categorical boundaries of each emotion as a result of perceptual experience.

Cross-Cultural Work in Music Cognition: Challenges, Insights, and Recommendations.

Many foundational questions in the psychology of music require cross-cultural approaches, yet the vast majority of work in the field to date has been conducted with Western participants and Western music. For cross-cultural research to thrive, it will require collaboration between people from different disciplinary backgrounds, as well as strategies for overcoming differences in assumptions, methods, and terminology. This position paper surveys the current state of the field and offers a number of concrete recommendations focused on issues involving ethics, empirical methods, and definitions of "music" and "culture."

Time Course of Creativity in Dance.

Time-motion studies revolutionized the design and efficiency of repetitive work last century. Would time-idea studies revolutionize the rules of intellectual/creative work this century? Collaborating with seven professional dancers, we set out to discover if there were any significant temporal patterns to be found in a timeline coded to show when dancers come up with ideas and when they modify or reject them. On each of 3 days, the dancers were given a choreographic problem (or task) to help them generate a novel, high quality contemporary dance phrase. They were videoed as they worked on this task for sessions of 15, 30, and 45 min. At the end of each 15 min interval during each session, we had them perform the phrase they were creating. They recorded and then coded the video of themselves dancing during these sessions by using a coding language we developed with them to identify when ideas are introduced, modified, and rejected. We found that most ideas are created early and that though these early ideas are aggressively pruned early on, many still make it into the final product. The two competing accounts of creativity in design research make predictions for the temporal structure of creativity. Our results support neither account, rather showing a more blended version of the two. The iterative design view, arguably the dominant view, is that good ideas are the product of generating many ideas, choosing one fairly early, committing to it, and iteratively improving it. The "fail fast fail often" view is that good ideas are the product of rapidly generating and discarding ideas and holding back from early commitment to any one in particular. The result of holding back commitment, typically, is not that an idea is taken up later and then incrementally improved at the last minute, as much as that later designs are not completely novel, instead incorporating the best parts of the entire sequence of ideas. In our study, we found no evidence that one account or the other was more predictive for the domain of contemporary dance. The behavior of the dancers that we studied revealed elements of both, calling into question how predictive these theories are.

The use of music in aged care facilities: A mixed-methods study.

Music is frequently used in aged care, being easily accessible and cost-effective. Research indicates that certain types of musical engagement hold greater benefits than others. However, it is not clear how effectively music is utilized in aged care facilities and what the barriers are to its further use. This study used a mixed-methods paradigm, surveying 46 aged care workers and conducting in-depth interviews with 5, to explore how music is used in aged care facilities in Australia, staff perceptions of the impact of music on residents, and the barriers to more effective implementation of music in aged care settings.

The black sheep effect: The case of the deviant ingroup robot.

The black sheep effect (BSE) describes the evaluative upgrading of norm-compliant group members (ingroup bias), and evaluative downgrading of deviant (norm-violating) group members, relative to similar outgroup members. While the BSE has been demonstrated extensively in human groups, it has yet to be shown in groups containing robots. This study investigated whether a BSE towards a 'deviant' robot (one low on warmth and competence) could be demonstrated. Participants performed a visual tracking task in a team with two humanoid NAO robots, with one robot being an ingroup member and the other an outgroup member. The robots offered advice to the participants which could be accepted or rejected, proving a measure of trust. Both robots were also evaluated using questionnaires, proxemics, and forced preference choices. Experiment 1 (N = 18) manipulated robot grouping to test our group manipulation generated ingroup bias (a necessary precursor to the BSE) which was supported. Experiment 2 (N = 72) manipulated the grouping, warmth and competence of both robots, predicting a BSE towards deviant ingroup robots, which was supported. Results indicated that a disagreeable ingroup robot is viewed less favourably than a disagreeable outgroup robot. Furthermore, when interacting with two independent robots, a "majority rule" effect can occur in which each robot's opinion is treated as independent vote, with participants significantly more likely to trust two unanimously disagreeing robots. No effect of warmth was found. The impact of these findings for human-robot team composition are discussed.

Immediate Feedback Improves Career Decision Self-Efficacy and Aspirational Alignment.

Misalignment between career and education aspirations has been associated with poorer achievement during adolescence and unstable employment in adulthood. In this study, we evaluated whether a brief in-school intervention improved career decision self-efficacy and aspirational alignment. We sampled 211 teenagers living in disadvantaged areas of Western Sydney, Australia using a quasi-experimental non-equivalent groups design. Students completed pre- and post-questionnaires which measured aspirational alignment and career decision self-efficacy. Students in the intervention condition (n = 102) received automated feedback on the alignment of their career and education aspirations, as well as a career information pamphlet detailing the educational pathways to a range of popular careers. Students in the control condition completed both questionnaires but only received feedback and the pamphlet at the end of the study. The intervention improved alignment of career and education aspirations, as well as increased some dimensions of career decision self-efficacy. Students in the intervention group more frequently identified the correct qualification for their career aspiration in the post-questionnaire (57.9%) compared with the pre-questionnaire (48.1%). Students with misaligned aspirations in the intervention group reported higher self-efficacy for gathering occupational information and selecting goals following the intervention. There were no pre-post differences for students in the control condition. The practical significance of this study is that an easy, low-cost intervention can improve aspirational alignment between career and education aspirations, as well as aspects of career decision self-efficacy.

Long-term memory for contemporary dance is distributed and collaborative.

Professional dancers appear to be the embodied records of works of choreography that have been created, rehearsed and performed. Their precision in recalling extended sequences of movement developed for these works defies the conventional methods used to investigate memory. A distributed cognition view holds that memory will not only be individualistic, but also extended across a dance ensemble. Working closely with the highly skilled dancers of Australian Dance Theatre (ADT), we set out to develop an ecologically valid method that elicited memory recall and lapsing. Dancers were divided into two "teams" with each team asked to choose excerpts for memory recall from the company's extensive repertoire that would challenge individual dancers in the other team. There were 14 trials; 12 involved the dancers recalling dance excerpts on their own (solo condition) and 2 with a partner (duet condition). In the ADT studio, seven dancers recalled (reproduced) as much of the excerpt as possible in the absence of an accompanying soundscape. Recall was extensive, but contained lapses, and these recall failures form the core of the analysis in this study. Four novel types of memory recall were identified: static shapes, isolated movements, partial and full movement sequences; and two strategies for recall: looking for movement by moving and collaborative sketching. Four types of errors were observed: errors of detail, order, omission, and additions. Analysis was conducted through a new method of counting 'choreographic items'. The most detailed recall (73-96%) was for the two duet excerpts with significantly poorer recall of excerpts from complex group sections of a dance. Movement gist was generally retained. The types of recall and types of errors observed pointed to the use of not only procedural memory and chaining but also contextual cues as aids to movement recall. Collaborative elements of recall were observed that suggest the importance of distributed cognition and collective memory within a contemporary dance ensemble.

Musical Features and Affective Responses to Personalized Playlists in People With Probable Dementia.

OBJECTIVES: Personalized music playlists are increasingly being utilized in aged care settings. This study aims to investigate how musical features influence the affective response to music of people with probable dementia. METHODS: A factorial experiment (2 × 2 × 3) was conducted to investigate the influence of tempo (fast, slow), mode (major, minor), and lyrics (none, negative, positive). Ninety-nine people with probable dementia were randomly assigned to 3 conditions, listening to 3 personalized playlists. Galvanic skin response and activation of facial action units were measured. RESULTS: Music with fast tempos increased arousal and reduced enjoyment. Music in minor keys increased activation of the depressor anguli oris, suggesting increased sadness. Lyrics had no significant effect on response. DISCUSSION: The findings demonstrate that both tempo and mode influenced the response of the listener. As well as accounting for personal preferences, music for people with dementia should be carefully targeted toward the affective outcome desired.

Intentionality of a co-actor influences sensorimotor synchronisation with a virtual partner.

Interpersonal sensorimotor synchronisation requires individuals to anticipate and adapt to their partner's movement timing. Research has demonstrated that the intentionality of a co-actor affects joint action planning, however, less is known about whether co-actor intentionality affects sensorimotor synchronisation. Explicit and implicit knowledge of a synchronisation partner's intentionality may influence coordination by modulating temporal anticipation and adaptation processes. We used a computer-controlled virtual partner (VP) consisting of tempo-changing auditory pacing sequences to simulate either an intentional or unintentional synchronisation partner. The VP was programmed to respond to the participant with low or moderate degrees of error correction, simulating a slightly or moderately adaptive human, respectively. In addition, task instructions were manipulated so that participants were told they were synchronising with either another person or a computer. Results indicated that synchronisation performance improved with the more adaptive VP. In addition, there was an influence of the explicit partner instruction, but this was dependent upon the degree of VP adaptivity and was modulated by subjective preferences for either the human or the computer partner. Beliefs about the intentionality of a synchronisation partner may thus influence interpersonal sensorimotor synchronisation in a manner that is modulated by preferences for interacting with intentional agents.

Music and Dementia: Individual Differences in Response to Personalized Playlists.

Personalized music playlists are increasingly being used in health-care contexts to address the psychological and behavioral symptoms in people with dementia. However, there is little understanding of how people with different mental health histories and symptoms respond differently to music. A factorial experiment was conducted to investigate the influence of depression, anxiety, apathy, and cognitive decline on affective response to music. Ninety-nine people with dementia listened to three music playlists based on personal preferences. Activation of facial action units was measured, and behavioural responses continuously observed. Results demonstrated that people with high levels of depression and with symptoms of Alzheimer's type dementia demonstrated increased levels of sadness when listening to music. People with low depression but high levels of apathy demonstrated the highest behavioral evidence of pleasure during music listening, although behavioral evidence declined with severity of cognitive impairment. It is concluded that as well as accounting for personal preferences, music interventions for people with dementia need to take mental health history and symptoms into account.