Effectiveness of Gerontechnology Empowerment Program on Awareness and Use of Mobile Apps Among Older Adults for Instrumental Activities of Daily Living: Protocol for a Cluster Randomized Controlled Trial.

BACKGROUND: Instrumental activities of daily living (iADLs) are crucial for older adults to live independently. Health care and technological advancements will increase the older adult population and life expectancy globally. Difficulties with iADLs impact older adults' quality of life. Mobile apps can assist older adults, but many require help due to limited awareness. Lack of awareness is a barrier to app use. Existing literature mainly covers health care and app design, needing more focus on iADL apps for older adults. OBJECTIVE: The study objectives encompass 2 main aspects: first, to evaluate the awareness, use, and factors influencing the use of apps among older adults for iADLs; and second, to create and assess the effectiveness of a gerontechnology empowerment program (GEP) for older adults on the awareness and use of apps for iADLs. METHODS: This research uses a quantitative approach divided into 2 distinct phases. In phase 1, we conduct a descriptive survey to assess the level of awareness and use of mobile apps for iADLs and identify the factors that influence the use of such apps among older adults. To ensure clarity and comprehension among participants, we provide them with a subject information sheet in both Kannada and English. The data collected during this phase enable us to gain insights into awareness levels, use patterns, and factors that shape older adults' use of apps for iADLs. The results serve as the foundation for designing the GEP. In phase 2, a cluster randomization method will be used to select older adults aged 60 to 75 years in Udupi district, Karnataka, India, who are active smartphone users. These participants will be divided into 2 groups: the experimental and the control groups. The experimental group will join the GEP. The sample size for phase 1 is 554, and phase 2 is 50. To assess the effectiveness of this program, we will measure the outcomes before and after its implementation using the same assessment tools used in phase 1. RESULTS: This study is funded by the Indian Council of Medical Research (Adhoc/193/2022/SBHSR on November 18, 2022). Phase 1 data collection is expected to be completed by November 2023, and phase 2 is scheduled to commence in the upcoming months. Phase 1 and 2 findings will be analyzed and discussed in the main paper, which we intend to submit to a high-quality peer-reviewed journal for publication. The research protocol, informed consent forms, and associated documentation received approval from institutional ethics committees (214/2020). CONCLUSIONS: Upon the successful testing of the GEP, it can be recommended that welfare departments encourage older adults to use mobile apps for iADLs and establish training programs to provide support to older adults in using these apps. TRIAL REGISTRATION: Clinical Trials Registry - India CTRI/2020/09/027977; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NDUxMzM=&Enc=&userName=027977. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/53587.

Electrophysiological correlates of sustained conscious perception.

Previous research on the neural correlates of consciousness (NCC) in visual perception revealed an early event-related potential (ERP), the visual awareness negativity (VAN), to be associated with stimulus awareness. However, due to the use of brief stimulus presentations in previous studies, it remains unclear whether awareness-related negativities represent a transient onset-related response or correspond to the duration of a conscious percept. Studies are required that allow prolonged stimulus presentation under aware and unaware conditions. The present ERP study aimed to tackle this challenge by using a novel stimulation design. Male and female human participants (n = 62) performed a visual task while task-irrelevant line stimuli were presented in the background for either 500 or 1000 ms. The line stimuli sometimes contained a face, which needed so-called visual one-shot learning to be seen. Half of the participants were informed about the presence of the face, resulting in faces being perceived by the informed but not by the uninformed participants. Comparing ERPs between the informed and uninformed group revealed an enhanced negativity over occipitotemporal electrodes that persisted for the entire duration of stimulus presentation. Our results suggest that sustained visual awareness negativities (SVAN) are associated with the duration of stimulus presentation.

Measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in persons on the autism spectrum: A preliminary Rasch analysis.

BACKGROUND: Persons on the autism spectrum exhibit poorer body awareness than neurotypical persons. Since movement quality may be regarded as an expression of body awareness, assessment of movement quality is important. Sound assessments of measurement properties are essential if reliable decisions about body awareness interventions for persons on the autism spectrum are to be made, but there is insufficient research. OBJECTIVE: To assess measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in an autism and a neurotypical reference group. METHODS: Persons on the autism spectrum (n=108) and neurotypical references (n=32) were included. All were assessed with BAS MQ. Data were analyzed according to the Rasch model. RESULTS: BAS MQ was found to have acceptable unidimensionality, supported by the fit statistics. The hierarchical ordering showed that coordination ability was the most difficult, followed by stability and relating. Response category functioning worked as intended for 19 out of 23 items. There were few difficult items, which decreased targeting. Reliability measures were good. BAS MQ discriminated between the autism and the reference groups, with the autism group exhibiting poorer movement quality, reflecting clinical observations and previous research. CONCLUSIONS: BAS MQ was found to have acceptable measurement properties, though suffering from problems with targeting item difficulty to person ability for persons on the autism spectrum. The BAS MQ may, along with experienced movement quality, contribute to clinically relevant information of persons on the autism spectrum, although we encourage refinements and further analyses to improve its measurement properties.

The Impact of Various Cockpit Display Interfaces on Novice Pilots' Mental Workload and Situational Awareness: A Comparative Study.

Future airspace is expected to become more congested with additional in-service cargo and commercial flights. Pilots will face additional burdens in such an environment, given the increasing number of factors that they must simultaneously consider while completing their work activities. Therefore, care and attention must be paid to the mental workload (MWL) experienced by operating pilots. If left unaddressed, a state of mental overload could affect the pilot's ability to complete his or her work activities in a safe and correct manner. This study examines the impact of two different cockpit display interfaces (CDIs), the Steam Gauge panel and the G1000 Glass panel, on novice pilots' MWL and situational awareness (SA) in a flight simulator-based setting. A combination of objective (EEG and HRV) and subjective (NASA-TLX) assessments is used to assess novice pilots' cognitive states during this study. Our results indicate that the gauge design of the CDI affects novice pilots' SA and MWL, with the G1000 Glass panel being more effective in reducing the MWL and improving SA compared with the Steam Gauge panel. The results of this study have implications for the design of future flight deck interfaces and the training of future pilots.

Translation and validation of the Chinese version of the Self-awareness Scale for Nurses.

Background: Levels of self-awareness may affect the decision-making ability of clinical nurses and may also be related to mental health. Therefore, it is crucial to develop tools to identify nurses' level of self-awareness. The purpose of this study was to investigate the reliability and validity of a short scale among Chinese nurses and to explore the factors associated with nurses' self-awareness. Methods: A total of 957 participants were recruited, 549 participants were used for reliability tests and 408 subjects were used for impact factor studies. They completed the General Information Questionnaire, the Self-Awareness Scale for Nurses, and the Psychological Distress Scale. Exploratory factor analysis, confirmatory factor analysis, Cronbach's alpha, and retest reliability were used to investigate the psychometric properties of the Self-Awareness Scale for Nurses. Multiple regression analyses were used in this study to investigate the relationship between nurses' self-awareness and the independent variables. Results: A 4-factor model of the Chinese version of the Self-Awareness Scale for Nurses was validated. The overall Cronbach's alpha value for the Chinese version of the Self-Awareness Scale for Nurses was 0.873. Cronbach's alpha values for each subscale ranged from 0.808 to 0.979. Significant predictors of each dimension of the Self-awareness and the total score of the scale were age and work experience. Conclusion: The Chinese version of the Self-Awareness Scale for Nurses is a valid and reliable scale.

Automation function and malfunction: effects on human performance in accident handling tasks.

By conducting a mixed-design experiment using simplified accident handling tasks performed by two-person teams, this study examined the effects of automation function and condition (before, during, and after malfunction) on human performance. Five different and non-overlapping functions related to human information processing model were considered and their malfunctions were set in a first-failure way. The results showed that while the automation malfunction impaired task performance, the performance degradation for information analysis was more severe than response planning. Contrary to other functions, the situation awareness for response planning and response implementation tended to increase during malfunctioning and decrease after. In addition, decreased task performance reduced trust in automation, and malfunctions in earlier stages of information processing resulted in lower trust. Suggestions provided for the design and training related to automation emphasise the importance of high-level cognitive support and the benefit of involving automation error handling in training.

The effects of automation function and malfunction on human performance are important for design and training. The experimental results in this study revealed the significance of high-level cognitive support. Also, introducing automation error handling in training can be helpful in improving situation awareness of the teams.

Awareness and practice of Revised Code of Dental Ethics and Consumer Protection Act among dental practitioners in Andhra Pradesh: A cross sectional study.

BACKGROUND: Given the imperative for dental practitioners to be familiar with the existing ethical principles and laws governing their practice, this study aimed to evaluate awareness and practice of the dentists (code of ethics) regulations 2014 and consumer protection act 2019 among dental practitioners in Andhra Pradesh state, India. METHODS: A cross sectional study was conducted among 384 dental practitioners in Andhra Pradesh state, India. A questionnaire consisting of 25 items was used to assess awareness and practice of the dentists (code of ethics) regulations and consumer protection act. The data collected were analysed using IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. RESULTS: Only 53(13.8%) dental practitioners in the study were aware that the dentists (code of ethics) regulations had been revised in 2014. About 190 (49.5%) practitioners were aware of the precise period for mandatory preservation of patient records. Most dental practitioners (278, 72.4%) accepted commissions in the form of gifts or cash from laboratories, radiologists, or pharmacists and 306 (79.7%) dental practitioners used unregistered dental lab technicians as employees in their practice. Furthermore, 297 (77.3%) practitioners were found to provide or sell drugs to patients in their clinic/office. The new regulations under consumer protection act 2019 were unknown to 194 (50.5%) dental practitioners. CONCLUSIONS: The present study indicates that the awareness of dental practitioners towards the dentists (code of ethics) regulations 2014 and consumer protection act 2019 is inadequate. It highlights the need for training programmes and curriculum changes with a focus on ethical and legal issues in clinical dental practice.

The effects of language proficiency and awareness of time limit in animated vs. text-based situational judgment tests.

BACKGROUND: Situational Judgment Tests (SJTs) are commonly used in medical school admissions. However, it has been consistently found that native speakers tend to score higher on SJTs than non-native speakers, which can be particularly problematic in the admission context due to the potential risk of limited fairness. Besides type of SJT, awareness of time limit may play a role in subgroup differences in the context of cognitive load theory. This study examined the influence of SJT type and awareness of time limit against the background of language proficiency in a quasi high-stakes setting. METHODS: Participants (N = 875), applicants and students in healthcare-related study programs, completed an online study that involved two SJTs: one with a text-based stimulus and response format (HAM-SJT) and another with a video-animated stimulus and media-supported response format (Social Shapes Test, SST). They were randomly assigned to a test condition in which they were either informed about a time limit or not. In a multilevel model analysis, we examined the main effects and interactions of the predictors (test type, language proficiency and awareness of time limit) on test performance (overall, response percentage). RESULTS: There were significant main effects on overall test performance for language proficiency in favor of native speakers and for awareness of time limit in favor of being aware of the time limit. Furthermore, an interaction between language proficiency and test type was found, indicating that subgroup differences are smaller for the animated SJT than for the text-based SJT. No interaction effects on overall test performance were found that included awareness of time limit. CONCLUSION: A SJT with video-animated stimuli and a media-supported response format can reduce subgroup differences in overall test performance between native and non-native speakers in a quasi high-stakes setting. Awareness of time limit is equally important for high and low performance, regardless of language proficiency or test type.

A spatial version of the Stroop task for examining proactive and reactive control independently from non-conflict processes.

Conflict-induced control refers to humans' ability to regulate attention in the processing of target information (e.g., the color of a word in the color-word Stroop task) based on experience with conflict created by distracting information (e.g., an incongruent color word), and to do so either in a proactive (preparatory) or a reactive (stimulus-driven) fashion. Interest in conflict-induced control has grown recently, as has the awareness that effects attributed to those processes might be affected by conflict-unrelated processes (e.g., the learning of stimulus-response associations). This awareness has resulted in the recommendation to move away from traditional interference paradigms with small stimulus/response sets and towards paradigms with larger sets (at least four targets, distractors, and responses), paradigms that allow better control of non-conflict processes. Using larger sets, however, is not always feasible. Doing so in the Stroop task, for example, would require either multiple arbitrary responses that are difficult for participants to learn (e.g., manual responses to colors) or non-arbitrary responses that can be difficult for researchers to collect (e.g., vocal responses in online experiments). Here, we present a spatial version of the Stroop task that solves many of those problems. In this task, participants respond to one of six directions indicated by an arrow, each requiring a specific, non-arbitrary manual response, while ignoring the location where the arrow is displayed. We illustrate the usefulness of this task by showing the results of two experiments in which evidence for proactive and reactive control was obtained while controlling for the impact of non-conflict processes.

Measuring team situation awareness through team communication: A study on nuclear main control room crews.

Situation awareness (SA) in complex socio-technical systems is considered a key cognitive activity, as control crews are often engaged in simultaneous task processes and are required to monitor and evaluate system parameters, making decisions and projections for the future accordingly. However, measuring SA at the team level is still a challenging area of research within the topic. In our research, we applied verbal protocol analysis as an alternative method to assess nuclear power plant control room crews' team SA. We conducted a study of 10 control room crews, examining their intrateam communication and its relatedness to team performance. We have found that communication categories related to the second and third levels of team SA increased significantly after the onset of an emergency event. Furthermore, while none of the team communication categories was related to team performance before the emergency event, all of them showed a strong positive correlation with team performance after the emergency situation occurred. Our results underline the importance of adequate verbalization of key information within the team, so as to support the rapid and accurate development of team SA during emergency situations.

An integrative view of the role of prefrontal cortex in consciousness.

The involvement of the prefrontal cortex (PFC) in consciousness is an ongoing focus of intense investigation. An important question is whether representations of conscious contents and experiences in the PFC are confounded by post-perceptual processes related to cognitive functions. Here, I review recent findings suggesting that neuronal representations of consciously perceived contents-in the absence of post-perceptual processes-can indeed be observed in the PFC. Slower ongoing fluctuations in the electrophysiological state of the PFC seem to control the stability and updates of these prefrontal representations of conscious awareness. In addition to conscious perception, the PFC has been shown to play a critical role in controlling the levels of consciousness as observed during anesthesia, while prefrontal lesions can result in severe loss of perceptual awareness. Together, the convergence of these processes in the PFC suggests its integrative role in consciousness and highlights the complex nature of consciousness itself.

Physicians' emotion awareness and emotion regulation training during medical education: a systematic scoping review protocol.

INTRODUCTION: The objective of this systematic scoping review is to identify what approaches have been implemented in medical education programmes to teach medical students the skills to identify and manage emotions that may be elicited in them during physician-patient interactions and in the clinical environment. Emotions of all involved in the clinical encounter are central to the process of clinical care. However, a gap remains addressing and teaching medical students about recognising and dealing with their own emotions. METHODS AND ANALYSIS: This scoping review will follow the updated JBI (The Johanna Briggs Institute) methodology guidance for the conduct and reporting of systematic scoping reviews, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. A search strategy was developed and applied to five databases. Terms used included medical education, medical curriculum, medical students, emotion (regulation), psychological well-being and mental health. Additionally, a grey literature and reference list search will be conducted. Two independent reviewers will first screen titles and abstracts followed by a second, full-text screening phase. Publications to be included will contain information and data about teaching approaches such as lectures, and other teaching material on physicians' emotion awareness and emotion regulation training in medical education. ETHICS AND DISSEMINATION: This study will review existing literature on emotion awareness and emotion regulation training in medical education, and a systematic scoping review does not require ethical approval. The results of this scoping review will be submitted for publication to relevant peer-reviewed journals and will be used to inform the development and implementation of training programmes and research studies aimed at preparing medical students to identify and manage their own emotions in the clinical environment.

Rapid online assessment of reading and phonological awareness (ROAR-PA).

Phonological awareness (PA) is at the foundation of reading development: PA is introduced before formal reading instruction, predicts reading development, is a target for early intervention, and is a core mechanism in dyslexia. Conventional approaches to assessing PA are time-consuming and resource intensive: assessments are individually administered and scoring verbal responses is challenging and subjective. Therefore, we introduce a rapid, automated, online measure of PA-The Rapid Online Assessment of Reading-Phonological Awareness-that can be implemented at scale without a test administrator. We explored whether this gamified, online task is an accurate and reliable measure of PA and predicts reading development. We found high correlations with standardized measures of PA (CTOPP-2, r = .80) for children from Pre-K through fourth grade and exceptional reliability (α = .96). Validation in 50 first and second grade classrooms showed reliable implementation in a public school setting with predictive value of future reading development.

Evidence of elevated situational awareness for active duty soldiers during navigation of a virtual environment.

U.S. service members maintain constant situational awareness (SA) due to training and experience operating in dynamic and complex environments. Work examining how military experience impacts SA during visual search of a complex naturalistic environment, is limited. Here, we compare Active Duty service members and Civilians' physiological behavior during a navigational visual search task in an open-world virtual environment (VE) while cognitive load was manipulated. We measured eye-tracking and electroencephalogram (EEG) outcomes from Active Duty (N = 21) and Civilians (N = 15) while they navigated a desktop VE at a self-regulated pace. Participants searched and counted targets (N = 15) presented among distractors, while cognitive load was manipulated with an auditory Math Task. Results showed Active Duty participants reported significantly greater/closer to the correct number of targets compared to Civilians. Overall, Active Duty participants scanned the VE with faster peak saccade velocities and greater average saccade magnitudes compared to Civilians. Convolutional Neural Network (CNN) response (EEG P-300) was significantly weighted more to initial fixations for the Active Duty group, showing reduced attentional resources on object refixations compared to Civilians. There were no group differences in fixation outcomes or overall CNN response when comparing targets versus distractor objects. When cognitive load was manipulated, only Civilians significantly decreased their average dwell time on each object and the Active Duty group had significantly fewer numbers of correct answers on the Math Task. Overall, the Active Duty group explored the VE with increased scanning speed and distance and reduced cognitive re-processing on objects, employing a different, perhaps expert, visual search strategy indicative of increased SA. The Active Duty group maintained SA in the main visual search task and did not appear to shift focus to the secondary Math Task. Future work could compare how a stress inducing environment impacts these groups' physiological or cognitive markers and performance for these groups.

Non-technical skills needed by medical disaster responders- a scoping review.

BACKGROUND: There is no universal agreement on what competence in disaster medicine is, nor what competences and personal attributes add value for disaster responders. Some studies suggest that disaster responders need not only technical skills but also non-technical skills. Consensus of which non-technical skills are needed and how training for these can be provided is lacking, and little is known about how to apply knowledge of non-technical skills in the recruitment of disaster responders. Therefore, this scoping review aimed to identify the non-technical skills required for the disaster medicine response. METHOD: A scooping review using the Arksey & O´Malley framework was performed. Structured searches in the databases PuBMed, CINAHL Full Plus, Web of Science, PsycInfo and Scopus was conducted. Thereafter, data were structured and analyzed. RESULTS: From an initial search result of 6447 articles, 34 articles were included in the study. These covered both quantitative and qualitative studies and different contexts, including real events and training. The most often studied real event were responses following earthquakes. Four non-technical skills stood out as most frequently mentioned: communication skills; situational awareness; knowledge of human resources and organization and coordination skills; decision-making, critical-thinking and problem-solving skills. The review also showed a significant lack of uniform use of terms like skills or competence in the reviewed articles. CONCLUSION: Non-technical skills are skills that disaster responders need. Which non-technical skills are most needed, how to train and measure non-technical skills, and how to implement non-technical skills in disaster medicine need further studies.

Support for a hypothetical sugar-sweetened beverage tax in Taiwan.

Sugar-sweetened beverages (SSBs) are drinks that contain added sugar or sweeteners and provide calories with no additional nutrients, and some countries have imposed additional taxes on the SSBs to reduce consumption, which is considered an SSB tax policy. This study used a cross-sectional online survey to examine the patterns of public support for an SSB tax in Taiwan. The sample included 1617 adults aged ≥ 20 years, who answered the survey questionnaire between May 2020 and April 2021. The respondents were recruited using convenience sampling, but sampling weights were applied to represent the Taiwanese population. Generalized ordered logit models with sampling weights were used to examine the correlates of public support for an SSB tax. Results showed that ~60% of the respondents supported the SSB tax and 47% perceived the tax to be effective. The respondents who were aware of the perceived health risks of SSBs or those who believed that one should be partly responsible for the health impact of SSBs were more likely to show support for the SSB tax. In adjusted regression models, both one's perceived risk and perceived responsibility of SSBs were positively associated with the perceived effectiveness of the SSB tax after sociodemographic characteristics were controlled. These research findings show evidence that there is public support for implementing an SSB tax to reduce SSB consumption in Taiwan.

Values-Based Medicine Is an Ethical Concept for Implementing the Ethical Principles in Daily Practice.

Values-based medicine (VsBM) is an ethical concept, and bioethical framework has been developed to ensure that medical ethics and values are implemented, pervasive, and powerful parameters influencing decisions about health, clinical practice, teaching, medical industry, career development, malpractice, and research. Neurosurgeons tend to adopt ethics according to their own values and to what they see and learn from teachers. Neurosurgeons, in general, are aware about ethical codes and the patient's rights. However, the philosophy, concept, and principles of medical ethics are rarely included in the training programs or in training courses. The impact of implementing, observing the medical ethics and the patients' value and culture on the course, and outcome of patients' management should not underestimate. The main principles of medical ethics are autonomy, beneficence, nonmaleficence, justice, dignity, and honesty, which should be strictly observed in every step of medical practice, research, teaching, and publication. Evidence-based medicine has been popularized in the last 40-50 years in order to raise up the standard of medical practice. Medical ethics and values have been associated with the medical practice for thousands of years since patients felt a need for treatment. There is no conflict between evidence-based medicine and values-based medicine, as a medical practice should always be performed within a frame of ethics and respect for patients' values. Observing the principles of values-based medicine became very relevant as multicultural societies are dominant in some countries and hospitals in different corners of the world.

A cognitive task analysis of final year nursing students' situation awareness in simulated deteriorating patient events: A mixed methods study.

AIM: The aim of this study was to: (1) use cognitive task analysis to describe final year nursing students situation awareness in recognising, responding and escalating care of deteriorating patients in ward settings; and (2) make recommendations for training and practice. DESIGN: A mixed methods cognitive task analysis with a convergent triangulation design. METHOD: Data collection involved observations of 33 final year nursing students in simulated deteriorating patient scenarios and retrospective cognitive interviews. A process tracing technique was applied to identify the cues to deterioration participants perceived; how cue perception altered as situational demands increased; the extent that participants made connections between perceived cues and reached a situational understanding; and the factors that influenced and constrained participants situation awareness. Qualitative and quantitative findings are woven together and presented using descriptive statistics, illustrative quotations and timeline extractions. RESULTS: The median cue perception was 65.4% and 57.6% in the medical and surgical scenarios, respectively. Perception was negatively influenced by incomplete vital sign monitoring as situations escalated; limited physical assessments; passive scanning behaviours; poor task automaticity; and excessive cognitive demands. Incomplete perception, poor cue integration and underdeveloped mental models influenced situational understanding. Escalation calls did not always accurately reflect situations and a reporting mindset was evident. Clinical exposure to deteriorating patients was described as variable and opportunistic. REPORTING METHOD: The study is reported in accordance with the Good Reporting of a Mixed Methods Study (GRAMMS) checklist. PATIENT OR PUBLIC CONTRIBUTION: Patients and public were not involved in this research.