Medical Errors in Iowa: Prevalence and Patients' Perspectives.

OBJECTIVES: The following primary objectives of this study were to: (1) establish baselines of prevalence and causes of medical errors experienced by Iowans in medical settings, (2) determine whether Iowa patients were informed of the errors by the responsible healthcare providers, (3) understand reasons why Iowans who experienced medical errors did or did not report the errors, and (4) discover how Iowans view mandatory reporting of medical errors. METHODS: A total of 1010 Iowa adults took part in a telephone survey in summer 2017. Interviews were completed via random landlines and random digit dialing of cell phone numbers. RESULTS: Nearly one fifth of surveyed Iowa adults (18.8%) reported being involved in a medical error in their own care or in the care of someone close to them, and yet only four in 10 (39.1%) were notified of the error by the responsible provider. Most Iowans strongly agree that Iowa hospitals (79.5%), physicians (74.1%), and nursing homes (82.2%) should be required to report all medical errors to the patient and to a state agency. CONCLUSIONS: A significant proportion of Iowans will experience a medical error. They also desire full transparency from healthcare providers with respect to medical errors, including notifying the patient when an error occurs and mandating that providers report errors to a state-based agency. Iowa regulators should carefully assess and initiate stringent regulatory guidelines for mandatory reporting of medical errors.

Can dogs use vocal intonation as a social referencing cue in an object choice task?

Evidence from the literature indicates that dogs' choices can be influenced by human-delivered social cues, such as pointing, and pointing combined with facial expression, intonation (i.e., rising and falling voice pitch), and/or words. The present study used an object choice task to investigate whether intonation conveys unique information in the absence of other salient cues. We removed facial expression cues and speech information by delivering cues with the experimenter's back to the dog and by using nonword vocalizations. During each trial, the dog was presented with pairs of the following three vocal cues: Positive (happy-sounding), Negative (sad-sounding), and Breath (neutral control). In Experiment 1, where dogs received only these vocal cue pairings, dogs preferred the Positive intonation, and there was no difference in choice behavior between Negative or Breath. In Experiment 2, we included a point cue with one of the two vocal cues in each pairing. Here, dogs preferred containers receiving pointing cues as well as Negative intonation, and preference was greatest when both of these cues were presented together. Taken together, these findings indicate that dogs can indeed extract information from vocal intonation alone, and may use intonation as a social referencing cue. However, the effect of intonation on behavior appears to be strongly influenced by the presence of pointing, which is known to be a highly salient visual cue for dogs. It is possible that in the presence of a point cue, intonation may shift from informative to instructive.

Effector-independent and effector-dependent sequence representations underlie general and specific perceptuomotor sequence learning.

Perceptuomotor sequence learning could be due to learning of effector-independent sequence information (e.g., response locations), effector-dependent information (e.g., motor movements of a particular effector), or both. Evidence also suggests that learning of statistical regularities in sequences (general-regularity learning) and specific sequences (specific-sequence learning) are dissociable. The authors examined the degree to which general and specific-sequence learning rely on effector-independent and effector-dependent representations. During training, participants typed sequences that followed a construction rule with a subset of sequences repeatedly processed. At test, effector-independent and effector-dependent learning was examined with respect to general-regularity and specific-sequence learning. Results suggest that general-regularity learning is subserved by effector-independent sequence representations, whereas specific-sequence learning is subserved by effector-dependent sequence representations, further dissociating these types of learning.

The representation of object viewpoint in human visual cortex.

Understanding the nature of object representations in the human brain is critical for understanding the neural basis of invariant object recognition. However, the degree to which object representations are sensitive to object viewpoint is unknown. Using fMRI we employed a parametric approach to examine the sensitivity to object view as a function of rotation (0 degrees-180 degrees ), category (animal/vehicle) and fMRI-adaptation paradigm (short or long-lagged). For both categories and fMRI-adaptation paradigms, object-selective regions recovered from adaptation when a rotated view of an object was shown after adaptation to a specific view of that object, suggesting that representations are sensitive to object rotation. However, we found evidence for differential representations across categories and ventral stream regions. Rotation cross-adaptation was larger for animals than vehicles, suggesting higher sensitivity to vehicle than animal rotation, and was largest in the left fusiform/occipito-temporal sulcus (pFUS/OTS), suggesting that this region has low sensitivity to rotation. Moreover, right pFUS/OTS and FFA responded more strongly to front than back views of animals (without adaptation) and rotation cross-adaptation depended both on the level of rotation and the adapting view. This result suggests a prevalence of neurons that prefer frontal views of animals in fusiform regions. Using a computational model of view-tuned neurons, we demonstrate that differential neural view tuning widths and relative distributions of neural-tuned populations in fMRI voxels can explain the fMRI results. Overall, our findings underscore the utility of parametric approaches for studying the neural basis of object invariance and suggest that there is no complete invariance to object view in the human ventral stream.

Does a causal relation exist between the functional hemispheric asymmetries of visual processing subsystems?

Past research indicates that specific shape recognition and spatial-relations encoding rely on subsystems that exhibit right-hemisphere advantages, whereas abstract shape recognition and spatial-relations encoding rely on subsystems that exhibit left-hemisphere advantages. Given these apparent regularities, we tested whether asymmetries in shape processing are causally related to asymmetries in spatial-relations processing. We examined performance in four tasks using the same stimuli with divided-visual-field presentations. Importantly, the asymmetry observed in any one task did not correlate with the asymmetries observed in the other tasks in ways predicted by extant theories. Asymmetries in shape processing and spatial-relations encoding may not be due to a common causal force influencing multiple subsystems.

Interactive visual and postvisual processes and their roles in form-specific memory.

Effects of depth of encoding on form-specific memory were examined. After viewing words (e.g., "bear") presented centrally during initial encoding, participants completed word stems (e.g., "BEA") presented laterally and pattern masked during subsequent test. When the encoding task was perceptual, letter-case specific memory was not observed, unlike in previous experiments without pattern masking. However, when the encoding task required both perceptual and conceptual processing, letter-case specific memory was observed in direct right-hemisphere, but not in direct left-hemisphere, test presentations, like in previous studies without pattern masking. Results were not influenced by whether stems were completed to form the first words that came to mind or words explicitly retrieved from encoding. Depth of encoding may influence form-specific memory through interactive processing of visual and postvisual information.

Interhemispheric communication of abstract and specific visual-form information.

Pairs of letters were compared after being viewed in different visual fields (i.e. across-hemispheres, AH) or in the same visual field (i.e. within-hemisphere, WH). In an abstract-category comparison task, participants decided whether two letter exemplars belonged to the same abstract category (e.g. "k" and "K") or not (e.g. "k" and "P") and performed more accurately in AH trials than in WH trials. In a specific-exemplar comparison task, they decided whether two letters within the same abstract category were the same specific exemplars (e.g. "k" and "k") or not (e.g. "k" and "K") and performed more accurately in WH trials than in AH trials. This pattern of results was observed when the exemplars in a category were visually similar (e.g. "k" and "K", "a" and "a") but not when they were visually dissimilar (e.g. "a" and "A"). The reversed association technique was used to confirm the independence of subsystems underlying abstract category and specific-exemplar comparisons. Most important, the results support the theory that a specific-exemplar subsystem is more detrimentally affected by interhemispheric transfer of information than an abstract category subsystem.