Three Conceptual Models of Patient and Public Involvement in Standard-setting: From Abstract Principles to Complex Practice

Clinical practice guidelines have been critiqued for prescribing standardized care that neglects patients’ personal circumstances and knowledge in health care decisions. To make care more patient centred, standard-setters are urged to involve patients and the public in guideline development and use. Despite widespread principled support for such Patient and Public Involvement (PPI), the underlying principles guiding PPI in standardization of care are mired on confusion and contradiction. Based on the PPI literature in general, and informed by empirical research on guideline development, it is possible to identify three rationales that justify PPI in clinical standard setting. Each rationale gives rise to a conceptual model which outlines a distinct purpose of participation, who is to be included, and what they are expected to contribute. The Consumer Choice model aims to involve autonomous consumers to personalize clinical care. The Democratic Voice model aims for health care recommendations to better reflect collective values of citizens. The Lay Expertise model aims to re-contextualize universal evidence by including experiential patient knowledge. However, these models can and should not function as ‘Gold Standards’ to be consistently followed in practice. First, the models rely on two distinct types of representation, resulting in contradictory notions of how to be a good representative. Second, imposing models on practice requires a top-down control that is practically and politically problematic. Not only is control difficult to achieve, it may compromise the participatory ideal of participants co-determine practice, and may result in excluding the values and views of ‘real’ patients and public entirely.     

L'accession à l'opérativité formelle chez les enfants intellectuellement précoces

This study is an attempt to contribute data concerning the cognitive functioning and development of intellectually gifted children, at the threshold of formal operational stage. It ascribes to the theory of the operational development of intelligence according to Piaget. “Gifted”, children and “average” children of an equivalent mental age (12 years and 6 months) were compared. A second group of gifted children of the same chronological age as the average children completed this study. Longeot's “Échelle de Développement de la Pensée Logique” was used for all the subjects. The results reveal dissynchronical aspects within the genesis of gifted children. They are discussed taking into account the task characteristics (type of reasoning they require) and functional specificities of compared subjects.     

Auditory attentional blink: masking the second target is necessary, delayed masking is sufficient.

When two target items (T1 and T2) are presented in rapid succession among fillers, processing T2 is often impaired. This phenomenon is known as the attentional blink (AB). Within the visual modality, this second-target deficit generally occurs only if T2 is masked by a trailing item. The current study was designed to examine whether masking of T2 also plays a critical role in the auditory AB. Results showed a reliable AB effect even when the item following T2 was replaced by silence. However, the AB deficit was abolished when T2 was the last presented stimulus. Our results suggest that, as in vision, T2 masking is necessary for the AB to take place in audition, but that masking is effective even when delayed, providing evidence that the phenomenon shares some functional mechanisms across sensory modalities.     

Is banner blindness genuine? Eye tracking internet text advertising

Over the last decade or so, the Internet has become a privileged media for advertisement. Despite this increase in popularity, several studies suggested that Internet users ‘avoid’ looking at ads (what is often referred to as the banner blindness phenomena). This conclusion, however, rests mostly on indirect evidence that participants do not remember the ad content. Therefore, it is unclear whether participants actually fixated the ads and how their gaze behaviour is related to memory for the ad. In the present study, we investigated whether Internet users avoid looking at ads inserted on a non‐search website using an analysis of eye movements, and if the ad content is kept in memory. Our results show that most participants fixate the ads at least once during their website visit. Moreover, even though the congruency between the ad and the editorial content had no effect on fixation duration on the ad, congruent ads were better memorised than incongruent ads. This study provides a novel and systematic method for assessing the processing and retention of advertisements during a website visit. Copyright © 2010 John Wiley & Sons, Ltd.     

RSK2 signaling in brain habenula contributes to place aversion learning

RSK2 is a Ser/Thr kinase acting in the Ras/MAPK pathway. Rsk2 gene deficiency leads to the Coffin-Lowry Syndrome, notably characterized by cognitive deficits. We found that mrsk2 knockout mice are unable to associate an aversive stimulus with context in a lithium-induced conditioned place aversion task requiring both high-order cognition and emotional processing. Virally mediated shRNA-RSK2 knockdown in the habenula, whose involvement in cognition is receiving increasing attention, also ablated contextual conditioning. RSK2 signaling in the habenula, therefore, is essential for this task. Our study reveals a novel role for RSK2 in cognitive processes and uncovers the critical implication of an intriguing brain structure in place aversion learning.     

The role of form and meaning in the processing of written morphology: A priming study in French developing readers

Three visual priming experiments using three different prime durations (60 ms in Experiment 1, 250 ms in Experiment 2, and 800 ms in Experiment 3) were conducted to examine which properties of morphemes (form and/or meaning) drive developing readers’ processing of written morphology. French third, fifth, and seventh graders and adults (the latter as a control group) performed lexical decision tasks in which targets were preceded by morphological (e.g., tablette–TABLE, “little table–table”), pseudoderived (e.g., baguette–BAGUE, “little stick–ring”), orthographic control (e.g., abricot–ABRI, “apricot–shelter”), and semantic control (e.g., Tulipe–FLEUR, “tulip–flower”) primes. Across all groups, different patterns of priming were observed in both morphological and orthographic/semantic control conditions, suggesting that they all process morphemes as units when reading. In developing readers, the processing of written morphology is triggered by the form properties of morphemes, and their semantic properties are activated later in the time course of word recognition. In adults, patterns of priming were similar except that the activation of the form properties of morphemes decreased earlier in the time course of word recognition. Taken together, these findings indicate that French developing readers process both the form and meaning properties of morphemes when reading and support a progressive quantitative change in the development of morphological processing over the course of reading development.