Does Hub‐and‐Spoke organization of healthcare system promote workers' satisfaction?

The healthcare services network is a recent organizational structure of healthcare services that are interdependent and organized as a network on the basis of the Hub‐and‐Spoke model. This questionnaire‐based study analyzed socio‐psychological well‐being of health workers both in terms of team‐related experience and individual satisfaction and engagement with one's work in a Hub‐and‐Spoke healthcare service in comparison to non‐network healthcare service. Workers from two different public healthcare services involved in the treatment of the same skeletal rare diseases participated in the Study. We expected that working under a Hub‐and‐Spoke healthcare service—involving teamwork and cooperation among different healthcare services within the units, as well as among workers belonging to different units—would lead to greater psychological team‐related and individual benefits. In line with predictions, the findings showed that under a Hub‐and‐Spoke healthcare service, health workers felt highly interdependent by their team fellows and developed shared cognitions (i.e., team mental models) about their integration and their tasks to a higher extent than non‐network ones. They were also individually more satisfied of their job and displayed higher work engagement than non‐network workers. Beneficial team‐related dynamics, such as perceived interdependence, were responsible for the differences between the Hub‐and‐Spoke workers and non‐network ones. The implications of the present findings were discussed in terms of promotion of health workers' satisfaction and well‐being.     

The effect of reinforcement probability on time discrimination in the midsession reversal task

We examined how biasing time perception affects choice in a midsession reversal task. Given a simultaneous discrimination between stimuli S1 and S2, with choices of S1 reinforced during the first, but not the second half of the trials, and choices of S2 reinforced during the second, but not the first half of the trials, pigeons show anticipation errors (premature choices of S2) and perseveration errors (belated choices of S1). This suggests that choice depends on timing processes, on predicting when the contingency reverses based on session duration. We exposed 7 pigeons to a midsession reversal task and manipulated the reinforcement rate on each half of the session. Compared to equal reinforcement rates on both halves of the session, when the reinforcement rate on the first half was lower than on the second half, performance showed more anticipation and less perseveration errors, and when the reinforcement rate on the first half was higher than on the second half, performance showed a remarkable reduction of both types of errors. These results suggest that choice depends on both time into the session and the outcome of previous trials. They also challenge current models of timing to integrate local effects.     

Thought Experiments in Philosophy: A Neo-Kantian and Experimentalist Point of View

The paper addresses the question of the nature and limits of philosophical thought experiments. On the one hand, experimental philosophers are right to claim that we need much more laboratory work in order to have more reliable thought experiments, but on the other hand a naturalism that is too radical is incapable of clarifying the peculiarity of thought experiments in philosophy. Starting from a historico-critical reconstruction of Kant’s concept of the “experiments of pure reason”, this paper outlines an account of thought experiments in philosophy that tries to reconcile the thesis of a principled difference between scientific and philosophical TEs with the position of a methodological naturalism that does not admit any difference in kind between the methods of science and of philosophy.

     

Age-related quantitative and qualitative changes in decision making ability

The "frontal aging hypothesis" predicts that brain senescence affects predominantly the prefrontal regions. Preliminary evidence has recently been gathered in favour of an age-related change in a typically frontal process, i.e. decision making, using the Iowa Gambling Task (IGT), but overall findings have been conflicting. Following the traditional scoring method, coupled with a qualitative analysis, in the present study we compared IGT performance of 40 young (mean age: 27.9+/-4.7) and 40 old (mean age: 65.4+/-8.6) healthy adults and of 18 patients affected by frontal lobe dementia of mild severity (mean age: 65.1+/-7.4, mean MMSE score: 24.1+/-3.9). Quantitative findings support the notion that decision making ability declines with age; moreover, it approximates the impairment observed in executive dysfunction due to neurodegeneration. Results of the qualitative analysis did not reach statistical significance for the motivational and learning decision making components considered, but approached significance for the attentional component for elderly versus young normals, suggesting a possible decrease in the ability to maintain sustained attention during complex and prolonged tasks as the putative deficit underlying impaired decision making in normal aging.     

Modeling behavioral measures of error detection in choice tasks: response monitoring versus conflict monitoring

The present study investigated the mechanisms underlying error detection in the error signaling response. The authors tested between a response monitoring account and a conflict monitoring account. By implementing each account within the neural network model of N. Yeung, M. M. Botvinick, and J. D. Cohen (2004), they demonstrated that both accounts make different predictions as to how error signaling performance is influenced by varying the participants' response criterion. These predictions were tested in an experiment using the Eriksen-flanker task. The qualitative pattern as well as a model fit favored the response monitoring account, which states that error detection is mediated by detecting internal error corrections.     

Effect of time of day on arithmetic fact retrieval in a number-matching task

The goal of this study is aimed to investigate a possible effect of time of day on arithmetic fact retrieval in a number-matching task. We tested 96 students (age range 19-33 years) at 9 a.m. and at 1 p.m., in a counterbalanced order. The subjective alertness levels were also recorded. As regards retrieval efficiency, the results showed that the sum interference effect was significantly more pronounced in the morning (9 a.m.) than at midday (1 p.m.). As expected, participants showed higher subjective alertness levels at 1 p.m. than at 9 a.m.. However, the difference of subjective alertness did not completely explain differences in interference at two testing sessions. The results could be explained with respect to the variation of working memory efficiency during the day.     

Sex-specific clinical correlates of hoarding in obsessive-compulsive disorder

Little is known about whether the clinical correlates of hoarding behavior are different in men and women with obsessive-compulsive disorder (OCD). In the current study, we evaluated the association of hoarding with categories of obsessions and compulsions, psychiatric disorders, personality dimensions, and other clinical characteristics separately in 151 men and 358 women with OCD who were examined during the OCD Collaborative Genetics Study. We found that, among men but not women, hoarding was associated with aggressive, sexual, and religious obsessions and checking compulsions. In men, hoarding was associated with generalized anxiety disorder and tics whereas, among women, hoarding was associated with social phobia, post-traumatic stress disorder, body dysmorphic disorder, nail biting, and skin picking. In women but not men, hoarding was associated with schizotypal and dependent personality disorder dimensions, and with low conscientiousness. These findings indicate that specific clinical correlates of hoarding in OCD are different in men and women and may reflect sex-specific differences in the course, expression, and/or etiology of hoarding behavior in OCD.     

Prevalence and correlates of hoarding behavior in a community-based sample

Little is known about the prevalence and correlates of hoarding behavior in the community. We estimated the prevalence and evaluated correlates of hoarding in 742 participants in the Hopkins Epidemiology of Personality Disorder Study. The prevalence of hoarding was nearly 4% (5.3%, weighted) and was greater in older than younger age groups, greater in men than women, and inversely related to household income. Hoarding was associated with alcohol dependence; paranoid, schizotypal, avoidant, and obsessive-compulsive personality disorder traits; insecurity from home break-ins and excessive physical discipline before 16 years of age; and parental psychopathology. These findings suggest that hoarding may be relatively prevalent and that alcohol dependence, personality disorder traits, and specific childhood adversities are associated with hoarding in the community.     

Do fish count? Spontaneous discrimination of quantity in female mosquitofish

The spontaneous tendency to join the largest social group was used to investigate quantity discrimination in fish. Fish discriminated between shoals that differed by one element when the paired numbers were 1vs2, 2vs3 and 3vs4, but not when 4vs5 or larger. Using large numerosities (>4), the ability to discriminate between two numbers improved as the numerical distance between them increased and a significant discrimination was found only with ratios of 1:2 or smaller (4vs8, 8vs16 and 4vs10). Experiments to control for non-numerical variables evidenced the role played by the total area of stimuli with both large and small numerosities; the total quantity of movement of the fish within a shoal appeared also important but only when large numerosities were involved. Even though the pattern of discrimination exhibited by female mosquitofish is not fully consistent with any of the existing models of quantity representation, our results seem to suggest two distinct mechanisms in fish, one used to compare small numbers of objects and one used when larger numerosities are involved.     

A case of partial biotinidase deficiency associated with autism.

We report the case of a child with partial biotinidase deficiency and autistic developmental disorder. We arrived at the diagnosis of biotinidase deficiency when the child was almost 4 years of age. Consequently, he began cofactor biotin treatment (10 mg daily) which did not resolve his autistic behavior. His younger brother was affected by partial biotinidase deficiency diagnosed at birth through our neonatal screening program. He was precociously treated with cofactor biotin therapy (10 mg daily) and did not show any behavioral abnormality or developmental delay. Since the brain is quite vulnerable to biotin deficiency, delayed biotin therapy could result in neurological damage. Our patient is the first case of partial biotinidase deficiency associated with autism. We hypothesize that the low biotinidase activity could have caused biotin deficiency in his brain and cerebrospinal fluids and consequently serious neurological problems, such as stereotyped and autistic behaviors, which were irreversible in spite of biotin supplementation.