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PubMed2002

Posture used by anaesthetists during laryngoscopy.

BACKGROUND: There is little advice on the posture to be used when intubating the trachea. Does the stance used depend on experience? METHODS: Twenty-six subjects with varying experience of intubation were photographed during laryngoscopy of an intubation training mannequin. Posture was measured from the photographs and the data were analysed with the Mann-Whitney U-test. RESULTS: The less experienced group had shallower lines of sight, levered more, and stood with their face closer to the mannequin (P=0.037, 0.018 and 0.06 respectively). CONCLUSIONS: Novice anaesthetists should be given explicit instructions on correct trolley height and should be taught to intubate with a straight back.

Anesthesiology↗
PubMed2004

Simultaneous incisor retraction and distal molar movement with microimplant anchorage.

AIM: To show how microscrew implants provide orthodontic clinicians with several advantages, eg, the elimination of interarch mechanics for correcting sagittal discrepancies, the reduction of treatment time, the simplification of treatment mechanics, the correction of midline discrepancies without interarch mechanics, and the ability to move entire quadrants rather than individual teeth. MATERIAL AND METHODS: A step-by- step procedure for inserting microscrews is shown, along with several treated patients, which together demonstrate the mentioned advantages of this technique. RESULTS: The authors show how microscrews can rescue treatments that have achieved less than ideal occlusion during the course of therapy and offer readers explicit instructions for placing these microimplants. CONCLUSION: Microscrews offer orthodontic clinicians a minimally intrusive method of intra-arch anchorage that can translate entire quadrants with no untoward reciprocal results that afflict interarch techniques. Clinicians can correct sagittal discrepancies and midline deviations, and gain space for arch-length discrepancies with judicious use of microscrew anchorage.

Adult↗
PubMedDate not supplied

Reproductive health counseling for young men: what does it do?

A reproductive health intervention combining a highly explicit half-hour slide-tape program with a personal health consultation was provided to male patients aged 15-18 at a large health maintenance organization. A test of the consultation's impact against a control group provides no support for the argument that highly explicit instruction in contraception encourages early initiation of intercourse. In fact, the consultation may have reduced pressure to become sexually active among young men who had never had sexual intercourse. There is also some evidence that the consultation helped improve the effectiveness of contraceptive practice among the men who were sexually active at follow-up; those exposed to the consultation were more likely than those who were not to report that their last intercourse was protected by the pill and that their main method of contraception in the previous year was the pill. Compared with those in the control group, patients who received the health consultation scored higher on measures of fertility knowledge and knowledge of the prevention of sexually transmitted diseases, including AIDS. Furthermore, the young men who had the consultation were more likely to have practiced testicular self-examination. In many cases, however, the positive effects of the consultation were stronger or were only statistically significant among those who had not been sexually active at the time of the baseline survey.

Adolescent↗
PubMed1988

The facilitation of selective attention in preschoolers.

Allocation of attention was examined on a selective attention task in which some items were relevant (i.e., their locations should be remembered) and some were irrelevant. 100 4- and 5-year-olds formed 4 experimental conditions and 1 control group. 3 experimental groups had 1 added feature to aid selectivity (fewer stimuli, increased perceptual salience of the difference between relevant and irrelevant stimuli, or extra reminders of the locations of relevant and irrelevant stimuli). The fourth experimental condition included all features. A story and explicit instructions identified which objects were relevant. During study times, children opened doors (marked with cages or houses) of a box to reveal animals or household objects. Selectivity (opening mainly relevant doors) was high, compared to previous studies using no story with 6-year-olds, even in the control condition. Selectivity increased significantly beyond the level in the control condition only when all facilitative features were combined. Selectivity was not significantly related to recall. This outcome, in conjunction with previous research, suggests a lag between the production of a strategy and its facilitative effect on recall.

Attention↗
PubMed1979

The development and evaluation of a behavioral weight-reduction program.

The development of a comprehensive weight-reduction program and its implementation in the clinic are described. The program consisted of explicit instructions on food monitoring, stimulus control, chaining, exercise, and self-reinforcement. The results of pilot research indicated that the program produced reliable weight loss and that its implementation in a group format was more positive. A formal experiment evaluated the effectiveness of program components in a 2 x 2 factorial design after ten weeks of treatment and at three-month and one-year follow-ups. There was significant weight loss with no main or interaction effects. At follow-up, those exposed to exercise and/or contingency management better maintained their weight loss or continued to lose. Data on the implementation of the program in a clinical setting are presented and these results compare favorably with reports from other clinics using behavior modification. It is suggested that our more positive results may be related to an emphasis on activity and life-style change in addition to changing eating behavior.

Adolescent↗
PubMed1983

Ten commandments for effective consultations.

If internists are not explicitly instructed in how to perform consultations, the outcome of their consultative efforts may be suboptimal. We suggest that consultations will be more helpful if the following principles are followed: the consultant should determine the question that is being asked, establish the urgency of the consultation, gather primary data, communicate as briefly as appropriate, make specific recommendations, provide contingency plans, understand his own role in the process, offer educational information, communicate recommendations directly to the requesting physician, and provide appropriate follow-up. If these ten "commandments" are followed, the consultation is more likely to be effective and satisfactory for all the participants.

Humans↗
PubMed1978

Anagram solution speed as a joint function of manifest anxiety and number of category sets.

Anagrams constructed from words in 1,2,3, or 4 conceptual categories were administered in random sequences to subjects scoring at the extremes of the Taylor Manifest Anxiety Scale. Scince explicit instructions were given to the subjects concerning the nature of the categories involved, it is assumed that sets for responding with words from these categories were present from the start. The results demonstrate a negative relation of solution rate to number of category sets and an interaction of this variable with manifest anxiety. Anxiety facilitates performance in the presence of a single category set but inhibits performance when multiple sets are concurrently operative. The latter finding is consistent with the drive interpretation of manifest anxiety by Taylor and Spence.

Anxiety↗
PubMed1981

Part I. Seg insect for the "executive" multifocal. (Or it really can be done the way you want it).

Design principles of the one-piece Franklin type bifocal are described and illustrated. Correct (and incorrect) methods for verifying decentration are explained. Examples of typical decentration problems are given as well as explicit instructions for telling the lab how to lay out the blank for surfacing. A formula for determining the maximum frame/lens size that will cut out of a given blank is provided.

Eyeglasses↗
PubMed1980

Chemical face peel.

Chemexfoliation is extremely useful as an adjunctive tool to the cosmetic surgeon, but it is essential that the procedure not be taken lightly. Anyone can swab the face with a solution, but injudicious patient selection and inattention to details can easily lead immediately to disaster. If the patient is well informed as to expectations and the surgeon understands all the ramifications of the procedure, continued confidence in this type of surgery will remain firm. The procedure is carried out by a team approach. The surgeon applies the solution and provides the patient with postoperative instructions, but the patient then must become a part of the team and follow these instructions explicitly in order to insure the best possible surgical result. If the procedure is properly done and precautions are addressed, the rewards of a refined facial appearance can be enjoyed by the patient, and the surgeon may experience a true sense of accomplishment.

Adult↗
PubMed1995

Are clinicians intervening with their patients who smoke? A "real-world" assessment of 45 clinics in the upper Midwest.

OBJECTIVE: To determine the level of intervention provided by primary care physicians to individuals who smoke. SETTING: 45 primary care clinics throughout the upper Midwest. PATIENTS: 6,086 men and women (M:F = 1:2), ages 50 to 68, who sought medical care at any one of the 45 primary care clinics and completed two questionnaires regarding preventive medical services received during the previous 3 years (1990-1993). RESULTS: Of patients who smoke, 92% reported that their clinician had asked about their smoking status. Additionally, 86% reported being informed at their clinic of the dangers of tobacco use. A smaller percentage of individuals (60.1%) reported being explicitly advised on how to quit, and fewer still (27.2%) reported being referred to a stop smoking program. CONCLUSIONS: While most clinicians inquire about their patients' smoking status and recommend they quit, there currently exists a deficiency in the translation of these recommendations into concise, explicit instructions on how to quit. By increasing the frequency of clinicians giving specific advice about how to quit, the overall success rate of the public health campaign against tobacco use will be greatly enhanced.

Aged↗
PubMed1997

Parental right to determine whether to use aggressive treatment for an early gestational age infant: the Messenger case.

Manslaughter charges were brought against Dr. Gregory Messenger, a Michigan (USA) dermatologist, for removing his extremely premature infant son from a ventilator in the neonatal intensive care unit. Prior to delivery the neonatologist had told the parents that at the infant's age there was a 50-70% mortality and that if the child did survive there was a 20-40% chance of severe intraventricular hemorrhage. The newborn infant had been placed on mechanical life support despite the explicit instructions of the parents that they did not want aggressive or resuscitative measures used on their 780g., infant born at 25 weeks gestational age. The defendant argued that given the child's precarious medical status, it was the right of the parents to determine whether or not to institute aggressive medical interventions. The jury acquitted the father of all charges.

Adult↗
PubMed1998

The concept of nation-state in Italian elementary school children: spontaneous concepts and effects of teaching.

Two experiments were conducted. In Experiment 1, the definitions given by kindergarteners, third graders, and sixth graders (N = 60) for several political terms were searched for a characteristic-to-defining-shift (Keil, 1989). The children were presented with seven words: kingdom, king, border, tax, soldier, capital city, and policeman and were asked (a) if and where they had ever heard each of them and, if they had, (b) to explain their meanings. Kindergarten children did not know most of the terms or defined them mainly by means of characteristic but nondefining features. The third graders appeared to represent the state only in physical terms. Soldiers and policemen were described as employees but not as public servants. In Experiment 2, the extent to which children's misconceptions can be changed through explicit instruction was examined. A curriculum lasting about 16 hr was implemented with a group of fourth graders (N = 30). On pretest, most of the children depicted the state in the same ways as the third graders had in Experiment 1. After the curriculum implementation, nearly all of the children showed a political conception of the state, describing it not only in terms of a territory in which a population is settled but also in terms of government.

Age Factors↗
PubMed1995

High-priority event instructions affect implicit and explicit memory tests.

Previous work has shown that instructing subjects to give special priority to one target event in a list enhances recall for that event, but impairs recall for the events immediately preceding it (Tulving, 1969). We examined the benefit of high-priority instructions, and the retrograde amnesia for previous items, in three experiments that included two explicit tests of memory (free recall and cued recall with word-stem cues) and an implicit test (word-stem completion). Experiments 1 and 2 revealed a beneficial effect of high-priority instructions on memory for the target events in both free recall and primed word-stem completion. Retrograde amnesia for previous events was either absent (Experiment 1) or modest (Experiment 2) in free recall; however, no evidence for amnesia occurred on the implicit test. In Experiment 3, we asked if the benefit of high-priority instructions on the implicit test was due to contamination from intentional recollection, by employing the logic of the retrieval-intentionality criterion via a levels-of-processing manipulation. The results showed a beneficial effect of high-priority instructions on free recall, word-stem cued recall, and word-stem completion. Level of processing affected the two explicit tests, but not the implicit test, indicating that it induced incidental retrieval. We conclude that the benefit of high-priority instructions occurred on all three tests used in these experiments. In contrast, the phenomenon of retrograde amnesia occurred in free recall, but not in primed word-stem completion.

Adult↗
PubMed2026

Implicit and explicit statistical learning in reading: Evidence from a randomized controlled-learning study and computational modeling.

A key challenge in reading acquisition is understanding how learners extract the complex probabilistic mappings between print, meaning, and sound. Statistical learning (SL) theory offers a mechanistic account of how such mappings are acquired, whether implicitly through exposure or explicitly through instruction. We conducted a randomized controlled-learning study in Chinese, a writing system characterized by multiple sub-lexical regularities linking orthography, semantics, and phonology. Ninety-five 2nd-3rd graders with or at risk for dyslexia were randomly assigned to one of three groups: an implicit-SL training group exposed to repeated lexical and sublexical orthography-semantics-phonology associations, an explicit-SL training group receiving the same input plus explicit instruction on the sublexical print-sound mapping, and a no-SL control group. Both SL groups outperformed controls on the characters they were trained on, as well as on untrained characters that required generalization. However, only the explicit group demonstrated abstraction of print-sound mapping to novel items. Neural network simulations further revealed distinct mechanisms supporting implicit and explicit SL, consistent with a dual-system account of reading acquisition. Together, these findings (1) clarify how implicit and explicit learning distinctly support the discovery of statistical structure in written language and (2) underscore the implicit-explicit dual learning mechanism underlying reading acquisition.

Humans↗
PubMed1993

When is a mug not a mug? Effects of content, naming, and instructions on children's drawings.

Two hundred seventy 5-year-old children produced a copy drawing of a transparent glass mug with its handle turned away. In a factorial design three factors were manipulated to examine their additive or independent influence on the child's production of either view-specific or canonical (i.e., with the handle at the side) depictions: the content of the mug, the label used to describe it, and the explicitness of instruction. The results showed, first, that each of these variations in task demands exerted an influence on the canonicality/view-specificity of the children's drawings. Second, these influences were both facilitative and prohibitive. So, for example, general instructions prompted canonical drawings, while very explicit instructions elicited view-specific depictions. Third, each factor exerted an independent influence upon whether or not the handle was included--there were no interactions between factors on the production of the two types of picture. These results provide further evidence against simple associations between children's drawings and their cognitive abilities. They suggest that what children produce in studies of "drawing" may well simply inform us about the development of an understanding of adults' communicative intent.

Age Factors↗
PubMed2005

Effects of alphabeticality, practice and type of instruction on reading an artificial script: an fMRI study.

In neuroimaging studies of word reading in natural scripts, the effect of alphabeticality is often confounded with the effect of practice. We used an artificial script to separately manipulate the effects of practice and alphabeticality following training with and without explicit letter instructions. Participants received multi-session training in reading nonsense words, written in an artificial script, wherein each phoneme was represented by 2 discrete symbols . Three training conditions were compared: alphabetical whole words with letter decoding instruction (explicit); alphabetical whole-words (implicit) and non-alphabetical whole-words (arbitrary). Each participant was trained on the arbitrary condition and on one of the alphabetical conditions (explicit or implicit). fMRI scans were acquired after training during reading of trained words and relatively novel words in the alphabetical and arbitrary conditions. Our results showed greater activation in the explicit compared to the arbitrary conditions, but only for relatively-novel words, in the left posterior inferior frontal gyrus (IFG). In the implicit condition, the left posterior IFG was active in both trained and relatively novel words. These results indicate the involvement of the left posterior IFG in letter decoding, and suggest that reading of explicitly well-trained words did not rely on letter decoding, while in implicitly trained words letter decoding persisted into later stages. The superior parietal lobules showed reduced activation for items that received more practice, across all training conditions. Altogether, our results suggest that the alphabeticality of the word, the amount of practice and type of instructions have independent and interacting effects on brain activation during reading.

Adult↗
PubMed2006

Motor, visual and egocentric transformations in children with Developmental Coordination Disorder.

AIM: This study aimed to test the internal modelling deficit (IMD) hypothesis using the mental rotation paradigm. BACKGROUND: According to the IMD hypothesis, children with Developmental Coordination Disorder (DCD) have an impaired ability to internally represent action. Thirty-six children (18 DCD) completed four tasks: two versions of a single-hand rotation task (with and without explicit imagery instructions), a whole-body imagery task and an alphanumeric rotation task. RESULTS: There was partial support for the hypothesis that children with DCD would display an atypical pattern of performance on the hand rotation task, requiring implicit use of motor imagery. Overall, there were no significant differences between the DCD and control groups when the hand task was completed without explicit instructions, on either response time or accuracy. However, when imagery instructions were introduced, the controls were significantly more accurate than the DCD group, indicating that children with DCD were unable to benefit from explicit cuing. As predicted, the controls were also significantly more accurate than the DCD group on the whole-body task, with the accuracy of the DCD group barely rising above chance. Finally, and as expected, there was no difference between the groups on the alphanumeric task, a measure of visual (or object-related) imagery. CONCLUSIONS: The inability of the DCD group to utilize specific motor imagery instructions and to perform egocentric transformations lends some support to the IMD hypothesis. Future work needs to address the question of whether the IMD itself is subgroup-specific.

Analysis of Variance↗
PubMed2004

Embedded-explicit emergent literacy intervention II: goal selection and implementation in the early childhood classroom.

This article, the second in a two-part series, provides guidance to speech-language pathologists (SLPs) for implementing the explicit component of the embedded-explicit emergent literacy intervention model for at-risk preschool and kindergarten children. The explicit component refers to the provision of regular structured therapeutic interactions that intentionally target critical emergent literacy goals. This article describes fundamental principles of explicit literacy instruction, identifies literacy domains targeted as part of explicit literacy instruction, and presents examples of how early childhood classrooms can be organized to implement the embedded-explicit model.

Child, Preschool↗