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Previous research has demonstrated performance inefficiencies among perfectionists, which may be mitigated via the adoption of ‘good enough’ heuristic-based information acquisition strategies; particularly in complex tasks. This study investigated whether training perfectionists to use reduced-processing strategies during decision-making could reduce their checking and maximising tendencies, improve their accuracy, and reduce time on task. Sixty participants completed eight decision scenarios; two at pre-training, four during training, and two at post-training. Scenarios were from firefighting and crime scene investigation (CSI) contexts, which required participants to access feature-related text boxes to acquire information on three possible options. Firefighting and CSI scenarios were used to gauge performance and mental demand at both pre- and post-training. Participants were assigned to one of the three training conditions: Control (i.e., no training), Elimination by Aspects, and Satisficing. All participants completed four firefighting tasks, receiving feedback on each. Participants then completed two perfectionism measures to assess their relative levels of Perfectionistic Concerns and Perfectionistic Strivings. Components of perfectionism significantly predicted changes in accuracy, latency, unique features accessed, and recursions made during decision-making. Participants who trained in reduced-processing strategies did not significantly improve task performance (compared to control), however did show a reduction in the number of unique features accessed. Further, perfectionism did significantly explain variability in change scores but to different extents depending on task context. While training translated to greater reductions in the number of unique features accessed, other proposed benefits of using reduced-processing strategies were not observed. The study contributes to knowledge of human-centred design and elucidates the factors that may influence the successful introduction and adoption of reduced-processing or other training strategies.

The readback/hearback loop is a communicative protocol used in many high-risk environments to ensure that a verbal instruction has been heard correctly by a receiver. However, it does not necessarily ensure that an instruction has been understood. Using an international sample of hydroelectric power generation controllers, this study examined whether particular linguistic (complete and partial readbacks) and prosodic (final intonation, filler, and interturn delay) cues contained within a readback response could signal to listeners the extent to which speakers had understood an instruction. The results indicated that different prosodic cues are used to detect nonunderstandings, depending upon the linguistic content of the readback. The results have implications for training and system design in distributed environments.

Objective: This research was designed to examine the impact of heuristic-based approaches to the acquisition of task-related information on the selection of an optimal alternative during simulated in-flight decision making. Background: The work integrated features of naturalistic and normative decision making and strategies of information acquisition within a computer-based, decision support framework. Method: The study comprised two phases, the first of which involved familiarizing pilots with three different heuristic-based strategies of information acquisition: frequency, elimination by aspects, and majority of confirming decisions. The second stage enabled participants to choose one of the three strategies of information acquisition to resolve a fourth (choice) scenario. Results: The results indicated that task-oriented experience, rather than the information acquisition strategies, predicted the selection of the optimal alternative. It was also evident that of the three strategies available, the elimination by aspects information acquisition strategy was preferred by most participants. Conclusion: It was concluded that task-oriented experience, rather than the process of information acquisition, predicted task accuracy during the decision-making task. It was also concluded that pilots have a preference for one particular approach to information acquisition. Application: Applications of outcomes of this research include the development of decision support systems that adapt to the information-processing capabilities and preferences of users.

The study aimed to examine the role of, and potential interplay between, cue utilisation and cognitive reflection in email users’ ability to accurately (and efficiently) differentiate between phishing and genuine emails. 145 participants completed the Cognitive Reflection Test (CRT), a phishing diagnostic task, and the Expert Intensive Skill Evaluation (EXPERTise 2.0) battery, which provided a gauge of users’ cue utilisation in the domain. The results revealed an interaction between users’ cognitive utilisation and cue reflection, whereby users low in both facets performed significantly worse in diagnosing phishing emails than all other groups. Further, those participants with both higher cue utilisation and cognitive reflection took significantly longer to make their diagnosis. It is concluded that a high level of cognitive reflection was able to compensate for a lower level of cue utilisation, and vice versa. Participants reported using seven types of cue during diagnosis, however, there was no significant relationship between the types of cues used and users’ level of cue utilisation. Taken together, the findings have implications to the design of user-level interventions in relation to the identification of vulnerable users, as well as the need to consider training approaches that extend beyond the use of simple cue inventories.

Preoperative cognitive reserve and brain integrity may explain commonly observed intraoperative fluctuations seen on a standard anesthesia depth monitor used ubiquitously in operating rooms throughout the nation. Neurophysiological variability indicates compromised regulation and organization of neural networks. Based on theories of neuronal integrity changes that accompany aging, we assessed the relative contribution of: 1) premorbid cognitive reserve, 2) current brain integrity (gray and white matter markers of neurodegenerative disease), and 3) current cognition (specifically domains of processing speed/working memory, episodic memory, and motor function) on intraoperative neurophysiological variability as measured from a common intraoperative tool, the Bispectral Index Monitor (BIS). This sub-study included participants from a parent study of non-demented older adults electing unilateral Total Knee Arthroplasty (TKA) with the same surgeon and anesthesia protocol, who also completed a preoperative neuropsychological assessment and preoperative 3T brain magnetic resonance imaging scan. Left frontal two-channel derived EEG via the BIS was acquired preoperatively (un-medicated and awake) and continuously intraoperatively with time from tourniquet up to tourniquet down. Data analyses used correlation and regression modeling. Fifty-four participants met inclusion criteria for the sub-study. The mean (SD) age was 69.5 (7.4) years, 54% were male, 89% were white, and the mean (SD) American Society of Anesthesiologists score was 2.76 (0.47). We confirmed that brain integrity positively and significantly associated with each of the cognitive domains of interest. EEG intra-individual variability (squared deviation from the mean BIS value between tourniquet up and down) was significantly correlated with cognitive reserve (r = -.40, p = .003), brain integrity (r = -.37, p = .007), and a domain of processing speed/working memory (termed cognitive efficiency; r = -.31, p = .021). Hierarchical regression models that sequentially included age, propofol bolus dose, cognitive reserve, brain integrity, and cognitive efficiency found that intraoperative propofol bolus dose (p = .001), premorbid cognitive reserve (p = .008), and current brain integrity (p = .004) explained a significant portion of intraoperative intra-individual variability from the BIS monitor. Older adults with higher premorbid reserve and less brain disease were more stable intraoperatively on a depth of anesthesia monitor. Researchers need to replicate findings within larger cohorts and other surgery types.

Cardiac-resynchronization therapy is recommended for patients with advanced, symptomatic heart failure. This clinical trial found benefit in asymptomatic patients, but since the rate of death was not affected, it remains to be seen whether clinical guidelines will be modified to include asymptomatic patients. This clinical trial found benefit with cardiac-resynchronization therapy in asymptomatic patients, but since the rate of death was not affected, it remains to be seen whether clinical guidelines will be modified to include asymptomatic patients. Patients with cardiac disease and reduced left ventricular function are at increased risk for arrhythmia-related sudden death and heart failure. The placement of an implantable cardioverter–defibrillator (ICD) improves survival and reduces the risk of sudden death in appropriately selected patients with cardiac disease. 1 – 3 However, life-prolonging defibrillator therapy is associated with an increased risk of first and recurrent heart-failure events. 4 Cardiac-resynchronization therapy (CRT) with biventricular pacing is an effective adjunctive therapy to pharmacologic management in reducing the rate of hospitalization in symptomatic patients with advanced heart-failure symptoms (New York Heart Association [NYHA] class III or IV), an ejection fraction of . . .

Genetic influence on blood pressure Compared to other common complex diseases, it has proved remarkably difficult to establish the genetic basis of blood-pressure elevation. A multi-stage genome-wide association study involving 200,000 individuals of European descent provides some of the missing detail in the genetic picture. The study identified 16 relevant loci, of which only 6 contain genes previously known or suspected to regulate blood pressure. An association was found between hypertension, the thickness of the left ventricular wall, stroke and coronary artery disease, but not kidney disease or kidney function. Comparison with data from more than 75,000 people of East Asian, South Asian and African ancestries confirmed that many of the variants identified in European-ancestry subjects also influence blood pressure in other populations. Blood pressure is a heritable trait 1 influenced by several biological pathways and responsive to environmental stimuli. Over one billion people worldwide have hypertension (≥140 mm Hg systolic blood pressure or ≥90 mm Hg diastolic blood pressure) 2 . Even small increments in blood pressure are associated with an increased risk of cardiovascular events 3 . This genome-wide association study of systolic and diastolic blood pressure, which used a multi-stage design in 200,000 individuals of European descent, identified sixteen novel loci: six of these loci contain genes previously known or suspected to regulate blood pressure ( GUCY1A3 – GUCY1B3 , NPR3 – C5orf23 , ADM , FURIN – FES , GOSR2 , GNAS – EDN3 ); the other ten provide new clues to blood pressure physiology. A genetic risk score based on 29 genome-wide significant variants was associated with hypertension, left ventricular wall thickness, stroke and coronary artery disease, but not kidney disease or kidney function. We also observed associations with blood pressure in East Asian, South Asian and African ancestry individuals. Our findings provide new insights into the genetics and biology of blood pressure, and suggest potential novel therapeutic pathways for cardiovascular disease prevention.