Words matter: Effects of instructional cues on pressure pain threshold values in healthy people.

BACKGROUND: Pressure pain threshold (PPT) measurements require standardised verbal instructional cues to ensure that the increasing pressure is stopped at the correct time consistently. This study aimed to compare how PPT values and their test-retest reliability were affected by different instructional cues. METHODS: At two separate sessions, two PPT measurements were taken at the anterior knee for each of four different instructional cues: the cue of the German Neuropathic Research Network instructions ('DFNS'), the point where pressure first feels uncomfortable ('Uncomfortable'), 3/10 on the numerical pain rating scale ('3NPRS'), and where pain relates to an image from the pictorial-enhanced NPRS scale ('Pictorial'). Linear mixed modeling was used to quantify differences between pairs of instructional cues. Test-retest reliability was estimated using intraclass correlation coefficients (ICC[2,1] and ICC[2,k]). RESULTS: Twenty participants were recruited. The cue resulting in greatest PPT value was DFNS (394.32 kPa, 95%CI [286.32 to 543.06]), followed by Pictorial (342.49 kPa, 95%CI [248.68 to 471.68]), then Uncomfortable (311.85 kPa, 95%CI [226.43 to 429.48]), and lastly 3NPRS (289.78 kPa, 95%CI [210.41 to 399.09]). Five of six pairwise contrasts were statistically significant. Regardless of the cues, the point estimates of ICC (2,1) ranged from 0.80 to 0.86, and the ICC (2,k) values ranged from 0.89 to 0.93. No statistically significant differences were found between any pairwise contrasts of reliability indices. CONCLUSION: Words matter when instructing people when to stop testing in pressure algometry. Clinicians should use the same instructional cue when assessing pain thresholds to ensure reliability.

Patient-Representing Population's Perceptions of GPT-Generated Versus Standard Emergency Department Discharge Instructions: Randomized Blind Survey Assessment.

BACKGROUND: Discharge instructions are a key form of documentation and patient communication in the time of transition from the emergency department (ED) to home. Discharge instructions are time-consuming and often underprioritized, especially in the ED, leading to discharge delays and possibly impersonal patient instructions. Generative artificial intelligence and large language models (LLMs) offer promising methods of creating high-quality and personalized discharge instructions; however, there exists a gap in understanding patient perspectives of LLM-generated discharge instructions. OBJECTIVE: We aimed to assess the use of LLMs such as ChatGPT in synthesizing accurate and patient-accessible discharge instructions in the ED. METHODS: We synthesized 5 unique, fictional ED encounters to emulate real ED encounters that included a diverse set of clinician history, physical notes, and nursing notes. These were passed to GPT-4 in Azure OpenAI Service (Microsoft) to generate LLM-generated discharge instructions. Standard discharge instructions were also generated for each of the 5 unique ED encounters. All GPT-generated and standard discharge instructions were then formatted into standardized after-visit summary documents. These after-visit summaries containing either GPT-generated or standard discharge instructions were randomly and blindly administered to Amazon MTurk respondents representing patient populations through Amazon MTurk Survey Distribution. Discharge instructions were assessed based on metrics of interpretability of significance, understandability, and satisfaction. RESULTS: Our findings revealed that survey respondents' perspectives regarding GPT-generated and standard discharge instructions were significantly (P=.01) more favorable toward GPT-generated return precautions, and all other sections were considered noninferior to standard discharge instructions. Of the 156 survey respondents, GPT-generated discharge instructions were assigned favorable ratings, "agree" and "strongly agree," more frequently along the metric of interpretability of significance in discharge instruction subsections regarding diagnosis, procedures, treatment, post-ED medications or any changes to medications, and return precautions. Survey respondents found GPT-generated instructions to be more understandable when rating procedures, treatment, post-ED medications or medication changes, post-ED follow-up, and return precautions. Satisfaction with GPT-generated discharge instruction subsections was the most favorable in procedures, treatment, post-ED medications or medication changes, and return precautions. Wilcoxon rank-sum test of Likert responses revealed significant differences (P=.01) in the interpretability of significant return precautions in GPT-generated discharge instructions compared to standard discharge instructions but not for other evaluation metrics and discharge instruction subsections. CONCLUSIONS: This study demonstrates the potential for LLMs such as ChatGPT to act as a method of augmenting current documentation workflows in the ED to reduce the documentation burden of physicians. The ability of LLMs to provide tailored instructions for patients by improving readability and making instructions more applicable to patients could improve upon the methods of communication that currently exist.

Usability of consumer product self-assembly instructions - a historical review of ergonomics research to create an international standard.

Selling products in kit form to consumers benefits both manufacturers and consumers - provided the instructions enable the customer to assemble the components correctly and safely. Poor usability of some self-assembly instructions is a continuing cause of consumer complaints- but the subject of only occasional ergonomics research interest. Relevant studies are widely dispersed across the literature - and across decades - but their findings generally agree on what makes some self-assembly illustrations more effective than others. This has just not been consolidated in any formally recognised guidance. This study has produced a comprehensive review of published work on the usability of self-assembly instructions (which need to convey most information pictorially) and makes detailed recommendations for best practice in their presentation. The evidence for the recommended best practices discussed in this paper will be reflected in the publication of an international standard that which is currently in the final drafting stages.

This review of published research into effective presentational techniques for self-assembly instructions was instigated to support a proposal for an international standard. That is now under development incorporating requirements based on the high degree of consensus the review found across a wide spread of types of study, locations and years.

Effect of mobile app-based oral hygiene instructions on clinical parameters, oral bacterial diversity, and composition of subgingival microbiota in periodontitis patients.

Introduction: Oral hygiene instruction (OHI) is essential during periodontitis treatment. Various OHI approaches have been explored, including mobile apps. Objective: To evaluate the mobile app-based OHI's effect on periodontitis management by analyzing clinical parameters and subgingival microbiota. Methods: Forty-four periodontitis patients were randomly assigned into two groups. The test group (n = 22) received scaling and root planing (SRP), OHI, and mobile app-based OHI, whereas the control group (n = 22) received SRP and OHI. Full mouth plaque score (FMPS), bleeding on probing (BOP) and probing pocket depth at the sampling sites (site-PPD) were assessed at baseline, one- and three-month visits. The 16S rRNA next-generation sequencing (NGS) was used to analyze subgingival plaque samples. Results: Significant reduction in FMPS, BOP, and site-PPD at one- and three-month visits compared to baseline (p < 0.001) with no significant differences across groups (p > 0.05). In test groups, intra-group analysis showed better improvement in BOP and site-PPD (p < 0.05) than control. The diversity and composition of subgingival microbiota did not differ between groups or timepoints (p > 0.05). Conclusions: Mobile app-based OHI showed no superior effects on improving clinical parameters and subgingival microbiota compared to conventional OHI. Further investigation into its long-term impact on periodontitis treatment is needed.

The role of alpha oscillations in free- and goal-directed semantic associations.

Alpha oscillations are known to play a central role in several higher-order cognitive functions, especially selective attention, working memory, semantic memory, and creative thinking. Nonetheless, we still know very little about the role of alpha in the generation of more remote semantic associations, which is key to creative and semantic cognition. Furthermore, it remains unclear how these oscillations are shaped by the intention to "be creative," which is the case in most creativity tasks. We aimed to address these gaps in two experiments. In Experiment 1, we compared alpha oscillatory activity (using a method which distinguishes genuine oscillatory activity from transient events) during the generation of free associations which were more vs. less distant from a given concept. In Experiment 2, we replicated these findings and also compared alpha oscillatory activity when people were generating free associations versus associations with the instruction to be creative (i.e. goal-directed). We found that alpha was consistently higher during the generation of more distant semantic associations, in both experiments. This effect was widespread, involving areas in both left and right hemispheres. Importantly, the instruction to be creative seems to increase alpha phase synchronisation from left to right temporal brain areas, suggesting that intention to be creative changed the flux of information in the brain, likely reflecting an increase in top-down control of semantic search processes. We conclude that goal-directed generation of remote associations relies on top-down mechanisms compared to when associations are freely generated.

The effect of internal, external, and holistic focus of attention on standing long jump performance in novice and skilled karatekas.

An important application for training instructions is found in directing one's attentional focus. This direction can occur in different internal, external, or holistic forms. However, comparison between these three forms of instructions is a relatively recent development rarely reported at different skill levels or various sports including karate. Therefore, the present study attempts to investigate the effects of three forms of instructions on standing long jump performance in skilled and novice karatekas. The participants were 60 skilled and novice karatekas (all females; mean age: 21.32 ± 1.65) who completed 12 standing long jump trials under different focus conditions (3 trials for each condition: internal, external, holistic and control condition) in a counterbalanced order. Our findings suggested significant main effects, indicating that skilled karatekas outperformed the novices. The findings also showed that regardless of skill levels, the participants exhibited similar performance under external and holistic focus conditions while performance in both of these conditions was superior compared to performance under internal focus and control conditions. No difference was observed between the control and internal focus conditions. It seems that skilled and novice karatekas may benefit from holistic and external focus of attention instructions which enhance their motor performance. Thus, it is recommended that coaches should incorporate these two types of attentional focus instructions into their training sessions.

Understanding caregiver preferences and technology access to plan improvement of pediatric emergency department discharge instructions.

INTRODUCTION: Approximately 95% of children treated in emergency departments (EDs) in Alberta, Canada, are discharged home. Discharge teaching is an opportunity to provide caregivers with the information that they need to manage their child's condition at home and ensure appropriate follow-up. Our ED lacked a standard discharge instruction process. In preparation for local quality improvement, we sought to understand caregiver preferences regarding discharge instructions by assessing the preferred format, need for translated resources, and ability to effectively access electronic information using a Quick Response (QR) code. METHODS: This project was completed at a tertiary pediatric ED in Calgary, Alberta in July and August 2021. Caregivers of pediatric patients were invited to complete a survey. Families requiring an interpreter were not eligible; however, this was recorded to estimate translation needs. Survey questions addressed preference of discharge instruction modality (verbal, printed, electronic), primary language spoken at home, ability to use English resources, and ability to use QR codes. Descriptive analyses were performed, and preferences were compared. RESULTS: Of 117 caregivers approached, 104 completed the survey (89%). Caregivers had a strong preference for receiving written discharge instructions, with 98% desiring either electronic or printed resources in addition to verbal instructions. There was a similar likelihood of using printed (75%) versus electronic (79%) resources (p = 0.5). Three percent of families were unable to complete the survey due to a language barrier. Of the 104 participants, 19% noted that their primary language at home was not English but that they would still use English discharge instructions. Eighty percent of participants were able to successfully use the QR code. CONCLUSIONS: Caregivers had a strong preference for receiving written discharge instructions, with electronic or paper formats preferred equally. Translated resources will be important for some families. QR codes may be an effective tool for distributing electronic resources to most but not all families.

RéSUMé: INTRODUCTION: Environ 95 % des enfants traités dans les services d'urgence (SU) en Alberta, au Canada, sont renvoyés chez eux. L'enseignement de la sortie est une occasion de fournir aux soignants les informations dont ils ont besoin pour gérer l'état de leur enfant à la maison et assurer un suivi approprié. Notre DE ne disposait pas d'un processus standard d'instruction de décharge. En prévision de l'amélioration de la qualité à l'échelle locale, nous avons cherché à comprendre les préférences des aidants en ce qui concerne les instructions de congé en évaluant le format préféré, le besoin de ressources traduites et la capacité d'accéder efficacement à l'information électronique à l'aide d'un code de réponse rapide (QR). MéTHODES: Ce projet a été réalisé à un DE pédiatrique tertiaire à Calgary, en Alberta, en juillet et août 2021. Les soignants de patients pédiatriques ont été invités à répondre à un sondage. Les familles qui avaient besoin d'un interprète n'étaient pas admissibles, mais cela a été enregistré pour estimer les besoins en traduction. Les questions du sondage portaient sur la préférence de la modalité d'enseignement du congé (verbale, imprimée, électronique), la langue principale parlée à la maison, la capacité d'utiliser les ressources en anglais et la capacité d'utiliser les codes QR. Des analyses descriptives ont été effectuées et les préférences ont été comparées. RéSULTATS: Sur les 117 personnes approchées, 104 ont répondu au sondage (89 %). Les aidants naturels avaient une forte préférence pour les instructions écrites de sortie, 98 % désirant des ressources électroniques ou imprimées en plus des instructions verbales. La probabilité d'utiliser des ressources imprimées (75 %) et électroniques (79 %) était semblable (p = 0,5). Trois pour cent des familles n'ont pas pu répondre au sondage en raison d'une barrière linguistique. Sur les 104 participants, 19 % ont indiqué que leur langue principale à la maison n'était pas l'anglais, mais qu'ils continueraient d'utiliser les instructions de sortie en anglais. Quatre-vingt pour cent des participants ont réussi à utiliser le code QR. CONCLUSIONS: Les aidants naturels avaient une forte préférence pour recevoir des instructions écrites de sortie, avec des formats électroniques ou papier préférés également. Les ressources traduites seront importantes pour certaines familles. Les codes QR peuvent être un outil efficace pour distribuer des ressources électroniques à la plupart des familles, mais pas à toutes.

Ethical requirements of instructions for authors of complementary and alternative medicine journals: a cross-sectional study.

BACKGROUND: Medical research in complementary and alternative medicine (CAM) has increased recently, raising ethical concerns about the moral status of CAM. Medical academic journals are responsible for conducting ethical review (ER) of manuscripts to protect the interests of human subjects and to make ethical results available before deciding to publish. However, there has been no systematic analysis of the ER in CAM journals. This study is aim to evaluate the current status of ethical requirements and compliance in CAM journals. METHODS: This is a cross-sectional study. We reviewed instructions for authors (IFAs) of CAM journals included in the Journal Citation Reports (2021) ( https://jcr.clarivate.com ) for general information and requirements for ER. We also browsed the manuscripts regarding randomized controlled trials published by CAM journals in Q1 and Q2 section from January to June, 2023, to check the actual situation of ethical requirement. Descriptive statistics and Fisher's exact test were used for statistical analysis. RESULTS: 27 journals and 68 manuscripts were ultimately included. 92.6% (25/27) IFAs included keywords of ER, indicating the presence of ethical considerations. However, no specific ER was required for CAM (n = 0). We categorized journals by Geographic origin, JCR section, Year of electronic JCR, Types of studies, % of OA Gold to explore the factors that could influence CAM journals to have certain ethical review policies. The results showed there was no statistical significance in certain ethical review policy in any classification of journals (p > 0.05). All RCT manuscripts included in the study generally met the requirements of the published journals for ethical review. CONCLUSIONS: All IFAs discussed ER, but the content was scattered, unfocused, and there were no specific ER requirements regarding CAM. Although the manuscripts basically met the requirements of the journal, it was not possible to get closer to the process of ER in the manuscript. To ensure full implementation of these policies in the future, CAM journals should require authors to provide more details, or to form a list of items necessary for CAM ethical review.

Is video demonstration for type III sleep studies performance worse than technical face-to-face teaching?

PURPOSE: Obstructive sleep apnea (OSA) is the most common sleep-disordered breathing. The high prevalence makes its diagnosis a priority. To perform type III sleep studies, patients usually receive instructions from a technician. The switch to instructions through a video could save professionals time and make OSA diagnosis more accessible. This study aimed to compare the technical quality of type III sleep studies when instructions are provided by face-to-face technical teaching or via video. METHODS: One hundred consecutive patients aged ≥ 18 years with suspected OSA were randomly assigned to receive device placement instructions in person by a technician or through video (50 in each group). The overall quality of the sleep studies was analyzed by determining the number of technically invalid studies. The recording quality of four sensors (pulse oximeter, nasal flow cannula, chest, and abdominal bands) was evaluated by checking for signal artifacts. RESULTS: The majority (86%) of the studies were valid. 20% of the studies in the face-to-face group and 8% of the studies in the video-instruction group were technically invalid, but no statistically significant difference was found (p = 0.148). The quality of the oximetry signal was better in those who received video instructions (p = 0.05). Regarding the recording quality of the remaining sensors, no significant differences were found. CONCLUSIONS: Type III sleep studies with previous explanation through a video are as effective as those with an explanation performed by a technician, with associated advantages, without increased errors. The quality of the oximetry signal was better in the video group, a critical signal for OSA diagnosis.

Raters and examinees training for objective structured clinical examination: comparing the effectiveness of three instructional methodologies.

BACKGROUND: Utilizing the objective structured clinical examination (OSCE) ensures objectivity when it comes to the assessment of nursing students' skills and competency. However, one challenge in OSCE integration is rater and examinee training and orientation. AIM: This study employed a quasi-experimental design to evaluate the effectiveness of different instructional methodologies in training and preparing raters and examinees for the OSCE. METHODS: Participants were divided into three group of training methodologies: online, simulation, and traditional lecture (six raters and 18 examinees were assigned to each group). A total of 18 raters and 54 examinees partook. RESULTS: The study found that raters trained through simulation exhibited a slight agreement with their rates, compared to those who were trained online and in traditional lectures. Moreover, examinees who were trained through the simulation methodology performed better compared to those trained via the other methodologies. CONCLUSIONS: The study findings indicate that using simulation by training raters and examinees in the OSCE is the most effective approach.

Oral health of chemotherapy patients before and after provision of oral hygiene instructions at a tertiary care hospital: pre-post design.

OBJECTIVE: Disturbances in the oral mucosa is a major concern among patients undergoing chemotherapy. One of the most significant barriers in the implementation of oral care is the lack of knowledge. The aim of the study was to assess gingival and periodontal health status of chemotherapy patients before and after the provision of oral hygiene instructions. METHODS: A single group, pre-post test was conducted to assess oral health status of patients at the daycare chemotherapy, Aga Khan University Hospital, Karachi, Pakistan. Oral hygiene instructions were given with study models and leaflets. Patients were followed for 6-weeks. Oral health was assessed by using Simplified-Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI). Differences in indices were analyzed in STATA version-15.0 using Generalized Estimating Equation (GEE) and Wilcoxon Signed-rank test. RESULTS: Out of 74, 53 (72%) patients completed study follow-up. Improvement in the OHI-S was found in 14 (26%) patients (p-value < 0.001). GEE showed that age [adjusted OR = 1.10; 95% CI: 1.03-1.11], current chemotherapy cycle [adjusted OR = 1.19; 95% CI: 0.98-1.46], highest education level [Adjusted OR = 1.37; 95% CI: 1.08-12.7] and cancer therapy [Adjusted OR = 0.12; 95% CI: 0.24-0.55] were significantly associated with the change in OHI-S. Wilcoxon signed-rank test showed positive changes in the CPI (p-value < 0.001). CONCLUSIONS: Basic oral hygiene instructional intervention can be effective in improving the oral hygiene of chemotherapy patients. Nurses should also play a key role in providing psychological and nutritional support to patients.

Enabling People With Intellectual and Sensory Disabilities to Trigger a Tablet's Delivery of Task Instructions by Walking to the Tablet: Proof-of-Concept Study.

BACKGROUND: People with intellectual and sensory or sensory-motor disabilities tend to have problems performing multistep tasks. To alleviate their problems, technological solutions have been developed that provide task-step instructions. Instructions are generally delivered at people's request (eg, as they touch an area of a computer or tablet screen) or automatically, at preset intervals. OBJECTIVE: This study carried out a preliminary assessment of a new tablet-based technology system that presented task-step instructions when participants with intellectual and sensory disabilities walked close to the tablet (ie, did not require participants to perform fine motor responses on the tablet screen). METHODS: The system entailed a tablet and a wireless camera and was programmed to present instructions when participants approached the tablet, that is, when the camera positioned in front of the tablet detected them. Two instructions were available for each task step. One instruction concerned the object(s) that the participants were to collect, and the other instruction concerned the "where" and "how" the object(s) collected would need to be used. For 3 of the six participants, the two instructions were presented in succession, with the second instruction presented once the required object(s) had been collected. For the other 3 participants, the two instructions were presented simultaneously. Instructions consisted of pictorial representations combined with brief verbal phrases. The impact of the system was assessed for each of the 2 groups of participants using a nonconcurrent multiple baseline design across individuals. RESULTS: All participants were successful in using the system. Their mean frequency of correct task steps was close to or above 11.5 for tasks including 12 steps. Their level of correct performance tended to be much lower during the baseline phase when they were to receive the task-step instructions from a regular tablet through scrolling responses. CONCLUSIONS: The findings, which need to be interpreted with caution given the preliminary nature of the study, suggest that the new tablet-based technology system might be useful for helping people with intellectual and sensory disabilities perform multistep tasks.

Enhancing Surgical Task Adherence Through a Rewards-Driven Mobile Application: A Single-Arm Intervention Feasibility Study.

INTRODUCTION: Ensuring patients follow preoperative and postoperative instructions is vital for maximizing surgical success. This pilot study investigates the feasibility of using monetary incentives through a nudge engine application-based model of omnichannel communication to prompt adherence to preoperative and postoperative instructions. METHODS: Over a six-month period, we conducted a longitudinal study employing the TheraPay® Rewards app at Maimonides Medical Center in Brooklyn, United States. Our recruitment efforts targeted English and Spanish-speaking patients with smartphones through in-person visits and phone calls. Participants received a $15 credit on a gift card for each completed task. The tasks included preoperative validations such as obtaining primary care physician clearance, completing preoperative assessments, undergoing preoperative scans with accompanying compact disks (CDs), and discontinuing specific medications. Postoperative validations included attending postoperative visits, proper incision care, discontinuation of narcotics at three weeks, and initiation of the first physical therapy session. RESULTS: We enrolled 16 patients with a mean age of 59.5 years (SD 11.68), the majority being male (n = 10, 62.5%). Preoperatively, task completion rates ranged from 83% to 100%. Postoperatively, rates varied from 20% to 100%. Preoperative task adherence averaged at 98.7% (SD 2.2%), while postoperative adherence averaged 60% (SD 21%). CONCLUSION: Our study indicates that financial incentives delivered through a gamified approach effectively encourage patients to complete essential preoperative tasks, suggesting a promise for enhancing adherence. Nonetheless, the decrease in postoperative task adherence highlights the necessity for careful implementation. Future investigations should compare cancellation rates and outcome measures to gain deeper insights into the effectiveness of app-based incentives in improving surgical outcomes and patient adherence.

On the possible advantages of combining small lineups with instructions that discourage guessing-based selection.

The primary argument for including large numbers of known-to-be innocent fillers in lineups is that guessing-based selections are dispersed among a large number of lineup members, leading to low innocent-suspect identification rates. However, a recent study using the two-high threshold eyewitness identification model has demonstrated advantages of smaller lineups at the level of the processes underlying the observable responses. Participants were more likely to detect the presence of the culprit and less likely to select lineup members based on guessing in smaller than in larger lineups. Nonetheless, at the level of observable responses, the rate of innocent-suspect identifications was higher in smaller compared to larger lineups due to the decreased dispersion of guessing-based selections among the lineup members. To address this issue, we combined smaller lineups with lineup instructions insinuating that the culprit was unlikely to be in the lineup. The goal was to achieve a particularly low rate of guessing-based selections. These lineups were compared to larger lineups with neutral instructions. In two experiments, culprit-presence detection occurred with a higher probability in smaller compared to larger lineups. Furthermore, instructions insinuating that the culprit was unlikely to be in the lineup reduced guessing-based selection compared to neutral instructions. At the level of observable responses, the innocent-suspect identification rate did not differ between smaller lineups with low-culprit-probability instructions and larger lineups with neutral instructions. The rate of culprit identifications was higher in smaller lineups with low-culprit-probability instructions than in larger lineups with neutral instructions.

Comparison of Postprocedure Cardiac Catheterization Recovery Instructions on Participant's Perceived Comprehension and Satisfaction.

PURPOSE: The purpose of this study was to evaluate the effect of education timing on patient satisfaction and perceived knowledge comprehension of recovery instructions in cardiac catheterization patients. DESIGN: This prospective quasi-experimental single-blinded study was blinded to the participant. METHODS: This study was conducted between January and August 2022 in the cardiac catheterization laboratory of a New York metropolitan community hospital. Seventy-seven cardiac catheterization participants were randomized into two groups. The intervention group (n = 40) received instructions preprocedurally, while the control group (n = 37) received instructions per standard of care postprocedurally. The study team designed a nine-question satisfaction and perceived comprehension survey, which was used as the primary data collection tool. Data were collected through telephone interviews conducted 24 to 48 hours postprocedure. Chi-square (χ2) analysis was used to determine associations between the two groups. FINDINGS: Results revealed the participants in the intervention group (97.5%, n = 39) were more satisfied than those in the control group (83.8%, n = 31). Satisfaction with instructions about managing arterial bleeding was higher in the intervention group (100%, n = 40) than in the control group (83.8%, n = 31). There was a statistically significant difference in perceived comprehension of management of arterial bleeding (χ2 = 5.22, P < .05) and management difficulty urinating (χ2 = 5.69, P < .05), where the intervention group scored significantly higher than the control group. Major feedback from participants included recommendations to enhance written instructions for clarity. CONCLUSIONS: Delivering instructions preprocedurally compared to the standard of care revealed higher patient satisfaction and perceived comprehension of recovery instructions in cardiac catheterization patients. This study demonstrates how clinical nurses can translate nursing research into patient-centered outcomes, bridging research and practice gaps.

A cross-sectional analysis of reporting guideline and clinical trial registration policies in nephrology journals.

OBJECTIVE: To determine the extent to which nephrology journals recommend and require reporting guideline adherence and clinical trial registration. BACKGROUND: Despite a rising disease burden, research published on chronic kidney disease (CKD) and the field of nephrology has failed to keep pace and is limited. To improve the quality of research in the field of nephrology, reporting guidelines have been developed to minimize such deficits in research quality. However, the extent to which nephrology journals require and use reporting guidelines in addition to clinical trial registration is unknown. METHODS: Sixty-two Nephrology journals were selected through the 2021 Scopus CiteScore tool. Each journal's Instructions for Authors was assessed to determine endorsement of study design-specific reporting guidelines or clinical trial registration. Researchers used R (version 4.2.1) and RStudio to create data summaries of descriptive statistics for nephrology journal reporting guidelines. RESULTS: Clinical trial registration was required by 52% (32/62) of nephrology journals within our sample. The reporting guideline for clinical trials, CONSORT, was required by 17.74% (11/62) of journals. The EQUATOR Network was mentioned by 46.77% (29/62) of journals, while 9.67% (6/62) failed to mention the ICMJE. The reporting guideline for systematic review, PRISMA, was only required by 12.90% (8/62) of journals. When contacting journal editors, 9.67% (6/62) responded and 4.83% (3/62) provided clarifying information. CONCLUSIONS: Reporting guidelines and clinical trial registration are suboptimally required and recommended by nephrology journals. Their adoption may decrease bias and increase research quality. Thus, nephrology journals should consider a more complete endorsement of these safeguards.

Effects of attentional instructions on the behavioral and neural mechanisms of speech auditory feedback control.

The present study investigated how instructions for paying attention to auditory feedback may affect speech error detection and sensorimotor control. Electroencephalography (EEG) and speech signals were recorded from 21 neurologically intact adult subjects while they produced the speech vowel sound /a/ and received randomized ±100 cents pitch-shift alterations in their real-time auditory feedback. Subjects were instructed to pay attention to their auditory feedback and press a button to indicate whether they detected a pitch-shift stimulus during trials. Data for this group was compared with 22 matched subjects who completed the same speech task under altered auditory feedback condition without attentional instructions. Results revealed a significantly smaller magnitude of speech compensations in the attentional-instruction vs. no-instruction group and a positive linear association between the magnitude of compensations and P2 event-related potential (ERP) amplitudes. In addition, we found that the amplitude of P2 ERP component was significantly larger in the attentional-instruction vs. no-instruction group. Source localization analysis showed that this effect was accounted for by significantly stronger neural activities in the right hemisphere insula, precentral gyrus, postcentral gyrus, transverse temporal gyrus, and superior temporal gyrus in the attentional-instruction group. These findings suggest that attentional instructions may enhance speech auditory feedback error detection, and subsequently improve sensorimotor control via generating more stable speech outputs (i.e., smaller compensations) in response to pitch-shift alterations. Our data are informative for advancing theoretical models and motivating targeted interventions with a focus on the role of attentional instructions for improving treatment outcomes in patients with motor speech disorders.

Knowledge and attitude towards home quarantine instructions and associations with history of Covid-19 infection in Malaysia.

INTRODUCTION: Although COVID-19 has entered the endemic phase, individuals infected with COVID-19 are required to adhere to home quarantine measures. By exploring the public's knowledge and attitude towards recommended home quarantine measures, their readiness in containing potential COVID-19 outbreak can be determined. This study aimed to assess the public knowledge and attitude towards home quarantine instructions and their association with history of COVID-19 infections. METHODS: This was a web-based cross-sectional study conducted among the public in Malaysia between August to October 2022. All Malaysian adults over 18 years of age were included. Knowledge on home quarantine instructions and COVID-19 warning signs were measured using "True," "False," or "I'm not sure", while attitude towards home quarantine instructions was measured using a five-point Likert Scale. The questionnaire was initially constructed in English and then translated into the national language, Bahasa Malaysia. Face and content validation were performed. The internal consistency of the questionnaire was found to be satisfactory. RESULTS: 1,036 respondents were analyzed, comprised mostly of females (743, 71.6%) with a history of COVID-19 (673, 64.9%). In the knowledge domain, more than 80% of the respondents answered 9 out of 11 home quarantine instructions statements correctly. 457 (44.1%) were unaware or unsure about the minimum distance of the infected individual's bed from the rest of the occupants in a shared bedroom. The respondents reported relatively weaker knowledge in identifying uncommon warning signs of COVID-19 deterioration, including anuria (162, 44.5%), ingestion problems (191, 52.5%), and immobility (195, 53.6%). In the attitude domain, more than 90% of respondents answered correctly in 8 out of 9 questions. Respondents with a previous history of COVID-19 infections had better knowledge than COVID-19 infection-naïve individuals towards both home quarantine instructions and COVID-19 warning signs. CONCLUSION: Most respondents had good knowledge and attitude towards home quarantine instructions, with those previously infected with COVID-19 showing greater awareness of uncommon warning signs. However, there was a notable lack of awareness regarding physical distancing within shared rooms, appropriate disinfectant use and mobility limitation within the household. This study highlights the knowledge gaps to be improved in future educational campaigns.

An Age-Progression Intervention for Smoking Cessation: A Pilot Study Investigating the Influence of Two Sets of Instructions on Intervention Efficacy.

BACKGROUND: Research on age-progression facial morphing interventions for smoking cessation has not investigated the effect of different instructions for intervention delivery. The objective of this pilot study was to investigate the influence of two instruction types used to deliver the intervention on efficacy of the intervention. METHOD: Women were recruited and randomly allocated to an age-progression intervention session with (i) neutral instructions; (ii) instructions designed to reassure; or (iii) a condition that controlled for participant engagement ("control"). The conditions were delivered in a one-time procedure, after which primary (quitting intentions) and secondary (cigarettes/week, quit attempts) outcomes were measured immediately post-intervention, and at 1 and 3 months. RESULTS: Seventy-two women (M = 25.7; SD = 0.9) were recruited and randomly allocated to condition (Neutral n = 27, Reassuring n = 22, Control n = 23). Quitting intentions were higher in the Reassuring versus Control arm (3 months post-intervention, F = 4.37, p = 0.016, 95% CI [0.231, 2.539], eta2 = 0.11); quit attempts were greater in the two intervention arms (58%) versus Control (1-month post-intervention, 15%) (χ2 = 9.83, p < 0.05, OR 1.00 [0.28, 3.63]). CONCLUSIONS: Findings highlight the importance of optimising instructions to enhance intervention efficacy. TRIAL REGISTRATION: clinicaltrials.gov Record: NCT03749382.