Translation and cultural adaptation of the HELPS Reading Fluency Program into Brazilian Portuguese: A report of systematic adaptation processes and initial evidence of efficacy.

Introduction: Across multiples languages, research demonstrates the important relationship between reading fluency and comprehension. Put simply, a fluent reader has greater attention and memory resources to use higher-order functions in reading, resulting in better comprehension of text. Some reading fluency interventions have shown positive results in improving students' text reading fluency and comprehension; however, this research has predominantly been conducted with English-speaking students. For instance, until this report, a comprehensive search revealed only one prior study that evaluated an intervention strategy designed to improve students' reading fluency in Brazilian Portuguese and no prior studies evaluated an intervention program with that population of students. Methods: The main goals of this two-part project were to (a) systematically translate, culturally adapt, and pilot test the Helping Early Literacy with Practice Strategies (HELPS) reading fluency program for use in Brazilian Portuguese (referred to as, HELPS-PB); and (b) conduct a preliminary quasi-experimental study of the HELPS-PB program with 23 students in grades 3 to 5 who needed a reading fluency intervention. Results and Discussion: This report documents the processes and successful adaptation of existing English- and Spanish-versions of HELPS into a new HELPS-PB program. It also offers preliminary evidence showing that students receiving HELPS-PB significantly improved their text reading fluency comparted to students in a control group. Implications for research, practice, and the adaptation of reading fluency programs into other languages are discussed.

Effects of light finger touch on the regularity of center-of-pressure fluctuations during quiet bipedal and single-leg postural tasks.

BACKGROUND: The use of extra sources of sensory information associated with light fingertip touch to enhance postural steadiness has been associated with increased attentional demands, whereas the regularity of center of pressure (COP) fluctuations has been interpreted as a marker of the amount of attention invested in posture control. RESEARCH QUESTION: This study addressed whether increased attentional demands associated with postural tasks involving light finger touch might be reflected by measures of COP regularity. METHODS: The experiments involved quiet bipedal stance (n = 8 participants) and single-legged stance (n = 14 participants). Each participant was instructed to stand as quietly as possible on a force plate, either touching an external rigid surface (applied force < 1 N, light touch condition), or not (no touch condition). Postural steadiness was assessed by traditional COP measurements (COP Area, RMS, and velocity), whereas the regularity of postural sway was based on estimates of the sample entropy (SaEn) of the COP time series. RESULTS: Traditional parameters of postural sway and COP regularity (inversely related to SaEn COP measurements) were reduced during the touch conditions as compared to the no-touch conditions, for both bipedal quiet stance and single-legged stance. Decreased COP regularity with light touch was mainly reflected in the direction of the largest postural sway (i.e. in the sagittal plane for bipedal stance and in the frontal plane for single-legged stance). SIGNIFICANCE: The present results suggest that actively touching an external surface with the fingertip, besides increasing postural steadiness, generated an externally oriented (presumably cognitive-dependent) focus of attention, so that participants invested less attention on the postural task per se (as suggested by increased SaEn), which might be associated with a more "automatic" control of posture.

Medidas Implícitas en Cognición: Una Aproximación al Estudio de la Automaticidad / Implicit Measures in Cognition: An Approach to the Study of Automaticity

Resumen La investigación en cognición implícita ha aumentado de manera vertiginosa durante las últimas décadas, principalmente por el uso generalizado de procedimientos experimentales conocidos como medidas implícitas. A diferencia de los cuestionarios de autoinforme, estas metodologías impiden que sesgos como la deseabilidad social afecten las respuestas de los participantes, lo que permite abordar temas sensibles. Sin embargo, las medidas implícitas difieren en aspectos como las instrucciones, los materiales o los indicadores conductuales analizados. Debido a esto, hay controversia sobre la naturaleza de los procesos que están siendo medidos, las características que se les atribuyen y, por ende, la posibilidad de hacer comparaciones entre los estudios que emplean diferentes medidas implícitas. Basándose en un modelo de procesamiento dual, este trabajo propone que las medidas implícitas pueden entenderse como indicadores de procesos automáticos. A partir de dicha propuesta, se discuten los requisitos que las medidas implícitas deben cumplir y algunos desafíos para la investigación en automaticidad.

Abstract The research on implicit cognition has increased dramatically over the past few decades, mainly because of the widespread use of experimental procedures known as implicit measurements. In contrast to self-report questionnaires, these methodologies prevent biases as social desirability from affecting participants' responses, allowing sensitive issues to be addressed. However, the implicit measures differ in central aspects as the instructions, materials, or behavioral indicators analyzed. For those reasons, there is controversy about the nature of the processes being measured, the characteristics attributed to them, and, therefore, the possibility of making comparisons between studies that use different implicit measures. Based on a dual processing model, this paper proposes that implicit measures can be understood as indicators of automatic processes. Finally, we will discuss the requirements that implicit measures must satisfy, and some challenges for research in automaticity.

Modelling Longitudinal Directional Associations Between Self-regulation, Physical Activity, and Habit: Results from a Cross-lagged Panel Model.

BACKGROUND: The directionality of associations between self-regulatory variables, behavior, and automaticity is seldomly tested. In this study, we aimed to examine a volitional, self-regulatory sequence of variables proposed in the Health Action Process Approach framework (intention → action plans → action control → behavior) and its relationship with the construct of automaticity of the physical activity habit. METHODS: Longitudinal data was collected from high school students (N = 203, Mage = 15.39 (SD = 1.43), 52% women) at three measurement points. First, a confirmatory factor analysis measurement model was used to examine the study variables across measurement points. Next, a cross-lagged panel model was used to test directionality between variables. RESULTS: After adequate fit of the measurement model was confirmed, a mechanism integrating self-regulation with behavior and automaticity was examined. The hypothesized directionality between variables was verified overall by cross-lagged analysis. However, for the intention-action plan association, the inverse relationship was found: plans were associated with subsequent intentions, but intentions did not predict plans. Moreover, automaticity was not associated with subsequent physical activity behavior. CONCLUSIONS: In general, our findings supported the hypothesized longitudinal direction of the associations, confirming that self-regulation may lead to behavior performance and automaticity. Unexpected findings and implications for intervention and future research are discussed.

An unusual ectopic ventricular rhythm in a young woman.

A case of a 22-year-old young pregnant woman with palpitations and near syncope is presented. Holter monitoring showed very frequent premature beats and runs of wide complex tachycardia, refractory to antiarrhythmic drugs. Electrophysiologic evaluation disclosed spontaneous automatism arising in an atriofascicular pathway. Differential diagnosis is discussed.

Cardiac automaticity: basic concepts and clinical observations.

PURPOSE: The purpose of this report was to review the basic mechanisms underlying cardiac automaticity. Second, we describe our clinical observations related to the anatomical and functional characteristics of sinus automaticity. METHODS: We first reviewed the main discoveries regarding the mechanisms responsible for cardiac automaticity. We then analyzed our clinical experience regarding the location of sinus automaticity in two unique populations: those with inappropriate sinus tachycardia and those with a dominant pacemaker located outside the crista terminalis region. RESULTS: We studied 26 patients with inappropriate sinus tachycardia (age 34 ± 8 years; 21 females). Non-contact endocardial mapping (Ensite 3000, Endocardial Solutions) was performed in 19 patients and high-density contact mapping (Carto-3, Biosense Webster with PentaRay catheter) in 7 patients. The site of earliest atrial activation shifted after each RF application within and outside the crista terminalis region, indicating a wide distribution of atrial pacemaker sites. We also analyzed 11 patients with dominant pacemakers located outside the crista terminalis (age 27 ± 7 years; five females). In all patients, the rhythm was the dominant pacemaker both at rest and during exercise and located in the right atrial appendage in 6 patients, in the left atrial appendage in 4 patients, and in the mitral annulus in 1 patient. Following ablation, earliest atrial activation shifted to the region of the crista terminalis at a slower rate. CONCLUSIONS: Membrane and sub-membrane mechanisms interact to generate cardiac automaticity. The present observations in patients with inappropriate sinus tachycardia and dominant pacemakers are consistent with a wide distribution of pacemaker sites within and outside the boundaries of the crista terminalis.

Validation of a Visual-Spatial Secondary Task to Assess Automaticity in Laparoscopic Skills.

INTRODUCTION: Our objective was to assess reliability and validity of a visual-spatial secondary task (VSST) as a method to measure automaticity on a basic simulated laparoscopic skill model. In motor skill acquisition, expertise is defined by automaticity. The highest level of performance with less cognitive and attentional resources characterizes this stage, allowing experts to perform multiple tasks. Conventional validated parameters as operative time, objective assessment skills scales (OSATS), and movement economy, are insufficient to distinguish if an individual has reached the more advanced learning phases, such as automaticity. There is literature about using a VSST as an attention indicator that correlates with the automaticity level. METHODS: Novices with completed and approved Fundamentals of Laparoscopic Surgery course, and laparoscopy experts were enrolled for an experimental study and measured under dual tasks conditions. Each participant performed the test giving priority to the primary task while at the same time they responded to a VSST. The primary task consisted of 4 interrupted laparoscopic stitches (ILS) on a bench-model. The VSST was a screen that showed different patterns that the surgeon had to recognize and press a pedal while doing the stitches (PsychoPsy software, Python, MacOS). Novices were overtrained on ILS until they reach at least 100 repetitions and then were retested. Participants were video recorded and then assessed by 2 blinded evaluators who measured operative time and OSATS. These scores were considered indicators of quality for the primary task. The VSST performance was measured by the detectability index (DI), which is a ratio between correct and wrong detections. A reliable evaluation was defined as two measures of DI with less than 10% of difference, maintaining the cutoff scores for performance on the primary task (operative time <110 seg and OSATS >17 points). RESULTS: Novices (n = 11) achieved reliable measure of the test after 2 (2-5) repetitions on the preassessment and 3.75 (2-5) on the postassessment (p = 0.04); whereas laparoscopy experts (n = 4) did it after 3.5 (3-4) repetitions. Proficiency cutoff scores for the primary task were achieved on every measure for novices (prepost overtraining) and experts. Expert performance on VSST was DI 0.78 (0.69-0.87). Novice performance was significantly better on postassessment (DI-pre 0.48 [0.06-0.71] vs DI-post 0.78 [0.48-0.95], p = 0.003). Overtraining consisted in 140 (100-210) repetitions of ILS for all novices, made in 8 hours (3-15). By categorizing DI based on expert performance, novices with DI-post >0.65 achieved better OSATS score and less operative time than novices with DI-post<0.65 (p = 0.007 y, p = 0.089, respectively). CONCLUSION: Measuring automaticity is feasible using a VSST. This instrument is reliable and has a face, content and construct validity. A DI over 0.65 may be a cutoff point correlated with high standard performance on the primary task. This instrument measures performance on laparoscopic skills, and along with conventional indicators, would better define advance levels of expertise. More studies are required applying this VSST to achieve external validity by reproducing our results.