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Younge R, Jani B, Rosenthal D, Lin SX. Does continuity of care have an effect on diabetes quality measures in a teaching practice in an urban underserved community? J Health Care Poor Underserved 2014; 23:1558-65. [PMID: 23698670 DOI: 10.1353/hpu.2012.0193] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Teaching clinics are an important source of care for urban, minority, underserved communities and face great challenges to improve quality of care for diabetics. This study examined the impact of continuity with the same primary care provider on health care process and outcome measures for patients with diabetes treated at an urban, family medicine resident teaching practice. The Modified Modified Continuity of Care Index was used to measure care continuity. The diabetes care quality measures were based on the NCQA HEDIS and Diabetes Recognition Program. Low levels of care continuity were associated with poor HbA1c control and higher levels of care continuity were associated with good LDL control. These findings suggest that improving care continuity should be considered in a systems-based approach to address disparities in diabetes care. Additional research is needed to include the patient's perspective in measuring care continuity and patient outcomes.
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Ferris R, Zhang Q, Rosenthal D, Gildener-Leapman N, Gibson SP, Singh A, Ridge J, Raben D, Wang D, Chung C. Correlation of Fc Gamma Receptor (FcγR) IIa and IIIa Polymorphisms With Clinical Outcome in Patients Treated With Cetuximab-Based Chemoradiation in the RTOG 0522 Trial. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2013.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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128
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Setton J, Lee N, Huang S, Waldron J, Zhang Z, Shi W, O'Sullivan B, Rosenthal D, Hutcheson K, Garden A. A Multi-institution Pooled Analysis of G-Tube Dependence in Patients With Oropharyngeal Cancer Treated With Definitive IMRT. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2013.11.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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129
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Young BD, Keller A, Rosenthal D. Quality-space theory in olfaction. Front Psychol 2014; 5:1. [PMID: 24474945 PMCID: PMC3893576 DOI: 10.3389/fpsyg.2014.00001] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 01/02/2014] [Indexed: 01/28/2023] Open
Abstract
Quality-space theory (QST) explains the nature of the mental qualities distinctive of perceptual states by appeal to their role in perceiving. QST is typically described in terms of the mental qualities that pertain to color. Here we apply QST to the olfactory modalities. Olfaction is in various respects more complex than vision, and so provides a useful test case for QST. To determine whether QST can deal with the challenges olfaction presents, we show how a quality space (QS) could be constructed relying on olfactory perceptible properties and the olfactory mental qualities then defined by appeal to that QS of olfactory perceptible properties. We also consider how to delimit the olfactory QS from other modalities. We further apply QST to the role that experience plays in refining our olfactory discriminative abilities and the occurrence of olfactory mental qualities in non-conscious olfactory states. QST is shown to be fully applicable to and useful for understanding the complex domain of olfaction.
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130
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Leahy MJ, Chan F, Lui J, Rosenthal D, Tansey T, Wehman P, Kundu M, Dutta A, Anderson CA, Del Valle R, Sherman S, Menz FE. An analysis of evidence-based best practices in the public vocational rehabilitation program: Gaps, future directions, and recommended steps to move forward. JOURNAL OF VOCATIONAL REHABILITATION 2014. [DOI: 10.3233/jvr-140707] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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131
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Kelly L, Walters L, Rosenthal D. Community-based medical education: is success a result of meaningful personal learning experiences? EDUCATION FOR HEALTH (ABINGDON, ENGLAND) 2014; 27:47-50. [PMID: 24934943 DOI: 10.4103/1357-6283.134311] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Community-based medical education (CBME) is the delivery of medical education in a specific social context. Learners become a part of social and medical communities where their learning occurs. Longitudinal integrated clerkships (LICs) are year-long community-based placements where the curriculum and clinical experience is typically delivered by primary care physicians. These programs have proven to be robust learning environments, where learners develop strong communication skills and excellent clinical reasoning. To date, no learning model has been offered to describe CBME. METHODS The characteristics of CBME are explored by the authors who suggest that the social and professional context provided in small communities enhances medical education. The authors postulate that meaningfulness is engendered by the authentic context, which develops over time. These relationships with preceptors, patients and the community provide meaningfulness, which in turn enhances learning. RESULTS AND DISCUSSION The authors develop a novel learning model. They propose that the context-rich environment of CBME allows for meaningful relationships and experiences for students and that such meaningfulness enhances learning.
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132
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Villafañe J, Feinstein JA, Jenkins KJ, Vincent RN, Walsh EP, Dubin AM, Geva T, Towbin JA, Cohen MS, Fraser C, Dearani J, Rosenthal D, Kaufman B, Graham TP. Hot Topics in Tetralogy of Fallot. J Am Coll Cardiol 2013; 62:2155-66. [DOI: 10.1016/j.jacc.2013.07.100] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 06/26/2013] [Accepted: 07/01/2013] [Indexed: 12/13/2022]
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133
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Blalock S, Chan F, Rosenthal D, Ogawa M, Maxey D, Feinstein J. Magnetic resonance imaging of the right ventricle in pediatric pulmonary arterial hypertension. Pulm Circ 2013; 3:350-5. [PMID: 24015335 PMCID: PMC3757829 DOI: 10.4103/2045-8932.114763] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) causes changes in the right ventricle (RV), affecting RV size and function, ultimately leading to death. These changes have been evaluated by cardiac MRI (CMR) in adults with PAH, but not in children. Using CMR in pediatric patients with PAH, we examined how RV size and function (1) compare to normal data, (2) change over time, and (3) compare to similar studies in the adult population. Data from two institutions were retrospectively reviewed. Subjects with PAH and a CMR were included. Baseline CMR variables (right and left ventricular end-diastolic and end-systolic volumes indexed for body surface area, and calculated stroke volume and ejection fraction) were compared to normative data and follow-up CMR data. Twenty-six subjects (15 female), age 2-16 (mean 11) years, with idiopathic PAH were included. All patients were on PAH medication, and 65% on prostacyclin therapy. The baseline 6-Minute Walk Distance (6MWD; 481 ± 137) was normal. RV volumes and ejection fraction were markedly abnormal compared to normal data (P < 0.001). Follow-up CMRs were analyzed in 15 patients. RV volumes and function and LV stroke volume showed no significant change over one year. Our pediatric patients with PAH have markedly abnormal right ventricles by CMR but have normal walk distances. The lack of change in CMR parameters over one year may represent a stable cohort and is different than similar studies in adults.
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135
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Lin A, Liu E, Keating M, Maeda K, Hollander S, Rosenthal D. School Re-Integration for Pediatric VADs. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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136
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Almond C, Smoot L, VanderPluym C, Singh T, Blume E, Rosenthal D, Bastardi H, Dillis S, Daly K. Are Smaller Children Waiting Longer? Trends in Median Waiting Time for Smaller Children Listed for Heart Transplant in the US. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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137
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Maeda K, Asija R, Hollander S, Williams G, Yeh J, Rosenthal D, Reinhartz O. Low Dose Factor Eight Inhibitor Bypassing Activity (FEIBA) for Incessant Bleeding in Pediatric Patients on Mechanical Circulatory Support (MCS). J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.767] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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138
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Lin A, Liu E, Keating M, Maeda K, Hollander S, Rosenthal D. Pediatric Outpatient VAD Experience at Stanford. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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139
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Methodius-Rayford W, Combs JM, Wellons ED, Poindexter JM, Rosenthal D. Cryopreserved saphenous vein allograft for infragenicular bypass in the presence of foot infection. Vascular 2013; 21:221-3. [PMID: 23518848 DOI: 10.1177/1708538113478755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report our distal bypass experience with cryopreserved saphenous vein allograft (CSVA) in 12 patients presenting with infection and no autologous saphenous vein available. Twelve patients underwent 13 arterial reconstructions. The mean age of the cohort was 68.4 years. Ninety-two percent (92%) of the patients presented with Rutherford Class 5 or 6 disease which required wide debridement and copious irrigation of all infected tissue beds. All distal anastomoses were to infragenicular vessels. Two patients died with patent grafts during follow-up for an 83% survival rate. Three grafts failed during follow-up between one and 36.3 months, of which two underwent amputation for an 82% limb salvage rate. The primary and primary assisted patency rate was 40% and 60% at 18 months follow-up, respectively, and no recurrent infections. In patients who have complex risk factors and the presence of infection, CSVA appears to be a reasonable option for limb salvage.
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140
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Stein ML, Bruno JL, Konopacki KL, Kesler S, Reinhartz O, Rosenthal D. Cognitive outcomes in pediatric heart transplant recipients bridged to transplantation with ventricular assist devices. J Heart Lung Transplant 2013; 32:212-20. [DOI: 10.1016/j.healun.2012.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 11/02/2012] [Accepted: 11/10/2012] [Indexed: 11/29/2022] Open
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141
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Rosenthal D. Higher-order awareness, misrepresentation and function. Philos Trans R Soc Lond B Biol Sci 2012; 367:1424-38. [PMID: 22492758 DOI: 10.1098/rstb.2011.0353] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Conscious mental states are states we are in some way aware of. I compare higher-order theories of consciousness, which explain consciousness by appeal to such higher-order awareness (HOA), and first-order theories, which do not, and I argue that higher-order theories have substantial explanatory advantages. The higher-order nature of our awareness of our conscious states suggests an analogy with the metacognition that figures in the regulation of psychological processes and behaviour. I argue that, although both consciousness and metacognition involve higher-order psychological states, they have little more in common. One thing they do share is the possibility of misrepresentation; just as metacognitive processing can misrepresent one's cognitive states and abilities, so the HOA in virtue of which one's mental states are conscious can, and sometimes does, misdescribe those states. A striking difference between the two, however, has to do with utility for psychological processing. Metacognition has considerable benefit for psychological processing; in contrast, it is unlikely that there is much, if any, utility to mental states' being conscious over and above the utility those states have when they are not conscious.
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142
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Stagg P, Rosenthal D. Why community members want to participate in the selection of students into medical school. Rural Remote Health 2012. [DOI: 10.22605/rrh1954] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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143
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Armbrüster M, Kovnir K, Friedrich M, Teschner D, Wowsnick G, Hahne M, Gille P, Szentmiklósi L, Feuerbacher M, Heggen M, Girgsdies F, Rosenthal D, Schlögl R, Grin Y. Al13Fe4 as a low-cost alternative for palladium in heterogeneous hydrogenation. NATURE MATERIALS 2012; 11:690-3. [PMID: 22683821 DOI: 10.1038/nmat3347] [Citation(s) in RCA: 219] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 05/02/2012] [Indexed: 05/06/2023]
Abstract
Replacing noble metals in heterogeneous catalysts by low-cost substitutes has driven scientific and industrial research for more than 100 years. Cheap and ubiquitous iron is especially desirable, because it does not bear potential health risks like, for example, nickel. To purify the ethylene feed for the production of polyethylene, the semi-hydrogenation of acetylene is applied (80 × 10(6) tons per annum; refs 1-3). The presence of small and separated transition-metal atom ensembles (so-called site-isolation), and the suppression of hydride formation are beneficial for the catalytic performance. Iron catalysts necessitate at least 50 bar and 100 °C for the hydrogenation of unsaturated C-C bonds, showing only limited selectivity towards semi-hydrogenation. Recent innovation in catalytic semi-hydrogenation is based on computational screening of substitutional alloys to identify promising metal combinations using scaling functions and the experimental realization of the site-isolation concept employing structurally well-ordered and in situ stable intermetallic compounds of Ga with Pd (refs 15-19). The stability enables a knowledge-based development by assigning the observed catalytic properties to the crystal and electronic structures of the intermetallic compounds. Following this approach, we identified the low-cost and environmentally benign intermetallic compound Al(13)Fe(4) as an active and selective semi-hydrogenation catalyst. This knowledge-based development might prove applicable to a wide range of heterogeneously catalysed reactions.
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Hollander SA, Bernstein D, Yeh J, Dao D, Sun HY, Rosenthal D. Outcomes of children following a first hospitalization for dilated cardiomyopathy. Circ Heart Fail 2012; 5:437-43. [PMID: 22570362 DOI: 10.1161/circheartfailure.111.964510] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We hypothesized that children with dilated cardiomyopathy who require hospital admission are at increased risk for death or transplantation during their first hospitalization and in the first year that follows. We also assessed the value of routine data collected during that time to predict death or the need for transplantation prior to discharge and within 1 year of admission. METHODS AND RESULTS We conducted a retrospective review of 83 pediatric patients with dilated cardiomyopathy whose initial hospitalization fell between 2004 and 2009. The mean age at hospitalization was 7 years. The majority of patients demonstrated moderate or severe left ventricular dysfunction on initial echocardiogram (80%) and/or the need for intravenous inotropes within 7 days of hospital admission (69%). Five patients (6%) died, and 15 (18%) were transplanted in the initial hospitalization. At 1 year, 11/71 (15%) had died, and 27/71 (38%) were transplanted. The overall freedom from death, transplantation, or rehospitalization at 1 year following admission was 21%. Fractional shortening, left ventricular ejection fraction, serum cholesterol, uric acid, mixed venous saturation, and atrial filling pressures were all predictive of death or transplantation during the initial hospitalization. Left ventricular ejection fraction was predictive of death or transplantation at 1 year. CONCLUSIONS The first hospitalization for dilated cardiomyopathy marks a period of high risk for clinical decline, end stage heart failure, and the need for cardiac transplantation. Echocardiographic function and hemodynamic and serum measurements may aid in predicting outcomes. Despite medical management, most patients will be rehospitalized and/or require cardiac transplantation within 1 year of admission.
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145
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Liu E, Lin A, Ogawa M, Rosenthal D. 807 Outpatient Milrinone Therapy in Young Children with Advanced Heart Failure. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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146
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Castleberry C, Chin C, Rosenthal D, Bernstein D, Hollander S, Tyan D. 392 Complement Fixation by C1q vs MFI: Detection of Clinically Relevant Antibodies. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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147
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Marino BS, Cassedy AE, Drotar D, Wernovsky G, Franklin R, Brown K, Rosenthal D, Breidert J, Riedel M, Kazak A, Wray J. PSYCHOSOCIAL MORBIDITY FACTORS MEDIATE THE RELATIONSHIP BETWEEN HEART DISEASE COMPLEXITY AND LOWER QUALITY OF LIFE. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60774-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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148
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Hollander SA, Reinhartz O, Chin C, Yeh J, Maeda K, Mallidi H, Bernstein D, Rosenthal D. Use of the Impella 5.0 as a bridge from ECMO to implantation of the HeartMate II left ventricular assist device in a pediatric patient. Pediatr Transplant 2012; 16:205-6. [PMID: 21923883 DOI: 10.1111/j.1399-3046.2011.01578.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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149
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Lau H, Rosenthal D. The higher-order view does not require consciously self-directed introspection: response to Malach. Trends Cogn Sci 2011. [DOI: 10.1016/j.tics.2011.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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150
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Lau H, Rosenthal D. Empirical support for higher-order theories of conscious awareness. Trends Cogn Sci 2011; 15:365-73. [PMID: 21737339 DOI: 10.1016/j.tics.2011.05.009] [Citation(s) in RCA: 383] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Revised: 05/25/2011] [Accepted: 05/27/2011] [Indexed: 11/25/2022]
Abstract
Higher-order theories of consciousness argue that conscious awareness crucially depends on higher-order mental representations that represent oneself as being in particular mental states. These theories have featured prominently in recent debates on conscious awareness. We provide new leverage on these debates by reviewing the empirical evidence in support of the higher-order view. We focus on evidence that distinguishes the higher-order view from its alternatives, such as the first-order, global workspace and recurrent visual processing theories. We defend the higher-order view against several major criticisms, such as prefrontal activity reflects attention but not awareness, and prefrontal lesion does not abolish awareness. Although the higher-order approach originated in philosophical discussions, we show that it is testable and has received substantial empirical support.
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