Effects of task oriented conflict of inter-subgroups on information exchange in group decision making

The purpose of this study was to examine the effects of task oriented conflict of inter-sub-groups on pooling of unshared information and information exchange between members, on cognition of information, and on perception in group decision making. The subjects were 30 female nursing school students. They discussed the flictious selection of a sub-chiefnurse in a group consisting of five members. Information about fictitious candidates (candidate A and candidate B) was given to the group members before discussion and consisted of shared information and unshared information. Information were positive, negative and neutral as classfied by preliminary study. In advance one groups were considered of two followers who believed that candidate A was qualified, and the other two who believed that candidate B was qualified (henceforth task-oriented conflict condition) and the other were considered of all four followers who believed that candidate A was qualified. The results were as follows: (1) Unshared information was more conveyed and neutral information was less interpreted and conveyed in task-oriented conflict condition. (2) Followers had more negative evaluations of the leader, the followers, and the discussion in task oriented conflict condition. The results were discussed from the point of view of the nature of task oriented conflict, group goal, and quality of information exchange.

Involving patients with dementia in decisions to initiate treatment:Effect on patient acceptance, satisfaction and medication prescription

BACKGROUND: Shared decision-making is advocated but may be affected by cognitive impairment. Measures of shared decision-making provide global descriptions of communication without detailed analysis of the subtle ways in which doctors invite patient input. AIMS: We aimed to explore medication decisions in dementia, using a standardised Treatment Recommendation Coding Scheme. METHOD: We analysed 71 video-recorded dementia diagnostic meetings from nine memory clinics. Recommendations were coded as pronouncements ('I will start you on medication'), proposals ('Shall we try medication?'), suggestions ('Would you like to try medication?'), offers ('I can prescribe medication') or assertions ('There is medication'). Patient responses were coded as acceptance ('I'd like to have that'), active resistance ('I'm not very keen') and passive resistance (minimal or no response). Cognitive test scores, prescription rates and satisfaction were assessed and associations were explored. RESULTS: Doctors used suggestions in 42% of meetings, proposals in 25%, assertions in 13%, pronouncements in 11% and offers in 9%. Over 80% of patients did not indicate clear acceptance. Patients were most likely to actively resist after suggestions. There was no association between cognitive impairment and recommendation format. Patients were less satisfied with pronouncements. Patient preference did not influence whether medication was prescribed. CONCLUSIONS: Doctors initially nominate people with dementia as the decision maker, and this is unaffected by cognitive impairment. Over 80% of patients resisted starting medication, mostly through passive resistance, the most common form of disagreement in communication. Medication still tended to be prescribed, indicating that factors other than patient preference affect prescription. DECLARATIONS OF INTEREST: None

Patient and companion concerns when receiving a dementia diagnosis: an observational study of dementia diagnosis feedback meetings

Receiving a diagnosis of dementia is a life-changing event and can cause strong emotional reactions. The aim of this study was to examine patient and companion concerns expressed during dementia diagnosis feedback meetings. Sixty consultations between 19 health-care professionals (HCPs), 60 patients and 59 companions were video-recorded and transcribed. Concerns were identified from the transcripts and were (a) content analysed, (b) coded as elicited by the HCP or volunteered by the patient or companion, and (c) coded according to whether the HCP encouraged or discouraged elaboration of the concern. A total of 249 concerns were identified (average four concerns per consultation). There were three areas of findings: (a) patients and companions were concerned about the symptoms of dementia and receiving a diagnosis; other concerns related to patients’ mental and physical health, and prognosis, (b) HCPs elicited more patient than companion concerns and mostly elicited concerns aligned with the agenda of diagnosis feedback, and (c) HCPs were more likely to encourage elaboration when they elicited the concern. Nearly 40 per cent of concerns were discouraged by the HPC changing topic, with concerns about prognosis most commonly discouraged. The findings suggest that there were a wide variety of concerns at dementia diagnosis, many extending beyond the experience of dementia symptoms. HCP avoidance of concerns about prognosis demonstrated delicacy in discussing the deteriorating course of dementia

"He was shot because america will not give up on racism":Martin Luther King Jr. And the african american civil rights movement in British schools

This article examines how Martin Luther King Jr. and the movement with which he is often synonymous are taught in UK schools, as well as the consequences of that teaching for twenty-first-century understandings of Britain's racial past and present. The UK's King-centric approach to teaching the civil rights movement has much in common with that in the US, including an inattention to its transnational coordinates. However, these shared (mis)representations have different histories, are deployed to different ends, and have different consequences. In the UK, study of the African American freedom struggle often happens in the absence of, and almost as a surrogate for, engagement with the histories of Britain's own racial minorities and imperial past. In short, emphasis on the apparent singularity of US race relations and the achievements of the mid-twentieth-century African American freedom struggle facilitates cultural amnesia regarding the historic and continuing significance of race and racism in the UK. In light of the Windrush scandal and the damning 2018 Royal Historical Society report on “Race, Ethnicity and Equality in UK History,” this article argues both for better, more nuanced and more relevant teaching of King and the freedom struggle in British schools, and for much greater attention to black British history in its own right

Riboflavin/UVA Collagen Cross-Linking-Induced Changes in Normal and Keratoconus Corneal Stroma

Purpose To determine the effect of Ultraviolet-A collagen cross-linking with hypo-osmolar and iso-osmolar riboflavin solutions on stromal collagen ultrastructure in normal and keratoconus ex vivo human corneas. Methods Using small-angle X-ray scattering, measurements of collagen D-periodicity, fibril diameter and interfibrillar spacing were made at 1 mm intervals across six normal post-mortem corneas (two above physiological hydration (swollen) and four below (unswollen)) and two post-transplant keratoconus corneal buttons (one swollen; one unswollen), before and after hypo-osmolar cross-linking. The same parameters were measured in three other unswollen normal corneas before and after iso-osmolar cross-linking and in three pairs of swollen normal corneas, in which only the left was cross-linked (with iso-osmolar riboflavin). Results Hypo-osmolar cross-linking resulted in an increase in corneal hydration in all corneas. In the keratoconus corneas and unswollen normal corneas, this was accompanied by an increase in collagen interfibrillar spacing (p<0.001); an increase in fibril diameter was also seen in two out of four unswollen normal corneas and one unswollen keratoconus cornea (p<0.001). Iso-osmolar cross-linking resulted in a decrease in tissue hydration in the swollen normal corneas only. Although there was no consistent treatment-induced change in hydration in the unswollen normal samples, iso-osmolar cross-linking of these corneas did result in a compaction of collagen fibrils and a reduced fibril diameter (p<0.001); these changes were not seen in the swollen normal corneas. Collagen D-periodicity was not affected by either treatment. Conclusion The observed structural changes following Ultraviolet-A cross-linking with hypo-osmolar or iso-osmolar riboflavin solutions are more likely a consequence of treatment-induced changes in tissue hydration rather than cross-linking

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead