The Impact of Strategic Trajectory Optimization on Illusory Target Biases During Goal-Directed Aiming

During rapid aiming, movements are planned and executed to avoid worst-case outcomes that require time and energy to correct. As such, downward movements initially undershoot the target to avoid corrections against gravity. Illusory target context can also impact aiming bias. Here, the authors sought to determine how strategic biases mediate illusory biases. Participants aimed to Müller-Lyer figures in different directions (forward, backward, up, down). Downward biases emerged late in the movement and illusory biases emerged from peak velocity. The illusory effects were greater for downward movements at terminal endpoint. These results indicate that strategic biases interact with the limb-target control processes associated with illusory biases. Thus, multiple control processes during rapid aiming may combine and later affect endpoint accuracy (D. Elliott et al., 2010)

Effector mass and trajectory optimization in the online regulation of goal-directed movement

Goal-directed aiming movements are planned and executed so that they optimize speed, accuracy and energy expenditure. In particular, the primary submovements involved in manual aiming attempts typically undershoot targets in order to avoid costly time and energy overshoot errors. Furthermore, in aiming movements performed over a series of trials, the movement planning process considers the sensory information associated with the most recent aiming attempt. The goal of the current study was to gain further insight into how the sensory consequences associated with the recent and forthcoming aiming attempts impact performance. We first examined whether performers are more conservative in their aiming movements with a heavy, as opposed to a light, stylus by determining whether primary submovements undershot the target to a greater extent in the former due to an anticipated increase in spatial variability. Our results show that movements with the heavy stylus demonstrated greater undershoot biases in the primary submovements, as well as greater trial-to-trial spatial variability at specific trajectory kinematic landmarks. In addition, we also sought to determine whether the sensory information experienced on a previous aiming movement affected movement planning and/or online control on the subsequent aiming attempt. To vary the type sensory consequences experienced on a trial-to-trial basis, participants performed aiming movements with light and heavy styli in either blocked or random orderings of trials. In the random-order conditions, some participants were provided advance information about stylus mass for the upcoming trial, while others were not. The blocked and random trial orders had minimal impacts on end point aiming performance. Furthermore, similarities in the times to key kinematic landmarks in the trajectories of the random-order groups suggest that recent trial experience had a greater effect on the upcoming aiming movement compared with advance task knowledge

The Multiple Process Model of Goal-Directed Reaching Revisited

Recently our group forwarded a model of speed-accuracy relations in goal-directed reaching. A fundamental feature of our multiple process model was the distinction between two types of online regulation: impulse control and limb-target control. Impulse control begins during the initial stages of the movement trajectory and involves a comparison of actual limb velocity and direction to an internal representation of expectations about the limb trajectory. Limb-target control involves discrete error-reduction based on the relative positions of the limb and the target late in the movement. Our model also considers the role of eye movements, practice, energy optimization and strategic behavior in limb control. Here, we review recent work conducted to test specific aspects of our model. As well, we consider research not fully incorporated into our earlier contribution. We conclude that a slightly modified and expanded version of our model, that includes crosstalk between the two forms of online regulation, does an excellent job of explaining speed, accuracy, and energy optimization in goal-directed reaching

The Influence of Visual Feedback and Prior Knowledge About Feedback on Vertical Aiming Strategies

Two experiments were conducted to examine time and energy optimization strategies for movements made with and against gravity. In Experiment 1, we manipulated concurrent visual feedback, and knowledge about feedback. When vision was eliminated upon movement initiation, participants exhibited greater undershooting, both with their primary submovement and their final endpoint, than when vision was available. When aiming downward, participants were more likely to terminate their aiming following the primary submovement or complete a lower amplitude corrective submovement. This strategy reduced the frequency of energy-consuming corrections against gravity. In Experiment 2, we eliminated vision of the hand and the target at the end of the movement. This procedure was expected to have its greatest impact under no vision conditions where no visual feedback was available for subsequent planning. As anticipated, direction and concurrent visual feedback had a profound impact on endpoint bias. Participants exhibited pronounced undershooting when aiming downward and without vision. Differences in undershooting between vision and no vision were greater under blocked feedback conditions. When performers were uncertain about the impending feedback, they planned their movements for the worst-case scenario. Thus movement planning considers the variability in execution, and avoids outcomes that require time and energy to correct

The development of path integration: combining estimations of distance and heading

Efficient daily navigation is underpinned by path integration, the mechanism by which we use self-movement information to update our position in space. This process is well-understood in adulthood, but there has been relatively little study of path integration in childhood, leading to an underrepresentation in accounts of navigational development. Previous research has shown that calculation of distance and heading both tend to be less accurate in children as they are in adults, although there have been no studies of the combined calculation of distance and heading that typifies naturalistic path integration. In the present study 5-year-olds and 7-year-olds took part in a triangle-completion task, where they were required to return to the startpoint of a multi-element path using only idiothetic information. Performance was compared to a sample of adult participants, who were found to be more accurate than children on measures of landing error, heading error, and distance error. 7-year-olds were significantly more accurate than 5-year-olds on measures of landing error and heading error, although the difference between groups was much smaller for distance error. All measures were reliably correlated with age, demonstrating a clear development of path integration abilities within the age range tested. Taken together, these data make a strong case for the inclusion of path integration within developmental models of spatial navigational processing

Household air pollution from solid fuel use as a dose-dependent risk factor for cognitive impairment in northern China

The relationship between exposure to household air pollution (HAP) from solid fuel use and cognition remains poorly understood. Among 401 older adults in peri-urban northern China enrolled in the INTERMAP-China Prospective Study, we estimated the associations between exposure to HAP and z-standardized domain-specific and overall cognitive scores from the Montreal Cognitive Assessment. Interquartile range increases in exposures to fine particulate matter (53.2-µg/m3) and black carbon (0.9-µg/m3) were linearly associated with lower overall cognition [- 0.13 (95% confidence interval: - 0.22, - 0.04) and - 0.10 (- 0.19, - 0.01), respectively]. Using solid fuel indoors and greater intensity of its use were also associated with lower overall cognition (range of point estimates: - 0.13 to - 0.03), though confidence intervals included zero. Among individual cognitive domains, attention had the largest associations with most exposure measures. Our findings indicate that exposure to HAP may be a dose-dependent risk factor for cognitive impairment. As exposure to HAP remains pervasive in China and worldwide, reducing exposure through the promotion of less-polluting stoves and fuels may be a population-wide intervention strategy to lessen the burden of cognitive impairment

GPAQ-R: development and psychometric properties of a version of the general practice assessment questionnaire for use for revalidation by general practitioners in the UK.

BACKGROUND: The General Practice Assessment Questionnaire (GPAQ) has been widely used to assess patient experience in general practice in the UK since 2004. In 2013, new regulations were introduced by the General Medical Council (GMC) requiring UK doctors to undertake periodic revalidation, which includes assessment of patient experience for individual doctors. We describe the development of a new version of GPAQ - GPAQ-R which addresses the GMC's requirements for revalidation as well as additional NHS requirements for surveys that GPs may need to carry out in their own practices. METHODS: Questionnaires were given out by doctors or practice staff after routine consultations in line with the guidance given by the General Medical Council for surveys to be used for revalidation. Data analysis and practice reports were provided independently. RESULTS: Data were analysed for questionnaires from 7258 patients relating to 164 GPs in 29 general practices. Levels of missing data were generally low (typically 4.5-6%). The number of returned questionnaires required to achieve reliability of 0.7 were around 35 for individual doctor communication items and 29 for a composite score based on doctor communication items. This suggests that the responses to GPAQ-R had similar reliability to the GMC's own questionnaire and we recommend 30 completed GPAQ-R questionnaires are sufficient for revalidation purposes. However, where an initial screen raises concern, the survey might be repeated with 50 completed questionnaires in order to increase reliability. CONCLUSIONS: GPAQ-R is a development of a well-established patient experience questionnaire used in general practice in the UK since 2004. This new version can be recommended for use in order to meet the UK General Medical Council's requirements for surveys to be used in revalidation of doctors. It also meets the needs of GPs to ask about patient experience relating to aspects of practice care that are not specific to individual general practitioners (e.g. receptionists, telephone access) which meet other survey requirements of the National Health Service in England. Use of GPAQ-R has the potential to reduce the number of surveys that GPs need to carry out in their practices to meet the various regulatory requirements which they face

Perinatal risk factors for neonatal encephalopathy: an unmatched case-control study

OBJECTIVE: Neonatal encephalopathy (NE) is the third leading cause of child mortality. Preclinical studies suggest infection and inflammation can sensitise or precondition the newborn brain to injury. This study examined perinatal risks factor for NE in Uganda. DESIGN: Unmatched case-control study. SETTING: Mulago National Referral Hospital, Kampala, Uganda. METHODS: 210 term infants with NE and 409 unaffected term infants as controls were recruited over 13 months. Data were collected on preconception, antepartum and intrapartum exposures. Blood culture, species-specific bacterial real-time PCR, C reactive protein and placental histology for chorioamnionitis and funisitis identified maternal and early newborn infection and inflammation. Multivariable logistic regression examined associations with NE. RESULTS: Neonatal bacteraemia (adjusted OR (aOR) 8.67 (95% CI 1.51 to 49.74), n=315) and histological funisitis (aOR 11.80 (95% CI 2.19 to 63.45), n=162) but not chorioamnionitis (aOR 3.20 (95% CI 0.66 to 15.52), n=162) were independent risk factors for NE. Among encephalopathic infants, neonatal case fatality was not significantly higher when exposed to early neonatal bacteraemia (OR 1.65 (95% CI 0.62 to 4.39), n=208). Intrapartum antibiotic use did not improve neonatal survival (p=0.826). After regression analysis, other identified perinatal risk factors (n=619) included hypertension in pregnancy (aOR 3.77), male infant (aOR 2.51), non-cephalic presentation (aOR 5.74), lack of fetal monitoring (aOR 2.75), augmentation (aOR 2.23), obstructed labour (aOR 3.8) and an acute intrapartum event (aOR 8.74). CONCLUSIONS: Perinatal infection and inflammation are independent risk factors for NE in this low-resource setting, supporting a role in the aetiological pathway of term brain injury. Intrapartum antibiotic administration did not mitigate against adverse outcomes. The importance of intrapartum risk factors in this sub-Saharan African setting is highlighted

Living systematic reviews: 4. Living guideline recommendations

While it is important for the evidence supporting practice guidelines to be current, that is often not the case. The advent of living systematic reviews has made the concept of "living guidelines" realistic, with the promise to provide timely, up-to-date and high-quality guidance to target users. We define living guidelines as an optimization of the guideline development process to allow updating individual recommendations as soon as new relevant evidence becomes available. A major implication of that definition is that the unit of update is the individual recommendation and not the whole guideline. We then discuss when living guidelines are appropriate, the workflows required to support them, the collaboration between living systematic reviews and living guideline teams, the thresholds for changing recommendations, and potential approaches to publication and dissemination. The success and sustainability of the concept of living guideline will depend on those of its major pillar, the living systematic review. We conclude that guideline developers should both experiment with and research the process of living guidelines

The Multiple Process Model of Goal-directed Reaching Revisited

Recently our group forwarded a model of speed-accuracy relations in goal-directed reaching. A fundamental feature of our multiple process model was the distinction between two types of online regulation: impulse control and limb-target control. Impulse control begins during the initial stages of the movement trajectory and involves a comparison of actual limb velocity and direction to an internal representation of expectations about the limb trajectory. Limb-target control involves discrete error-reduction based on the relative positions of the limb and the target late in the movement. Our model also considers the role of eye movements, practice, energy optimization and strategic behavior in limb control. Here, we review recent work conducted to test specific aspects of our model. As well, we consider research not fully incorporated into our earlier contribution. We conclude that a slightly modified and expanded version of our model, that includes crosstalk between the two forms of online regulation, does an excellent job of explaining speed, accuracy, and energy optimization in goal-directed reaching