Awareness Lost: a neuroimaging-based comparison between pathological and pharmacological loss of consciousness

Consciousness is a phenomenon that has so far evaded detailed description. However, with the help of modern brain imaging techniques, we can examine some of the mechanisms underlying changes in its prominence. In the experiments described in this thesis, we used structural and functional magnetic resonance imaging to discover new brain alterations occurring during two types of loss of consciousness: pharmacological (propofol anesthesia) and pathological (disorders of consciousness: vegetative state/unresponsive wakefulness syndrome, in which no awareness is assumed, and minimally conscious state, with fluctuating low-level consciousness). In both cases, we found loss of consciousness to be associated with a breakdown of three brain networks involved in higher-order processing: the default mode network, external control network, and salience network. These networks have been associated with internal awareness, external awareness, and saliency detection, respectively. Furthermore, their connectivity with the thalamus was severely disrupted. Our findings suggest that these changes could be a general hallmark of loss of consciousness. Additionally, we developed several novel techniques to examine changing brain dynamics, which could be used to search for other mechanisms underlying loss of consciousness. In contrast to anesthesia, loss of consciousness in patients with disorders of consciousness is the result of structural brain damage. We performed an analysis of white and gray matter damage occurring in these patients and found it to be widespread, with damage in midline default mode network regions potentially discriminating between unconscious and conscious patients.Our results indicate that structural and resting state functional magnetic resonance imaging might have the potential to improve differential diagnosis in disorders of consciousness

Structural brain injury in patients with disorders of consciousness: A voxel-based morphometry study.

MAIN OBJECTIVE: Disorders of consciousness (DOC; encompassing coma, vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious state minus/plus (MCS-/+)) are associated with structural brain injury. The extent of this damage remains poorly understood and merits a detailed examination using novel analysis techniques. Research design/methods and procedures: This study used voxel-based morphometry (VBM) on structural magnetic resonance imaging scans of 61 patients with DOC to examine grey and white matter injury associated with DOC, time spent in DOC, aetiology and diagnosis. MAIN OUTCOMES AND RESULTS: DOC and time spent in DOC were found to be associated with widespread structural brain injury, although the latter did not correlate strongly with injury in the right cerebral hemisphere. Traumatic, as compared to non-traumatic aetiology, was related to more injury in the brainstem, midbrain, thalamus, hypothalamus, basal forebrain, cerebellum, and posterior corpus callosum. Potential structural differences were found between VS/UWS and MCS and between MCS- and MCS+, but need further examination. CONCLUSIONS: The findings indicate that both traumatic and non-traumatic DOC are associated with widespread structural brain injury, although differences exist that could lead to aetiology-specific treatment strategies. Furthermore, the high degree of atrophy occurring after initial brain injury prompts the development and use of neuroprotective techniques to potentially increase patients\u27 chances of recovery

Understanding information security culture: a survey in small and medium sized enterprises

Information security is a relevant fact for current organizations. There are factors inextricably linked to this issue, and one cannot talk about information security in an organization without addressing and understanding the information security culture of that institution. Maximizing the organizational culture within an organization will enable the safeguard of information security. For that, we need to understand which the inhibiting and the enabling factors are. This paper contributes to point out those factors by presenting the results of a survey concerning information security culture in small and medium sized enterprises (SMEs). We discuss the results in the light of related literature, and we identify future works aiming to enhance information security within organizations

Impact of the ‘Contributing Factors in Construction Accidents’ (ConCA) model

In 2005 the ‘Contributing factors in Construction Accidents’ framework (ConCA) introduced a sociotechnical systems approach to risk management in construction. ConCA demonstrated the value of exploring distal factors and identifying underlying or latent causes: It promoted an understanding of construction accidents as systemic accidents and challenged an industry-wide culture of blaming frontline workers. A decade later the original article has been cited by research from 37 countries, shaping inquiries and initiatives to improve safety in both the UK and Australia. But to what extent has systems thinking infiltrated practitioners and policy-makers’ views? Despite broader views of contributing factors, many practitioners still view workers in a negative light, holding them responsible for accidents because of complacency, cynicism about safety, or a high-tolerance for risk. This paper evaluates the impact of the ConCA framework, updates it, and develops our understanding of the relationships between immediate circumstances and distal factors, as seen by an expert panel of participants (n = 32). A more in-depth ‘ConCA+’ framework is proposed. It challenges the negative perceptions of workers, and supports shifting the emphasis of risk management away from worker behaviors and towards resolving wider systemic issues. New directions are proposed which show how knowledge management, job design, technological innovation, empowerment and collaboration should be the focus of future work

Learning from speaking up by learning to speak up

Action Contro

Exploring the meaning of safety in the context of health care

Action Contro

The price of working abroad: Well-being among immigrant and native workers

Background: The merging of cultures has led to a more diverse workforce in organizations which has implications that should be taken into account, especially regarding occupational health. Studies undertaken worldwide have found that immigrant workers are subject to less well-being than their native counterparts. Very little is known about the determinants of those differences at the individual level. The present study explores the prediction of psychological health as a function of the origin of the worker (immigrant vs. native) with the ‘Big Five’ personality traits and the perception of safety climate as predictors. Method: Three hundred and ten workers (42.6% immigrants, 57.4% natives) participated in the study. Predictors, criterion, and biographical variables were assessed by means of a self-administrated questionnaire. Multiple regression models were subsequently performed. Results: We found no relevant differences between immigrants and natives in well-being, but there were differences in the predictors. Immigrants’ well-being (R2 adj =.23) was explained mainly by emotional stability (ß =.41, p =.000) and extraversion (ß =.22, p =.004), whereas natives’ well-being (R2 adj =.37) was determined only by emotional stability (ß =.35, p =.000). Perception of safety climate was not involved in any model. Conclusions: The differential profile between immigrant and native workers provides support to the consideration of immigration as a risk factor, recommending the organizations to develop action plans to facilitate the acculturative process. Antecedentes La fusión de culturas ha llevado a una fuerza de trabajo más diversa en las organizaciones, lo que tiene implicaciones para la salud en el trabajo. Estudios realizados en diferentes países han encontrado que los trabajadores inmigrantes están sujetos a menos bienestar que sus equivalentes nativos. Se sabe muy poco sobre los determinantes de esas diferencias a nivel individual. El presente estudio explora la predicción del bienestar psicológico según el origen del trabajador (inmigrante vs. nativo) usando los «Cinco Grandes» y la percepción del clima de seguridad como predictores. Método Trescientos diez trabajadores (42.6% inmigrantes, 57.4% nativos) participaron en el estudio. Las variables de interés se evaluaron mediante un cuestionario autoadministrado, para después realizar estadísticos descriptivos y modelos de regresión múltiple. Resultados Aunque no se encuentran diferencias en el bienestar de inmigrantes y nativos, sí las hay en sus predictores. Así, el bienestar de los inmigrantes (R2adj = .23) tiene como predictores la estabilidad emocional (ß = .41, p = .000) y la extraversión (ß = .22, p = .004), pero en el caso de los nacionales el bienestar (R2adj = .37) tiene solamente la estabilidad emocional como predictor (ß = .35, p = .000). La percepción de clima de seguridad no participa en los modelos predictivos. Conclusiones Los resultados apoyan la propuesta de considerar ser inmigrante como un factor de riesgo en la prevención de riesgos laborales, promoviendo que las organizaciones desarrollen planes de acción para facilitar la adaptación a la cultura de acogida

Propofol-Induced Frontal Cortex Disconnection: A Study of Resting-State Networks, Total Brain Connectivity, and Mean BOLD Signal Oscillation Frequencies.

Propofol is one of the most commonly used anesthetics in the world, but much remains unknown about the mechanisms by which it induces loss of consciousness. In this resting-state functional magnetic resonance imaging study, we examined qualitative and quantitative changes of resting-state networks (RSNs), total brain connectivity, and mean oscillation frequencies of the regional blood oxygenation level-dependent (BOLD) signal, associated with propofol-induced mild sedation and loss of responsiveness in healthy subjects. We found that detectability of RSNs diminished significantly with loss of responsiveness, and total brain connectivity decreased strongly in the frontal cortex, which was associated with increased mean oscillation frequencies of the BOLD signal. Our results suggest a pivotal role of the frontal cortex in propofol-induced loss of responsiveness

Triangulation and the importance of establishing valid methods for food safety culture evaluation

The research evaluates maturity of food safety culture in five multi-national food companies using method triangulation, specifically self-assessment scale, performance documents, and semi-structured interviews. Weaknesses associated with each individual method are known but there are few studies in food safety where a method triangulation approach is used for both data collection and data analysis. Significantly, this research shows that individual results taken in isolation can lead to wrong conclusions, resulting in potentially failing tactics and wasted investments. However, by applying method triangulation and reviewing results from a range of culture measurement tools it is possible to better direct investments and interventions. The findings add to the food safety culture paradigm beyond a single evaluation of food safety culture using generic culture surveys