The evolutionary origins of volition

It appears to be a straightforward implication of distributed cognition principles that there is no integrated executive control system (e.g. Brooks 1991, Clark 1997). If distributed cognition is taken as a credible paradigm for cognitive science this in turn presents a challenge to volition because the concept of volition assumes integrated information processing and action control. For instance the process of forming a goal should integrate information about the available action options. If the goal is acted upon these processes should control motor behavior. If there were no executive system then it would seem that processes of action selection and performance couldn’t be functionally integrated in the right way. The apparently centralized decision and action control processes of volition would be an illusion arising from the competitive and cooperative interaction of many relatively simple cognitive systems. Here I will make a case that this conclusion is not well-founded. Prima facie it is not clear that distributed organization can achieve coherent functional activity when there are many complex interacting systems, there is high potential for interference between systems, and there is a need for focus. Resolving conflict and providing focus are key reasons why executive systems have been proposed (Baddeley 1986, Norman and Shallice 1986, Posner and Raichle 1994). This chapter develops an extended theoretical argument based on this idea, according to which selective pressures operating in the evolution of cognition favor high order control organization with a ‘highest-order’ control system that performs executive functions

The decoupled representation theory of the evolution of cognition - a critical assessment

Sterelny’s Thought in a Hostile World (2003) presents a complex, systematically structured theory of the evolution of cognition centered on a concept of decoupled representation. Taking Godfrey-Smith’s (1996) analysis of the evolution of behavioral flexibility as a framework, the theory describes increasingly complex grades of representation beginning with simple detection and culminating with decoupled representation, said to be belief-like, and it characterizes selection forces that drive evolutionary transformations in these forms of representation. Sterelny’s ultimate explanatory target is the evolution of human agency. This paper develops a detailed analysis of the main cognitive aspects. It is argued that some of the major claims are not correct: decoupled representation as defined doesn’t capture belief-like representation, and, properly understood, decoupled representation turns out to be ubiquitous amongst multicellular animals. However some of the key ideas are right, or along the right lines, and suggestions are made for modifying and expanding the conceptual framework

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures