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PubMed1988

Blood alcohol measurements in the emergency department: who needs them?

We surveyed North Carolina emergency physicians to determine current medical practices regarding the use of blood alcohol concentrations using a hypothetical scenario. Most physicians (88 per cent) would not have obtained blood alcohol concentrations in a patient who had alcohol on his breath but was coherent and cooperative. For marginally impaired patients, more liberal use of blood alcohol concentrations and explicit instructions to avoid driving while impaired might improve patient care and promote highway safety.

Adult↗

PubMed2002

Incidence and nature of unblinding by authors: our experience at two radiology journals with double-blinded peer review policies.

OBJECTIVE: The purpose of our study was to prospectively determine the incidence and nature of unblinding by authors as to their identities or institutions in their submission of original major manuscripts to two radiology journals with double-blinded peer review policies. MATERIALS AND METHODS: The editors of two radiology journals reviewed 880 major original manuscripts submitted to their journals during a 6-month period without knowledge of the identities and institutions of the authors. Each manuscript was inventoried for possible author or institutional unblinding and for the specific types of unblinding violations. RESULTS: Of 880 manuscripts, 300 (34%) contained information that potentially unblinded the identities of the authors, their institutions, or both. The editors correctly identified the authors or institutions in 221 (74%) of the 300 manuscripts, which represented 25% of the total manuscripts. The most frequent unblinding violations were statement of the authors' initials within the manuscript, referencing work "in press," identifying references as the authors' previous work, and revealing the identity of the institution in the figures. CONCLUSION: Despite explicit instructions to authors, 34% of 880 prospectively evaluated manuscripts submitted to two radiology journals contained information that potentially or definitely unblinded the identities of the authors or their institutions.

Authorship↗

PubMed2002

Assessment of fine motor skill in musicians and nonmusicians: differences in timing versus sequence accuracy in a bimanual fingering task.

While professional musicians are generally considered to possess better control of finger movements than nonmusicians, relatively few reports have experimentally addressed the nature of this discrepancy in fine motor skills. For example, it is unknown whether musicians perform with greater skill than control subjects in all aspects of different types of fine motor activities. More specifically, it is not known whether musicians perform better than control subjects on a fine motor task that is similar, but not identical, to the playing of their primary instrument. The purpose of this study was to examine the accuracy of finger placement and accuracy of timing in professional musicians and nonmusicians using a simple, rhythmical, bilateral fingering pattern and the technology that allowed separate assessment of these two parameters. Professional musicians (other than pianists) and nonmusicians were given identical, detailed and explicit instructions but not allowed physically to practice the finger pattern. After verbally repeating the correct pattern for the investigator, subjects performed the task on an electric keyboard with both hands simultaneously. Each subject's performance was then converted to a numerical score. While musicians clearly demonstrated better accuracy in timing, no significant difference was found between the groups in their finger placement scores. These findings were not correlated with subjects' age, sex, limb dominance, or primary instrument (for the professional musicians). This study indicates that professional musicians perform better in timing accuracy but not spatial accuracy while executing a simple, novel, bimanual motor sequence.

Adult↗

PubMed1997

Inducing positive mood without demand characteristics.

The possibility that a state of private self-awareness induced by a small mirror can facilitate the effect of procedures which induce a positive mood was investigated. Participants were 171 female and 60 male undergraduates who were randomly assigned to one of six conditions in a 2 (Mirror vs No-mirror) x 3 (Control vs Velten manipulation vs Music manipulation) design. As predicted, participants who experienced the Velten and Music manipulations in the presence of the mirror reported elevated mood relative to control participants. The mood of participants who experienced the Velten and Music manipulations without the mirror did not differ from the mood of control participants. The potential benefits of using a small mirror as a substitute for explicit instructions about the expected effect of mood-induction procedures are discussed.

Adolescent↗

PubMed2004

What's it all about? Investigating reading comprehension strategies in young adults with down syndrome.

The purpose of reading is for the reader to construct meaning from the text. For many young adults with Down syndrome, knowing what the text is all about is difficult, and so for them the activity of reading becomes simply the practice of word calling. It is suggested in the literature that for those individuals with Down syndrome, learning can continue into adolescence and that this may be the optimal time for learning to occur. However, a review of the literature revealed limited empirical research specifically relating to the reading comprehension of young adults with Down syndrome. Recent findings from Latch-On (Literacy And Technology Hands On), a research-based literacy and technology program for young adults with Down syndrome at the University of Queensland, revealed that comprehension remained the significant area of difficulty and showed least improvement (Moni & Jobling, 2001). It was suggested by Moni and Jobling (2001) that explicit instruction in comprehension using a variety of strategies and meaningful, relevant texts was required to improve the ability of young adults with Down syndrome to construct meaning from written texts. This paper is based on an action research project that was developed within the Latch-On program. The project utilised a modification of Elliot's (1991) action research model and was conducted to investigate specific teaching and learning strategies that would enhance the reading comprehension of young adults with Down syndrome. The participants were 6 young adults with Down syndrome ranging in age from 18 to 25 years. As the data from this project are still being analysed, preliminary findings of one participant are presented as a case study. The preliminary findings appear to indicate that the program of specific teaching and learning reading comprehension strategies used in this project was beneficial in the participant's reading comprehension.

Adolescent↗

PubMed2005

Memory for word location during reading: eye movements to previously read words are spatially selective but not precise.

In two experiments, readers' use of spatial memory was examined by asking them to determine whether an individually shown probe word had appeared in a previously read sentence (Experiment 1) or had occupied a right or left sentence location (Experiment 2). Under these conditions, eye movements during the classification task were generally directed toward the right, irrespective of the location of the relevant target in the previously read sentence. In two additional experiments, readers' knowledge of prior sentence content was examined either without (Experiment 3) or with (Experiment 4) an explicit instruction to move the eyes to a target word in that sentence. Although regressions into the prior sentence were generally directed toward the target, they rarely reached it. In the absence of accurate spatial memories, readers reached previously read target words in two distinct steps--one that moved the eyes in the general vicinity of the target, and one that homed in on it.

Decision Making↗

PubMed2005

Recall order determines the magnitude of directed forgetting in the within-participants list method.

In three experiments, we investigated the effect of recall order on directed forgetting when the within-participants list method is used. Experiment 1 showed that participants tend to recall to-be-remembered (R) items before to-be-forgotten (F) items when they can recall items in any order. In Experiment 2, recall order was manipulated (F-R or R-F). The results showed that only the R-F order led to directed forgetting. Finally, in Experiment 3, recall order was also manipulated, and half of the participants were explicitly instructed to use a relational strategy when both F and R items were presented. Again, only the R-F order led to directed forgetting. These results demonstrate that directed forgetting under the list method hinges on the output order in which participants recall the F and R information. Thus, output order should be taken into account by researchers investigating specific mechanisms that lead to directed forgetting.

Humans↗

PubMed2005

Sequential task predictability in task switching.

Many studies of task switching have found that a prolonged preparation time reduces switch costs. An alternative manipulation of task preparation is based on sequential task predictability, rather than preparation time. In Experiments 1 and 2 of the present study, participants performed explicitly instructed task sequences (i.e., AABB) and were then transferred to a random sequence. The observed benefit of predictability-based task preparation was not switch specific. In Experiment 3, the participants changed from random to predictable tasks. The observed predictability benefit again was not switch specific. The data thus suggest that task switching does not necessarily require a switch-specific reconfiguration process. Rather, task-specific control processes may be needed in both task switches and repetitions.

Association Learning↗

PubMed1990

Vivid memories of emotional events: the accuracy of remembered minutiae.

It has been claimed that emotional arousal causes a narrowing of attention, and, therefore, impoverished memory encoding. On this view, if details of an emotional event are reported subsequently, these details must be after-the-fact reconstructions that are open to error. Our study challenges these claims. Using a long-term (2-week), incidental learning procedure, we found that emotion promotes memory both for information central to an event and for peripheral detail. This contrasts with the results of explicit instructions to remember or to attend closely to the event, both of which seem to promote memory for the event's gist at the expense of detail. The likely mechanisms underlying these effects are discussed.

Adult↗

PubMed1993

Constraining effects of examples in a creative generation task.

In three experiments we tested the conformity hypothesis--that subjects' ideas would conform to examples they had been shown--by using a creative generation paradigm in which subjects imagined and sketched new exemplars of experimenter-defined categories. Designs made by subjects who had first seen three examples of ideas were compared with those of control subjects, who received no examples. In all three experiments, the designs of subjects who had seen the examples were more likely to contain features of the examples. This conformity effect did not significantly decrease in Experiment 2, when a 23-min task was interpolated between viewing the examples and generating related ideas. The hypothesis that the observed conformity effects may have been caused by subjects' assumptions that they should try to generate ideas similar to the examples was refuted in Experiment 3; explicitly instructing subjects to create ideas that were very different from the examples did not decrease conformity to the examples, and instructing them to conform to the examples significantly increased conformity. The results show that recent experience can lead to unintentional conformity, constraining the generation of creative ideas.

Adolescent↗

PubMed2000

Functionality and spatial relations in memory and language.

We examined whether the functionality of spatial relations affects the construction and memory of information in situation models. A functional relationship involves the interaction of entities that is implied by either typical use or contextual demands. Previous research has shown that spatial relations are less likely to be encoded during comprehension unless there is extensive prior knowledge, explicit instructions to attend to spatial information, or a clear emphasis on spatial information. If the construction of a situation model is guided by a need to understand the functional structure of a situation, then functional spatial relations should be more likely to be encoded. The results of our study showed that sentences with functional spatial relations were read faster and remembered better in both recall and recognition tests than sentences with nonfunctional spatial relations.

Adult↗

PubMed2005

[Effects of contextual variation during encoding on decontextualization of episodic memory].

Two experiments examined whether or not contextual variation during encoding of a list enhances decontextualization of episodic memory of the list. A total of 86 undergraduates incidentally encoded a list of 24 nouns twice under the same (same-context repetition condition) or different (different-context repetition condition) contexts with a one-week inter-encoding interval. One week after the second encoding of the list, the undergraduates were asked to free recall the list under the third neutral context. Context was manipulated by the combination of three contextual elements: physical features of environment, types of encoding tasks, and social factors. Experiment 1 revealed superiority of same-to different-context repetition condition, whereas the preceding studies manipulating only environmental features found superiority of different-to same-context repetition condition. Experiment 2, in which participants were explicitly instructed that the list used in the first and the second encoding sessions were identical, replicated the findings of Experiment 1. The present findings suggest that contextual variation between episodes does not enhance decontextualization of episodic memory.

Adult↗

PubMed1998

Teaching clinical reasoning as a thinking frame.

OBJECTIVE: Clinical reasoning concepts can be viewed as descriptions of mental operations or as a thinking frame--a structure to organize and support clinical thinking. This study examined an approach for teaching clinical reasoning as a thinking frame to occupational therapy students. METHOD: A quasi-experimental, pretest-posttest design was used with a convenience sample of 10 undergraduate occupational therapy seniors. All participants (a) acquired the thinking frame of clinical reasoning concepts through explicit instruction and (b) practiced that thinking frame with an external aid--the Clinical Reasoning Case Study Format. The accuracy of participants' definitions of clinical reasoning concepts before and after this learning experience were examined to assess their acquisition of the thinking frame. The content of clinical reasoning case studies were examined to assess students' application of the thinking frame to clinical situations. RESULTS: Wilcoxon signed rank tests done on presemester and postsemester definitions ratings indicated that the latter were rated significantly higher than the former for (a) narrative reasoning (p = .008), (b) procedural reasoning (p = .005), (c) interactive reasoning (p = .006), (d) pragmatic reasoning (p = .008), and (e) conditional reasoning (p = .01). The content of participants' clinical reasoning case studies indicated that they were able to apply clinical reasoning concepts. CONCLUSION: The results suggest that using a clinical reasoning thinking frame to organize clinical observations is an effective way to help entry-level occupational therapy students learn and apply clinical reasoning concepts.

Adult↗

PubMedDate not supplied

Pain management in day-case surgery.

BACKGROUND: Effective pain management following day surgery is a challenging issue. For the majority of patients severe pain is uncommon. However, a number of patients experience considerable pain following discharge. Uncontrolled pain is one of the main causes of re-admission to an inpatient bed following day surgery and a leading cause of patient dissatisfaction with it. CONCLUSION: This article reviews the literature and there is a discussion of the issues concerning effective pain management in day surgery. The drugs commonly used in day surgery practice are outlined to demonstrate the constraints that day surgery practices can impose on effective pain management. Day surgery is continually expanding and hip replacement and cholecystectomy are now being undertaken in day surgery facilities (Amarnath et al 2002, Berger 2003). The role of the nurse in effective pain management is therefore crucial amid such innovative developments as, even when explicitly instructed, the majority of patients still experience some post-operative pain.

Ambulatory Surgical Procedures↗

PubMedDate not supplied

Clinical reminders in ambulatory care.

Computerized reminders are a tool to improve patient care, increase compliance, and reduce medical liability in ambulatory health care. Continuity of care is often hard to achieve given large patient loads, cost containment pressures, and regulatory requirements. Recall reminders prompt patients to make or keep appointments for health maintenance or screening exams. Physician reminders are issued to clinicians at or between visits when their patients have specific screening or diagnostic needs. Reminder systems based on clinical protocols have the added advantage of providing explicit instructions for workup or treatment of abnormal conditions. These reminder systems are especially useful to standardize care in offices with many providers. Implementation of reminder systems is aided by careful staff preparation and resource allocation. Ultimately, reminder systems enhance quality of care, increase patient satisfaction, and reduce costs through improved continuity of care and early detection of serious illness.

Ambulatory Care Information Systems↗

PubMed1999

[Strategic focusing of attention during narrative reading].

In 2 experiments based on the constructionist view of text comprehension, we investigated whether readers are able to strategically use, in a problem solving matter, spatial and temporal information that varies in its relevance to the goals of the protagonists. In order to accomplish this, we varied the specificity of the protagonists' goal descriptions. Both experiments consisted of a reading section, a test, and a questionnaire, and differed only in respect to when the questionnaire was administered. The results of both experiments showed that readers were able to use spatial and temporal information of narrative texts in a strategic matter, and they even did so without explicit instruction. This focus of attention, however, was not uniformly reflected in the reading times. Memory data showed a clear disadvantage for temporal information as compared to spatial information. This was the case even though both types of information had been equally well identified in the questionnaire as crucial to the problem solving process of the protagonist.

Attention↗

PubMed1991

Dose-related caffeine discrimination in normal volunteers: individual differences in subjective effects and self-reported cues.

A within subject design was used to study a caffeine versus placebo drug discrimination in five volunteers who were not explicitly instructed that the drug conditions involved caffeine and placebo. The caffeine (200 or 300mg) versus placebo discrimination was acquired by all subjects and remained stable (78-90% accuracy) throughout the study which spanned 5 to 8.7 months across the subjects. A full caffeine dose-response function (50 to 400 or 600mg) was determined repeatedly under test conditions in each subject; caffeine produced orderly dose-related increases in caffeine identification in all subjects. The present study evaluated individual subject data to examine the correspondence between the subjective effects of caffeine versus placebo and the cues subjects reported as being important to making the discrimination. Although the subjective effects and self-reported cues differed across subjects, there was a correspondence within subjects. Prominent self-reported cues for caffeine included jittery/nervous/anxious (four subjects) and alert/active (one subject); self-reported cues for placebo included tired and/or headache (three subjects) and absence of drug effect (two subjects). The reporting of tired and headache as cues for the placebo condition suggests that caffeine withdrawal may produce stimulus effects relevant to the caffeine versus placebo discrimination.

Journal Article↗

PubMed2001

Implicit learning of a perceptual-motor skill after stroke.

BACKGROUND AND PURPOSE: A motor skill can be learned implicitly, without awareness of what is being learned. The purpose of this study was to examine the ability of adults who had unilateral stroke to learn implicitly a perceptual-motor task. SUBJECTS: Subjects were 47 people who were poststroke and 36 control subjects. METHODS: Participants performed sequences of hand movements in response to target lights in 2 conditions: a patterned sequence and a random sequence. Participants were not given explicit knowledge of the presence of the 2 conditions. Those who had stroke performed with the upper-extremity ipsilateral to the lesion. RESULTS: Subjects who had stroke performed more slowly than control subjects. For both groups, times decreased with practice of the patterned sequence, increased with introduction of the random sequence, and decreased again with reintroduction of the patterned sequence. Group differences persisted in a retention test given the next day of the patterned sequence, and both groups showed decreased times over the course of the retention test. DISCUSSION AND CONCLUSION: People with stroke are able to learn a perceptual-motor task even without explicit instructions regarding the patterned sequence embedded in the task.

Analysis of Variance↗