Exploring the role of communication in effective nurse leadership and patient care

Nurses have to be aware of their personal responsibility to demonstrate effective leadership and thereby contribute to safe and effective patient care. One of the primary skills that nurses can use to become effective leaders is communication. This article explores how communication is a vital tool in enabling nurse leaders to motivate their team members and advocate for patients. The author details some of the essential communication skills that nurses require if they are to promote person-centred care and explores the often-neglected areas of non-verbal and written communication. By possessing a full range of communication skills, nurses can empower themselves to lead clinical teams and advocate for patients.

How to take a comprehensive patient history

RATIONALE AND KEY POINTS

A significant proportion of diagnoses are made based on history taking, often alongside physical assessments and laboratory investigations. Taking a thorough patient history is fundamental for the accurate diagnosis and effective management of health conditions. This article outlines a step-by-step process for taking a comprehensive patient history and discusses the evidence for this procedure. • History taking is a structured but flexible process of gathering relevant information from patients to inform diagnosis and treatment. • Important communication skills for nurses when history taking include active listening, empathetic communication and cultural sensitivity. • By actively engaging the patient in a conversation about their health issues, the nurse facilitates their participation and autonomy. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when taking a patient history. • How you could use this information to educate nursing students or colleagues on taking a patient history.

Three roots of online toxicity: disembodiment, accountability, and disinhibition

Online communication is central to modern social life, yet it is often linked to toxic manifestations and reduced well-being. How and why online communication enables these toxic social effects remains unanswered. In this opinion, we propose three roots of online toxicity: disembodiment, limited accountability, and disinhibition. We suggest that virtual disembodiment results in a chain of psychological states primed for deleterious social interaction. Drawing from differences between face-to-face and online interactions, the framework highlights and addresses the fundamental problems that result in impaired communication between individuals and explicates its effects on social toxicity online.

Incorporating verbal and nonverbal aspects to enhance a model of patient communication in cancer care: A grounded theory study

PURPOSE

High-quality communication is essential to patient-centered care. Existing communication models and research tends to focus on what is said verbally with little attention to nonverbal aspects of communication. In sensitive and emotionally intensive healthcare encounters, such as in cancer care, provider and patient nonverbal behavior may be particularly important for communicating with empathy. Therefore, the aim of this study was to develop a conceptual model of communication that accounts for nonverbal behavior.

METHODS

We followed a systematic grounded theory design that involved semi-structured interviews with 23 providers, including nurse practitioners, physicians, surgeons, and physician's assistants. Using constant comparative analysis, we analyzed transcripts and developed a grounded theory model of communication accounting for nonverbal behavior.

RESULTS

The major themes included building rapport, gauging how patients will take bad news, ensuring patients' understanding of their conditions, staying honest but hopeful, centering but guiding patient through cancer care, conveying empathy while managing heightened emotions, and ensuring patient understanding. Throughout the process, providers synthesize both verbal and nonverbal information and apply what they learn to future encounters.

CONCLUSIONS

The results extend existing models of patient-centered communication and invite communication intervention and research that incorporates nonverbal behavior. The model contributes an understanding of the full process of communication in clinical encounters.

Strategies for Effective Dentist-Patient Communication: A Literature Review

The effectiveness of high-quality dental care predominantly lies on the communication between dentist and patient. However, little literature has reported the importance of these "soft skills" in dental practice. The aim of this literature review is to explore strategies for effective dentist-patient communication. Dentist-patient communication is a bidirectional process involving the exchange of ideas that should be clear (easy to understand), correct (accurate), concise (to the point), complete (with essential information), and cohesive (well-organized). Effective communication empowers patients with the knowledge required to make an informed decision about their own oral health. It not only improves the dentist's efficiency and boosts patient confidence, but also alleviates patients' dental anxiety and fear, addresses patients' needs and preferences, increases patients' adherence, and enhances patient satisfaction. To enhance dentist-patient communication, dentists should take the patient-centered approach as a premise. The approach comprises understanding patients' illnesses, shared decision-making, and mindful intervention at the patient's own pace. In addition, dentists should use simple, succinct language, proper body posture, gestures, facial expressions, and eye contact when interacting with patients. Dentists should show empathy, encourage questions and feedback, employ visual aids, and give ample time to patients. Nowadays, dentists and their patients use messaging applications in their communication. This form of telecommunication is not only a convenient way of communication but also reduces the costs associated with a dentist visit. In conclusion, effective dentist-patient communication is vital for the success of dental practice. Dentists who prioritize communication and build positive relationships with their patients are more likely to achieve positive outcomes and foster the expansion of their dental practice.

Hear me out: the role of competent and warm vocal tones in risk communication

Risk communication involves conveying potential risks to the audience. It's crucial for shaping behavior and influencing individual well-being. Previous research predominantly focused on verbal and written aspects of risk communication, with less emphasis on nonverbal cues like vocal tone. Addressing this gap, our study explores the impact of competent and warm vocal tones on risk communication across two risky decision-making paradigms, the Balloon Analogue Risk Task (BART) in Study 1 and the Gambling Task in Study 2. Results show that competent and warm vocal tones are more persuasive than neutral tones, and their effectiveness varies in different decision-making scenarios. Additionally, participants' perceived competence and warmth of vocal tones mediate this persuasiveness. This study enhances our theoretical understanding of risk communication by incorporating the impact of vocal tones. Also, it carries practical implications for marketers and practitioners, demonstrating the importance of using voice as a medium to persuade in real-world scenarios.

Congenital Anosmia and Facial Emotion Recognition

Major functions of the olfactory system include guiding ingestion and avoidance of environmental hazards. People with anosmia report reliance on others, for example to check the edibility of food, as their primary coping strategy. Facial expressions are a major source of non-verbal social information that can be used to guide approach and avoidance behaviour. Thus, it is of interest to explore whether a life-long absence of the sense of smell heightens sensitivity to others' facial emotions, particularly those depicting threat. In the present, online study 28 people with congenital anosmia (mean age 43.46) and 24 people reporting no olfactory dysfunction (mean age 42.75) completed a facial emotion recognition task whereby emotionally neutral faces (6 different identities) morphed, over 40 stages, to express one of 5 basic emotions: anger, disgust, fear, happiness, or sadness. Results showed that, while the groups did not differ in their ability to identify the final, full-strength emotional expressions, nor in the accuracy of their first response, the congenital anosmia group successfully identified the emotions at significantly lower intensity (i.e. an earlier stage of the morph) than the control group. Exploratory analysis showed this main effect was primarily driven by an advantage in detecting anger and disgust. These findings indicate the absence of a functioning sense of smell during development leads to compensatory changes in visual, social cognition. Future work should explore the neural and behavioural basis for this advantage.

"They must have seen it, you know." Body talk, extension talk, and action talk: A qualitative study on how palliative care patients and their significant others express experiencing these nonverbal cues

Communication about life-threatening disease and palliative care is essential but often experienced as difficult by those concerned and has mainly been studied in terms of its verbal components. Despite the fundamentality of nonverbal communication, its dimensions in care, especially in the communication by patients and their significant others, has not been as extensively examined. Drawing on a secondary qualitative content analysis of data from 23 interviews-15 with patients in specialized palliative home care in Sweden and 8 with their significant others-this study aims at understanding and characterizing how patients verbally express experiences of conveying nonverbal cues about life-threatening disease and its consequences and how their significant others express perceiving these cues. Patients expressed experiences of nonverbal communication in the form of cues conveying meaning about their disease and its consequences, often beyond their control. Whether and how the patients reinforced these cues verbally, depended on individual needs, care for others, and evaluations of relationships. Significant others acknowledged the presence of nonverbal cues and tried to interpret their meaning. Both patients and significant others emphasized the importance of nonverbal cues and actively related to how cues in the form of bodily appearance, aids, objects and acts, serve communicative functions about disease and its consequences. These dimensions of nonverbal communication are characterized as: body talk, extension talk and action talk. This study contributes to an international knowledge base on the complexities of nonverbal communicative aspects in these dimensions and how it affects patients and significant others. Professionals should be aware that dimensions of care, such as prescribed aids, from the patients' perspective can be perceived as nonverbal cues that might "speak of" disease progression.

Brief Report: Quantifying Speech Production Coordination from Non- and Minimally-Speaking Individuals

PURPOSE

Non-verbal utterances are an important tool of communication for individuals who are non- or minimally-speaking. While these utterances are typically understood by caregivers, they can be challenging to interpret by their larger community. To date, there has been little work done to detect and characterize the vocalizations produced by non- or minimally-speaking individuals. This paper aims to characterize five categories of utterances across a set of 7 non- or minimally-speaking individuals.

METHODS

The characterization is accomplished using a correlation structure methodology, acting as a proxy measurement for motor coordination, to localize similarities and differences to specific speech production systems.

RESULTS

We specifically find that frustrated and dysregulated utterances show similar correlation structure outputs, especially when compared to self-talk, request, and delighted utterances. We additionally witness higher complexity of coordination between articulatory and respiratory subsystems and lower complexity of coordination between laryngeal and respiratory subsystems in frustration and dysregulation as compared to self-talk, request, and delight. Finally, we observe lower complexity of coordination across all three speech subsystems in the request utterances as compared to self-talk and delight.

CONCLUSION

The insights from this work aid in understanding of the modifications made by non- or minimally-speaking individuals to accomplish specific goals in non-verbal communication.

Quality of asynchronous webchats vs in-person consultations for postpartum depression in China: a cross-sectional, mixed methods study using standardized patients

Background

Prompt professional care for postpartum depression (PPD) is difficult to obtain in China. Though online consultations improve accessibility and reduce stigma, the quality of services compared to in-person consultations is unclear.

Methods

Five trained, undisclosed "standardized patients" (SPs) made "asynchronous webchats" visits and in-person visits with psychiatrists. Visits were made to 85 psychiatrists who were based in 69 hospitals in ten provincial capital cities. The care between online and in-person consultations with the same psychiatrist was compared, including diagnosis, guideline adherence, and patient-centeredness. False discovery rate (FDR) was used to adjust p values. Third visits using asynchronous webchats were made to psychiatrists who offered discrepant diagnoses. Thematic content analysis was used for the discrepancies.

Findings

The proportion of diagnostic accuracy was lower for online than in-person visits (76.5% [65/85] vs 91.8% [78/85]; pFDR = 0.0066), as were the proportions of completing questions involving clinical history (16.6% vs 42.7%; pFDR < 0.0001), and management decisions (16.2% vs 27.5%; pFDR < 0.0001) consistent with recommended guidelines. Patient-centeredness was lower online than in-person (pFDR < 0.0001). Fifteen of 16 psychiatrists completed third visits, most of them considered lack of nonverbal information online as a key barrier.

Interpretation

Online consultations using asynchronous webchats were inferior to in-person consultations, with respect to diagnostic accuracy, adherence to recommended clinical guidelines, and patient-centeredness. To fully realise the potential benefits of online consultations and to prevent safety issues, there is an urgent need for major improvement in the quality and oversight of these consultations.

Funding

China Medical Board, National Natural Science Foundation of China, and Swiss Agency for Development and Cooperation Global Cooperation Department.

Virtually simulated interpersonal touch negatively affects perceived closeness and social affiliation to an avatar partner

Interpersonal touch is an essential component of human non-verbal communication, facilitating social affiliation and bonding. With the widespread use of digital interfaces and online platforms in all realms of human interactions, there are fewer opportunities for communicating through touch. Popular online platforms that virtually simulate human interactions rely primarily on visual and auditory modalities, providing limited or no capacity for the exchange of tactile cues. Previous studies of virtual interactions have explored the simulation of social touch using haptic devices, but little is known about how the visual representation of interpersonal touch is perceived and integrated into a virtual social experience. In two studies we examined how the exchange of virtual touch mediated by simulated 3-dimensional human characters, or avatars, within an online virtual environment influenced affiliation towards an unfamiliar interaction partner. Surprisingly, the exchange of virtual touch negatively affected the perceived closeness and affiliation to the partner and the social evaluation of the interaction but did not affect the level of physiological arousal during the interaction. These results indicate that the visual representation of social touch is sufficient to virtually communicate touch-related cues that impact social affiliation, but the influence of touch may be dependent on the interaction context.

Space-time mapping relationships in sensorimotor communication during asymmetric joint action

Background

Sensorimotor communication is frequently observed in complex joint actions and social interactions. However, it remains challenging to explore the cognitive foundations behind sensorimotor communication.

Methods

The present study extends previous research by introducing a single-person baseline condition and formulates two distinct categories of asymmetric joint action tasks: distance tasks and orientation tasks. This research investigates the action performance of 65 participants under various experimental conditions utilizing a 2 (cooperative intention: Coop, No-coop) × 2 (task characteristic: distance, orientation) × 4 (target: T1, T2, T3, T4) repeated-measures experimental design to investigate the cognitive mechanisms underlying sensorimotor communication between individuals.

Results

The results showed that (1) target key dwell time, motion time, total motion time, and maximum motion height in the Coop condition are more than in the No-coop condition. (2) In the distance task without cooperative intention, the dwell time of T4 is smaller than T1, T2, T3, and its variability of T1, T2, T3, and T4 were no different. In the distance task with cooperative intention, the dwell time and its variability of T1, T2, T3, and T4 displayed an increasing trend. (3) In the orientation task without cooperative intention, the dwell time of T1 is smaller than T2, T3, T4, and variability of the target keys T1, T2, T3, and T4 had no difference. In the orientation task with cooperative intention, the dwell time and variability of the target keys T1, T2, T3, and T4 had increasing trends.

Conclusions

Those findings underscore the importance of cooperative intention for sensorimotor communication. In the distance task with cooperative intention, message senders establish a mapping relationship characterized by "near-small, far-large" between the task distance and the individual's action characteristics through sensorimotor experience. In the orientation task with cooperative intention, message senders combined sensorimotor experience and verbal metaphors to establish a mapping relationship between task orientation and action characteristics, following the sequence of "left-up, right-up, left-down, right-down" to transmit the message to others.

Breastfeeding experience of postnatal mothers separated from preterm infants after discharge: a phenomenology qualitative approach

BACKGROUND

Breastfeeding practices are influenced by the maternal-infant bond relationship. Mothers of preterm infants in the puerperium face many challenges and support is needed to maintain breastfeeding after hospital discharge. This study explored the breastfeeding experiences among mothers of preterm infants and challenges that influenced their breastfeeding practices.

METHODS

A qualitative phenomenological approach was used involving the mothers of preterm infants during the puerperium in Shanghai who fulfilled the inclusion criteria and consented to participate in the study. The mothers were recruited using purposive sampling. Eighteen participants were interviewed using semi-structured in-depth interviews. All interviews were recorded in digital audio, transcribed verbatim, and analyzed using thematic analysis.

FINDINGS

The breastfeeding experience among mothers of preterm infants included four themes: breastfeeding motivation, breastfeeding challenges, breastfeeding support and education, and response to parental stress. Breastfeeding challenges included perceived insufficient milk, bottle preference, and maternal-infant separation. Two sub-themes of breastfeeding support included breastfeeding knowledge and approach.

CONCLUSION

To overcome breastfeeding challenges and improve the breastfeeding rate of preterm infants after discharge, medical professionals must develop individualized breastfeeding plans based on a comprehensive assessment of the needs of mothers who delivered a preterm infant.

Parent-Child Communication Incongruence in Pediatric Healthcare

Parents play a key role in providing children with health-related information and emotional support. This communication occurs both in their homes and in pediatric healthcare environments, such as hospitals, outpatient clinics, and primary care offices. Often, this occurs within situations entailing heightened stress for both the parent and the child. There is considerable research within the communication literature regarding the nature of both verbal and nonverbal communication, along with the way in which these communication modalities are either similar (i.e., congruent) or dissimilar (i.e., incongruent) to one another. However, less is known about communication congruency/incongruency, specifically in parent-child relationships, or within healthcare environments. In this narrative review, we explore the concept of verbal and nonverbal communication incongruence, specifically within the context of parent-child communication in a pediatric healthcare setting. We present an overview of verbal and nonverbal communication and propose the Communication Incongruence Model to encapsulate how verbal and nonverbal communication streams are used and synthesized by parents and children. We discuss the nature and possible reasons for parental communication incongruence within pediatric settings, along with the consequences of incongruent communication. Finally, we suggest a number of hypotheses derived from the model that can be tested empirically and used to guide future research directions and influence potential clinical applications.

AI Hyperrealism: Why AI Faces Are Perceived as More Real Than Human Ones

Recent evidence shows that AI-generated faces are now indistinguishable from human faces. However, algorithms are trained disproportionately on White faces, and thus White AI faces may appear especially realistic. In Experiment 1 (N = 124 adults), alongside our reanalysis of previously published data, we showed that White AI faces are judged as human more often than actual human faces-a phenomenon we term AI hyperrealism. Paradoxically, people who made the most errors in this task were the most confident (a Dunning-Kruger effect). In Experiment 2 (N = 610 adults), we used face-space theory and participant qualitative reports to identify key facial attributes that distinguish AI from human faces but were misinterpreted by participants, leading to AI hyperrealism. However, the attributes permitted high accuracy using machine learning. These findings illustrate how psychological theory can inform understanding of AI outputs and provide direction for debiasing AI algorithms, thereby promoting the ethical use of AI.

Connecting cues: The role of nonverbal cues in perceived responsiveness

Nonverbal cues powerfully shape interpersonal experiences with close others; yet, there has been minimal cross-fertilization between the nonverbal behavior and close relationships literatures. Using examples of responsive nonverbal behavior conveyed across vocal, tactile, facial, and bodily channels of communication, we illustrate the utility of assessing and isolating their effects to differentiate the contributions of verbal and nonverbal displays of listening and responsiveness to relationship outcomes. We offer suggestions for methodological approaches to better capture responsive behavior across verbal and nonverbal channels, and discuss theoretical and practical implications of carrying out this work to better clarify what makes people feel understood, validated, listened to, and cared for.

Role of Emotion Reactivity to Predict Facial Emotion Recognition Changes with Aging

Emotional intelligence includes an assortment of factors related to emotion function. Such factors involve emotion recognition (in this case via facial expression), emotion trait, reactivity, and regulation. We aimed to investigate how the subjective appraisals of emotional intelligence (i.e. trait, reactivity, and regulation) are associated with objective emotion recognition accuracy, and how these associations differ between young and older adults. Data were extracted from the CamCAN dataset (189 adults: 57 young/118 older) from assessments measuring these emotion constructs. Using linear regression models, we found that greater negative reactivity was associated with better emotion recognition accuracy among older adults, though the pattern was opposite for young adults with the greatest difference in disgust and surprise recognition. Positive reactivity and depression level predicted surprise recognition, with the associations significantly differing between the age groups. The present findings suggest the level to which older and young adults react to emotional stimuli differentially predicts their ability to correctly identify facial emotion expressions. Older adults with higher negative reactivity may be able to integrate their negative emotions effectively in order to recognize other's negative emotions more accurately. Alternatively, young adults may experience interference from negative reactivity, lowering their ability to recognize other's negative emotions.

Head movement and its relation to hearing

Head position at any point in time plays a fundamental role in shaping the auditory information that reaches a listener, information that continuously changes as the head moves and reorients to different listening situations. The connection between hearing science and the kinesthetics of head movement has gained interest due to technological advances that have increased the feasibility of providing behavioral and biological feedback to assistive listening devices that can interpret movement patterns that reflect listening intent. Increasing evidence also shows that the negative impact of hearing deficits on mobility, gait, and balance may be mitigated by prosthetic hearing device intervention. Better understanding of the relationships between head movement, full body kinetics, and hearing health, should lead to improved signal processing strategies across a range of assistive and augmented hearing devices. The purpose of this review is to introduce the wider hearing community to the kinesiology of head movement and to place it in the context of hearing and communication with the goal of expanding the field of ecologically-specific listener behavior.

From criminal interrogations to investigative interviews: a bibliometric study

This paper presents the results of a bibliometric study providing a comprehensive overview of the social science research conducted on criminal interrogations and investigative interviews since the 1900s. The objectives are to help researchers to further understand the research field, to better communicate research findings to practitioners, to help practitioners understand the breadth of scientific knowledge on criminal interrogations and investigative interviews, and to foster dialog between researchers and practitioners. To begin, after a brief description of Web of Science, we describe how we developed our database on criminal interrogations and investigative interviews. Then, we report the yearly evolution of articles, the journals where they were published, the research areas covered by this research field, as well as the authors, the institutions and the countries that published the most on a variety of topics related to criminal interrogations and investigative interviews. Finally, we present the most used keywords and the most cited articles, and examine the research on questionable tactics and techniques in the research field of criminal interrogations and investigative interviews. This paper ends with a critical look at the results, for the benefit of researchers and practitioners interested in criminal interrogations and investigative interviews.

Head motion synchrony in unidirectional and bidirectional verbal communication

Interpersonal communication includes verbal and nonverbal communication. Verbal communication comprises one-way (e.g., a speech or lecture) and interactive verbal communication (e.g., daily conversations or meetings), which we frequently encounter. Nonverbal communication has considerable influence on interpersonal communication, and body motion synchrony is known to be an important factor for successful communication and social interaction. However, most research on body motion synchrony has been elucidated by either the setting of one-way verbal transmission or the verbal interaction setting, and it remains unclear whether verbal directionality and interactivity affect body motion synchrony. One-way and two-way (interactive) verbal communication is implicated in designed or undesigned leader-follower relationships, and also in the complexity and diversity of interpersonal interactions, where two-way verbal communication is more complex and diverse than in the one-way condition. In this study, we tested head motion synchrony between the one-way verbal communication condition (in which the roles of the speaker and listener are fixed) and the two-way verbal communication condition (where the speaker and listener can freely engage in a conversation). Therefore, although no statistically significant difference in synchrony activity (relative frequency) was found, a statistically significant difference was observed in synchrony direction (temporal lead-lag structure as mimicry) and intensity. Specifically, the synchrony direction in two-way verbal communication was close to zero, but this in one-way verbal communication was synchronized with the listener's movement predominantly delayed. Furthermore, synchrony intensity, in terms of the degree of variation in the phase difference distribution, was significantly higher in the one-way verbal communication than in the two-way condition, with bigger time-shifts being observed in the latter. This result suggests that verbal interaction does not affect the overall frequency of head motion synchrony but does affect the temporal lead-lag structure and coherence.

"Reading" the room: healthcare chaplains' challenges, insights and variations in entering rooms and engaging with patients and families

Recent research has described broad types of healthcare chaplains' activities, but many questions remain about how these professionals perform these tasks, whether variations occur, and if so, in what ways. Twenty-three chaplains were interviewed in-depth. Chaplains described engaging in highly dynamic processes, involving both verbal and non-verbal interactions. They face challenges and vary in ways of starting interactions, using verbal and non-verbal cues, and communicating through physical appearance. In these processes, when entering patients' rooms, they seek to "read the room," follow patients' leads, look for cues, match the energy/mood in the room, and adjust their body language appropriately, while maintaining open-ended stances. They face choices of what, if anything, to communicate through clothing (e.g., wearing clerical collars or crosses) and can confront additional challenges with members of groups different than their own, at times requiring further sensitivity. These data, the first to examine challenges chaplains confront entering patients' rooms and engaging in non-verbal communication, can enhance understandings of these issues, and help chaplains and other healthcare professionals provide more sensitive and astute context-based care. These findings thus have critical implications for education, practice, and research concerning chaplains and other providers.

The use of nonverbal communication when assessing witness credibility: a view from the bench

The aim of this article is to provide a better understanding of how, in practice, judges use nonverbal communication during bench trials. The article starts with an overview of legal rules on how judges are supposed to assess witness credibility and use nonverbal communication, and briefly addresses the impact of those rules on lower courts and the limited data about judges in bench trials. Subsequently, we present the methods and the results from an online survey carried out with Quebec judges. While a number of judges have beliefs consistent with the scientific literature, findings reported in this article show that many judges have beliefs inconsistent with the scientific literature, and many are silent on culture-related differences in nonverbal behavior. The article ends with a discussion on the implications of the results for scholars and practitioners, including why findings reported in this article are cause for concern for adversarial justice systems.

General figure and face-specific closure ability: predictors of trait-autism?

Little research has examined the association between general figure closure speed, a stratum I ability within the Cattell-Horn-Carroll (CHC) model of intelligence, and face-specific closure ability; an important consideration, as some research suggests face processing is independent of other abilities. Additionally, figure closure ability (general and face) may correlate negatively with trait-autism, due to theorised autism-related difficulties in global processing. Therefore, in addition to developing a psychometrically robust short-form Mooney face detection task, we administered the Gestalt Figure Completion Test and the Autism Spectrum Quotient to a sample of 263 general community adults. We found convergent validity between face-specific and general figure closure ability (r = .44, 95%CI:[.30, .58]). Furthermore, based on a latent variable model, general figure closure ability was directly, and face-specific figure closure ability indirectly, negatively associated with trait-autism (i.e., nonverbal communication). We conclude that face detection ability evidences convergent validity with general figure closure ability and can be measured reliably in less than four minutes. Finally, a general, rather than face-specific, figure closure process may tap more directly into autism-like nonverbal communication ability, supporting the notion that global processing abilities of non-face objects may better reflect the requirements to ‘fill in the gaps’ in social contexts.

The effect of orthodontic treatment on smile attractiveness: a systematic review

BACKGROUND

Smile attractiveness is a primary factor for patients to seek orthodontic treatment, however, there is yet no systematic evaluation of this topic in the literature.

OBJECTIVES

To assess the current evidence on the effect of orthodontic treatment on smile attractiveness.

SEARCH METHODS

Seven electronic databases (MEDLINE, Cochrane Library, Virtual Health Library, SCOPUS, Web of Science, Google Scholar and Embase) were searched on 14 September 2022.

SELECTION CRITERIA

Studies evaluating smile attractiveness before and after orthodontic treatment or only after completion of orthodontic treatment.

DATA COLLECTION AND ANALYSIS

Extracted data included study design and setting, sample size and demographics, malocclusion type, treatment modality and method for outcome assessment. Risk of bias was assessed with the ROBINS-I tool for non-randomised studies. Random-effects meta-analyses of mean differences and their 95% confidence intervals (CIs) were planned a priori.

METHODS

After elimination of duplicate studies, data extraction and risk of bias assessment according to the Cochrane guidelines, an evaluation of the overall evidence was performed. The included studies were evaluated based on the characteristics of their study and control groups and based on their main research question. Also, all outcome measures were standardized into a common assessment scale (0-100), in order to obtain more easily interpretable results.

RESULTS

Ten studies were included in this review, nine of which were assessed as being at serious risk of bias and one at moderate risk of bias. The large heterogeneity between the included studies did not allow for a meta-analysis. Orthodontic treatment has a moderately positive effect on smile attractiveness. When compared to no treatment, orthodontic treatment with premolar extractions improves smile attractiveness by 22%. Also, surgical correction of Class III cases increases smile attractiveness by 7.5% more than camouflage treatment. No other significant differences were shown between different types of treatment.

CONCLUSION

Based on the available data, orthodontic treatment seems to moderately improve the attractiveness of the smile. There is significant bias in the current literature assessing the effect of orthodontics on smile attractiveness; therefore, the results cannot be accepted with certainty.

Emotion in Organizations: Theory and Research

The workplace elicits a wide range of emotions and, likewise, emotions change our experience of the workplace. This article reviews the scientific field of emotion in organizations, drawing from classic theories and cutting-edge advances to integrate a disparate body of research. The review is organized around the definition of emotion as an unfolding sequence of processes: We interpret the world around us for its subjective meaning, which results in emotional experience. Emotional experience, in turn, has consequences for behaviors, attitudes, and cognition. Emotional experience also elicits expressive cues that can be recognized by others. Each process in the emotion sequence can be regulated. Processes can also iterate until emotion is shared throughout workgroups and even entire organizations. A distinct body of organizationally relevant research exists for each process, and emotional intelligence refers to effectiveness across all. Differences across culture and gender, future research directions, and practical implications are discussed.

Person-attuned musical interactions (PAMI) in dementia care. Complex intervention research for constructing a training manual

Introduction

Music is of vital importance for cognition, human care, and the formation of social communities throughout life. Dementia is a neurocognitive disorder that affects cognitive domains, and in late-stage dementia, care is needed in all aspects of daily living. Within residential care home contexts, carers play a significant role for the "caring culture" but often lack professional training in verbal and non-verbal communication skills. Thus, there is a need for training carers to respond to the multidimensional needs of persons with dementia. Music therapists use musical interactions but are not trained to train carers. Therefore, our aim was to explore person-attuned musical interactions (PAMI), and additionally, to develop and evaluate a training manual to be used by music therapists when supporting and training carers in non-verbal communication with persons with late-stage dementia in residential care home contexts.

Research process

With a realist perspective and systems thinking and within the framework for complex intervention research, the research group integrated several overlapping subprojects by applying a non-linear and iterative research process. Core elements related to person-centered dementia care as well as learning objectives were considered through the following four phases; Developing, Feasibility, Evaluation, and Implementation.

Results

The result was a training manual for qualified music therapists to use when teaching and collaborating with carers about how to implement PAMI in dementia care. The manual included comprehensive resources, a clear structure for training, defined learning objectives, and integration of theory.

Discussion

With increased knowledge about caring values and non-verbal communication, residential care home cultures may develop carer competencies and provide professional attuned care for persons with dementia. Further piloting and testing to examine the general effect on caring cultures is needed.

Technologically-assisted communication attenuates inter-brain synchrony

The transition to technologically-assisted communication has permeated all facets of human social life; yet, its impact on the social brain is still unknown and the effects may be particularly intense during periods of developmental transitions. Applying a two-brain perspective, the current preregistered study utilized hyperscanning EEG to measure brain-to-brain synchrony in 62 mother-child pairs at the transition to adolescence (child age; M = 12.26, range 10-14) during live face-to-face interaction versus technologically-assisted remote communication. The live interaction elicited 9 significant cross-brain links between densely inter-connected frontal and temporal areas in the beta range [14-30 Hz]. Mother's right frontal region connected with the child's right and left frontal, temporal, and central regions, suggesting its regulatory role in organizing the two-brain dynamics. In contrast, the remote interaction elicited only 1 significant cross-brain-cross-hemisphere link, attenuating the robust right-to-right-brain connectivity during live social moments that communicates socio-affective signals. Furthermore, while the level of social behavior was comparable between the two interactions, brain-behavior associations emerged only during the live exchange. Mother-child right temporal-temporal synchrony linked with moments of shared gaze and the degree of child engagement and empathic behavior correlated with right frontal-frontal synchrony. Our findings indicate that human co-presence is underpinned by specific neurobiological processes that should be studied in depth. Much further research is needed to tease apart whether the "Zoom fatigue" experienced during technological communication may stem, in part, from overload on more limited inter-brain connections and to address the potential cost of social technology for brain maturation, particularly among youth.

Quantitative Head Dynamics Associated with Interpersonal (Grandiose-Manipulative) Psychopathic Traits in Incarcerated Youth

Clinicians have long noted that individuals with elevated psychopathic traits can be characterized by unique interpersonal styles, including prolonged eye contact, invasion of interpersonal space, and frequent use of hand gestures. Such forms of nonverbal communication can be measured via hand, body, and head position and dynamics. Previous studies have developed an automated algorithm designed to capture head position and dynamics from digital recordings of clinical interviews in a sample of incarcerated adult men. We observed that higher psychopathy scores were associated with stationary head dwell time. Here, we applied a similar automated algorithm to assess head position and dynamics on videotaped clinical interviews assessing psychopathic traits from n = 242 youth housed at a maximum-security juvenile correctional facility. We observed that higher psychopathy scores (assessed via the Hare Psychopathy Checklist: Youth Version [PCL:YV]) were associated with unique patterns of head dynamics. Specifically, PCL:YV Total, Factor 1 (measuring grandiose-manipulative and callous-unemotional traits), and Facet 1 (measuring grandiose-manipulative traits) scores were associated with a higher proportion of time spent in a head dynamics pattern consisting of moderate movement away from the average head position. This study lays the groundwork for future investigations to apply quantitative methods to better understand patterns of nonverbal communication styles in clinical populations characterized by severe antisocial behavior.

Darwin's illegitimate children: How body language experts undermine Darwin's legacy

The Expression of the Emotions in Man and Animals has received and continues to receive much attention from emotion researchers and behavioural scientists. However, the common misconception that Darwin advocated for the universality of emotional reactions has led to a host of unfounded and discredited claims promoted by 'body language experts' on both traditional and social media. These 'experts' receive unparalleled public attention. Thus, rather than being presented with empirically supported findings on non-verbal behaviour, the public is exposed to 'body language analysis' of celebrities, politicians and defendants in criminal trials. In this perspective piece, we address the misinformation surrounding non-verbal behaviour. We also discuss the nature and scope of statements from body language experts, unpacking the claims of the most viewed YouTube video by a body language expert, comparing these claims with actual research findings, and giving specific attention to the implications for the justice system. We explain how body language experts use (and misuse) Darwin's legacy and conclude with a call for researchers to unite their voices and work towards stopping the spread of misinformation about non-verbal behaviour.

A Model for Effective Nonverbal Communication between Nurses and Older Patients: A Grounded Theory Inquiry

Nonverbal communication is an inevitable art to be effectively mastered by nurses. Nurse nonverbal communication has many benefits when it is effective. For instance, nonverbal communication is important to convey affective and emotional information, and demonstrate respect for and build therapeutic relationships with older patients. As the older population is growing fast worldwide, effective nonverbal communication with older patients is an essential skill for nurses and will improve patients' satisfaction and the quality of care. Therefore, this article presents a model to guide effective nonverbal communication between nurses and older patients. A Grounded Theory approach guided the study. Data were collected between July 2018 and January 2020 through overt participant observations and individual interviews. Purposive and theoretical sampling were used to select 13 clinically experienced nurses, 4 nursing students, and 8 older adults. Data analysis encompassed open coding, axial coding, and selective coding. The results showed that effective nonverbal communication emerged as the co-phenomenon hinged within context and/or environment and is influenced by certain factors. This model, which is in support of person-centered communication and care, advocates for effective nonverbal communication between nurses and older patients.

Effect of teleconferencing variables on faculty impression of mock residency applicants

Purpose

The objective of this study was to assess how teleconferencing variables influence faculty impressions of mock residency applicants.

Methods

In October 2020, we conducted an online experiment studying five teleconferencing variables: background, lighting, eye contact, internet connectivity, and audio quality. We created interview videos of three mock residency applicants and systematically modified variables in control and intervention conditions. Faculty viewed the videos and rated their immediate impression on a 1-10 scale. The effect of each variable was measured as the mean difference between the intervention and control impression ratings. One-way analysis of variance (ANOVA) was performed to assess whether ratings varied across applicants. Paired-samples Wilcoxon signed-rank tests were conducted to assess the significance of the effect of each variable.

Results

Of 711 faculty members who were emailed a link to the experiment, 97 participated (13.6%). The mean ratings for control videos were 8.1, 7.2, and 7.6 (P < .01). Videos with backlighting, off-center eye contact, choppy internet connectivity, or muffled audio quality had lower ratings when compared with control videos (P < .01). There was no rating difference between home and conference room backgrounds (P = .77). Many faculty participants reported that their immediate impressions were very much or extremely influenced by audio quality (60%), eye contact (57%), and internet connectivity (49%).

Conclusions

Teleconferencing variables may serve as a source of assessment bias during residency interviews. Mock residency applicants received significantly lower ratings when they had off-center eye contact, muffled audio, or choppy internet connectivity, compared to optimal teleconferencing conditions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44186-022-00053-w.

Compositionality in Different Modalities: A View from Usage-Based Linguistics

The field of linguistics concerns itself with understanding the human capacity for language. Compositionality is a key notion in this research tradition. Compositionality refers to the notion that the meaning of a complex linguistic unit is a function of the meanings of its constituent parts. However, the question as to whether compositionality is a defining feature of human language is a matter of debate: usage-based and constructionist approaches emphasize the pervasive role of idiomaticity in language, and argue that strict compositionality is the exception rather than the rule. We review the major discussion points on compositionality from a usage-based point of view, taking both spoken and signed languages into account. In addition, we discuss theories that aim at accounting for the emergence of compositional language through processes of cultural transmission as well as the debate of whether animal communication systems exhibit compositionality. We argue for a view that emphasizes the analyzability of complex linguistic units, providing a template for accounting for the multimodal nature of human language.

Visualizing Collaboration in Teamwork: A Multimodal Learning Analytics Platform for Non-Verbal Communication

Developing communication skills in collaborative contexts is of special interest for educational institutions, since these skills are crucial to forming competent professionals for today’s world. New and accessible technologies open a way to analyze collaborative activities in face-to-face and non-face-to-face situations, where collaboration and student attitudes are difficult to measure using traditional methods. In this context, Multimodal Learning Analytics (MMLA) appear as an alternative to complement the evaluation and feedback of core skills. We present a MMLA platform to support collaboration assessment based on the capture and classification of non-verbal communication interactions. The developed platform integrates hardware and software, including machine learning techniques, to detect spoken interactions and body postures from video and audio recordings. The captured data is presented in a set of visualizations, designed to help teachers to obtain insights about the collaboration of a team. We performed a case study to explore if the visualizations were useful to represent different behavioral indicators of collaboration in different teamwork situations: a collaborative situation and a competitive situation. We discussed the results of the case study in a focus group with three teachers, to get insights in the usefulness of our proposal. The results show that the measurements and visualizations are helpful to understand differences in collaboration, confirming the feasibility the MMLA approach for assessing and providing collaboration insights based on non-verbal communication.

Neural Correlates of Variation in Personal Space and Social Functioning in Schizophrenia and Healthy Individuals

BACKGROUND

Changes in the regulation of interpersonal distance, or "personal space" (PS), have been repeatedly observed in schizophrenia and, in some studies, linked to negative symptoms. However, the neurobiological basis of these impairments is poorly understood.

METHODS

Personal space measurements, functional connectivity of a brain network sensitive to intrusions into PS, and symptoms of social withdrawal and anhedonia were assessed, and associations among these outcomes measured, in 33 individuals with a psychotic disorder (primarily schizophrenia [SCZ]) and 36 control subjects (CON).

RESULTS

Personal space size was significantly higher (P = .002) and PS permeability (reflecting the capacity to tolerate intrusions into PS) was significantly lower (P = .021) in the SCZ relative to the CON group, and both measures were significantly correlated with social anhedonia and withdrawal in the full sample (all P < .007). Moreover, functional connectivity between the PS and default mode (DM) networks was significantly correlated with the permeability, but not the size, of PS in the full sample and in the SCZ and CON groups separately, and with social withdrawal in the SCZ group. Lastly, the association between PS-DM network connectivity and social withdrawal in the SCZ group was fully mediated by PS permeability.

DISCUSSION

Neural and behavioral aspects of PS regulation are linked to social motivation in both healthy individuals and those with psychotic disorders, suggesting that measurements of PS could serve as transdiagnostic markers of social functioning.

Conditions Influencing Effective Nurse Nonverbal Communication With Hospitalized Older Adults in Cameroon

Effective communication between nurses and patients is an important factor to quality nursing care but ineffective nonverbal communication could take a toll on health care. Therefore, understanding the factors that influence nonverbal communication between nurses and hospitalized older adults could help solve communication problems, thus improve nursing care. A sample of 13 nurses and 4 student nurses from two hospitals in Cameroon participated in the study. Data were collected using participant observations and semi-structured interviews, and analyzed using open coding and constant comparative analysis. Three categories were identified as influencing factors: nurse views of hospitalized older adults, hospitalized older adult-related factors, and nurse intrinsic factors. Effective nurses’ nonverbal communication with hospitalized older adults relies mostly on nurses’ intrinsic factors. Identification and nurturing of the positive nurse intrinsic factors are important to develop effective nonverbal communication skills among nurses.

It Happened to a Friend of Mine: The Influence of Perspective-taking on the Acknowledgment of Sexual Assault Following Ambiguous Sexual Encounters

Failure to acknowledge that one has been the victim of sexual violence is an important, yet understudied, barrier that prevents women from seeking appropriate support following sexual violence. Drawing from a literature of demonstrating the benefits of self-distancing when evaluating emotionally charged personal information, the effects of self-distancing on acknowledgment of sexual assault were tested. Four experimental studies (N_total = 1,609) manipulated perspective-taking, either by asking women to imagine a series of hypothetical sexual encounters as experiences that happened to themselves or to their friends, or by asking women to describe a sexual experience from a first- or third-person perspective. Findings from the studies suggest that taking another person's perspective can help women to label ambiguous sexual experiences as more inappropriate and coercive. Notably, this did not seem to stem from women downplaying or dismissing experiences when they imagined themselves, as they reported anticipating more negative and less positive emotions in the scenarios where they imagined themselves compared to a friend. Nonetheless, in spite of the stronger anticipated negative emotional response when imagining themselves, women were less open to information about resources associated with sexual assault and support when they imagined themselves compared to a friend. This pattern of findings replicated for own, past sexual experiences but only to the extent that women spontaneously engaged in distanced perspective-taking themselves. This research suggests in addition to using contextual information to disambiguate and determine whether a sexual experience was inappropriate, taking a distanced perspective might provide a route through which women can come to terms with the experience and open up to the use of community-based services and sexual assault resources.

Power-Posing Robots: The Influence of a Humanoid Robot’s Posture and Size on its Perceived Dominance, Competence, Eeriness, and Threat

When interacting with sophisticated digital technologies, people often fall back on the same interaction scripts they apply to the communication with other humans—especially if the technology in question provides strong anthropomorphic cues (e.g., a human-like embodiment). Accordingly, research indicates that observers tend to interpret the body language of social robots in the same way as they would with another human being. Backed by initial evidence, we assumed that a humanoid robot will be considered as more dominant and competent, but also as more eerie and threatening once it strikes a so-called power pose. Moreover, we pursued the research question whether these effects might be accentuated by the robot’s body size. To this end, the current study presented 204 participants with pictures of the robot NAO in different poses (expansive vs. constrictive), while also manipulating its height (child-sized vs. adult-sized). Our results show that NAO’s posture indeed exerted strong effects on perceptions of dominance and competence. Conversely, participants’ threat and eeriness ratings remained statistically independent of the robot’s depicted body language. Further, we found that the machine’s size did not affect any of the measured interpersonal perceptions in a notable way. The study findings are discussed considering limitations and future research directions.

Older Adults’ Interpretation of Nurses’ Nonverbal Communication in Cameroon: A Grounded Theory Inquiry

Communication is central to nursing care. Yet, the nonverbal aspect of communication tends to be neglected or underestimated in nursing studies. Research has shown that older patients interpret nurses’ communication messages during the clinical encounter. This article conceptualizes older adults’ interpretation of and need for nonverbal communication (NVC) to enhance patient-centered communication advocated by the World Health Organization. The Corbin and Strauss (2015) inductive Grounded Theory approach was used to collect data from 3 hospital units in Cameroon using in-depth interviews with eight older adults, thirteen nurses, and four student nurses between July 2018 and January 2020. Open coding, axial coding, and selective coding were used for analysis, which reveals that interpretations of NVC can be positive or negative. It means that older adults view nurses either as angels or as difficult persons, depending on the nurses’ positive or negative NVC and behaviors. These interpretations lead to consequences ranging from a preference for some nurses to noncompliance with care. The results further show that older adults need active listening, humor, and affection from nurses. Information regarding older adults’ interpretation of and need for NVC can be used to improve curriculum content and to develop skills in and awareness of NVC with older adults. It is recommended that further research expand on effective nonverbal techniques during COVID-19 times where the meaning of facial expressions and voice inflection can be disrupted.

Words are just Noise, let your Actions Speak: Impact of Nonverbal Communication on Undergraduate Medical Education

Objective

To explore student's perceptions regarding impact of kinesics (facial expressions, gestures, head movements and postures) on undergraduate medical education.

Methods

A qualitative exploratory online survey was conducted from July-Sept 2020 among purposively chosen final year BDS students (n=150) of three dental colleges of Islamabad during COVID-19 lockdown phase. Semi-structured survey questions were validated and piloted before execution. Thematic analysis was performed, and consensus was built among all authors regarding findings, hence ensuring analytical triangulation.

Results

Response rate was 46% (69/150). Twenty sub-themes emerged under three domains of kinesics. Participants told that 'neutral expressions' frequently used by teachers create 'boring learning environment' and 'hesitation among students to ask questions.' A smile of teacher imparts 'new degree of interest in the subject' and gives 'freedom of expression' to the students. On contrary, anger 'demotivate' students, instills 'fear among them', make them anxious therefore, they are 'unable to understand lectures' which ultimately leads to 'loss interest in the subject'. Use of gestures by teachers creates 'enjoyable teaching-learning process' but movements such as clearing throat or shaky legs produce 'constant split-second interruption'. Moreover, standing posture of teachers bring 'interest and alertness among students'.

Conclusion

Nonverbal communication can have positive or negative impact on undergraduate medical education. Therefore, teachers may start lecture with a smile and anger should be avoided to produce friendly and healthy learning environment. Faculty training is required for the effective use of nonverbal communication strategies to create an optimal learning environment for the students.

Perceiving the Other Self: An Experimental First-Person Account of Nonverbal Social Interaction

In psychology, the topics of the self and social perception in nonverbal interaction have been intensively examined but have so far been limited to certain aspects of their interdependence. The self is conceived mostly as a bundle of functions and personality traits that predominantly resist integration, except in the form of mental representations that do not allow conscious access to the processes that generate them. Similarly, in nonverbal interaction, the sending and receiving of particular social cues via different modalities are considered and usually traced back to subpersonal, especially neuronal processes. Because this does not allow the full potential of conscious self-development in social interaction to be exploited, the nexus between the two topics is examined in this study via an empirical first-person method with qualitative and quantitative aspects. A hypothesis about introspectively observable mental activity occurring in dyadic nonverbal interaction is developed and experimentally investigated. The results show that previous theoretical models can be supplemented by a sublayer of potentially conscious mental interaction that, because of its invariance regarding partial personality aspects, suggests a holistic and dynamic concept of the self.

Prediction of Communication Effectiveness During Media Skills Training Using Commercial Automatic Non-verbal Recognition Systems

It is well recognised that social signals play an important role in communication effectiveness. Observation of videos to understand non-verbal behaviour is time-consuming and limits the potential to incorporate detailed and accurate feedback of this behaviour in practical applications such as communication skills training or performance evaluation. The aim of the current research is twofold: (1) to investigate whether off-the-shelf emotion recognition technology can detect social signals in media interviews and (2) to identify which combinations of social signals are most promising for evaluating trainees' performance in a media interview. To investigate this, non-verbal signals were automatically recognised from practice on-camera media interviews conducted within a media training setting with a sample size of 34. Automated non-verbal signal detection consists of multimodal features including facial expression, hand gestures, vocal behaviour and 'honest' signals. The on-camera interviews were categorised into effective and poor communication exemplars based on communication skills ratings provided by trainers and neutral observers which served as a ground truth. A correlation-based feature selection method was used to select signals associated with performance. To assess the accuracy of the selected features, a number of machine learning classification techniques were used. Naive Bayes analysis produced the best results with an F-measure of 0.76 and prediction accuracy of 78%. Results revealed that a combination of body movements, hand movements and facial expression are relevant for establishing communication effectiveness in the context of media interviews. The results of the current study have implications for the automatic evaluation of media interviews with a number of potential application areas including enhancing communication training including current media skills training.

Nonverbal pre-performance expressions of professional darts players distinguish between good and poor performance

The present research attempted to extend prior research that showed that thin-slices of pre-performance nonverbal behavior (NVB) of professional darts players gives valid information to observers about subsequent performance tendencies. Specifically, we investigated what kind of nonverbal cues were associated with success and informed thin-slice ratings. Participants (N = 61) were first asked to estimate the performance of a random sample of videos showing the preparatory NVB of professional darts players (N = 47) either performing well (470 clips) or poorly (470 clips). Preparatory NVB was assessed via preparation times and Active Appearance Modeling using Noldus FaceReader. Results showed that observers could distinguish between good and poor performance based on thin-slices of preparatory NVB (p = 0.001, d = 0.87). Further analyses showed that facial expressions prior to poor performance showed more arousal (p = 0.011, ƞ²_p = 0.10), sadness (p = 0.040, ƞ²_p = 0.04), and anxiety (p = 0.009, ƞ²_p = 0.09) and preparation times were shorter (p = 0.001, ƞ²_p = 0.36) prior to poor performance than good performance. Lens model analyses showed preparation times (p = 0.001, rho = 0.18), neutral (p = 0.001, rho = 0.13), sad (rho = 0.12), and facial expressions of arousal (p = 0.001, rho = 0.11) to be correlated with observers’ performance ratings. Hence, preparation times and facial cues associated with a player’s level of arousal, neutrality, and sadness seem to be valid nonverbal cues that observers utilize to infer information about subsequent perceptual-motor performance.

Distinct timescales for the neuronal encoding of vocal signals in a high-order auditory area

The ability of the auditory system to selectively recognize natural sound categories while maintaining a certain degree of tolerance towards variations within these categories, which may have functional roles, is thought to be crucial for vocal communication. To date, it is still largely unknown how the balance between tolerance and sensitivity to variations in acoustic signals is coded at a neuronal level. Here, we investigate whether neurons in a high-order auditory area in zebra finches, a songbird species, are sensitive to natural variations in vocal signals by recording their responses to repeated exposures to identical and variant sound sequences. We used the songs of male birds which tend to be highly repetitive with only subtle variations between renditions. When playing these songs to both anesthetized and awake birds, we found that variations between songs did not affect the neuron firing rate but the temporal reliability of responses. This suggests that auditory processing operates on a range of distinct timescales, namely a short one to detect variations in vocal signals, and longer ones that allow the birds to tolerate variations in vocal signal structure and to encode the global context.

Deception and Lie Detection in the Courtroom: The Effect of Defendants Wearing Medical Face Masks

During the COVID-19 pandemic, defendants and witnesses (as well as the prosecution and defense counsel) may wear medical face masks to prevent the spread of the virus. Alternatively, courtrooms proceedings may take place virtually. In this article, we discuss how these deviations from normal procedures may affect jurors' lie detection ability and decision-making. Although research addressing this specific question does not exist, we are able to formulate an informed view based on the extensive deception literature. Since nonverbal signs of deception in the face and body are virtually absent, we conclude that medical face mask-wearing or virtual courtroom proceedings will not hamper jurors' lie detection abilities. If jurors can hear the speech well, they may become better at detecting deception if they pay more attention to speech content, which may occur as a result of mask-wearing in the courtroom.

Mobile App (WHEELS) to Promote a Healthy Lifestyle in Wheelchair Users With Spinal Cord Injury or Lower Limb Amputation: Usability and Feasibility Study

BACKGROUND

Maintaining a healthy lifestyle is important for wheelchair users' well-being, as it can have a major impact on their daily functioning. Mobile health (mHealth) apps can support a healthy lifestyle; however, these apps are not necessarily suitable for wheelchair users with spinal cord injury or lower limb amputation. Therefore, a new mHealth app (WHEELS) was developed to promote a healthy lifestyle for this population.

OBJECTIVE

The objectives of this study were to develop the WHEELS mHealth app, and explore its usability, feasibility, and effectiveness.

METHODS

The WHEELS app was developed using the intervention mapping framework. Intervention goals were determined based on a needs assessment, after which behavior change strategies were selected to achieve these goals. These were applied in an app that was pretested on ease of use and satisfaction, followed by minor adjustments. Subsequently, a 12-week pre-post pilot study was performed to explore usability, feasibility, and effectiveness of the app. Participants received either a remote-guided or stand-alone intervention. Responses to semistructured interviews were analyzed using content analysis, and questionnaires (System Usability Score [SUS], and Usefulness, Satisfaction, and Ease) were administered to investigate usability and feasibility. Effectiveness was determined by measuring outcomes on physical activity, nutrition, sleep quality (Pittsburgh Sleep Quality Index), body composition, and other secondary outcomes pre and post intervention, and by calculating effect sizes (Hedges g).

RESULTS

Sixteen behavior change strategies were built into an app to change the physical activity, dietary, sleep, and relaxation behaviors of wheelchair users. Of the 21 participants included in the pilot study, 14 participants completed the study. The interviews and questionnaires showed a varied user experience. Participants scored a mean of 58.6 (SD 25.2) on the SUS questionnaire, 5.4 (SD 3.1) on ease of use, 5.2 (SD 3.1) on satisfaction, and 5.9 (3.7) on ease of learning. Positive developments in body composition were found on waist circumference (P=.02, g=0.76), fat mass percentage (P=.004, g=0.97), and fat-free mass percentage (P=.004, g=0.97). Positive trends were found in body mass (P=.09, g=0.49), BMI (P=.07, g=0.53), daily grams of fat consumed (P=.07, g=0.56), and sleep quality score (P=.06, g=0.57).

CONCLUSIONS

The WHEELS mHealth app was successfully developed. The interview outcomes and usability scores are reasonable. Although there is room for improvement, the current app showed promising results and seems feasible to deploy on a larger scale.

Imagining How Lines Were Drawn: The Appreciation of Calligraphy and the Facilitative Factor Based on the Viewer's Rating and Heart Rate

For this study, we examined how recognizing the writing process of calligraphy influences the cognitive and affective processes related to appreciating it, with the aim of contributing to both graphonomics and the psychology of aesthetics. To this end, we conducted two Web-based experiments in which some participants were instructed to view calligraphy by tracing it with their eyes (the tracing method), while others were told to feel free to think and imagine whatever they wanted. Study 1 (N = 103) revealed that the tracing method elicits stronger admiration, inspiration, and empathy in viewers. Study 2 (N = 87) showed that the tracing method decreases the average heart rate of those who do not frequently engage in calligraphy appreciation as they gaze at calligraphy for a minute-and-a-half (during the second half of the stimulus duration); this suggests that the tracing method could keep viewers from becoming bored while looking at calligraphy. In sum, the tracing method has positive effects on viewing calligraphy. From a broader perspective, the results imply that how in detail viewers recognize the process of creating an artwork will be a key determinant of art appreciation. In addition, our findings demonstrate how we can measure cardiac activities using the emerging technology of the photoplethysmogram (PPG).

Auditory cortical micro-networks show differential connectivity during voice and speech processing in humans

The temporal voice areas (TVAs) in bilateral auditory cortex (AC) appear specialized for voice processing. Previous research assumed a uniform functional profile for the TVAs which are broadly spread along the bilateral AC. Alternatively, the TVAs might comprise separate AC nodes controlling differential neural functions for voice and speech decoding, organized as local micro-circuits. To investigate micro-circuits, we modeled the directional connectivity between TVA nodes during voice processing in humans while acquiring brain activity using neuroimaging. Results show several bilateral AC nodes for general voice decoding (speech and non-speech voices) and for speech decoding in particular. Furthermore, non-hierarchical and differential bilateral AC networks manifest distinct excitatory and inhibitory pathways for voice and speech processing. Finally, while voice and speech processing seem to have distinctive but integrated neural circuits in the left AC, the right AC reveals disintegrated neural circuits for both sounds. Altogether, we demonstrate a functional heterogeneity in the TVAs for voice decoding based on local micro-circuits.