A service evaluation of parent adherence with dysphagia management therapy guidelines: Reports from family carers supporting children with complex needs in Greece

Purpose: Many children with complex needs exhibit eating, drinking and/or swallowing disorders (dysphagia). These children often have associated learning needs, and require assistance from carers for daily tasks such as eating and drinking. The aim of this study was to identify which strategies to manage dysphagia were challenging for family carers, and reasons for any non-adherence. Method: In this service evaluation researchers observed carers during mealtimes, and investigated carer opinions of strategies used to minimise the risks of dysphagia. Eight children with complex needs aged 3.4 - 7.5 years and their primary family caregiver participated. Results: Adherence with speech and language pathologists’ dysphagia recommendations overall was over 50% in all but one case. For specific strategies, the highest adherence was observed for diet modifications of foods (89%), communication during the mealtime (83%), amount of food to present (81%) and the pacing of fluids and foods (81%). Lower levels of adherence were identified in relation to postural management (58%), environmental changes (58%), utensils (56%) and preparatory strategies (49%). Conclusion: Adherence with use of strategies to support mealtimes was over 50% in all but one case. Findings suggest that support is essential in order to promote safe mealtimes, reduce family carers’ stress and increase knowledge, confidence and adherence in implementing dysphagia guidelines in the family home

The brain's temporal dynamics from a collective decision to individual action

Social animals constantly make decisions together. What determines if individuals will subsequently adjust their behavior to align with collective choices? Here, using functional magnetic resonance imaging in humans, we characterize a novel temporal model of brain response from the time a collective decision is made to the time an individual action is required. We reveal that whether a behavioral modification will occur is determined not necessarily by the brain’s response to the initial social influence, but by how that response(specifically in the orbitofrontal cortex; OFC) is mirrored at a later time when the individual selects their own action. This result suggests that the OFC may reconstitute an initial state of collective influence when individual action is subsequently needed. Importantly, these dynamics vary across individuals as a function of trait conformity and mediate the relationship between this personality characteristic and behavioral adjustment toward the group

Category-based Tail Comovement

Traditional financial theory predicts that comovement in asset returns is due to fundamentals. An alternative view is that of Barberis and Shleifer (2003) and Bar- beris, Shleifer and Wurgler (2005) who propose a sentiment based theory of comovement, delinking it from fundamentals. In their paper they view comovement under the prism of the standard Pearson's correlation measure, implicitly excluding extreme market events, such as the latest financial crisis. Poon, Rockinger and Tawn (2004) have shown that under such events different types of comovement or dependence may co-exist, and make a clear distinction between the four types of dependence: perfect dependent, independent, asymptotically dependent and asymptotically independent. In this paper we extend the sentiment based theory of comovement so as to cover the whole spectrum of dependence, including extreme comovement such as the one that can be observed in financial crises. One of the key contributions of this paper is that it formally proves that assets belonging to the same category comove too much in the tail and reclassifying an asset into a new category raises its tail dependence with that category

Human Frontal–Subcortical Circuit and Asymmetric Belief Updating

How humans integrate information to form beliefs about reality is a question that has engaged scientists for centuries, yet the biological system supporting this process is not well understood. One of the most salient attributes of information is valence. Whether a piece of news is good or bad is critical in determining whether it will alter our beliefs. Here, we reveal a frontal–subcortical circuit in the left hemisphere that is simultaneously associated with enhanced integration of favorable information into beliefs and impaired integration of unfavorable information. Specifically, for favorable information, stronger white matter connectivity within this system, particularly between the left inferior frontal gyrus (IFG) and left subcortical regions (including the amygdala, hippocampus, thalamus, putamen, and pallidum), as well as insular cortex, is associated with greater change in belief. However, for unfavorable information, stronger connectivity within this system, particularly between the left IFG and left pallidum, putamen, and insular cortex, is associated with reduced change in beliefs. These novel results are consistent with models suggesting that partially separable processes govern learning from favorable and unfavorable information

Anxiety promotes memory for mood-congruent faces but does not alter loss aversion

Pathological anxiety is associated with disrupted cognitive processing, including working memory and decision-making. In healthy individuals, experimentally-induced state anxiety or high trait anxiety often results in the deployment of adaptive harm-avoidant behaviours. However, how these processes affect cognition is largely unknown. To investigate this question, we implemented a translational within-subjects anxiety induction, threat of shock, in healthy participants reporting a wide range of trait anxiety scores. Participants completed a gambling task, embedded within an emotional working memory task, with some blocks under unpredictable threat and others safe from shock. Relative to the safe condition, threat of shock improved recall of threat-congruent (fearful) face location, especially in highly trait anxious participants. This suggests that threat boosts working memory for mood-congruent stimuli in vulnerable individuals, mirroring memory biases in clinical anxiety. By contrast, Bayesian analysis indicated that gambling decisions were better explained by models that did not include threat or treat anxiety, suggesting that: (i) higher-level executive functions are robust to these anxiety manipulations; and (ii) decreased risk-taking may be specific to pathological anxiety. These findings provide insight into the complex interactions between trait anxiety, acute state anxiety and cognition, and may help understand the cognitive mechanisms underlying adaptive anxiety

Neuro-computational account of arbitration between imitation and emulation during human observational learning

In observational learning (OL), organisms learn from observing the behavior of others. There are at least two distinct strategies for OL. Imitation involves learning to repeat the previous actions of other agents, while in emulation, learning proceeds from inferring the goals and intentions of others. While putative neural correlates for these forms of learning have been identified, a fundamental question remains unaddressed: how does the brain decides which strategy to use in a given situation? Here we developed a novel computational model in which arbitration between the strategies is determined by the predictive reliability, such that control over behavior is adaptively weighted toward the strategy with the most reliable prediction. To test the theory, we designed a novel behavioral task in which our experimental manipulations produced dissociable effects on the reliability of the two strategies. Participants performed this task while undergoing fMRI in two independent studies (the second a pre-registered replication of the first). Behavior manifested patterns consistent with both emulation and imitation and flexibly changed between the two strategies as expected from the theory. Computational modelling revealed that behavior was best described by an arbitration model, in which the reliability of the emulation strategy determined the relative weights allocated to behavior for each strategy. Emulation reliability - the model's arbitration signal - was encoded in the ventrolateral prefrontal cortex, temporoparietal junction and rostral cingulate cortex. Being replicated across two fMRI studies, these findings suggest a neuro-computational mechanism for allocating control between emulation and imitation during observational learning