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Inappropriate shocks from an S-ICD
Case: A 62-year-old man attended electively for implantation of a subcutaneous implantable cardioverter defibrillator (S-ICD) for primary prevention due to dilated cardiomyopathy with severe left ventricular systolic dysfunction (LVSD). His past medical history included type II diabetes. Screening prior to implant demonstrated that the primary and alternative vectors were acceptable. The S-ICD was implanted under general anaesthetic using a two-incision technique. The generator was placed in an intermuscular position. Both pockets were flushed with normal saline. The sensing was programmed to the primary vector. Routine defibrillation threshold testing was performed successfully with a shock impedance of 68 Ohms. On return to the ward, the patient received two inappropriate shocks due to noise (Figure 1). Interrogation revealed a drop in R wave amplitude and intermittent noise seen in both the primary and alternate vectors. These both utilize the proximal electrode. A chest X-ray demonstrated a small amount of air overlying the proximal electrode (Figure 1). device was briefly deactivated to allow for resorption. Unfortunately, the patient re-presented 10 weeks later with a further inappropriate shock, which again was due to noise and a transient drop in R wave amplitude. Repeat chest X-rays showed resorption of the air previously seen and that the pin remained through the header. The sensing was still programmed to the primary vector. On interrogation of the device, noise was reproducible with patient movement on the secondary vector, but not on either the primary or alternate vectors. The device was deactivated. After seeking advice from Boston, the patient attended for explant and re-implant of a new S-ICD system. Visual inspection at the time of explant confirmed that the pin was through the header and screwed in. The device was returned to Boston for further analysis. Analysis of both the generator and lead failed to identify any issue that could have caused or contributed to the inappropriate shocks. To date, the patient has not had any issues with the new device. ❑ [Image Omitted]
Journal Article
0230 Sleep and Interrogation: Does Losing Sleep Impact Criminal History Disclosure?
Abstract
Introduction
Despite centuries of using sleep deprivation during interrogation, there is virtually no scientific evidence on how sleep shapes behavior in interrogation settings. Moreover, investigative interviews are often conducted at night, or with fatigued subjects. To evaluate the impact of sleeplessness on subjects’ behavior during investigative interviews, an experimental study examined the impact of moderate sleep restriction on information disclosure and behavioral reactions during interviews about past illegal acts.
Methods
Healthy participants (N=120) were recruited from the university community and randomly assigned to either maintain or curb their sleep (up to 4 hours a night) across two days. Back in the laboratory individuals privately indicated whether they committed various illegal acts. Participants were interviewed while video-recorded about the most severe act they acknowledged. After the initial disclosure, participants listened to a ‘model’ statement, an unrelated example of a person’s detailed event account designed to encourage additional disclosure, after which they again provided information about their offense. Key variables were the severity of the illegal behavior reported and the amount of information provided before and after the model statement (blindly coded from transcripts for quantity and quality).
Results
Sleep-restricted participants slept on average 4.5 hours less (confirmed via actigraphy), reported no differences in perceived treatment by the interviewer, and tended to report less severe offenses. Critically, sleep-restricted participants provided almost 20% less information during their initial disclosure (d = .53, p =.01). After the model statement, however, disclosure was generally higher and similar across conditions (d = .15, p = .35). Sleep-restricted individuals also reported less overall motivation to recall information (d=.27, p = .01).
Conclusion
Results suggest that even moderate sleep loss can inhibit criminal disclosure during interviews, and that reduced motivation could play a role. Also, the use of the model statement could compensate for this effect.
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Journal Article
The psychology of false confessions : forty years of science and practice
Provides a comprehensive and up-to-date review of the development of the science behind the psychology of false confessions
Four decades ago, little was known or understood about false confessions and the reasons behind them. So much has changed since then due in part to the diligent work done by Gisli H. Gudjonsson. This eye-opening book by the Icelandic/British clinical forensic psychologist, who in the mid 1970s had worked as detective in Reykjavik, offers a complete and current analysis of how the study of the psychology of false confessions came about, including the relevant theories and empirical/experimental evidence base. It also provides a reflective review of the gradual development of the science and how it can be applied to real life cases.
Based on Gudjonsson's personal account of the biggest murder investigations in Iceland's history, as well as other landmark cases, The Psychology of False Confessions: Forty Years of Science and Practice takes readers inside the minds of those who sit on both sides of the interrogation table to examine why confessions to crimes occur even when the confessor is innocent. Presented in three parts, the book covers how the science of studying false confessions emerged and grew to become a regular field of practice. It then goes deep into the investigation of the mid-1970s assumed murders of two men in Iceland and the people held responsible for them. It finishes with an in-depth psychological analysis of the confessions of the six people convicted.
* Written by an expert extensively involved in the development of the science and its application to real life cases
* Covers the most sensational murder cases in Iceland's history
* Deep analysis of the 'Reykjavik Confessions' adds crucial evidence to understanding how and why coerced-internalized false confessions occur, and their detrimental and lasting effects on memory
The Psychology of False Confessions: Forty Years of Science and Practice is an important source book for students, academics, criminologists, and clinical, forensic, and social psychologists and psychiatrists.
eBook
Dialogue, argumentation, and education : history, theory, and practice
\"New pedagogical visions and technological developments have brought argumentation to the fore of educational practice. Whereas students previously 'learned to 'argue', they now 'argue to learn': collaborative argumentation-based learning has become a popular and valuable pedagogical technique, across a variety of tasks and disciplines. Researchers have explored the conditions under which arguing to learn is successful, have described some of its learning potentials (such as for conceptual change and reflexive learning) and have developed Internet-based tools to support such learning. However, the further advancement of this field presently faces several problems, which the present book addresses. Three dimensions of analysis - historical, theoretical and empirical - are integrated throughout the book. Given the nature of its object of study - dialogue, interaction, argumentation, learning and teaching - the book is resolutely multidisciplinary, drawing on research on learning in educational and psychological sciences, as well as on philosophical and linguistic theories of dialogue and argumentation\"-- Provided by publisher.
Book
Éditorial
On voudrait y ajouter comme le font De Ridder et alii, l'impact majeur des transformations probables sur la formation au management dans lequel une part importante de nos millenials semble d'engager avec régularité (voir le succes durable des business school). Dans le contexte nord-américain, le prestigieux NBER (National Bureau of Economic Research) propose une étude4 d'ampleur portant sur 10 000 entreprises et 32 000 établissements industriels leur appartenant, qui met en évidence trois points: - les styles de management different fortement selon les entreprises; - mais ils different également à l'intérieur d'une entreprise, selon les établissements ; le management constitue un driver puissant de la productivité des établissements; - Ces pratiques de management sont fortement liées à la performance, et elles comptent pour à peu pres 20 % du gain de productivité pour les établissements les plus performants, une proportion qui est aussi grande, voire plus que des facteurs technologiques, comme la R&D ou les TIC. NBER, What drives differences in Management WP n°23300, Mars 2017, a paraître dans American Economic Review.
Journal Article