Ethical challenges from a problem-solving intervention with workplace involvement: a qualitative study among employees with common mental disorders, first-line managers, and rehabilitation coordinators

PURPOSE

This study aims to explore ethical challenges potentially arising from a problem-solving intervention with workplace involvement (PSI-WPI) in primary health care (with first-line manager involvement) for employees on sickness absence due to common mental disorders.

METHODS

A qualitative design guided by the theoretical framework for systematic identification of ethical aspects of healthcare technologies. Semi-structured interviews were performed with coordinators (n = 6), employees (n = 13), and first-line managers (n = 8). Reflexive thematic analysis was used to analyse and interpret themes.

RESULTS

A main theme was identified "the workplace and healthcare hold different organizational value logics" and four sub-themes: "the PSI-WPI challenged the organizational goals and values of the workplace and healthcare", "the PSI-WPI challenged organizational values on fairness", "the PSI-WPI challenged the professional roles of first-line managers and rehabilitation coordinators" and "the PSI-WPI introduced a need for the employee to juggle the employee and patient roles".

CONCLUSION

Different organizational value logics, values, and goals can introduce ethical challenges. We advise clarifying stakeholders' roles and preparing employees and managers for the return to work process by providing sufficient information. The ethical challenges and suggested measures to minimize them, should be considered when planning return to work interventions that involve several stakeholders.

Impasse-Driven problem solving: The multidimensional nature of feeling stuck

This study reports findings across four preregistered experiments (total N = 856) that establish the multidimensional nature of impasse and resolve two paradoxes implicit in the problem-solving literature: how a state of impasse can be at once necessary to solve a problem with insight yet also have appear to have a catastrophic effect on solution rates, and why individuals such as problem-solving and gaming enthusiasts seem to seek out this apparently aversive state. We introduce a new way of measuring impasse based on qualitative reports and subsequently confirmed through quantitative analysis that exploits two aspects of impasse: its dynamic and unstable nature (it can be resolved or unresolved) and its multidimensionality in terms of feelings of cognitive speediness, motivation, and affect. The feeling of being stuck varies between resolved and unresolved impasse in terms of feelings of speediness and positive affect, but not motivation, which remains constant. We demonstrate that the feeling of insight can be reliably elicited by experiencing and resolving impasse but also in the absence of impasse, which suggests that there is more than one path to an insight experience. This adds depths to current proposals of the cognitive mechanisms underlying both insight problem-solving and impasse. Our findings are robust across a range of problem types. The novel conception of impasse in this paper as dynamic and multidimensional has implications for theories of insight problem solving, and also wider implications for understanding how impasse can be resolved across different domains such as education and design.

The Intrinsic Value of Diversity in Team Leadership

Despite the demonstrated benefit of diversity within a team structure, there is a lack of diversity among leadership in professional organizations. An increase in diversity among leadership teams would allow for more effective communication with team members, better problem-solving skills, increased trust within a team environment, and greater inspiration for future generations. Therefore, diversity should be a core concept within a leadership team.

Stop and Think: A Case Study Illustrating the Implementation of Bright IDEAS-YA Being Delivered via Telehealth to a Young Adult Cancer Patient

Bright IDEAS-Young Adults (Bright IDEAS-YA) is a problem-solving skills training intervention that has been adapted for young adults with cancer. Presently, a multisite randomized control trial is being conducted to determine Bright IDEAS-YA's efficacy in supporting a young adult population. This case study demonstrates the young adult adaptation of Bright IDEAS - Bright IDEAS-YA - being delivered to a young adult cancer patient via telehealth. Telehealth is a novel delivery method for Bright IDEAS and Bright IDEAS-YA that was established due to COVID-19 safety precautions. The patient, who reported challenges in several life domains, was taught how to apply the Bright IDEAS-YA framework over six telehealth sessions. After completing the Bright IDEAS-YA framework, the patient reported increased feelings of confidence in managing new stressors, which was corroborated through outcome measures delivered during and following intervention. This case illustrates how early psychosocial intervention following a cancer diagnosis, delivered via telehealth, can help patients develop and implement personal strategies to reduce stress levels.

The irreconcilability of insight

We are said to experience insight when we suddenly and unexpectedly become aware of the solution to a problem that we previously took ourselves to be unable to solve. In the field of comparative cognition, there is rising interest in the question of whether non-human animals are capable of insightful problem-solving. Putative cases of animals demonstrating insight have generally attracted two types of criticism: first, that insight is being conflated with other cognitive capacities (e.g., causal cognition, or mental trial and error); and, second, that the relevant performances merely reflect associative learning-and on the received understanding of insight within comparative cognition, insight necessarily involves non-associative processes. I argue that even if we grant that some cases of animal insight do withstand these two criticisms, these cases of purported animal insight cannot shed light on the nature of insightful problem-solving in humans. For the phenomenon studied by cognitive psychologists under the heading of insight is fundamentally different from that studied in comparative cognition. In light of this impasse, I argue that the reinterpretation of the extant research on animal insight in terms of other high-level cognitive capacities (means-end reasoning in particular) can improve the prospect of a successful comparative research program.

Investigation of annual trucks fatal accidents in El Hajeb province of Morocco using TRIZ-Ishikawa diagram

A stretch of road in the province of EL HAJEB, located in the central-south region of Morocco, is classified among the roadways experiencing an accumulation of fatal traffic accidents, with a particular involvement of freight transport vehicles. Investigation reports elaborated for these fatal accidents specify that these accidents occurred when drivers lost control of their vehicles due to brake system failures, resulting in multiple fatalities. However, these investigation reports did not provide root causes of this phenomena. Scientific research efforts in this field are directed toward preventive solutions and proposing a comprehensive analytical approach. This study aims to elucidate the mechanisms behind these specific accident phenomena on the identified stretch in the city of EL HAJEB. To achieve the study's objective and identify the triggering or contributing factors of these failures, we employed a novel approach combining the TRIZ and Ishikawa tools. This is a systematic methodology for analyzing potential causes of accidents, allowing us to clarify the intricacies of the specific phenomena leading to accidents while systematizing the analysis process, thus contributing to enhancing the effectiveness of investigative teams. This article contributes to introducing a new analytical tool in the field of accident analysis.

A state response measurement model for problem-solving process data

In computer simulation-based interactive tasks, different people make different response processes to the same tasks, resulting in various action sequences. These sequences contain rich information, not only about respondents, but also about tasks. In this study, we propose a state response (SR) measurement model with a Bayesian approach for analyzing the process sequences, which assumes that each action made is determined by the individual's problem-solving ability and the easiness of the current problem state. This model is closer to reality compared with the action sub-model (referred to as DC model) of Chen's (2020) continuous-time dynamic choice (CTDC) measurement model that defines the easiness parameter only at the task level and ignores the task's process characteristics. The simulation study showed that the SR model performed well in parameter estimation. Moreover, the estimation accuracy of the SR model was quite similar to that of the DC model when state easiness parameters were equal within the task, but was much higher when within-task state easiness parameters were unequal. For the empirical data from the Program for International Student Assessment 2012, the SR model showed better model fit than the DC model. The estimates for state easiness parameters within each task were obviously different and made sense for characterizing task steps, further demonstrating the rationality of the proposed SR model.

Kea, bird of versatility. Kea parrots (Nestor notabilis) show high behavioural flexibility in solving a demonstrated sequence task

Social learning is an important aspect of dealing with the complexity of life. The transmission of information via the observation of other individuals is a cost-effective way of acquiring information. It is widespread within the animal kingdom but may differ strongly in the social learning mechanisms applied by the divergent species. Here we tested eighteen Kea (Nestor notabilis) parrots on their propensity to socially learn, and imitate, a demonstrated sequence of steps necessary to open an apparatus containing food. The demonstration by a conspecific led to more successful openings by observer birds, than control birds without a demonstration. However, all successful individuals showed great variation in their response topography and abandoned faithfully copying the task in favour of exploration. While the results provide little evidence for motor imitation they do provide further evidence for kea's propensity towards exploration and rapidly shifting solving strategies, indicative of behavioural flexibility.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10336-023-02127-y.

Harold Gillies, pioneer of modern plastic surgery, and Donald Morton, pioneer of modern surgical oncology: Master problem-solvers and surgical role models

Harold Gillies, plastic surgeon, and Donald Morton, surgical oncologist, were iconic pioneers in their respective fields. Both of them made their mark by identifying crucial practical problems and finding innovative ways of solving them. Gillies grappled with the challenge of restoring form and function to British military personnel injured in World War I, and he set up a dedicated facility for performing this work. He introduced many new reconstructive techniques that became the foundation of the modern specialty of plastic and reconstructive surgery, which he established and nurtured. Morton, in the United States, applied his problem-solving skills to the long-debated question of the best way to manage regional lymph nodes in patients with melanoma. He developed the innovative technique of sentinel lymph node biopsy and initiated large-scale international clinical trials to establish its validity and clinical value. This and other important contributions to the emerging field of surgical oncology earned Morton his reputation as a pioneer and leader of that specialty. The problems that confronted Gillies and Morton were completely different, but both demonstrated remarkable skills as master problem-solvers in their respective fields and made extraordinary contributions to the body of knowledge and welfare of patients. All surgeons must be problem-solvers because every patient who presents for surgical management represents a new problem (or set of problems) to be addressed. As surgeons, we would do well to consider individuals such as Gillies and Morton as role models for our own problem-solving activities in day-to-day clinical practice.

"Scie-losophy" a teaching and learning framework for the reconciliation of the P4C and the scientific method

Today's students face new challenges that demand high levels of intelligence and meta-thinking skills. Science-based educational pedagogies like STEM, 5E's, and discovery-based education have earned a strong reputation for nurturing children's reasoning and critical thinking skills. However, there's a need for them to be more open and conceptual in order to better prepare students for modern life's challenges. The realms of philosophical and scientific-based educational models currently dominate the educational arena. In retrospect, both models have inherent values that would benefit learners. It is beneficial to examine both methods to develop a teaching framework that fosters higher-order thinking, metacognition, and problem-solving skills. The objective of this paper is to delve into the essenceof the philosophy for children (P4C) method in comparison with the scientific method and their impact onstudents' learning. Using the six reasoning strands, I will systematically compare the two models for strengths and similarities. Throughout this comparison, I aim to maintain objectivity by by drawing on references and practical experience, avoiding any undue bias in favor of one model over the other. Subsequently, by applyingTrompenaars Hampden-Turner™ dilemmas reconciliation model, I will propose the Scie-losophy model, which represents reconciliation between the two methods for the benefit of the learner and the greater good of society. •Currently, philosophical, and scientific-based education models dominate the educational arena. Both models have inherent values that would benefit learners.•Adopting one approach above the other will yield less than optimal results. I strongly discourage following a saturated educational system in which one of the two methods is used exclusively.•I propose a model that represents reconciliation between the two methods for the benefit of the learner and the interest of society.

Analysis of factors affecting pharmacists' ability to identify and solve problems

BACKGROUND

Among Japanese pharmacists, there is a gap in their commitment to self-improvement and a possible gap in their ability to identify and solve problems. However, the factors causing this situation have not yet been clarified. This study was conducted to identify factors that influence the abilities of Japanese pharmacists to identify and solve problems, which are skills considered essential for this profession. A prior history of presenting at academic conferences was set as a surrogate outcome to clarify whether having this experience affects the factors.

METHODS

A nationwide internet-based survey was conducted among 300 participating hospitals and 300 community pharmacists. The survey was discontinued when the sample size of each group reached 300. The respondents were categorized into two groups on the basis of their experience of presenting at academic conferences in the survey item "status of self-improvement after employment." Their association with other survey items was determined using univariate and multivariate logistic regression analyses.

RESULTS

The multivariate analysis revealed that 152 (50.7%) hospital pharmacists and 41 (13.7%) community pharmacists had presented at academic conferences. Among the hospital pharmacists, the experience of presenting at academic conferences was significantly associated with the "age 30 s (*references 20 s)," "presence of pharmacists to consult," "experience supervising interns," and "number of types of self-improvement" factors. For the community pharmacists, prior conference presentation experience was significantly associated with "age over 70 s," "highest educational background (doctoral or master's degree)," and "number of types of self-improvement."

CONCLUSION

This pioneering study suggests that having prior experience of presenting at academic conferences as a surrogate outcome of pharmacists' problem-finding and problem-solving skills may be related to the support provided by human environmental factors at the facility, the status of self-improvement, and the highest educational background.

Validating the Utility of Multilocus Variable Number Tandem-repeat Analysis (MLVA) as a Subtyping Strategy to Monitor Listeria monocytogenes In-built Food Processing Environments

Listeria monocytogenes is a serious human pathogen and an enduring challenge to control for the ready-to-eat food processing industry. Cost-effective tools that can be deployed by commercial or in-house laboratories to rapidly investigate and resolve contamination events in the built food processing environment are of value to the food industry. Multilocus variable number tandem-repeat analysis (MLVA) is a molecular subtyping method, which along with other same-generation methods such as pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) is being superseded in disease tracking and outbreak investigations by whole-genome sequencing (WGS). In this paper, it is demonstrated that MLVA can continue to play a valuable role as a valid, fast, simple, and cost-effective method to identify and track Listeria monocytogenes subtypes in factory environments, with the method being highly congruent with MLST. Although MLVA does not have the discriminatory power of WGS to identify truly persistent clones, with careful interpretation of results alongside isolate metadata, it remains a powerful tool in situations and locations where WGS may not be readily available to food business operators.

The influence of induced dysphoria on autobiographical memory specificity and social problem solving: Examining the role of executive function

Negative mood induction leads to reductions in autobiographical memory specificity (AMS) and social problem-solving (SPS). The aim was to establish if executive function contributes to changes in AMS and SPS following negative mood induction. Forty-four participants (study 1) completed the autobiographical memory test and measures of executive function (letter & category fluency) before and after a positive or negative mood induction (MI). Forty participants (study 2) completed the means-end problem solving task (MEPS) and (letter & category) fluency tasks before and after a positive or negative MI. In study 1, participants exhibited impaired AMS and fluency performance following a sad MI. Decrease in memory specificity pre-to post-MI was related to reductions in happy mood and letter fluency. In study 2, participants exhibited poorer performance on the MEPS and fluency tasks following a sad MI. Decreases in the number of relevant solutions generated on the MEPS pre-to post-MI was linked to increases in sad mood and decreases in letter fluency. In both studies, the influence of mood became non-significant once the effect of executive function was accounted for, which suggests that changes in AMS and SPS in response to induced mood were related to concomitant changes in executive function.

Stressors and Maladaptive Coping Mechanisms Associated with Elevated Perinatal Depressive Symptoms and Suicidality Among Women Living with HIV in Uganda

BACKGROUND

Perinatal depression is highly prevalent among women living with HIV and contributes to nonadherence to the PMTCT (prevention of mother-to-child transmission) care continuum. We examined correlates of elevated depressive symptoms and suicidality in this population.

METHOD

Baseline data from 391 Ugandan women enrolled in a cluster randomized controlled trial of a depression care intervention were analyzed. Adult women with confirmed sero-positive HIV status were eligible if their gestation period was ≤ 32 weeks, and they had a Patient Health Questionnaire (PHQ-9) score ≥ 5. Correlates of elevated depressive symptoms (PHQ-9 > 9) and moderate-to-severe suicidal ideation (more than half of the days in the prior 2 weeks) were assessed using bivariate and multivariate logistic regression models, controlling for clustering within study sites by using a random effects specification (with study site as the random effect), as well as age and education.

RESULTS

The mean PHQ-9 score was 12.7 (SD = 5.1); 267 (68.3%) participants had elevated depressive symptoms, and 51 (13.0%) reported moderate-to-severe suicidality. In multiple logistic regression analysis, perceived provider stigma of childbearing [OR (95% CI) = 1.81 (1.16, 2.84)], greater use of negative problem-solving [OR (95% CI) = 1.09 (1.04, 1.15)], and lower general social support [OR (95% CI) = 0.50 (0.30, 0.82)] were correlated with elevated depression symptoms, while moderate-to-severe suicidal ideation was correlated with greater experience of physical interpersonal violence (IPV) and greater use of negative problem-solving.

CONCLUSIONS

Programs aimed at improving provider support for the childbearing needs of persons living with HIV, supporting women who are experiencing IPV, and helping women to develop effective problem-solving skills and social supports may reduce symptoms of perinatal depression and help optimize PMTCT care outcomes.

TRIAL REGISTRATION

Clinicaltrials.gov NCT03892915 (registered March 21, 2019).

Effects of problem-solving skills development training on resilience, perceived stress, and self-efficacy in nursing students: A randomised controlled trial

AIM

This study aimed to investigate the effects of problem-solving skills development training for nursing students on their levels of resilience, perceived stress, and self-efficacy.

BACKGROUND

Although there are many studies on the problem-solving skills of nursing students, few have been based on the social problem-solving model. Most are cross-sectional and descriptive studies. Surprisingly, the number of studies that examine the effects of training for problem solving in nursing students is also quite limited.

DESIGN

This was a single-blind, randomised controlled trial.

METHODS

The study was conducted at the department of nursing of a state university in Western Turkey. Seventy-two second-year nursing students initially participated in the study. The mean age of the participants was 19.97 ± 1.39 years. Of the participants, 72.2% were women, and 70.8% did not consider themselves academically successful. Participants were randomly assigned to the experimental or control group. The experimental group received problem-solving skills development training based on the Social Problem-Solving Model once a week in a total of seven weeks (eight sessions), in which two sessions were in the last week. Duration of each session took at least 55 min and 150 min at max. Data were collected using a self-administered questionnaire that included a personal information form, Resilience Scale for Nurses, Social Problem Solving-Inventory-Short Form, Perceived Stress Scale, and General Self-Efficacy Scale. Measurements were performed at three different times: at the beginning of the study (T0), immediately after the training provided to the experimental group (T1), and one month follow-up measurement after the intervention (T2). Repeated-measures analysis of variance and covariance were performed to analyse data.

RESULTS

The mean post-training and 1-month follow-up scores for problem-solving, resilience, and self-efficacy of the students in the experimental group (the mean of T1 and T2 scores) were significantly higher, and the mean post-training and 1-month follow-up perceived stress scores of the students in the experimental group was significantly lower than those of the control group.

CONCLUSIONS

This study concluded that problem-solving skills training based on a social problem-solving model provided to nursing students increased their social problem solving, resilience, and self-efficacy levels and reduced their perceived stress. Therefore, further studies that plan intervention and training programs aimed at improving the social problem-solving levels of nursing students and include social problem-solving courses in university curricula are recommended.

The effect of self-organized learning environments (SOLEs) pedagogy on the different aspects of learners' metacognitive skills in the Physical Sciences classroom

The development of metacognitive skills should be holistic, which implies that it should focus on different (metacognitive skills) aspects. However, the literature indicates that metacognitive skills are often investigated in general terms with little focus on their aspects. In response to the established findings this far, the current study aimed to examine the effect of Self-organized learning environments (SOLEs) pedagogy on the different aspects of learners' metacognitive skills in Physical Sciences classrooms. The study employed the quasi-experimental design in which four (two urban and two rural) groups (155 participants) were involved. Data were gleaned using a metacognition-self assessment scale (MSAS) questionnaire and analysed using descriptive (means and effect size) and inferential (t-test) statistics. The results indicate that SOLEs pedagogy improved all aspects of metacognitive skills, but empathy towards others improved more than other aspects such as Respect shown to me, Respect shown to others, and Respect shown towards problem-solving. The current study concludes that SOLEs pedagogy can holistically develop metacognitive skills as it improves all aspects of metacognitive skills. In addition, SOLEs pedagogy makes learners empathetic toward each other during the learning process, which results in a conducive learning environment.

A cooperation experiment with white-handed gibbons (Hylobates lar)

Cooperative behaviors among individuals of numerous species play a crucial role in social interactions. There is a special interest in investigating the occurrence of cooperation among apes because this knowledge could also shed light on evolutionary processes and help us understand the origin and development of cooperation in humans and primates in general. Gibbons are phylogenetically intermediate between the great apes and monkeys, and therefore represent a unique opportunity for comparisons. The aim of the present study was to discover whether or not white-handed gibbons (Hylobates lar) show cooperative behaviors. In order to test for the respective behaviors, the gibbons were presented with a commonly used experimental cooperative rope-pulling task. The gibbons in this study did not exhibit cooperative behaviors during the problem-solving task. However, prior training procedures could not be fully completed, hence this project constitutes only the onset of exploring cooperative behaviors in gibbons. Additional behavioral observations revealed that the gibbons spent significantly more time "out of arm's reach to everyone", suggesting that they are less often involved in social interactions, than other, more cooperative primates.

Implementation of a Clinical Problem-Solving Course for Students Challenged by Early Pharmacy Curriculum

OBJECTIVE

This study evaluates the impact of offering a clinical decision-making and problem-solving course to students academically challenged in early required clinical and pharmaceutical calculation courses on improving their ability to identify and solve drug-related problems.

METHODS

Faculty designed a course with a main objective for students with grades of C or lower in any of the 5 required first-year courses to gain plentiful practice with a systematic approach to identifying and solving drug therapy problems. Students' performance on course-embedded assessments mapped to problem-solver subdomain, a pre-Advanced Pharmacy Practice Experience (APPE) competency on the ability to identify drug-related problems, and performance on Pharmacy Curriculum Outcomes Assessment were compared to a control group of students from 2 previous cohorts who did not take the course but had a subpar academic performance. Pearson chi-square test and independent samples t test were utilized for categorical and continuous data, respectively.

RESULTS

The clinical decision-making and problem-solving course significantly improved student performance on pre-APPE competency to identify drug-related problems (first-attempt pass rate of 96% vs 30% when compared to a historic cohort), but not on Pharmacy Curriculum Outcomes Assessment. Student performance on case-based questions mapped to problem-solver subdomain exceeded internally set standard by 13.72% points.

CONCLUSION

Students demonstrated learning problem-solving and clinical decision-making, which improved their performance on course-embedded assessments and pre-APPE competency in identifying drug-related problems.

Harnessing Computational Complexity Theory to Model Human Decision-making and Cognition

A central aim of cognitive science is to understand the fundamental mechanisms that enable humans to navigate and make sense of complex environments. In this letter, we argue that computational complexity theory, a foundational framework for evaluating computational resource requirements, holds significant potential in addressing this challenge. As humans possess limited cognitive resources for processing vast amounts of information, understanding how humans perform complex cognitive tasks requires comprehending the underlying factors that drive information processing demands. Computational complexity theory provides a comprehensive theoretical framework to achieve this goal. By adopting this framework, we can gain new insights into how cognitive systems work and develop a more nuanced understanding of the relation between task complexity and human behavior. We provide empirical evidence supporting our argument and identify several open research questions and challenges in applying computational complexity theory to human decision-making and cognitive science at large.

Experiences of participating in a problem-solving intervention with workplace involvement in Swedish primary health care: a qualitative study from rehabilitation coordinator's, employee's, and manager's perspectives

BACKGROUND

Work-directed interventions that include problem-solving can reduce the number of sickness absence days. The effect of combining a problem-solving intervention with involvement of the employer is currently being tested in primary care in Sweden for employees on sickness absence due to common mental disorders (PROSA trial). The current study is part of the PROSA trial and has a two-fold aim: 1) to explore the experiences of participating in a problem-solving intervention with workplace involvement aimed at reducing sickness absence in employees with common mental disorders, delivered in Swedish primary health care, and 2) to identify facilitators of and barriers to participate in the intervention. Both aims targeted rehabilitation coordinators, employees on sickness absence, and first-line managers.

METHODS

Data were collected from semi-structured interviews with participants from the PROSA intervention group; rehabilitation coordinators (n = 8), employees (n = 13), and first-line managers (n = 8). Content analysis was used to analyse the data and the Consolidated Framework for Implementation Research was used to group the data according to four contextual domains. One theme describing the participation experiences was established for each domain. Facilitators and barriers for each domain and stakeholder group were identified.

RESULTS

The stakeholders experienced the intervention as supportive in identifying problems and solutions and enabling a dialogue between them. However, the intervention was considered demanding and good relationships between the stakeholders were needed. Facilitating factors were the manual and work sheets which the coordinators were provided with, and the manager being involved early in the return-to-work process. Barriers were the number of on-site meetings, disagreements and conflicts between employees and first-line managers, and symptom severity.

CONCLUSIONS

Seeing the workplace as an integral part of the intervention by always conducting a three-part meeting enabled a dialogue that can be used to identify and address disagreements, to explain CMD symptoms, and how these can be handled at the workplace. We suggest allocating time towards developing good relationships, provide RCs with training in handling disagreements, and additional knowledge about factors in the employee's psychosocial work environment that can impair or promote health to increase the RCs ability to support the employee and manager.

Low-Intensity mental health Support via a Telehealth Enabled Network for adults with diabetes (LISTEN): protocol for a hybrid type 1 effectiveness implementation trial

BACKGROUND

Mental health problems are common among people with diabetes. However, evidence-based strategies for the prevention and early intervention of emotional problems in people with diabetes are lacking. Our aim is to assess the real-world effectiveness, cost-effectiveness, and implementation of a Low-Intensity mental health Support via a Telehealth Enabled Network (LISTEN), facilitated by diabetes health professionals (HPs).

METHODS

A hybrid type I effectiveness-implementation trial, including a two-arm parallel randomised controlled trial, alongside mixed methods process evaluation. Recruited primarily via the National Diabetes Services Scheme, Australian adults with diabetes (N = 454) will be eligible if they are experiencing elevated diabetes distress. Participants are randomised (1:1 ratio) to LISTEN-a brief, low-intensity mental health support program based on a problem-solving therapy framework and delivered via telehealth (intervention) or usual care (web-based resources about diabetes and emotional health). Data are collected via online assessments at baseline (T0), 8 weeks (T1) and 6 months (T2, primary endpoint) follow-up. The primary outcome is between-group differences in diabetes distress at T2. Secondary outcomes include the immediate (T1) and longer-term (T2) effect of the intervention on psychological distress, general emotional well-being, and coping self-efficacy. A within-trial economic evaluation will be conducted. Implementation outcomes will be assessed using mixed methods, according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Data collection will include qualitative interviews and field notes.

DISCUSSION

It is anticipated that LISTEN will reduce diabetes distress among adults with diabetes. The pragmatic trial results will determine whether LISTEN is effective, cost-effective, and should be implemented at scale. Qualitative findings will be used to refine the intervention and implementation strategies as required.

TRIAL REGISTRATION

This trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN: ACTRN12622000168752) on 1 February, 2022.

Darwin's agential materials: evolutionary implications of multiscale competency in developmental biology

A critical aspect of evolution is the layer of developmental physiology that operates between the genotype and the anatomical phenotype. While much work has addressed the evolution of developmental mechanisms and the evolvability of specific genetic architectures with emergent complexity, one aspect has not been sufficiently explored: the implications of morphogenetic problem-solving competencies for the evolutionary process itself. The cells that evolution works with are not passive components: rather, they have numerous capabilities for behavior because they derive from ancestral unicellular organisms with rich repertoires. In multicellular organisms, these capabilities must be tamed, and can be exploited, by the evolutionary process. Specifically, biological structures have a multiscale competency architecture where cells, tissues, and organs exhibit regulative plasticity-the ability to adjust to perturbations such as external injury or internal modifications and still accomplish specific adaptive tasks across metabolic, transcriptional, physiological, and anatomical problem spaces. Here, I review examples illustrating how physiological circuits guiding cellular collective behavior impart computational properties to the agential material that serves as substrate for the evolutionary process. I then explore the ways in which the collective intelligence of cells during morphogenesis affect evolution, providing a new perspective on the evolutionary search process. This key feature of the physiological software of life helps explain the remarkable speed and robustness of biological evolution, and sheds new light on the relationship between genomes and functional anatomical phenotypes.

Puzzle game-based learning: a new approach to promote learning of principles of coronary artery bypass graft surgery

INTRODUCTION

Since learning with high educational quality requires an advanced intervention. This study seeks to answer how many puzzles game-based training can improve knowledge and cognitive function of surgical technology students in CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.

MATERIALS AND METHODS

This study was carried out as a quasi-experimental single-group pre-test-post-test, during which, after designing a puzzle game including various stages of surgery (from the preparation of the patient for surgical sutures and the necessary equipment to perform each stage), 18 people from third-year surgical technology students who met the inclusion criteria were entered in the study by convenience sampling method and based on the sample size determined using a similar study and they participated in the test of knowledge and cognitive function, that the validity and reliability were measured, before the intervention and 14 days after the intervention (using a puzzle game). Data were analyzed using descriptive and Wilcoxon statistical tests.

RESULTS

After the withdrawal of 2 people, 15 person (93.80 per cent) of the students were female, the average age of students was 21.87 ± 0.71 years, and 50% (8 people) of them were 22 years old. Also, the average score of the end-of-semester exam of the heart surgery technology course was 15.19 ± 2.30 (the lowest score was 11.25, and the highest score was 18.63), and the score of 43.80% (7 people) of them were in the range of 15.01-17.70, and their average of grade point average was 17.31 ± 1.10 (the lowest grade point average is 15 and the highest grade point average is 19.36) and grade point average 75% (11 people) of students were 16-18. The average scores of knowledge(5.75 ± 1.65 vs. 2.68 ± 0.79) and cognitive performance(6.31 ± 2.57 vs. 2.00 ± 1.09) of students in the post-intervention phase were significantly higher than the pre-intervention phase (P < 0.0001).

CONCLUSION

The results of the present study showed that the use of puzzle games in CABG surgery training led to a significant improvement in the knowledge and cognitive performance of surgical technology students regarding the stages of CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.

eDECIDE a web-based problem-solving interventions for diabetes self-management: Protocol for a pilot clinical trial

Background

In the US, diabetes affects 13.2% of African Americans, compared to 7.6% of Caucasians. Behavioral factors, such as poor diet, low physical activity, and general lack of good self-management skills and self-care knowledge are associated with poor glucose control among African Americans. African Americans are 77% more likely to develop diabetes and its associated health complications compared to non-Hispanic whites. A higher disease burden and lower adherence to self-management among this populations calls for innovative approaches to self-management training. Problem solving is a reliable tool for the behavior change necessary to improve self-management. The American Association of Diabetes Educators identifies problem-solving as one of seven core diabetes self-management behaviors.

Methods

We are using a randomized control trial design. Participants are randomized to either traditional DECIDE or eDECIDE intervention. Both interventions run bi-weekly over 18 weeks. Participant recruitment will take place through community health clinics, University health system registry, and through private clinics. The eDECIDE is an 18-week intervention designed to deliver problem-solving skills, goal setting, and education on the link between diabetes and cardiovascular disease.

Conclusion

This study will provide feasibility and acceptability of the eDECIDE intervention in community populations. This pilot trial will help inform a powered full-scale study using the eDECIDE design.

The effect of crossword puzzle activity used in distance education on nursing students' problem-solving and clinical decision-making skills: A comparative study

AIM

The study was planned to determine the effect of crossword puzzle activity in distance education on nursing students' problem-solving and clinical decision-making skills.

BACKGROUND

In online education, increasing nursing students' learning skills, motivations and participation is important.

DESIGN

The study is a randomized-controlled trial.

METHOD

The study sample consisted of 132 nursing students registered to the Pediatric Nursing distance course in the 2020-2021 academic year. 20 students who were assigned to the control group did not agree to participate in the study and did not fill in the data form. Accordingly, the study was completed with the participation of 112 students, with 66 students in the experimental group and 46 students in the control group. In the 14-week distance education, 20-question crossword puzzle activity per unit was applied to the students in the experimental group. The standards for reporting consort guidelines for reporting parallel group randomized trials were used to report this research. The students in the control group were taught in the form of presentation. At the beginning and end of the study, CDMNS and PSI were applied to the students. Ethics committee approval (Number: 2021/79) was obtained from the relevant university to conduct the research.

RESULTS

A statistically significant difference was found between pretest and posttest scores of the experimental group in PSI and CDMNS scales (p < 0.001).

CONCLUSION

Crossword puzzle activity used in distance education developed the students' problem-solving and clinical decision-making skills.

Study protocol of a telephone problem-solving intervention for Spanish-speaking caregivers of veterans post-stroke: an 8-session investigator-blinded, two-arm parallel (intervention vs usual care), randomized clinical trial

BACKGROUND

Stroke is one of the leading causes of death and the main cause of long-term disability in the United States. The significant risk factors of stroke among Hispanics are well-documented. The majority of stroke survivors return home following a stroke and are cared for by family caregivers. Due to the abrupt nature of strokes, caregivers experience unexpected changes and demands that oftentimes lead to caregiver burden and depression. Given the significant risk factors for stroke in Hispanics and the influence of culture in family norms and family management, we developed a telephone and online problem-solving intervention for Spanish-speaking stroke caregivers. This study tests the impact of a telephone and online problem-solving intervention for Spanish-speaking stroke caregivers on caregiver outcomes.

METHODS

The design is a two-arm parallel randomized clinical trial with repeated measures. We will enroll 290 caregivers from 3 Veterans Affairs (VA) medical centers. Participants randomized into the intervention arm receive a problem-solving intervention that uses telephone and online education and care management tools on the previously developed and nationally available RESCUE en Español Caregiver website. In the usual care group, participants receive the information and/or support caregivers of veterans with stroke normally receive through existing VA resources (e.g., stroke-related information and support). The primary outcome is change in caregiver's depressive symptoms at 1- and 12-weeks post-intervention. Secondary outcomes include changes in stroke caregivers' burden, self-efficacy, problem-solving, and health-related quality of life (HRQOL) and veterans' functional abilities. We will also determine the budgetary impact, the acceptability of the intervention and participation barriers and facilitators for Spanish-speaking stroke caregivers.

DISCUSSION

This is an ongoing study. It is the first known randomized controlled trial testing the effect of a telephone and online problem-solving intervention in Spanish for caregivers of veterans post-stroke. If successful, findings will support an evidence-based model that can be transported into clinical practice to improve the quality of caregiving post-stroke.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT03142841- Spanish Intervention for Caregivers of Veterans with Stroke (RESCUE Español). Registered on February 23, 2018. Protocol version 8. 08.11.2022.

Restructuring insight: An integrative review of insight in problem-solving, meditation, psychotherapy, delusions and psychedelics

Occasionally, a solution or idea arrives as a sudden understanding - an insight. Insight has been considered an "extra" ingredient of creative thinking and problem-solving. Here we propose that insight is central in seemingly distinct areas of research. Drawing on literature from a variety of fields, we show that besides being commonly studied in problem-solving literature, insight is also a core component in psychotherapy and meditation, a key process underlying the emergence of delusions in schizophrenia, and a factor in the therapeutic effects of psychedelics. In each case, we discuss the event of insight and its prerequisites and consequences. We review evidence for the commonalities and differences between the fields and discuss their relevance for capturing the essence of the insight phenomenon. The goal of this integrative review is to bridge the gap between the different views and inspire interdisciplinary research efforts for understanding this central process of human cognition.

Some Correct Strategies Are Better Than Others: Individual Differences in Strategy Evaluations Are Related to Strategy Adoption

Why do people shift their strategies for solving problems? Past work has focused on the roles of contextual and individual factors in explaining whether people adopt new strategies when they are exposed to them. In this study, we examined a factor not considered in prior work: people's evaluations of the strategies themselves. We presented undergraduate participants from a moderately selective university (N = 252; 64.8% women, 65.6% White, 67.6% who had taken calculus) with two strategies for solving algebraic word problems and asked them to rate these strategies and their own strategy on a variety of dimensions. Participants' ratings loaded onto two factors, which we label quality and difficulty. Participants' initial evaluations of the quality of the strategies were associated with whether they used the strategies at posttest, and this effect held even when controlling for individual and contextual factors. However, people's evaluations of the difficulty of the strategies were not consistently associated with their later adoption of those strategies. We also examined individual and contextual predictors of strategy ratings and strategy adoption. Participants' need for cognition and their spatial visualization ability were associated with their strategy evaluations, and the framing of the story problems was associated with their strategy adoption. The findings highlight that strategy adoption depends on multiple interacting factors, and that to understand strategy change, it is critical to examine how people evaluate strategies.

Examining the structural equation modeling between intrinsic-motivation, emotion regulation and AHDH: the mediating role of problem-solving, time-management, and behavioral-inhibition

Although Executive Functions has been considered as the main correlation of ADHD few studies have examined the effect of EFs on ADHD symptoms, in the samples with ADHD. This study aimed to examine the structure of EFs on ADHD students in a hypothesized model. After careful screening of ADHD among 1368 university students (with stratified and multistage cluster sampling), out of them, 211 students with ADHD diagnosis were selected purposefully. They received scales on their emotion regulation, motivation, adult ADHD, deficits in EFs, and diagnostic interview. Emotion regulation and intrinsic motivation were considered as input; behavioral-inhibition, time-management, and problem-solving were the mediators and ADHD subscales were as the output variables. Results showed that the model adequately fit the data. The model fit indices were χ2 = 27.081, df = 1, CFI = 0.99, GFI = 0.97, and PGFI = 0.02. The direct effects of intrinsic-motivation and emotion-regulation on all three mediators and indirect effects of them to ADHD subscales were significant. Based on the results, time-management mediated the relationship between motivation and emotion regulation and ADHD. Among EFs, emotion-regulation and intrinsic-motivation had fundamental influence to other aspects of EFs factors such as behavioral-inhibition, time-management, problem-solving, and attention deficit/hyperactivity disorder.

An exploratory investigation of the reliability and validity of the Independent-Interdependent Problem-Solving Style Scale

The Independent-Interdependent Problem-Solving Scale is based on Cross et al.'s conceptualisation of relational-interdependent self-construal. The IIPSS provides a relatively context-free measure of people's tendencies to solve problems independently or with the help of others. Because previous investigations have not provided extensive evidence for the reliability and validity of the IIPSS, the current research aimed to test the psychometric properties of this novel measure. Investigations of four student samples (combined N = 1157) and one sample comprised of academic researchers (N = 198) generally supported the reliability and validity of the IIPSS. Exploratory factor analysis of IIPSS items yielded a single factor structure. However, confirmatory factor analyses did not demonstrate good model fit for the one factor solution and instead yielded good model fit for two underlying factors. The IIPSS showed adequate test-retest reliability and predicted positive associations with social personality traits. It also showed no significant associations with measures of demand characteristics and social desirability. Future research needs to be undertaken to further assess the factor structure and address shortcomings of the present research such as utilising objective data in addition to self-reports to assess the scale's validity.

The effectiveness of psychoeducation and problem-solving on depression and treatment adherence in adolescents living with HIV in Botswana: an exploratory clinical trial

BACKGROUND

This study aimed to explore the effectiveness of psychological interventions (PI): psychoeducation, problem-solving, and rehearsal strategies on depression and adherence in HIV-infected adolescents in Botswana.

METHODS

Fifty adolescents living with HIV were randomized into control (n = 25) and intervention groups (n = 25), the latter being exposed to five weeks of PI sessions. The PHQ-9 and visual analog scale (VAS) were used to measure the outcomes: depression and adherence at pre-intervention, 5- and 24 weeks post-intervention.

RESULTS

The participants' mean age (SD) was 17.38 years (1.1), the two groups being similar in socio-demographic variables: gender (χ² = 2.22; p = 0.135) and age (U = 285, z =  - 0.55, p = 0.579). The intervention group scored significantly lower on depressive symptoms (PHQ-9 [F (1,50) = 12.0, p = 0.001, ƞ_p² = 0.20]) and higher on adherence score (VAS [F (1,50) = 13.5, p = 0.001, ƞ_p² = 0.22]) than the control group after 5 weeks. The post-hoc analysis showed that the significant improvements in depressive symptoms (z =  - 4.03, p < 0.01, r [effect size] = 0.88) and adherence (z =  - 4.05, p < 0.01, r = 0.88) at post-test in the intervention group were maintained at 24 weeks. This project was registered with ClinicalTrials.gov (NCT05482217).

CONCLUSION

The 5-week PI showed promising effectiveness in addressing depression and adherence in adolescents living with HIV in Botswana.

Intelligent tutoring systems for word problem solving in COVID-19 days: could they have been (part of) the solution?

The COVID-19 pandemic led to the lockdown of schools in many countries, forcing teachers and students to carry out educational activities remotely. In the case of mathematics, developing remote instruction based on both synchronous and asynchronous technological solutions has proven to be an extremely complex challenge. Specifically, this was the case in topics such as word problem solving, as this domain requires intensive supervision and feedback from the teacher. In this piece of research, we present an evaluation of how technology is employed in the teaching of mathematics, with particular relevance to learning during the pandemic. For that purpose, we conducted a systematic review, revealing the almost complete absence of experiments in which the use of technology is not mediated by the teacher. These results reflect a pessimistic vision within the field of mathematics education about the possibilities of learning when the student uses technology autonomously. Bringing good outcomes out of a bad situation, the pandemic crisis may represent a turning point from which to start directing the research gaze towards technological environments such as those mediated by artificial intelligence. As an example, we provide a study illustrating to what extent intelligent tutoring systems can be cost-effective compared to one-to-one human tutoring and mathematic learning-oriented solutions for intensive supervision in the teaching of word problem solving, especially appropriate for remote settings. Despite the potential of these technologies, the experience also showed that student socioeconomic level was a determining factor in the participation rate with an intelligent tutoring system, regardless of whether or not the administration guaranteed students' access to technological resources during the COVID-19 situation.

Design-Oriented Thinking in STEM education: Exploring the Impact on Preschool Children's Twenty-First-Century Skills

Given early childhood is a critical period for acquiring the twenty-first-century skills, the present study aimed to examine the effect of design-oriented STEM activities on the twenty-first-century skills of preschool children in line with the experimental design. A mixed factorial analysis of variance (ANOVA) of 3 (time: pre-test, post-test and persistence) × 2 (experimental group and control group) was used to test the hypothesis. The Bayesian factor analysis for mixed data was performed to identify the effects of design-oriented STEM education on differences between groups as well as within the group. The study results indicated that design-oriented STEM activities permanently increased the total scores of the children in the experimental group as regards the twenty-first-century skills. It also appeared that design-oriented STEM activities permanently enhanced all sub-dimensions of life and career skills; learning and innovation skills; and information, media and technology skills. In the end, a number of recommendations were presented in accordance with the results of the study.

Oversampled and undersolved: Depressive rumination from an active inference perspective

Rumination is a widely recognized cognitive deviation in depression. Despite the recognition, researchers have struggled to explain why patients cannot disengage from the process, although it depresses their mood and fails to lead to effective problem-solving. We rethink rumination as repetitive but unsuccessful problem-solving attempts. Appealing to an active inference account, we suggest that adaptive problem-solving is based on the generation, evaluation, and performance of candidate policies that increase an organism's knowledge of its environment. We argue that the problem-solving process is distorted during rumination. Specifically, rumination is understood as engaging in excessive yet unsuccessful oversampling of policy candidates that do not resolve uncertainty. Because candidates are sampled from policies that were selected in states resembling one's current state, "bad" starting points (e.g., depressed mood, physical inactivity) make the problem-solving process vulnerable for generating a ruminative "halting problem". This problem leads to high opportunity costs, learned helplessness and diminished overt behavior. Besides reviewing evidence for the conceptual paths of this model, we discuss its neurophysiological correlates and point towards clinical implications.

The association of prenatal manganese exposure with problem-solving skills and its mediation by the building blocks of executive function

BACKGROUND

Problem-solving skills build upon three core executive functions: inhibition, working memory, and cognitive flexibility. There is evidence of adverse associations of prenatal exposure to manganese (Mn) with core executive functions, but less is known about Mn associations with problem-solving or potential mediators of this association.

OBJECTIVES

This study aimed to investigate the association of prenatal Mn exposure with problem-solving and to identify potential neuropsychological mechanisms through which this association may be mediated.

METHODS

Study participants were 410 adolescents from the New Bedford Cohort (NBC) who have undergone periodic evaluations since their birth (1993-1998) to mothers residing near a Massachusetts Superfund site. We investigated the association of cord blood Mn with problem-solving measured by the Delis-Kaplan Executive Function System (D-KEFS) Sorting and Tower subtests (scores scaled to a mean ± SD of 10 ± 3) using multivariable linear regression. Inhibition and cognitive flexibility were also measured by the D-KEFS; working memory was measured with the Wide Range Assessment of Memory and Learning, 2nd edition. Regression-based causal mediation analysis was used to assess the proportion of the Mn-problem-solving association mediated by inhibition, working memory, and cognitive flexibility individually and jointly.

RESULTS

NBC adolescents (mean age 15.5 years) were socio-demographically diverse with 31 % in a low-income household at birth and had cord blood Mn concentrations similar to other general population samples. Mn was associated with Sorting but not Tower scores. Specifically, a doubling of cord blood Mn concentrations was associated with - 0.59 points lower (95 % CI: -1.16, -0.03) Sort Recognition score. In mediation analyses, there was suggestive evidence that inhibition, working memory, and cognitive flexibility combined mediated 30 % of the total effect of Mn on Sorting. When analyzed individually, working memory mediated a larger proportion (24 %) of the effect than inhibition or cognitive flexibility.

DISCUSSION

We observed adverse associations of cord blood Mn with problem-solving among adolescents. There was suggestive evidence that the building blocks of executive function jointly, and working memory individually, were potentially important mediators of this association.

Perspectives on mathematics competitions and their relationship with mathematics education

The nature of the area of mathematical competitions as a design science is considered, historical roots of mathematical problem-solving competitions are traced, the complementary aspects of mathematics as theory building and as problem solving are touched upon in relation to the practice of competitions. Two historical figures, Euler and Erdős, emerge, and the appropriateness of many of Euler's mathematical ventures are seen as role models for competition mathematics as first put into practice in mathematical competitions towards the end of the nineteenth century. Distinctions and definitions are made, a venture into identifying competition syllabi and the principal types of reasoning employed in solving competition problems is explored, and a description of the many different types of competitions is considered. Interaction between the field of mathematics itself and problem-solving competitions is briefly explored, as are the possibilities that open when competitions and their access to huge amounts of data, both national and international, are taken into account in research belonging to mathematics education. Finally, the range of topics addressed in this special issue of ZDM is covered, along with some possible conclusions relating to the components of the overview.

A comparison of the academic performance of graduate entry and undergraduate entry pharmacy students at the course exit level

INTRODUCTION

Graduate entry (GE) pharmacy students are trained in a shorter timeframe than undergraduate entry (UE) students. This study compares the academic performance of GE and UE pharmacy students at the course exit point.

METHODS

A retrospective analysis of final exam grades in written and objective structured clinical examination (OSCE) was performed between GE and UE students from three graduating cohorts. Final written examination contained clinical case study questions, whereas OSCE involved role play with simulated patients or doctors. Statistical analyses were performed by t-test and one-way analysis of variance at .05 significance level and Pearson's correlation coefficient.

RESULTS

No significant difference in academic performance was seen between GE and UE groups at course exit (P > .05). There was a trend for GE students performing marginally better in OSCE than UE students. Females showed better performances in verbal communication than males. GE males showed significantly lower empathy scores than all other groups. No significant difference was seen in problem-solving scores amongst all groups. Both UE and GE groups scored significantly better in written examinations compared with OSCE.

CONCLUSIONS

Graduate entry pharmacy students from accelerated learning pathway and UE students performed similarly at the course exit point, providing empirical support for non-traditional graduate entry pathway as a viable option.

Too perfect to be good? An investigation of magicians' Too Perfect Theory

The "Too Perfect Theory" states that if a trick is too perfect, it might paradoxically become less impressive, or give away its secret method. This theory suggests that an increased impossibility results in a less magical effect. The Too Perfect Theory is often applied to magic effects, but it conflicts with recent scientific investigations showing that participants' level of enjoyment of a magic performance is positively related to their perceived impossibility of the trick. The current article investigated whether an imperfect magic performance is more impressive than a perfect one. Across two experiments, we studied whether participants enjoy a performance more if the effect is not perfect. We also examined the different types of explanations people give to these two types of performances. The results showed that participants enjoyed a perfect performance more than an imperfect one. However, consistently with the Too Perfect Theory, participants watching the perfect performance also discovered the correct method behind the magic trick more frequently and believed the performance was staged more often. Moreover, participants' method explanation significantly impacted their reports about the performance.

Negative mood induction effects on problem-solving task in women with eating disorders: a multi-method examination

BACKGROUND

The effects of negative affect on problem-solving and its psychophysiological correlates are poorly understood in eating disorder populations.

METHODS

This study examined respiratory sinus arrhythmia (RSA) and skin conductance responses of women with Binge Eating Disorder (BED: n = 56), Anorexia Nervosa (AN: n = 12), Bulimia Nervosa (BN: n = 32), and 24 healthy controls (HCs) at baseline, and then during: a negative mood induction task, an adapted Means Ends Problem-Solving (MEPS) task, and recovery. The MEPS task included four interpersonal scenarios: (1) binge-eating as a solution to stress, (2) job loss, (3) rejection by friends, and (4) by a significant other.

RESULTS

We found that individuals with eating disorders reported less positive mood than HCs and individuals with BN and BED reported more negative mood and greater urges to binge than HCs. After a negative mood induction, women with BED provided significantly less effective problem-solving strategies compared to HCs and women with BN for the binge-eating MEPS scenario. Relative to baseline and the negative mood induction, all participants exhibited significantly higher skin conductance measures throughout the MEPS scenarios and recovery. BED showed significantly lower respiratory sinus arrhythmia (RSA) levels than individuals with BN and HCs throughout the protocol.

CONCLUSIONS

The multimethod findings suggest individuals with BED are likely to have disorder-specific problem-solving difficulties after a negative mood induction.

Domestication effects on social information transfer in chickens

Red junglefowl (RJF), ancestor of all domesticated chickens, is a highly social, omnivorous bird species, presumably with a capacity for social information sharing. During domestication, birds have been selected to live in large, dynamic groups, and this may have affected their social cognition. Here, we studied social information transfer in female RJF and domesticated White Leghorn (WL) chickens. Individuals were trained to open a puzzle-box feeder by pecking a lid and we then recorded the behaviour towards the same puzzle-box feeder for birds that had either observed the trained individual (“guided”) or saw the puzzle-box feeder for the first time (“naïve”). WL were considerably faster in approaching the feeder regardless of prior demonstration and pecked more at it. Both breeds were significantly faster to approach the puzzle-box feeder and pecked more after prior demonstration, but the effects were significantly stronger in WL. We conclude that both RJF and WL can utilize social information to address a novel problem, but during domestication this ability appears to have increased. The effects can be an effect of either social learning or stimulus enhancement. Some caution in this conclusion is necessary since we tested relatively few WL. Furthermore, possible confounding explanations include higher fearfulness in RJF and different effects of dominance interactions between demonstrators and observers.

Dynamics of hidden brain states when people solve verbal puzzles

When people try to solve a problem, they go through distinct steps (encoding, ideation, evaluation, etc.) recurrently and spontaneously. To disentangle different cognitive processes that unfold throughout a trial, we applied an unsupervised machine learning method to electroencephalogram (EEG) data continuously recorded while 39 participants attempted 153 Compound Remote Associates problems (CRA). CRA problems are verbal puzzles that can be solved in either insight-leaning or analysis-leaning manner. We fitted a Hidden Markov Model to the time-frequency transformed EEG signals and decoded each trial as a time-resolved state sequence. The model characterizes hidden brain states with spectrally resolved power topography. Seven states were identified with distinct activation patterns in the theta (4-7 Hz), alpha (8-9 Hz and 10-13 Hz), and gamma (25-50 Hz) bands. Notably, a state featuring widespread activation only in alpha-band frequency emerged, from this data-driven approach, which exhibited dynamic characteristics associated with specific temporal stages and outcomes (whether solved with insight or analysis) of the trials. The state dynamics derived from the model overlap and extend previous literature on the cognitive function of alpha oscillation: the "alpha-state" probability peaks before stimulus onset and decreases before response. In trials solved with insight, relative to solved with analysis, the alpha-state is more likely to be visited and maintained during preparation and solving periods, and its probability declines more sharply immediately preceding a response. This novel paradigm provides a way to extract dynamic features that characterize problem-solving stages and potentially provide a novel window into the nature of the underlying cognitive processes.

A classroom-based patient case activity as a potential formative indicator of pre-advanced pharmacy practice experience readiness

BACKGROUND AND PURPOSE

Pharmacy programs must assess student readiness for advanced pharmacy practice experiences (APPEs). This study evaluated: (1) if a relationship exists between student performance on a classroom-based patient case activity (Rx Review) and (2) performance on direct patient care and perceptions of the transferability of Rx Reviews to the APPE setting.

EDUCATIONAL ACTIVITY AND SETTING

Rx Reviews are timed, independent, prospective reviews of a patient's medical record intended to simulate pre-rounding activities common in acute and ambulatory care settings. Students complete 12 Rx Reviews across a skills laboratory course sequence. Rx Review scores were compared to performance on acute care and ambulatory care APPEs for students in the Class of 2019 using descriptive statistics for student scores and bivariate logistic regression for the association between Rx Review scores and performance outcomes on patient care APPEs. Student perceptions of the Rx Reviews were assessed through a survey. Descriptive statistics and qualitative responses were used to analyze responses to the multiple-choice survey questions and open-ended question, respectively.

FINDINGS

One hundred twenty-two students participated in the study. A relationship was found between students' Rx Review scores and performance in certain direct patient care APPEs, with students performing in the bottom 50% on Rx Reviews being more likely to perform poorly on those APPEs. Over 93% of students identified Rx Reviews as at least somewhat helpful in preparing them for APPEs.

SUMMARY

This study indicated that a classroom-based patient case activity could be used as a formative measure of APPE readiness.

Learning with a digital escape room game: before or after instruction?

In this study, we investigated whether playing an escape room game after explicit instruction (instruction-first group, N = 20) is more effective to learn about copyright and media law than playing the game before explicit instruction (problem-solving-first group, N = 21). This is an important question as escape room games are complex, problem-based learning environments that can overwhelm learners and thus hinder the acquisition of knowledge and skills. According to cognitive load theory, preparing learners with explicit instruction before problem-solving activities can overcome this problem leading to better learning. However, in the productive failure paradigm problem-solving before explicit instruction is seen as more effective, especially when it comes to the application of newly acquired knowledge to solve novel problems. Based on these two theories, we conducted an experiment and found that playing the developed digital escape room game after explicit instruction was more effective for knowledge retention and domain-specific self-efficacy with at the same time lower cognitive load. However, we found no differences regarding the application of knowledge as both groups scored equally high on transfer tasks. The result is discussed considering previous productive failure studies mostly conducted in the science and engineering domain. In sum, the instruction first approach proved to be effective for both knowledge acquisition and knowledge application, leading to higher domain-specific self-efficacy and lower cognitive load. Therefore, we conclude that the implementation of escape room games after instruction is an effective instructional approach and better suited to promote learning than playing escape room games before instruction.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s41039-022-00187-x.

Medicinal chemistry: The key to critical thinking in pharmacotherapy

INTRODUCTION

Medicinal chemistry is a polarizing subject for pharmacy students where, if not embraced, future pharmacists may be limited in their role as drug experts. An understanding of medicinal chemistry and its structure-activity relationships creates a strong foundation upon which our knowledge of pharmacotherapy is built.

PERSPECTIVE

As the field of pharmacy has shifted to an increasingly clinical role, with an emphasis on patient care as a member of the interprofessional team, pharmacy has also seen an increase in postgraduate training, specifically residencies and fellowships. Pharmacy students noting this trend may depreciate medicinal chemistry early in the curriculum and place more focus on therapeutics and clinical rotations. However, forgoing the fundamental understanding of medicinal chemistry may hinder pharmacy students' current breadth and understanding, and the ability to rationalize future developments in their practice. Medicinal chemistry empowers pharmacists with the ability to reason through medications' impact versus simply memorizing their actions. Pharmacists play a unique role as drug experts, with advanced problem-solving and critical thinking skills that set them apart from drug references and search engines.

IMPLICATIONS

As the field moves towards pharmacists as a member of the clinical team, the faculty should integrate medicinal chemistry throughout the doctor of pharmacy curricula. Faculty without this ability for a curriculum change should consider integration in their content. The field of pharmacy must take care to not allow clinical knowledge to significantly overshadow the importance of medicinal chemistry or run the risk of saturating the field with underprepared pharmacists.

The effectiveness of group problem-solving therapy on women's sexual function and satisfaction after mastectomy surgery

Background

Breast cancer is the second cause of death and the most common cancer in women worldwide, threatening different aspects of individual and mental health, quality of life, sexual function, and sexual satisfaction. This study aimed to determine the effectiveness of group counseling based on a problem-solving solution on women's sexual function and satisfaction after mastectomy surgery.

Methods

The present research was an open pilot study, with a pretest, a post-test, and a follow-up period. Of women referred to the Tehran Breast Cancer Institute, 32 were selected using convenience sampling. The group received eight 90-min sessions of problem-solving solution counseling. This approach is based on cognitive-behavioral therapy and can improve an individual's ability to cope with stressful life experiences. The data collection tool was FSFI and sexual satisfaction questionnaires, which were filled before the intervention (baseline), immediately after the intervention, and one month later (follow up). Data analysis was performed using SPSS 21 statistical software application at the certainty level of 95% (P < 0.05).

Results

The mean FSFI score increased from 18.37 ± 8.35 before the intervention to 20.88 ± 7.67 immediately after the intervention and 22.95 ± 5.79 one month later (P < 0.0001). Also, the mean sexual satisfaction score was 65.27 ± 5.98, 68.08 ± 5.61, and 70.46 ± 5.35 before the intervention, immediately after the intervention, and one month later, respectively (P < 0.05). The results also showed that although the two components of sexual function and satisfaction were statistically significant after sexual counseling, this improvement was not clinically progressive. The mean sexual function and satisfaction score was still low after sexual counseling.

Conclusions

It was observed that sexual function and satisfaction were improving among the patients after the intervention. Thus, sexual health counseling sessions are recommended for breast cancer patients.

Improving Our Understanding of Impaired Social Problem-Solving in Children and Adolescents with Conduct Problems: Implications for Cognitive Behavioral Therapy

In cognitive behavioral therapy (CBT) children and adolescents with conduct problems learn social problem-solving skills that enable them to behave in more independent and situation appropriate ways. Empirical studies on psychological functions show that the effectiveness of CBT may be further improved by putting more emphasis on (1) recognition of the type of social situations that are problematic, (2) recognition of facial expressions in view of initiating social problem-solving, (3) effortful emotion regulation and emotion awareness, (4) behavioral inhibition and working memory, (5) interpretation of the social problem, (6) affective empathy, (7) generation of appropriate solutions, (8) outcome expectations and moral beliefs, and (9) decision-making. To improve effectiveness, CBT could be tailored to the individual child's or adolescent's impairments of these psychological functions which may depend on the type of conduct problems and their associated problems.

Young children spontaneously invent three different types of associative tool use behaviour

Associative Tool Use (ATU) describes the use of two or more tools in combination, with the literature further differentiating between Tool set use, Tool composite use, Sequential tool use and Secondary tool use. Research investigating the cognitive processes underlying ATU has shown that some primate and bird species spontaneously invent Tool set and Sequential tool use. Yet studies with humans are sparse. Whether children are also able to spontaneously invent ATU behaviours and at what age this ability emerges is poorly understood. We addressed this gap in the literature with two experiments involving preschoolers (E1, N = 66, 3 years 6 months to 4 years 9 months; E2, N = 119, 3 years 0 months to 6 years 10 months) who were administered novel tasks measuring Tool set, Metatool and Sequential tool use. Participants needed to solve the tasks individually, without the opportunity for social learning (except for enhancement effects). Children from 3 years of age spontaneously invented all of the types of investigated ATU behaviours. Success rates were low, suggesting that individual invention of ATU in novel tasks is still challenging for preschoolers. We discuss how future studies can use and expand our tasks to deepen our understanding of tool use and problem-solving in humans and non-human animals.

Mediating effects of self-directed learning on the relationship between critical thinking and problem-solving in student nurses attending online classes: A cross-sectional descriptive study

BACKGROUND

With the increased prevalence of online education due to the coronavirus 2019 pandemic and advancements in information technology, essential competencies, such as critical thinking, self-directed learning, and problem-solving ability, should be examined among student nurses taking online classes.

OBJECTIVES

Based on the findings of several studies suggesting that critical thinking does not affect problem-solving, this study aimed to examine the relationship among critical thinking, self-directed learning, and problem-solving in student nurses attending online classes, and to determine whether self-directed learning could mediate the relationship between critical thinking and problem-solving.

DESIGN

Cross-sectional, descriptive design.

SETTING

K University in South Korea.

PARTICIPANTS

In total, 138 junior and senior nursing students were enrolled.

METHODS

The critical thinking disposition scale for nursing students, self-directed learning scale, and problem-solving scale for college students were used to quantify participants' responses.

RESULTS

Our results revealed significant positive correlations among critical thinking, self-directed learning, and problem-solving. Furthermore, self-directed learning (β = 0.78, p < 0.001) had a significant mediating effect on the relationship between critical thinking and problem-solving ability (Z = 5.10, p < 0.001).

CONCLUSION

Developing and implementing appropriate self-directed learning programs are critical for improving problem-solving ability affected by critical thinking among student nurses engaged in online education.

Perspective-taking and hindsight bias: When the target is oneself and/or a peer

President Trump reacted to a reporter's query about the coronavirus outbreak by stating that the reporter was a "lousy journalist", underscoring the importance of perspective-taking in social exchanges. Egocentrism is the belief that others share the same perspective as your own and hampers the perspective-taking of another naive person. An issue is whether it is seen in hindsight bias where we overestimate what we knew beforehand. Via a foreseeability-inevitability platform, participants were randomly assigned to make self-judgments for problem-solving from a foresight (no answers) or three hindsight (answers) conditions. In two hindsight conditions, participants were asked to ignore or not to ignore the answers. In the last condition, participants predicted for an unfamiliar peer asked to ignore the answers. Next, all participants made judgments again from the perspective of the peer. Predominately in hindsight, participants showed significant changes responding but with an appropriate baseline comparison showed essentially the same hindsight bias in judgments for themselves and the peer. Ignoring or not ignoring the answers produced the same outcome. This sharing of perspective-taking dovetails with individuals' believing their hindsight knowledge is commonly present among others. Although participants in hindsight believed their foreseeable predictions for the peer were more accurate or realistic, it was more challenging to predict for the peer than themselves. Implications for individuals' judgments about Donald Trump 's decision-making for COVID-19 are discussed. Researchers should examine perspective-taking in hindsight bias as everyday social interaction involves reasoning about others.

Planning in amnestic mild cognitive impairment: an fMRI study

INTRODUCTION

The memory impairment that is characteristic of amnestic mild cognitive impairment (aMCI) is often accompanied by difficulties in executive functioning, including planning. Though planning deficits in aMCI are well documented, their neural correlates are largely unknown, and have not yet been investigated with functional magnetic resonance imaging (fMRI).

OBJECTIVES

The aim of this study was to: (1) identify differences in brain activity and connectivity during planning in people with aMCI and cognitively healthy older adults, and (2) find whether planning-related activity and connectivity are associated with cognitive performance and symptoms of apathy.

METHODS

Twenty-five people with aMCI and 15 cognitively healthy older adults performed a visuospatial planning task (Tower of London; ToL) during fMRI. Task-related brain activation, spatial maps of task-related independent components, and seed-to-voxel functional connectivity were compared between the two groups and regressed against measures of executive functions (Trail Making Test difference score, TMT B-A; Digit Symbol Substitution Test, DSST), delayed recall (Rey Auditory Verbal Learning Test), and apathy (Apathy Evaluation Scale).

RESULTS

People with aMCI scored lower on task-switching (TMT B-A), working memory (DSST), and planning (ToL). During planning, people with aMCI had less activation in the bilateral anterior calcarine sulcus/cuneus, the bilateral temporal cortices, the left precentral gyrus, the thalamus, and the right cerebellum. Across all participants, higher planning-related activity in the supplementary motor area, the retrosplenial cortex and surrounding areas, and the right temporal cortex was related to better delayed recall. There were no between-group differences in functional connectivity, nor were there any associations between connectivity and cognition. We also did not find any associations between brain activity or connectivity and apathy.

CONCLUSION

Impaired planning in people with aMCI appears to be accompanied by lower activation in a diffuse cortico-thalamic network. Across all participants, higher planning-related activity in parieto-occipital, temporal, and frontal areas was related to better memory performance. The results point to the relevance of planning deficits for understanding aMCI and extend its clinical and neurobiological signature.