The use of information in online healthcare provider choice

In order to evaluate and facilitate the provision of health information online, we must first understand how it is perceived by those who use it. Two important considerations in research on patients’ information use in online healthcare provider choice are the need for a conceptual framework for studying information types and methods for studying information use. Therefore, our first contribution lies in using Donabedian's structure-process-outcome model of healthcare quality to identify specific patterns of preference and information use in online healthcare provider choice, and differences in information use between two healthcare provider types. Our second contribution lies in identifying differences in results between data collection methods (importance rating/selection, concurrent self-report of online information use and retrospective information use) in relation to choice tasks. In a mixed-methods design, provider type (primary and secondary care) was systematically varied during participants’ use of the infomediary NHS Choices. Participants preferred process topics over structure topics, in contrast with the results of concurrent and retrospective self-report. We conclude that the differences in results between the types of data collection method reflect underlying differences in choice task. Future research should address the use of novel infomediary user-interfaces, and infomediaries in relation to the use of other information sources and (e-)health literacy

Can captive orangutans (Pongo pygmaeus abelii) be coaxed into cumulative build-up of techniques?

While striking cultural variation in behavior from one site to another has been described in chimpanzees and orangutans, cumulative culture might be unique to humans. Captive chimpanzees were recently found to be rather conservative, sticking to the technique they had mastered, even after more effective alternatives were demonstrated. Behavioral flexibility in problem solving, in the sense of acquiring new solutions after having learned another one earlier, is a vital prerequisite for cumulative build-up of techniques. Here, we experimentally investigate whether captive orangutans show such flexibility, and if so, whether they show techniques that cumulatively build up (ratchet) on previous ones after conditions of the task are changed. We provided nine Sumatran orangutans (Pongo pygmaeus abelii) with two types of transparent tubes partly filled with syrup, along with potential tools such as sticks, twigs, wood wool and paper. In the first phase, the orangutans could reach inside the tubes with their hands (Regular Condition), but in the following phase, tubes had been made too narrow for their hands to fit in (Restricted Condition 1), or in addition the setup lacked their favorite materials (Restricted Condition 2). The orangutans showed high behavioral flexibility, applying nine different techniques under the regular condition in total. Individuals abandoned preferred techniques and switched to different techniques under restricted conditions when this was advantageous. We show for two of these techniques how they cumulatively built up on earlier ones. This suggests that the near-absence of cumulative culture in wild orangutans is not due to a lack of flexibility when existing solutions to tasks are made impossible

Parental provisioning drives brain size in birds

Large brains support numerous cognitive adaptations and therefore may appear to be highly beneficial. Nonetheless, the high energetic costs of brain tissue may have prevented the evolution of large brains in many species. This problem may also have a developmental dimension: juveniles, with their immature and therefore poorly performing brains, would face a major energetic hurdle if they were to pay for the construction of their own brain, especially in larger-brained species. Here, we explore the possible role of parental provisioning for the development and evolution of adult brain size in birds. A comparative analysis of 1,176 bird species shows that various measures of parental provisioning (precocial vs. altricial state at hatching, relative egg mass, time spent provisioning the young) strongly predict relative brain size across species. The parental provisioning hypothesis also provides an explanation for the well-documented but so far unexplained pattern that altricial birds have larger brains than precocial ones. We therefore conclude that the evolution of parental provisioning allowed species to overcome the seemingly insurmountable energetic constraint on growing large brains, which in turn enabled bird species to increase survival and population stability. Because including adult eco- and socio-cognitive predictors only marginally improved the explanatory value of our models, these findings also suggest that the traditionally assessed cognitive abilities largely support successful parental provisioning. Our results therefore indicate that the cognitive adaptations underlying successful parental provisioning also provide the behavioral flexibility facilitating reproductive success and survival

Mutational analysis of BTAF1-TBP interaction: BTAF1 can rescue DNA-binding defective TBP mutants

The BTAF1 transcription factor interacts with TATA-binding protein (TBP) to form the B-TFIID complex, which is involved in RNA polymerase II transcription. Here, we present an extensive mapping study of TBP residues involved in BTAF1 interaction. This shows that residues in the concave, DNA-binding surface of TBP are important for BTAF1 binding. In addition, BTAF1 interacts with residues in helix 2 on the convex side of TBP as assayed in protein-protein and in DNA-binding assays. BTAF1 drastically changes the TATA-box binding specificity of TBP, as it is able to recruit DNA-binding defective TBP mutants to both TATA-containing and TATA-less DNA. Interestingly, other helix 2 interacting factors, such as TFIIA and NC2, can also stabilize mutant TBP binding to DNA. In contrast, TFIIB which interacts with a distinct surface of TBP does not display this activity. Since many proteins contact helix 2 of TBP, this provides a molecular basis for mutually exclusive TBP interactions and stresses the importance of this structural element for eukaryotic transcription

Outcome of Colonic Surgery in Elderly Patients with Colon Cancer

Introduction. Colonic cancer is one of the most commonly diagnosed malignancies and most often occurs in patients aged 65 years or older. Aim. To evaluate the outcome of colonic surgery in the elderly in our hospital and to compare five-year survival rates between the younger and elderly patients. Methods. 207 consecutive patients underwent surgery for colon cancer. Patients were separated in patients younger than 75 and older than 75 years. Results. Elderly patients presented significantly more (P < .05) as a surgical emergency, had a longer duration of admission and were more often admitted to the ICU (P < .01). Also, elderly patients had significant more co-morbidities, especially cardiovascular pathology (P < .01). Post-operative complications were seen more often in the elderly, although no significant difference was seen in anastomotic leakage. The five-year survival rate in the younger group was 62% compared with 36% in the elderly (P < .05). DFS was 61% in the younger patients compared with 32% in the elderly (P < .05). Conclusion. Curative resection of colonic carcinoma in the elderly is well tolerated and age alone should not be an indication for less aggressive therapy. However, the type and number of co-morbidities influence post-operative mortality and morbidity

Problem-solving in groups of common marmosets (Callithrix jacchus): more than the sum of its parts

Human hypercooperativity and the emergence of division of labor enables us to solve problems not only effectively within a group but also collectively. Collective problem-solving occurs when groups perform better than the additive performance of separate individuals. Currently, it is unknown whether this is unique to humans. To investigate the evolutionary origin of collective problem-solving and potential precursors, we propose a continuum of group effects on problem-solving, from simple to complex ones, eventually culminating in collective problem-solving. We tested captive common marmosets with a series of problem-solving tasks, either alone or in a group. To test whether the performance of a group was more than the sum of its parts, we compared real groups to virtual groups (pooled scores of animals tested alone). Marmosets in real groups were both more likely to solve problems than marmosets within the virtual groups and to do so faster. Although individuals within real groups approached the problem faster, a reduction in neophobia was not sufficient to explain the greater success. Success within real groups arose because animals showed higher perseverance, especially after a fellow group member had found the solution in complex tasks. These results are consistent with the idea that group problem-solving evolved alongside a continuum, with performance improving beyond baseline as societies move from social tolerance to opportunities for diffusion of information to active exchange of information. We suggest that increasing interdependence and the adoption of cooperative breeding pushed our ancestors up this scale