Understanding observational learning: an interbehavioral approach

"I could 100% see myself getting hurt if I did it wrong": a qualitative exploration of exercise perceptions in people with chronic low back pain

PURPOSE

Traditionally, a specific "core" exercise focus has been favoured for chronic low back pain (CLBP) which contrasts holistic exercise approaches. This study aims to explore the perceptions of exercise in people with CLBP and whether exercise itself can convey implicit messages regarding its use in CLBP management in the absence of a clinical narrative.

MATERIALS AND METHODS

Participants were asked about their CLBP history, views of exercise for CLBP, and current exercise behaviours through online semi-structured interviews. Then, participants watched the interviewer perform the deadlift, Jefferson curl, and bird dog and were asked if they thought each individual exercise was beneficial for CLBP, and why. Data were analysed using reflexive thematic analysis through a critical realism and social constructivism lens.

RESULTS

All participants (n = 16) viewed all exercises as beneficial for health and pain relief, but perceived efficacy varied. "Core" exercises were deemed crucial for CLBP relief, while spinal flexion and external load were often perceived as potentially injurious. Distrust towards healthcare practitioners also influenced exercise perceptions.

CONCLUSION

People with CLBP perceive different exercises to either relieve pain or improve health. Healthcare practitioners can influence these perceptions, highlighting the need for consideration of exercise perceptions in clinical contexts.

A Modern Collaborative Behavior Analytic Approach to Incidental Naming

An important distinction has been drawn within the behavior-analytic literature between two types of naming. Naming that is reinforced is referred to as bidirectional naming, and naming that is not reinforced is referred to as incidental bidirectional naming. According to verbal behavior development theory children who demonstrate incidental naming have developed a verbal behavioral cusp, and often learn new language more rapidly as a result. A growing body of research has assessed incidental naming using what is described as an incidental naming experience, in which novel stimuli are presented and named by a researcher but with no direct differential reinforcement for subsequent naming responses by the participant. According to relational frame theory, such studies on incidental naming have typically involved presenting contextual cues that likely serve to establish the name relations between an object and its name. As such, contextual cues may play a critical role in the emergence of incidental naming responses, but there are no published studies that have systematically tested the potential role of contextual cues in relation to incidental naming. The current article provides a narrative review of the incidental naming literature, highlighting variables that remain to be explored in future research.

Effects of repeated unihemispheric concurrent dual-site tDCS and virtual reality games on motor coordination of sedentary adolescent girls

BACKGROUND

This study investigated the effects of repetitive unihemispheric concurrent dual-site anodal transcranial direct current stimulation (a-tDCSUHCDS) associated with the use of virtual reality games (VR) on the motor coordination of sedentary adolescent girls.

METHODS

Thirty-six inactive adolescent girls were randomly assigned into 3 groups (n = 12 per group): (1) VR + a-tDCSUHCDS, (2) VR + sham-tDCSUHCDS, and (3) Control. The VR + a-tDCSUHCDS and VR + s-tDCSUHCDS groups received the intervention three times a week for four weeks. In each experimental session, participants first received either 20 min of a-tDCSUHCDS (2 mA at each anodal electrode) targeting the primary motor cortex (M1) and the left dorsolateral prefrontal cortex (DLPFC) or sham and then performed VR for 1 h. The control group received no intervention. Eye-hand coordination (EHC) and bimanual coordination (BC) were measured at baseline, post-intervention, and two weeks later (retention test) using the automatic scoring mirror tracer and continuous two-arm coordination test, respectively.

RESULTS

Results showed that the EHC was significantly higher in the VR + a-tDCS and VR + s-tDCS groups at post-intervention (all ps< 0.001) and the retention test (all ps< 0.001) compared to the control group. Moreover, the EHC was significantly higher in the VR + a-tDCS group compared to the VR + s-tDCS group (p = 0.024) at the retention. Similarly, VR + a-tDCS and VR + s-tDCS improved BC compared to the control group at post-intervention (all ps< 0.001) and retention test (all ps< 0.001). In addition, higher BC was observed in the VR + a-tDCS group compared to the VR + s-tDCS group (p< 0.001) at the retention test.

CONCLUSIONS

Our results suggest that adding a-tDCSUHCDS to VR over 12 sessions may have an additional effect on VR training for improving and retaining motor coordination in sedentary adolescent girls.

A Self-Narrative Study: Changes in Physical Ability and Social Communication in Children with Autism through Taekwondo Training with Elements of Music Therapy from the Parents' Perspective

Autism spectrum disorder (ASD) significantly affects social and motor skills development in early, middle or even late childhood. To promote social and motor skills development among autistic children, an intervention consisting of Taekwondo and elements of music therapy was designed and implemented in Hong Kong. The objective of the current study is to investigate the effectiveness of this training, based on parents' observations of their children who had completed the key stage of the training. Thirteen parents or caregivers (n = 13) whose children with autism participated in our Taekwondo training for two months were interviewed. Three major themes were identified by thematic analysis: (A) social skills-related change after the intervention, (B) motor skills-related change after the intervention, (C) characteristics of the intervention (i.e., session arrangement, tutor/coach attitude). Our findings show that our training was perceived by parents to have a significant impact on the promotion of physical ability and social communication in autistic children.

The Media and Sexual Violence Among Adolescents: Findings from a Qualitative Study of Educators Across Vietnam

Growing access to technology and media has presented new avenues of influence on youth attitudes and norms regarding sexuality and sexual violence, as well as new technological pathways through which to perpetrate sexual violence. The aim of this research was to understand contextual influences on and needs for scale-up of sexual violence prevention programming in the media-violence context of Vietnam. We conducted 45 interviews with high school teachers (n = 15), university lecturers (n = 15), and affiliates from youth-focused community service organizations (n = 15) from across Vietnam. Additionally, we conducted four sector-specific focus groups with a sub-sample of interview participants (k = 4, n = 22). Media and technology were brought up consistently in relation to sexual violence prevention and sexual health information. Key informants noted that, in Vietnam, generational differences in acceptability of sex and lack of comprehensive sexuality education intersect with new technological opportunities for exposure to sexual information and media. This creates a complex landscape that can promote sexual violence through priming processes, instigate mimicry of violent media, and presents new opportunities for the perpetration of sexual violence though technology. Development of comprehensive sexual education, including violence prevention education, is imperative, with consideration of age-specific needs for Vietnamese youth.

Learning by observing: a systematic exploration of modulatory factors and the impact of observationally induced placebo and nocebo effects on treatment outcomes

Introduction

Observational learning (OL) refers to learning through observing other people's behavior. OL has been suggested as an effective and simple tool to evoke treatment expectations and corresponding placebo and nocebo effects. However, the exact mechanisms by which OL shapes treatment outcomes, its moderating factors and possible areas of application remain unclear. We thus reviewed the existing literature with two different literature searches to answer the following questions: Which influencing factors contribute to OL-induced placebo and nocebo effects (in healthy volunteers and patients) and how large are these effects (search 1)? In which medical fields has OL been used so far to modulate treatment expectancy and treatment outcomes in patients, their caregivers, and at-risk groups (search 2)? We also aimed to explore whether and how the assessment of treatment expectations has been incorporated.

Methods

We conducted two independent and comprehensive systematic literature searches, both carried out on September 20, 2022.

Results

We identified 21 studies that investigated OL-mediated placebo and nocebo effects for pain and itch, the (placebo) efficacy of sham treatment on anxiety, and the (nocebo) induction of medication side effects (search 1). Studies showed that OL can efficiently induce placebo and nocebo effects across different presentation modes, with medium effect sizes on average: placebo effects, d = 0.79 (range: d = -0.36-1.58), nocebo effects, d = 0.61 (range: d = 0.04-1.5). Although several moderating factors have been investigated, their contribution to OL-induced effects remains unclear because of inconsistent results. Treatment expectation was assessed in only four studies. Regarding medical applications of OL (search 2), we found 12 studies. They showed that OL was effectively applied in preventive, therapeutic and rehabilitative interventions and that it was mainly used in the field of psychosomatics.

Discussion

OL effects on treatment outcomes can be both positive and negative. Future research should investigate which individuals would benefit most from OL and how OL can be implemented most effectively to induce placebo and avoid nocebo effects in clinical settings.

Systematic review registration

This work was preregistered at the Center for Open Science as open-ended registration (doi: 10.17605/OSF.IO/FVHKE). The protocol can be found here: https://archive.org/details/osf-registrations-fvhke-v1.

Social learning-based health literacy promotion on the self efficacy and social anxiety of adolescents with type 1 diabetes

BACKGROUND AND OBJECTIVE

Type 1 diabetes mellitus one of the biggest health concerns around the world, is difficult to manage during adolescence. Among the non-medical methods of controlling this disease is empowerment through self-efficacy. Poor self-efficacy leads to social anxiety and ultimately deficiencies in diabetes. There is also a correlation among health literacy, self-efficacy, and social anxiety. Thus, the present study aimed to evaluate the impact of a literacy promotion training program based on social learning theory on the self-efficacy and social anxiety of adolescents with T1DM.

METHODS

The current research is a semi-experimental type that was carried out with the cooperation of 66 adolescents aged 15-18 years with type 1 diabetes in Iran (Tehran, 2022). It has control and intervention groups. The endocrinology and diabetes clinics of the intervention and control groups were randomly selected in a multi-stage manner (endocrine and diabetes clinic of children's medical center hospital for the control group and endocrine and diabetes clinic of Mofid hospital for the intervention group) and the participants were selected by Simple Random Sampling method (draw). The training program designed based on Bandura's social learning theory was used to teach adolescents during seven consecutive sessions of 30-45 min during one week. Questionnaires were completed before and one month after the intervention. Data were analysed in SPSS-25 software.

FINDINGS

The intervention for adolescents with T1DM in intervention group compared to the control group had a significant effect on improve health literacy (P<0.001), self-efficacy (P<0.001), and social anxiety (P<0.05).

CONCLUSIONS

The results can also be used to improve the capabilities of adolescents with T1DM, reduce and prevent disease complications, and develop operational-educational programs in the centers from which these adolescents receive various services.

TRIAL REGISTRATION

IRCT20210422051045N1.

Using the life course health development model to address pediatric mental health disparities

TOPIC

Early-life experiences, the transmission of health and disease within families, and the influence of cumulative risks as well as protective factors throughout life shape the trajectory of health, including mental health. Long-term health trajectories established early in life are influenced by biologic, social, and environmental factors. Negative trajectories may be more salient if exposures to adversity occur during critical developmental periods.

PURPOSE

The purpose of this brief is to (a) review pediatric health disparities related to depression and the intergenerational transmission of pediatric depression using a Life Course Health Development (LCHD) model and (b) provide recommendations for pediatric mental health research.

SOURCES

Peer-reviewed papers available for PubMed, CINAL, and Medline. Other sources include published books, papers, and gray materials.

CONCLUSIONS

The LCHD model is a perspective to guide and foster new scientific inquiry about the development of mental health outcomes over the life course. The model enables synthesis of mental health, nursing, and public health, linking mental health prevention, risk reduction, and treatment in children.

The Impact of Team Mindfulness on Project Team Performance: The Moderating Role of Effective Team Leadership

The current study aims to investigate the consequences of team mindfulness in project-based organizations by proposing team cohesion as an underlying mechanism and effective team leadership as a boundary condition through which team mindfulness promotes project team performance. Data were collected through a time-lagged survey from Pakistani employees (N = 379). The data supported the proposed model revealing that team mindfulness enhances team cohesion among employees, which increases project team performance and effective team leadership moderates this relationship. This study has identified the team-level factors that can be used by project managers to increase project team performance.

Girls at risk: FGM intentions among in-school adolescents of a rural community in Osun State, Nigeria

PURPOSE

Knowledge of adolescents' intention to sustain female genital mutilation (FGM) practice is required to guide efforts to eradicate FGM in Africa and Asia where about 200 million women are affected. Nigeria has one of the highest FGM cases in the world. The study sought to determine the knowledge, attitude, and intentions of adolescents to sustain FGM practice when they become parents.

MATERIALS AND METHODS

This study is a cross-sectional descriptive survey of 195 in-school adolescents aged 14-19 years, in Imesi-Ile, a rural town in South-west Nigeria selected through a multistage sampling method.

RESULTS

Overall, 44.6% of adolescents had good knowledge of FGM, while 44.6% had a positive attitude and 55.4% had a negative attitude towards FGM. More females (57.4%) have a negative attitude towards FGM. About 42.1% of adolescents intend to continue the practice of FGM, while 47% have no intentions and 10.8% remain undecided. Gender, age group and family affluence were not statistically associated with intention to continue FGM.

CONCLUSION

Intention to continue FGM practice is high among adolescents in the rural community. FGM eradication campaign among adolescents should seek to improve knowledge, attitude and intentions towards FGM practice.

Systems Thinking in an era of climate change: Does cognitive neuroscience hold the key to improving environmental decision making? A perspective on Climate-Smart Agriculture

Systems Thinking (ST) can be defined as a mental construct that recognises patterns and connections in a particular complex system to make the "best decision" possible. In the field of sustainable agriculture and climate change, higher degrees of ST are assumed to be associated with more successful adaptation strategies under changing conditions, and "better" environmental decision making in a number of environmental and cultural settings. Future climate change scenarios highlight the negative effects on agricultural productivity worldwide, particularly in low-income countries (LICs) situated in the Global South. Alongside this, current measures of ST are limited by their reliance on recall, and are prone to possible measurement errors. Using Climate-Smart Agriculture (CSA), as an example case study, in this article we explore: (i) ST from a social science perspective; (ii) cognitive neuroscience tools that could be used to explore ST abilities in the context of LICs; (iii) an exploration of the possible correlates of systems thinking: observational learning, prospective thinking/memory and the theory of planned behaviour and (iv) a proposed theory of change highlighting the integration of social science frameworks and a cognitive neuroscience perspective. We find, recent advancements in the field of cognitive neuroscience such as Near-Infrared Spectroscopy (NIRS) provide exciting potential to explore previously hidden forms of cognition, especially in a low-income country/field setting; improving our understanding of environmental decision-making and the ability to more accurately test more complex hypotheses where access to laboratory studies is severely limited. We highlight that ST may correlate with other key aspects involved in environmental decision-making and posit motivating farmers via specific brain networks would: (a) enhance understanding of CSA practices (e.g., via the frontoparietal network extending from the dorsolateral prefrontal cortex (DLPFC) to the parietal cortex (PC) a control hub involved in ST and observational learning) such as tailoring training towards developing improved ST abilities among farmers and involving observational learning more explicitly and (b) motivate farmers to use such practices [e.g., via the network between the DLPFC and nucleus accumbens (NAc)] which mediates reward processing and motivation by focussing on a reward/emotion to engage farmers. Finally, our proposed interdisciplinary theory of change can be used as a starting point to encourage discussion and guide future research in this space.

Research on the influencing factors of the citizen adoption process of China's national integrated online government service platform

Purpose

The Chinese government hopes to achieve the goal of benefiting citizens by building a National Integrated Online Government Service Platform (NIOGSP). However, citizens' low adoption of the platform makes it difficult for the government to achieve its goal. Research on the influencing factors of citizen adoption of NIOGSP can help the government fully understand the concerns and needs of its citizens and take targeted measures to increase citizen adoption.

Design/methodology/approach

First, this research builds a model of the citizen adoption process, including attention, retention and motivation, based on an observational learning model. Next, research variables are determined based on social cognitive theory, literature review and real-world needs. Finally, based on the questionnaire survey and structural equation model, the influencing factors of each stage of the citizen adoption process model are studied and the relationship between the three stages of the model is verified.

Findings

Results show that perceived usefulness (PU) and self-efficacy (SE) positively affect attention. SE positively affects retention, while perceived privacy (PP) negatively affects retention. PU, social influence, PP and anxiety positively affect motivation.

Originality/value

The conclusion of this study can provide reference for governments in various countries to establish and improve online one-stop government. In addition, this study verifies the citizen adoption process model and finds that there is no obvious causal relationship between attention and retention, but both have positive effects on motivation.

Family planning demand generation in Rwanda: Government efforts at the national and community level impact interpersonal communication and family norms

Between 2005 and 2020, total contraceptive use among married women in Rwanda increased from 17% to 64%. The aim of this study is to better understand how the Rwandan government’s mobilization and demand generation efforts have impacted community norms and interpersonal discourse surrounding family planning. Eight focus group discussions with family planning providers and 32 in-depth interviews with experienced modern contraceptive users were conducted in 2018 in the two Rwandan districts with the highest and the lowest contraceptive prevalence rates. Results suggest that outspoken government support, mass media, and community meetings were valuable sources of information about family planning. Information received through these channels generated interpersonal dialogue about contraceptives through both conversation and observation; however, rumors and misinformation remained a significant barrier to use. A once taboo subject is now normative among married couples. Continuing to address common fears and misinformation through communication channels such as mass media and community meetings may help to further increase contraceptive uptake in Rwanda.

Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: A Mixed Methods Systematic Review (Preprint)

Background

Objective

Methods

Results

Conclusions

International Registered Report Identifier (IRRID)

Criteria for Teaching Performance in Psychology: Invariance According to Age, Sex, and Academic Stage of Peruvian Students

The use of scales to assess the performance of professors from the students' standpoint is a generalized practice in higher education systems worldwide. The purpose of this study is to analyze the factorial structure and measure the invariance of the Scale of Teaching Performance of the Psychology Professor (EDDPsic) among groups according to gender, age, and academic stage. The sample of participants was composed of 316 Psychology students from the fourth and sixth semesters (basic cycles), and from the eighth and tenth semesters (disciplinary-professional cycles) of two renowned public universities in Lima, Peru. Two hundred and thirty-one participants were women (73%), and the mean age of students was 21.5 years old (SD = 2.37). The measurement invariance of the scale in the three study variables was underpinned by a multigroup confirmatory factor analysis (MGCFA) conducted using a five-factor model that showed the best fitness indices. It is concluded that significant differences in measuring teaching performance areas of the professor depend on the students' age difference and on their academic stage (to attend the disciplinary-professional cycles).

Exploring Virtual Doppelgangers as Movement Models to Enhance Voluntary Imitation

Virtual Reality (VR) setups offer the possibility to investigate interactions between model and observer characteristics in imitation behavior, such as in the chameleon effect of automatic mimicry. We tested the hypothesis that perceived affiliative characteristics of a virtual model, such as similarity to the observer and likability, will facilitate observers' engagement in voluntary motor imitation. In a within-subjects design, participants were exposed to four virtual characters of different degrees of realism and observer similarity (avatar numbers AN=1-4), ranging from an abstract stickperson to a personalized doppelganger avatar designed from 3d scans of the observer. The characters performed different trunk movements and participants were asked to imitate these. We defined functional ranges of motion (ROM) for spinal extension (bending backward, BB), lateral flexion (bending sideward, BS) and rotation in the horizontal plane (RH) based on shoulder marker trajectories as behavioral indicators of imitation. Participants' ratings on avatar appearance, characteristics and embodiment/ enfacement were recorded in an Autonomous Avatar Questionnaire (AAQ), factorized into three sum scales based on our explorative analysis. Linear mixed effects models revealed that for lateral flexion (BS), a facilitating influence of avatar type on ROM was mediated by perceived identificatory avatar properties such as avatar likability, avatar-observer-similarity and other affiliative characteristics (AAQ1). This suggests that maximization of model-observer similarity with a virtual doppelganger may be useful in observational modeling and this could be used to modify maladaptive motor behaviors in patients with chronic back pain.

Audience Control and the Emission of Stereotypy and Social Verbal Exchanges in Children With Autism and Developmental Disabilities

In 2 experiments, using a within-subjects alternating-conditions design, we measured our participants' stereotypic and verbal behavior under 2 audience conditions. Our participants were 8 children, ages 10 and 11 years, diagnosed with autism and related developmental disabilities. We measured the percentage of intervals with occurrences of stereotypy (Experiment 1) and the number of verbal operants emitted per minute (Experiment 2) in the presence of 2 types of audiences: members of the participants' own special education class and typically developing peers from general education classes. Results from both experiments demonstrated that participants emitted a lower percentage of intervals with stereotypy and higher rates of social verbal operants in the presence of their typically developing peers than in their self-contained special education classrooms.

Synchronous vs. non-synchronous imitation: Using dance to explore interpersonal coordination during observational learning

Observational learning can enhance the acquisition and performance quality of complex motor skills. While an extensive body of research has focused on the benefits of synchronous (i.e., concurrent physical practice) and non-synchronous (i.e., delayed physical practice) observational learning strategies, the question remains as to whether these approaches differentially influence performance outcomes. Accordingly, we investigate the differential outcomes of synchronous and non-synchronous observational training contexts using a novel dance sequence. Using multidimensional cross-recurrence quantification analysis, movement time-series were recorded for novice dancers who either synchronised with (n = 22) or observed and then imitated (n = 20) an expert dancer. Participants performed a 16-count choreographed dance sequence for 20 trials assisted by the expert, followed by one final, unassisted performance trial. Although end-state performance did not significantly differ between synchronous and non-synchronous learners, a significant decline in performance quality from imitation to independent replication was shown for synchronous learners. A non-significant positive trend in performance accuracy was shown for non-synchronous learners. For all participants, better imitative performance across training trials led to better end-state performance, but only for the accuracy (and not timing) of movement reproduction. Collectively, the results suggest that synchronous learners came to rely on a real-time mapping process between visual input from the expert and their own visual and proprioceptive intrinsic feedback, to the detriment of learning. Thus, the act of synchronising alone does not ensure an appropriate training context for advanced sequence learning.

Fatal farm injuries to Canadian children

Children on Canadian farms are at high risk for fatal injury. Ongoing surveillance of these deaths is required to affirm recurrent patterns of injury, and to determine whether historical approaches to prevention have resulted in declines in the occurrence of these traumatic events. We analyzed epidemiological patterns and trends in the occurrence of fatal pediatric farm injuries over 23 years. Records of deaths were obtained from the Canadian Agricultural Injury Reporting system. To contrast more recent data with injury patterns described historically, cases were compared between two time periods. An intentional consensus process was used to finalize key patterns and their clinical or social importance. 374 fatal farm injuries to children in Canada were identified over the 23 years of study; 253 in period 1 and 121 in period 2. While machinery and non-machinery causes of death varied between the two study periods, mean annual rates of fatal injury (approximately 4 per 100,000 children) remained similar. Notably emergent types of injury in recent years included those caused by all-terrain vehicles, skid steer loaders, and drownings. Observed declines in the numbers of fatal farm injuries are most likely attributable to analogous declines in the number of registered farms in Canada. Our findings call into question the effectiveness of pediatric farm safety initiatives that primarily focus on education. Second, while CAIR fatality data are maintained, surveillance of hospitalized injuries has been disbanded and the fatality records require updating. Only by doing so will such surveillance findings provide comprehensive information to inform prevention.

Group-based transmission of fatherhood among intergenerational African American fathers: A case study

PROBLEM

Nonresidential fatherhood contributes to the fact that over 70% of African American (AA) children grow up in homes without their biological fathers. In the absence of gender-specific parental guidance, AA young men who become fathers may lack paternal-parenting preparation.

METHODS

This secondary data analysis describes the verbal exchange of fatherhood perspectives among four experienced fathers and one adolescent father who participated in a pilot of group-based fatherhood intervention. Qualitative descriptive case study methodology guided by Social Learning Theory was used to explore the transmission of fathering perspectives between fathers.

FINDINGS

Qualitative thematic analysis affirmed that adverse emotional and psychological distress may be avoided with positive parenting preparedness. Culturally-specific group-based bidirectional learning can transmit fatherhood knowledge and skills to adolescent nonresidential fathers and this new perspective can contribute to adolescent wellbeing.

CONCLUSIONS

There is a need to investigate channels for AA adolescent boys, young men and fathers to engage in cultural-congruent paternal modeling in the event that their biological father or other social father role models are absent from their lives.

Aprendizagem Observacional em Crianças com Autismo: Efeitos do Ensino de Respostas de Monitoramento via Videomodelação

Resumo O presente estudo investigou o estabelecimento de respostas de monitoramento via videomodelação em duas crianças com transtorno do espectro autista e se essas respostas favoreceriam a aprendizagem observacional de tatos e textuais nessas crianças. Foram realizados pré e pós-testes de aprendizagem observacional via videomodelação. O treino de monitoramento foi realizado em três etapas: (1) ensino da resposta de monitoramento; (2) desenvolvimento de controle do responder do participante pelo responder do modelo e (3) controle do responder do participante pela consequência para o modelo. As duas crianças aprenderam a resposta de monitoramento em quatro sessões e houve a aquisição de tatos e textuais por aprendizagem observacional para um dos participantes. Discute-se o potencial da videomodelação para treinar comportamentos precorrentes necessários para a aprendizagem observacional.

Unified neural structured model: A new diagnostic tool in primary care psychiatry

Overlap of multiple mental disorders in each psychiatric patient has been emphasized and the style of assessment and intervention in each patient has been gradually changed. A new practical structured model that can comprehensively explain and assess the major mental disorders integratedly has been desired. In this report, the relationships between each of the major mental disorders and each neuropsychiatric component like personality, reward system, or reinforcement learning have been comprehensively reviewed to construct a new integrated structured model for assessing the overlapped mental conditions in primary care psychiatry. This new structured model contains the following three loops: "input-output-feedback loop" (external/environmental loop), "reward-learning loop" (learning loop), and "mood-reward sensitivity loop" (mood loop), which are connected by the functions of prefrontal cortex and basal ganglia. With this new concept, overlapped mental conditions in each psychiatric patient could be theoretically much simply and logically explained. In conclusion, with the proposed psychiatric structured model, we can simply explain and understand the overlapped mental disorders in each patient. Inventing and developing such basic psychiatric structured model would offer us new diagnostic and therapeutic tools to realize personalized medicine, especially in the field of primary care psychiatry.

Heat Loss Prevention Education Aids Nurses' Knowledge in Prevention of Hypothermia in Newborns

Newborns are at risk of developing hypothermia due to the instability of their thermoregulation systems and inability to adjust to changes in ambient temperature. This risk increases during hospitalization. Education is a strategy to improve nurses' understanding of the prevention of hypothermia in newborns in the hospital. This study aimed to analyze the impact of education about preventing heat loss on nurses' knowledge and behavior in preventing hypothermia in newborns. The study design was a quasi-experiment with one group pre-test-post-test and a total sample of 21 neonatal nurses who were selected using the consecutive sampling method. The results indicated that there was significant difference in nurses' knowledge and behavior pre- and post-education intervention (p < .001; α = .05). This study suggests that education on prevention of heat loss is an effective strategy to promote nurses' knowledge and behavior in preventing hypothermia.

Role-play as an educational tool in medication communication skills: Students' perspectives

Objectives:

Medication communication skills are vital aspects of patient care that may influence treatment outcomes. However, traditional pharmacology curriculum deals with imparting factual information, with little emphasis on patient communication. The current study aims to explore students’ perceptions of role-play as an educational tool in acquiring communication skills and to ascertain the need of role-play for their future clinical practice.

Materials and Methods:

This questionnaire-based study was done in 2^nd professional MBBS students. A consolidated concept of six training cases, focusing on major communication issues related to medication prescription in pharmacology, were developed for peer-role-play sessions for 2^nd professional MBBS (n = 122) students. Structured scripts with specific emphasis on prescription medication communication and checklists for feedback were developed. Prevalidated questionnaires measured the quantitative aspects of role-plays in relation to their relevance as teaching–learning tool, perceived benefits of sessions, and their importance for future use.

Statistical Analysis:

Data analysis was performed using descriptive statistics.

Results:

The role-play concept was well appreciated and considered an effective means for acquiring medication communication skills. The structured feedback by peers and faculty was well received by many. Over 90% of the students reported immense confidence in communicating therapy details, namely, drug name, purpose, mechanism, dosing details, and precautions. Majority reported a better retention of pharmacology concepts and preferred more such sessions.

Conclusions:

Most students consider peer-role-play as an indispensable tool to acquire effective communication skills regarding drug therapy. By virtue of providing experiential learning opportunities and its feasibility of implementation, role-play sessions justify inclusion in undergraduate medical curricula.

E-learning optimization: the relative and combined effects of mental practice and modeling on enhanced podcast-based learning-a randomized controlled trial

Enhanced podcasts increase learning, but evidence is lacking on how they should be designed to optimize their effectiveness. This study assessed the impact two learning instructional design methods (mental practice and modeling), either on their own or in combination, for teaching complex cognitive medical content when incorporated into enhanced podcasts. Sixty-three medical students were randomised to one of four versions of an airway management enhanced podcast: (1) control: narrated presentation; (2) modeling: narration with video demonstration of skills; (3) mental practice: narrated presentation with guided mental practice; (4) combined: modeling and mental practice. One week later, students managed a manikin-based simulated airway crisis. Knowledge acquisition was assessed by baseline and retention multiple-choice quizzes. Two blinded raters assessed all videos obtained from simulated crises to measure the students' skills using a key-elements scale, critical error checklist, and the Ottawa global rating scale (GRS). Baseline knowledge was not different between all four groups (p = 0.65). One week later, knowledge retention was significantly higher for (1) both the mental practice and modeling group than the control group (p = 0.01; p = 0.01, respectively) and (2) the combined mental practice and modeling group compared to all other groups (all ps = 0.01). Regarding skills acquisition, the control group significantly under-performed in comparison to all other groups on the key-events scale (all ps ≤ 0.05), the critical error checklist (all ps ≤ 0.05), and the Ottawa GRS (all ps ≤ 0.05). The combination of mental practice and modeling led to greater improvement on the key events checklist (p = 0.01) compared to either strategy alone. However, the combination of the two strategies did not result in any further learning gains on the two other measures of clinical performance (all ps > 0.05). The effectiveness of enhanced podcasts for knowledge retention and clinical skill acquisition is increased with either mental practice or modeling. The combination of mental practice and modeling had synergistic effects on knowledge retention, but conveyed less clear advantages in its application through clinical skills.

A call for research exploring social media influences on mothers' child feeding practices and childhood obesity risk

There is increasing interest in leveraging social media to prevent childhood obesity, however, the evidence base for how social media currently influences related behaviors and how interventions could be developed for these platforms is lacking. This commentary calls for research on the extent to which mothers use social media to learn about child feeding practices and the mechanisms through which social media influences their child feeding practices. Such formative research could be applied to the development and dissemination of evidence-based childhood obesity prevention programs that utilize social media. Mothers are identified as a uniquely important target audience for social media-based interventions because of their proximal influence on children's eating behavior and their high engagement with social media platforms. Understanding mothers' current behaviors, interests, and needs as they relate to their social media use and child feeding practices is an integral first step in the development of interventions that aim to engage mothers for obesity prevention. This commentary highlights the importance of mothers for childhood obesity prevention; discusses theoretical and analytic frameworks that can inform research on social media and mothers' child feeding practices; provides evidence that social media is an emerging context for social influences on mothers' attitudes and behaviors in which food is a salient topic; and suggests directions for future research.

Observational learning and pain-related fear: exploring contingency learning in an experimental study using colored warm water immersions

This study investigated observational learning of pain-related fear and subsequent extinction after first-hand exposure to the feared stimulus. Moreover, the specific contingencies that are learned when observing others in pain were explored. A differential fear-conditioning paradigm was used, showing video models displaying either a painful (CS+ color; aversively conditioned stimulus) or a neutral (CS- color; neutrally conditioned stimulus) facial expression in the presence of a colored warm water task (WWT; observation phase). In 1 condition (open WWT cover), the model's hand was immersed in the colored liquid, while in the other condition (closed WWT cover), no contact was displayed between the model and the liquid. During exposure, participants subsequently immersed their own hand into each WWT with equal temperatures. Results revealed successful acquisition of pain-related fear. Participants with higher levels of pain catastrophizing, intolerance of uncertainty, trait fear of pain, or dispositional empathy were more prone to develop pain-related fear. Pain-related fear extinguished quickly after direct exposure to both WWTs. Contingencies between the color of the WWT and either the painful facial expressions or the assumed properties of the colored liquid were learned in both conditions. Clinical implications and limitations of the current study are discussed, providing avenues for future research in observational learning of pain-related fear.

PERSPECTIVE

Pain-related fear promotes the development as well as the continuation of chronic pain. A better understanding of the acquisition and extinction of this fear may help to improve pain treatment programs. Furthermore, we intended to identify individuals who are more prone to develop pain-related fear.