Thinking in stories

This thesis considers cognitive narrative a component of intelligence that specializes in generality. In exploring the ubiquitous external (mediated) and internal (cognitive) functions of narrative it provides two contributions to the literature: a uniquely cross-discipline survey of narratology that bridges humanities, social science, and computational fields; and a theory to generate cognitive personal narratives from ongoing perception. The implications of narrative cognition and cognitive narrative are discussed as well as the limitations of this introductory theory and the grounds for promising future work.M.S

Patient and physician discordance of global disease assessment in juvenile dermatomyositis: Findings from the Childhood Arthritis & Rheumatology Research Alliance Legacy Registry

© 2020 The Author(s). Background: Global disease activity scores (gVAS) capture patient or family (PF) and physician (MD) assessments of disease. This study sought to measure discordance between PF and MD global activity scores in juvenile dermatomyositis (JDM), and determine factors associated with discordance. Methods: Patients with JDM were included from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry (N = 563). PF and MD gVAS were assessed for discordance, defined as a ≥ 2-point difference. Factors associated with discordant gVAS were compared in univariate analysis. Multivariable regression analysis was used to identify predictors of discordance. Results: Almost 40% (N = 219) of PF and MD gVAS were discordant. Among discordant scores, 68% of PF rated gVAS ≥2-points above MD, which was associated with calcinosis and lower quality of life and functional scores (p \u3c 0.01). MD gVAS rated ≥2-points above PF in 32%, which was associated with abnormal laboratory results, weakness, arthritis, rash and other skin changes, and current intravenous steroid treatment (p \u3c 0.01). In multivariate analysis, predictors for higher PF rating included calcinosis, lower quality of life and functional scores, while predictors for higher MD rating included rash, calcinosis, nailfold capillaroscopy changes, and current intravenous steroid treatment. Conclusions: Discordance between PF and MD gVAS was common in this JDM cohort. Overall, higher PF rating was associated with poorer patient reported outcome (PRO) scores, while higher MD rating was associated with poorer objective measures. This suggests PF and MD assessments of gVAS may be measuring different aspects of disease, highlighting the importance of integrating PROs into clinical practice and research

Goal Reasoning: Papers from the ACS Workshop

This technical report contains the 14 accepted papers presented at the Workshop on Goal Reasoning, which was held as part of the 2015 Conference on Advances in Cognitive Systems (ACS-15) in Atlanta, Georgia on 28 May 2015. This is the fourth in a series of workshops related to this topic, the first of which was the AAAI-10 Workshop on Goal-Directed Autonomy; the second was the Self-Motivated Agents (SeMoA) Workshop, held at Lehigh University in November 2012; and the third was the Goal Reasoning Workshop at ACS-13 in Baltimore, Maryland in December 2013

Implementing electronic substance use disorder and depression and anxiety screening and behavioral interventions in primary care clinics serving people with HIV: Protocol for the Promoting Access to Care Engagement (PACE) trial.

BackgroundSubstance use disorders (SUDs) and psychiatric disorders are common among people with HIV (PWH) and lead to poor outcomes. Yet these conditions often go unrecognized and untreated in primary care.MethodsThe Promoting Access to Care Engagement (PACE) trial currently in process examines the impact of self-administered electronic screening for SUD risk, depression and anxiety in three large Kaiser Permanente Northern California primary care clinics serving over 5000 PWH. Screening uses validated measures (Tobacco, Alcohol, Prescription medication, and other Substance use [TAPS]; and the Adult Outcomes Questionnaire [AOQ], which includes the Patient Health Questionnaire [PHQ-9] and Generalized Anxiety Disorder [GAD-2]) delivered via three modalities (secure messaging, tablets in waiting rooms, and desktop computers in exam rooms). Results are integrated automatically into the electronic health record. Based on screening results and physician referrals, behavioral health specialists embedded in primary care initiate motivational interviewing- and cognitive behavioral therapy-based brief treatment and link patients to addiction and psychiatry clinics as needed. Analyses examine implementation (screening and treatment rates) and effectiveness (SUD, depression and anxiety symptoms; HIV viral control) outcomes using a stepped-wedge design, with a 12-month intervention phase implemented sequentially in the clinics, and a 24-month usual care period prior to implementation in each clinic functioning as sequential observational phases for comparison. We also evaluate screening and treatment costs and implementation barriers and facilitators.DiscussionThe study examines innovative, technology-facilitated strategies for improving assessment and treatment in primary care. Results may help to inform substance use, mental health, and HIV services.Trial registrationNCT03217058

Shaping consumer imaginations: The role of self-focused attention in product evaluations

10.1509/jmkr.48.2.381Journal of Marketing Research482381-39