Enhancing Handwriting Performance of Children with Developmental Coordination Disorder (DCD) Using Computerized Visual Feedback.

Recent studies have analyzed the writing metrics of children with developmental coordination disorder (DCD) using computerized systems. To date, the use of computerized visual feedback to improve handwriting has not been investigated. This study aimed to examine the effects of computerized visual feedback on handwriting performance in time, spatial orientation, and pressure indices for children with DCD. Twenty-seven children aged 7 to 12 years with DCD assessed by the Movement Assessment Battery for Children and the Developmental Coordination Disorder Questionnaire received one weekly intervention session for 8 weeks, during which they twice copied an excerpt onto a tablet. Once, they received visual feedback where the writing color corresponded to the degree of pressure on the writing surface, and once they received no visual feedback. The two conditions were counterbalanced throughout the sessions. Pre-intervention sessions were compared with post-intervention sessions and with new texts for time, spatial orientation, and pressure measures. The findings revealed significantly decreased total and mean letter writing, in-air, and writing time and increased capacity in the visual feedback condition. In the spatial variables, a significant decrease in letter height variance was found. Pressure increased significantly throughout the intervention with visual feedback, whereas it decreased post-test in the writing task in both conditions and was maintained in the new text. Visual feedback intervention can increase the kinesthetic-haptic feedback required to regulate pressure during writing, promoting more efficient feedforward processes and improving output quality and capacity. The training effectiveness was transferable, and the intervention accessibility could increase student autonomy.

Assessment of children's writing features: A pilot method study of pen-grip kinetics and writing surface pressure.

The writing process is a complex task involving dexterous manipulation of the writing instrument by the hand digits and biomechanical ergonomic factors that contribute to handwriting efficiency and productivity. We describe a pilot study using an instrumented writing apparatus - a sensor (pen) and a digitized writing surface (tablet) - to measure the pen-grip kinetics (digit forces) and the pen pressure applied to the tablet during a writing task. Eight elementary school students with no handwriting difficulties copied a short story. The mean digit forces on the pen were compared with the mean pen pressure on the tablet at five interval points. Results revealed that the digit forces on the pen were significantly stronger than the pen pressure on the tablet. Results also showed significantly less digit-force variability throughout the writing task than the pen-pressure variability on the writing surface, which significantly lessened toward the end of the writing task. Information on these properties can broaden understanding of the elements that influence nonproficient handwriting in children with dysgraphia. Results also indicate the possible efficacy of a therapeutic tool for handwriting assessment and intervention using objective measurements during writing, warranting future studies with children with and without dysgraphia.

Change Blindness in Adolescents With Attention-Deficit/Hyperactivity Disorder: Use of Eye-Tracking.

Objective: This study investigated change detection of central or marginal interest in images using a change-blindness paradigm with eye tracking. Method: Eighty-four drug-naïve adolescents [44 with attention-deficit/hyperactivity disorder (ADHD)/40 controls with typical development] searched for a change in 36 pairs of original and modified images, with an item of central or marginal interest present or absent, presented in rapid alternation. Collected data were detection rate, response time, and gaze fixation duration, latency, and dispersion data. Results: Both groups' change-detection times were similar, with no speed-accuracy trade-off. No between-group differences were found in time to first fixation, fixation duration, or scan paths. Both groups performed better for items of central level of interest. The ADHD group demonstrated greater fixation dispersion in scan paths for central- and marginal-interest items. Conclusion: Results suggest the greater gaze dispersion may lead to greater fatigue in tasks that require longer attention duration.

Health literacy in an Israeli elderly population.

BACKGROUND: Health literacy is important for patients' comprehension of the health and medical messages conveyed to them and their meaning for them so that they can better manage their health. The aim of the study was to examine the level of health literacy within the elderly population. The hypothesis was that health literacy would be inadequate, and related to demographic variables. METHOD: Sixty men and women over the age of 65 who volunteered to participate in the study completed a 13-item health literacy questionnaire. RESULTS: Overall, the level of health literacy among the participants was mostly inadequate. They reported difficulty in reading medical material in Hebrew and understanding the doctor, thus requiring assistance (20%); difficulty in reading medical documents, completing medical forms and understanding medical terms; difficulty in reading the leaflet attached to medications (33%), test results (40%) and medical information written in English (66%) and difficulty searching the internet for information (53.3%). The level of health literacy was associated with education while the best profile for adequate health literacy was for those who spoke Hebrew and completed secondary education. CONCLUSIONS: Medical teams have an obligation to be alert and attentive to the level of health literacy of elderly patients and to modify communication and information to an accommodating degree, so that elderly patients can better manage their health.

Effect of age on spatial memory performance in real museum vs. computer simulation.

BACKGROUND: Healthy older adults frequently complain on difficulty in recalling the locations of objects of everyday use. Cognitive abilities decline with normal aging; inefficiencies of information processing, as well as deterioration of neuronal structures, may impede the performance of complex cognitive skills such as spatial memory. Extraneous, task-irrelevant cognitive load in real environments is usually high and might interfere with spatial memory abilities of older adults. The purpose of this study was to determine (1) the extent to which older adults maintain their cognitive capacity during a spatial memory task as compared to young adults and (2) whether this capacity is affected by performance of the task in a real environment setting where the cognitive demands are similar to a simulation, but the physical demands (navigating via walking versus via a mouse) vary. METHODS: In the museum, participants physically moved between display stations to locate hidden tokens performing a task in which an ongoing representation of previous searches had to be remembered. A comparable task was implemented via mouse actions on a computer simulation. Seventeen healthy older (60-80 years) and twenty younger (20-45 years) adults performed both tasks in a counterbalanced order. RESULTS: The younger group was superior to the older group in terms of success rate and completion time for both conditions. All participants performed better during the simulated task. The delta between the total performance score in the two settings of the older group was significantly larger as compared to the younger group, suggesting a differential impact of setting on the groups. CONCLUSIONS: Our results highlight the importance and feasibility of experimentation in ecologically relevant settings: differences were found in the way the cognitive performance of older and younger adults was affected by setting. Older adults appear to preserve basic cognitive abilities required for successful performance of object-location memory tasks. However, real museum setting appeared to impose higher demands on the older adults.

Survey of family doctors' attitudes towards statin treatment in patients with type 2 diabetes.

AIMS: Clinical guidelines advocate that cardiovascular benefits of statin treatment overweigh the risk of impairment of glucose metabolism. The aim of the study was to examine the attitudes of family doctors towards statin treatment in patients with type 2 diabetes. METHODS: We disseminated a questionnaire examining doctors' attitudes to existing clinical guidelines and the factors leading to a doctor's decision to prescribe statins to diabetic patients. RESULTS: Clinical policy and guidelines were defined by doctors as having the greatest influence on the decision to prescribe statins for diabetic patients particularly by salaried doctors in comparison to self-employed doctors (χ2 = 9.138, df = 3, p ≤ 0.01). When considering the ways healthcare services can assist cholesterol control, monetary compensation yielded higher importance by young doctors compared to mature doctors (χ2 = 8.15, df = 2, p ≤ 0.01), while nursing services in the clinic yielded higher importance by mature doctors in comparison to younger doctors(χ2 = 13.7, df = 2, p ≤ 0.01). CONCLUSIONS: Doctors defined a list of priorities for organizational support mechanisms that are likely to lead to the formation of an intervention plan for increasing the percentage of balanced cholesterol levels in patients with diabetes.

[ACCREDITATION IN HOSPITALS: ATTITUDES AND SATISFACTION OF STAFF MEMBERS FROM THE PROCESS].

INTRODUCTION: The accreditation process is an inseparable part of the healthcare system in many countries around the world and is an important part of the quality of care process. The team's collaboration is essential for completing the accreditation process. Therefore, their satisfaction with the process and attitudes toward it may influence its effective implementation in the short and long term. The purpose of this literature review was to describe the accreditation process, its advantages versus its shortcomings, and to present the research findings regarding the attitudes and satisfaction of the staff members in the process. The findings showed that staff attitudes toward the accreditation process are important for its implementation. The audit process has witnessed many positive and negative aspects that have a different effect on the satisfaction and attitudes of the staff at different points of time and different perspectives. In summary, despite the opposing positions of staff in the accreditation process in various studies, it seems that the staff's attitudes and satisfaction with the accreditation process is generally higher than low, although this can't be categorized unequivocally. For this, a deeper investigation is required, based on valid and reliable measurement tools.

How Adolescents with Autism Spectrum Disorder (ASD) Spontaneously Attend to Real-World Scenes: Use of a Change Blindness Paradigm.

Visual attention of adolescents with autism spectrum disorder (ASD) was assessed using a change blindness paradigm. Twenty-five adolescents with ASD aged 12-18 years and 25 matched typically developing (TD) adolescents viewed 36 pairs of digitized real-world images. Each pair of images was displayed in a 'flicker paradigm' whereby a particular item alternately appeared and disappeared. This item was either a central or a marginal detail of the scene. Change detection response times were measured and compared between groups. Marginal details were more difficult to detect than central details of the scenes in both groups, however, the response times of the ASD group were lower than the TD group. These results challenge the hypothesis of superior visual detection in ASD.