Using Flashcards and Descriptive Feedback to Teach Industrial Kitchen Equipment to a Student with Intellectual Disabilities in a Postsecondary Education Program.

With postsecondary education opportunities for adult students with intellectual and developmental disabilities (IDD) on the rise, it is important to find socially validated research-based methods that are appropriate for the university or other community-based postsecondary instructional settings. The present research examines the effects of using flashcards with descriptive feedback and opportunities to respond, to teach one student with intellectual disabilities, enrolled in a postsecondary education-training program, commonly used industrial kitchen equipment. Results showed that discrete trail instruction, which included an error correction strategy of descriptive feedback plus opportunities to correctly respond was highly effective in mastery and maintenance of kitchen equipment identification, and generalization when asked to locate those items in the university kitchen lab.

Nursing students' willingness to respond in disasters: a cross sectional study of facilitators and barriers.

INTRODUCTION: The preparedness of the healthcare system to address emergency situations is contingent on the inclination of healthcare personnel. Nursing students can serve as valuable resources to supplement the workforce during major incidents and disasters. This study investigated the facilitators and barriers of nursing students' willingness to respond to disasters at the Alborz University of Medical Sciences in 2022. METHODS: In this cross-sectional descriptive study, 234 nursing students were recruited using convenience sampling. A deductive-inductive questionnaire was developed and distributed through an online self-administered survey comprising demographic information and questions on barriers, facilitators, various disaster scenarios, preferred activities, and reasons for pursuing a nursing career. RESULTS: The mean willingness scores of nursing students in response to various disasters were as follows: 3.15 for natural disasters, 2.60 for man-made disasters, 2.94 for pandemics, and 3.32 overall. Among the disaster scenarios, the earthquake response obtained the highest willingness score, while infectious disease epidemics received the lowest score. The most and least willingness to perform activities during disaster response were related to bedside care and participation in patients' personal hygiene, respectively. Key determinants of participation included the possibility of immunization and concerns for family safety. CONCLUSION: The findings indicated that nursing students are generally willing to assist as members of the healthcare team during disasters. However, the willingness to respond to infectious disease epidemics and man-made disasters was below the norm. Concerns about family health and the risk of disease transmission were identified as primary barriers. Addressing these concerns is crucial to enhance nursing students' participation in disaster response.

Clinical characteristics of women with HIV in the RESPOND cohort: A descriptive analysis and comparison to men.

BACKGROUND: Women with HIV are globally underrepresented in clinical research. Existing studies often focus on reproductive outcomes, seldom focus on older women, and are often underpowered to assess sex/gender differences. We describe CD4, HIV viral load (VL), clinical characteristics, comorbidity burden, and use of antiretroviral therapy (ART) among women with HIV in the RESPOND study and compare them with those of the men in RESPOND. METHODS: RESPOND is a prospective, multi-cohort collaboration including over 34 000 people with HIV from across Europe and Australia. Demographic and clinical characteristics, including CD4/VL, comorbidity burden, and ART are presented at baseline, defined as the latter of 1 January 2012 or enrolment into the local cohort, stratified by age and sex/gender. We further stratify men by reported mode of HIV acquisition, men who have sex with men (MSM) and non-MSM. RESULTS: Women account for 26.0% (n = 9019) of the cohort, with a median age of 42.2 years (interquartile range [IQR] 34.7-49.1). The majority (59.3%) of women were white, followed by 30.3% Black. Most women (75.8%) had acquired HIV heterosexually and 15.9% via injecting drug use. Nearly half (44.8%) were receiving a boosted protease inhibitor, 31.4% a non-nucleoside reverse transcriptase inhibitor, and 7.8% an integrase strand transfer inhibitor. The baseline year was 2012 for 73.2% of women and >2019 for 4.2%. Median CD4 was 523 (IQR 350-722) cells/µl, and 73.6% of women had a VL <200 copies/mL. Among the ART-naïve population, women were more likely than MSM but less likely than non-MSM (p < 0.001) to have CD4 <200 cells/µL and less likely than both MSM and non-MSM (p < 0.001) to have VL ≥100 000 copies/mL. Women were also more likely to be free of comorbidity than were both MSM and non-MSM (p < 0.0001). CONCLUSION: RESPOND women are diverse in age, ethnicity/race, CD4/VL, and comorbidity burden, with important differences relative to men. This work highlights the importance of stratification by sex/gender for future research that may help improve screening and management guidelines specifically for women with HIV.

A Computational Modeling Approach for the Design of Genetic Control Systems that Respond to Transcriptional Activity.

Recent progress in synthetic biology has enabled the design of complex genetic circuits that interface with innate cellular functions, such as gene transcription, and control user-defined outputs. Implementing these genetic networks in mammalian cells, however, is a cumbersome process that requires several steps of optimization and benefits from the use of predictive modeling. Combining deterministic mathematical models with software-based numerical computing platforms allows researchers to quickly design, evaluate, and optimize multiple circuit topologies to establish experimental constraints that generate the desired control systems. In this chapter, we present a systematic approach based on predictive mathematical modeling to guide the design and construction of gene activity-based sensors. This approach enables user-driven circuit optimization through iterations of sensitivity analyses and parameter scans, providing a universal method to engineer sense and respond cells for diverse applications.

Effect of CICARE communication nursing model combined with motivational psychological intervention in patients with post-intensive care unit syndrome.

BACKGROUND: Post-intensive care syndrome (PICS) is a term used to describe a constellation of new or worsened dysfunctions in the physical, cognitive, or mental health status of critically ill patients after their discharge from the intensive care unit (ICU). These dysfunctions persist beyond the acute phase of illness and have a significant impact on both the patient and their family. Connect, Introduce, Communicate, Ask, Respond, Exit (CICARE) communication advocates that patients should be respected and accepted when receiving medical services. Clinicians should attach importance to the communication mode of feelings, including connection, introduction, communication, ask, response, and exit 6 steps. AIM: To assess the impact of CICARE communication on the reduction of anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms in patients transitioning from the ICU to other care settings. METHODS: This prospective, randomized, controlled study was performed between October 2021 and March 2023. Intensive Care Unit Memory Tool was used to evaluate patients' ICU memory. The Hospital Anxiety and Depression Scale was employed to determine the presence of anxiety or depression symptoms. Impact of Event Scale-Revised was utilized to assess the presence of PTSD. All data were processed and analyzed using R language software version 4.1.0. The measurement data were expressed as mean ± SD, and the t test was used. The count data were analyzed by the χ2 test and expressed as [n (%)]. RESULTS: In total, 248 subjects were included in this study. Among them, 206 were successfully followed up for three months after transfer from the ICU, and 42 cases were lost to follow-up. There was no significant difference in the composition of ICU memory between the two groups. The application of the CICARE communication nursing model combined with the motivational psychological intervention nursing model, as well as the adoption of only the motivational psychological intervention nursing model, demonstrated favorable effects on PICS. Both groups of patients showed a reduction in anxiety scores, depression scores, and PTSD scores following the implementation of these two nursing models. However, it is noteworthy that the experimental group exhibited greater improvements compared to the control group. CONCLUSION: Our findings suggest that CICARE communication nursing mode may have good influence on relieving PICS.

Programming therapeutic probiotics by self-tunable sense-and-respond genetic circuits.

Probiotics can be programmed to sense and respond to intracellular disease signals to deliver the desired therapeutic effectors. The sense-and-respond genetic circuits, especially self-tunable ones, hold promise in improving the precision, effectiveness, and intelligence of therapeutic activities. Here, we present notable advances in the creation of engineered probiotics that harbour sense-and-respond genetic circuits.

Engineering a Cortisol Sensing Enteric Probiotic.

Chronic stress can lead to prolonged adrenal gland secretion of cortisol, resulting in human ailments such as anxiety, post-traumatic stress disorder, metabolic syndrome, diabetes, immunosuppression, and cardiomyopathy. Real time monitoring of chronic increases in cortisol and intervening therapies to minimize the physiological effects of stress would be beneficial to prevent these endocrine related illnesses. Gut microbiota have shown the ability to secrete, respond, and even regulate endocrine hormones. One such microbe, Clostridium scindens, responds transcriptionally to cortisol. We engineered these cortisol responsive genetic elements from C. scindens into an enteric probiotic, E. coli Nissle 1917, to drive the expression of a fluorescent reporter allowing for the designing, testing, and building of a robust and physiologically relevant novel cortisol probiotic sensor. This smart probiotic was further engineered to be more sensitive and to respond to elevated cortisol by expressing tryptophan decarboxylase, thereby bestowing the ability to generate tryptamine and serotonin. Here we show that upon cortisol treatment the smart probiotic produces measurable amounts of tryptamine. Accumulated levels of these neuromodulators should improve mood, anxiety, and depression and drive down cortisol levels. Importantly, this work can serve as a model for the engineering of a sense-and-respond probiotic to modulate the gut-brain axis.

Enhancing a Willingness to Respond to Disasters and Public Health Emergencies Among Health Care Workers, Using mHealth Intervention: A Multidisciplinary Approach.

Health care workers (HCWs) are increasingly faced with the continuous threat of confronting acute disasters, extreme weather-related events, and protracted public health emergencies. One of the major factors that determines emergency-department-based HCWs' willingness to respond during public health emergencies and disasters is self-efficacy. Despite increased public awareness of the threat of disasters and heightened possibility of future public health emergencies, the emphasis on preparing the health care workforce for such disasters is inadequate in low-and-middle-income countries (LMICs). Interventions for boosting self-efficacy and response willingness in public health emergencies and disasters have yet to be implemented or examined among emergency HCWs in LMICs. Mobile health (mHealth) technology seems to be a promising platform for such interventions, especially in a resource-constrained setting. This paper introduces an mHealth-focused project that demonstrates a model of multi-institutional and multidisciplinary collaboration for research and training to enhance disaster response willingness among emergency department workers in Pakistan.

The Role of Self-Efficacy and Risk Perception in the Willingness to Respond to Weather Disasters Among Emergency Medicine Health Care Workers in Pakistan.

OBJECTIVE: Optimizing health care workers' (HCWs) willingness to respond (WTR) is critical in low-and-middle-income countries (LMICs) for proper health system functioning during extreme weather events. Pakistan frequently experiences weather-related disasters, but limited evidence is available to examine HCW willingness. Our study examined the association between WTR and behavioral factors among emergency department HCWs. METHODS: A cross-sectional survey was conducted from August to September 2022 among HCWs from 2 hospitals in Karachi, Pakistan. Non-probability purposive sampling was used to recruit participants. A survey tool was informed by Witte's Extended Parallel Process Model (EPPM). Multivariate logistic regression analyses were performed to examine the association between WTR and attitudes/beliefs as well as EPPM profiles. RESULTS: Twenty-nine percent of HCWs indicated a low WTR. HCWs using public transportation had a higher WTR. Perceived knowledge and skills, self-efficacy, and perceived impact of one's response showed positive associations with WTR if required. Perception that one's colleagues would report to work positively predicted WTR if asked. Consistent with the EPPM, HCWs with high efficacy and perceived threat were willing to respond to weather disasters. CONCLUSIONS: Our findings highlight the need of strengthening WTR by promoting self-efficacy and enhancing accurate risk perception as a response motivator, among emergency department HCWs in Pakistan.

Increasing Teacher Opportunities to Respond in a Head Start Program Using a Bug-In-Ear Coaching Model.

Early childhood teachers play a critical role in the kindergarten readiness of preschool age children. Yet, they often receive little and insufficient training in the use of evidence-based practices that can increase academic success and prevent undesired behaviors. As a result, preschool teachers tend to use more exclusionary practices when disciplining students. A promising strategy for developing the skills of preschool teachers is the use of bug-in-ear coaching, a coaching strategy where a trained individual provides in-the-moment support to a teacher from a location outside of the classroom. This study examined bug-in-ear coaching to support preschool teachers in using opportunities to respond during explicit math instruction. A multiple baseline design across teachers was used to assess the impact of the intervention on the teachers' rates of implementation of opportunities to respond. Bug-in-ear coaching was associated with an increased rate of opportunities to respond for all teachers during the intervention with a functional relation for two out of four teachers. All teachers' rates of opportunities to respond were below their intervention rates during maintenance. Further, teachers reported enjoying the intervention and the opportunity given to improve their practices. Teachers also expressed their desire to have this level of coaching in their centers.

Pathological complete response rate and clinical outcome after neoadjuvant therapy of HER2-low breast cancer: A National Cancer Database Analysis.

BACKGROUND: The interest in breast cancer with low HER2 expression as a distinct subtype is increasing. We aimed to explore the differences between HER2-low and HER2-zero breast cancer in their prognosis and rate of pathological complete response (pCR) after neoadjuvant therapy. METHODS: The National Cancer Database (NCDB) was used to select patients with breast cancer who received neoadjuvant therapy from 2004 to 2017. Logistic regression model was constructed for analysis of pCR. Cox proportional hazards regression model and Kaplan-Meier method were used for survival analysis. RESULTS: A total of 41500 breast cancer patients were included, among which 14814 (35.7%) had HER2-zero tumors and 26686 (64.3%) had HER2-low. HER2-low tumors were more commonly HR-positive in comparison with HER2-zero (66.3% versus 47.1%, P < 0.001). A lower rate of pCR was observed in HER2-low tumors than in HER2-zero tumors after neoadjuvant therapy in the total cohort (OR = 0.90; 95% CI [0.86-0.95]; P < 0.001) and in the subset of HR-positive (OR = 0.87; 95% CI [0.81-0.94]; P < 0.001). Patients with HER2-low tumors had a significantly superior survival than those with HER2-zero tumors (HR = 0.90; 95% CI [0.86-0.94]; P < 0.001), regardless of the HR status. Additionally, a marginal survival difference was also observed between HER2 IHC1+ and HER2 IHC2+/ISH-negative (HR = 0.91; 95% CI [0.85-0.97]; P = 0.003) cohorts. CONCLUSION: HER2-low tumors are a clinically relevant breast cancer subtype that is distinct from HER2-zero tumors. These findings may provide clues to appropriate therapeutic strategies for this subtype in the future.

Development of preparedness to respond to intimate partner violence scale among mental health professionals.

Objectives: Violence against women has been associated with serious health and mental health consequences. Health-care professionals play an important role in screening and providing care and support to victims of intimate partner violence (IPV) in the hospital setting. There is no culturally relevant tool to assess the mental health professional (MHP) preparedness to screen for partner violence in the clinical setting. This research aimed towards developing and standardizing scale to measure MHP preparedness and perceived skills in responding to IPV in the clinical setting. Materials and Methods: The scale was field tested with 200 subjects using consecutive sampling at a tertiary care hospital. Results: The exploratory factor analysis resulted in five factors constituting 59.2% of the total variance. The internal consistency Cronbach alpha 0.72 for the final 32-item scale was highly reliable and adequate. Conclusion: The final version of the Preparedness to Respond to IPV (PR-IPV) scale measures MHP PR-IPV in the clinical setting. Further, the scale can be used to evaluate the outcome of IPV interventions in different settings.

Blending Active Student Responding with Online Instruction to Evaluate Response Accuracy and Student Engagement.

High rates of active student responding and opportunities to respond are considered best-practice instructional strategies for learning. Many educators in higher education have shifted from teaching primarily in-person to either a hybrid or an online format over the past decade. The global pandemic hastened further shifts from in-person to online learning for many institutions of higher education. Given this rapid shift to online instruction, it is critical to evaluate evidence-based teaching practices in online formats. Although there is a robust body of literature that supports the effectiveness of embedding opportunities to respond and active student responding during in-person instruction, to date, there is limited research that evaluates the effects of increased opportunities to respond during synchronous online courses in post-secondary settings. Using an alternating treatments design, this study evaluated the effects of two active student response modalities on response accuracy for seventeen students enrolled in a synchronous online graduate course. The results suggest that students performed more accurately on post-lecture queries following conditions that required written active student responses compared to responds cards. Moreover, the accuracy of correct responding maintained across the exams and the cumulative final exam. Limitations and future implications are discussed.

Perceived Disaster Preparedness and Willingness to Respond among Emergency Nurses in South Korea: A Cross-Sectional Study.

INTRODUCTION: Emergency nurses serve a vital role in disaster situations. Understanding their disaster preparedness and willingness to respond to a disaster is important in maintaining appropriate disaster management. The purpose of this study was to explore emergency nurses' disaster preparedness and willingness to respond based on demographic and disaster-related characteristics, and their willingness to respond based on specific disaster situations. METHODS: In this descriptive, cross-sectional study, the Disaster Preparedness Questionnaire for Nurses and willingness to report to duty by type of event were used to collect data from 158 nurses working in four regional emergency medical centers from 1 December 2019 to 30 April 2020 in the early stages of the COVID-19 pandemic. RESULTS: Emergency nurses with personal disaster experience as a victim or witness (t = 3.65, p < 0.001), professional disaster experience (i.e., working as a nurse) (t = 3.58, p < 0.001), who were current members of Korean Disaster Medical Assistance Teams (t = 6.26, p < 0.001), and who received disaster-related training within a year (t = 5.84, p < 0.001) showed a high level of perceived disaster preparedness. Emergency nurses who have professional disaster experience (i.e., working as a nurse) (t = 2.42, p = 0.017), are on a current disaster team (t = 2.39, p = 0.018), and have received disaster training (t = 2.73, p = 0.007) showed a high level of willingness to respond. Our study showed a high willingness to respond to natural disasters and low willingness to respond to technological disasters. DISCUSSION: To promote the engagement of emergency nurses in disaster response, disaster education programs should be expanded. Enhancing the safety of disaster response environments through supplementing medical personnel, distributing available resources, and providing sufficient compensation for emergency nurses is also essential.

[CGRP antibodies in migraine prophylaxis : The new standard in migraine treatment?] / CGRP-Antikörper in der Migräneprophylaxe : Der neue Standard in der Migränetherapie?

Migraine is associated with a high individual level of suffering. Therefore, an effective preventive treatment is highly important. The spectrum of classical prophylactic drugs has now been expanded to include monoclonal antibodies against calcitonin gene-related peptide (CGRP) and its receptor. These antibodies have shown reliable efficacy compared to placebo and a rapid onset of action with a low rate of side effects and negligible interactions in pivotal studies. Recently, the efficacy of the antibody was shown in many studies even on drug-refractory migraine and migraine associated with medication overuse. Comprehensive head to head comparisons with previously established drugs and among the antibodies are not yet available; however, initial studies suggest better tolerability and efficacy compared to conventional drugs and other antibodies. The role of antibodies in established treatment cascades still needs to be clarified.

Factors associated with immunotherapy respond and survival in advanced non-small cell lung cancer patients.

OBJECTIVES: This study aimed to explore factors associated with immunotherapy respond and survival in advanced non-small cell lung cancer (aNSCLC) patients treated with immune checkpoint inhibitors (ICIs). METHODS: A total of 101 patients with aNSCLC receiving ICIs were included. The association between clinical factors and multiple endpoints including objective response rate (ORR), disease control rate (DCR), overall survival (OS) and progression-free survival (PFS) were investigated by multivariate analyses. RESULTS: Multivariate logistic analyses revealed that clinical stage, lactate dehydrogena (LDH), and any grade immune-related adverse events (irAEs) were independent predictors of ORR, while LDH and ICIs treatment type were independent predictors of DCR. In Multivariate Cox analysis, Eastern Cooperative Oncology Group performance status (ECOG PS), LDH, albumin (Alb), platelet to lymphocyte ratio (PLR), and any grade irAEs were independent factors for OS. Similarly, clinical stage, LDH, Alb, and any grade irAEs were independent factors for PFS. Pre-treatment prognostic score was established based on clinical stage, ECOG PS, LDH, Alb and PLR to classify patients into three groups: the good group (0-1 score), the intermediate group (2 scores) and the poor group (3-4 scores). The immunotherapy response was significantly different in various prognostic groups. Subset analyses showed pre-treatment prognostic score ≥ 3 tended to have a strong negative impact on survival among patients with programmed cell death-ligand 1 (PD-L1) expression ≥ 50%. CONCLUSIONS: Pre-treatment prognostic score based on clinical stage, ECOG PS, LDH, Alb and PLR may help to identify aNSCLC patients who may benefit from ICIs.

Neurotherapeutic implications of sense and respond strategies generated by astrocytes and astrocytic tumours to combat pH mechanical stress.

AIMS: Astrocytes adapt to acute acid stress. Intriguingly, cancer cells with astrocytic differentiation thrive even better in an acidic microenvironment. How changes in extracellular pH (pHe) are sensed and measured by the cell surface assemblies that first intercept the acid stress, and how this information is relayed downstream for an appropriate survival response remains largely uncharacterized. METHODS: In vitro cell-based studies were combined with an in vivo animal model to delineate the machinery involved in pH microenvironment sensing and generation of mechanoadaptive responses in normal and neoplastic astrocytes. The data was further validated on patient samples from acidosis driven ischaemia and astrocytic tumour tissues. RESULTS: We demonstrate that low pHe is perceived and interpreted by cells as mechanical stress. GM3 acts as a lipid-based pH sensor, and in low pHe, its highly protonated state generates plasma membrane deformation stress which activates the IRE1-sXBP1-SREBP2-ACSS2 response axis for cholesterol biosynthesis and surface trafficking. Enhanced surface cholesterol provides mechanical tenacity and prevents acid-mediated membrane hydrolysis, which would otherwise result in cell leakage and death. CONCLUSIONS: In summary, activating these lipids or the associated downstream machinery in acidosis-related neurodegeneration may prevent disease progression, while specifically suppressing this key mechanical 'sense-respond' axis should effectively target astrocytic tumour growth.

PulsePoint dispatch associated patient characteristics and prehospital outcomes in a mid-sized metropolitan area.

BACKGROUND: Mobile phone-based dispatch of volunteers to out-of-hospital cardiac arrests (OHCA) has been shown to increase the likelihood of early CPR and AED application. In the United States, limited characterization of patients encountered as a result of such systems exists. AIMS: Examine prehospital case characteristics and outcomes from a multi-year deployment of PulsePoint Respond in Pittsburgh, Pennsylvania. METHODS: PulsePoint event timing, location, and associated prehospital electronic health records (ePCRs) were obtained for EMS-encountered OHCA cases that did and did not generate PulsePoint alerts within the service area of Pittsburgh EMS from July 2016 to October 2020. ePCRs were reviewed and OHCA case characteristics were extracted according to the Utstein template. PulsePoint-associated OHCA and non-PulsePoint-associated OHCA were compared. RESULTS: Of 840 total PulsePoint dispatches, 64 (7.6%) were for OHCA associated with a resuscitation attempt. Forty-one (64.1%) were witnessed, 38 (59.4%) received bystander CPR, and 13 (20.0%) of these patients had an AED applied prior to EMS arrival. Twenty-seven (39.7%) had an initial shockable rhythm, and 31 (48.4%) patients achieved ROSC in the field. In the city of Pittsburgh, there were 1229 total OHCA during the study period, with an estimated 29.6% occurring in public. When PulsePoint-associated and publicly occurring non-PulsePoint-associated OHCA were compared, baseline characteristics (age, sex, witnessed status) were similar, but PulsePoint-associated OHCA received more bystander CPR (p = 0.008). CONCLUSIONS: A minority of PulsePoint dispatches in Pittsburgh were triggered by true OHCA. The majority of OHCA during the study period occurred within private residences where PulsePoint responders are not currently dispatched. PulsePoint dispatches were associated with prognostically favorable OHCA characteristics and increased bystander CPR performance.

Smartphone use among young drivers: Applying an extended Theory of Planned Behaviour to predict young drivers' intention and engagement in concealed responding.

Young drivers, aged 17-25 years, are more likely than other age groups to access social interactive technologies (e.g., Snapchat, Facebook) on their smartphones while driving. Many of these young drivers do so in a concealed manner, thereby diverting their eyes from the road for extended periods and increasing their crash risk. In accordance with previous research, an extended Theory of Planned Behaviour (TPB) was applied in this survey study to investigate psychosocial predictors of young drivers' intention, and behaviour, of responding to social interactive technology on a smartphone in a concealed manner. Participants (N = 154) resided in Australia, were aged 17-25 years, owned a provisional or an open licence, and owned a smartphone. Participants completed two online surveys administered 1-week apart. The first survey measured intention and assessed the TPB standard constructs of attitude, subjective norm, and perceived behavioural control, as well as the additional constructs of anticipated action regret, anticipated inaction regret, and problematic mobile phone usage. The first survey also assessed whether there were any differences in the salient beliefs (elicited in a previous study) about smartphone use between high and low intenders to engage in this behaviour. The second survey measured engagement in the behaviour of responding in a concealed manner in the previous week. Hierarchical multiple regression analyses showed the standard TPB accounted for 69% of variance in intention, and a further 4% was accounted for by the extended constructs. In the final model, all variables, except anticipated inaction regret, were significant predictors of intention. Intention was the only significant predictor of behaviour. A series of MANOVAs found significant differences in the salient belief items between high and low intenders (e.g., high intenders were more likely to believe that friends/peers and other drivers would approve of them engaging in this behaviour). These key findings can be used as focal points for public education messages to persuade young drivers to reduce the frequency of their smartphone use, which is vital to improve road safety for all users.

Decision Making: Healthy Heuristics and Betraying Biases.

Critical care settings are unpredictable, dynamic environments where clinicians face high decision density in suboptimal conditions (stress, time constraints, competing priorities). Experts have described two systems of human decision making: one fast and intuitive; the other slow and methodical. Heuristics, or mental shortcuts, a key feature of intuitive reasoning, are often accurate, applied instinctively, and essential for efficient diagnostic decision making. Heuristics are also prone to failures, or cognitive biases, which can lead to diagnostic errors. A variety of strategies have been proposed to mitigate biases; however, current understanding of such interventions to optimize diagnostic safety is still incomplete.