[Integration and differentiation in forensic expertise solving interdisciplinary tasks]

The purpose of the study is to consider the issues of integration and differentiation in forensic examination, to establish their significance in the formation of new types (genera) of forensic examination, in particular traceological and forensic medical examinations, to determine the possibilities of a comprehensive examination at the interdisciplinary level and the role of language in the production of complex examinations.

Surgeon level of expertise reported in Journal of Hand Surgery (American Volume) and (European Volume) publications

The purpose of the study was to evaluate the trend in documentation of surgeon level of expertise among the Journal of Hand Surgery (American Volume) and the Journal of Hand Surgery (European Volume) publications. A review of Journal of Hand Surgery (American Volume) and Journal of Hand Surgery (European Volume) databases for level of expertise between January 2015 and October 2019 was performed. Of 1042 articles identified, all 115 (20%) reporting level of expertise were published in Journal of Hand Surgery (European Volume). Since 2015, there has been an increase in reported level of expertise in Journal of Hand Surgery (European Volume) (2015: 8 (7%); 2016: 15 (13%); 2017: 22 (19%); 2018: 28 (24%); 2019: 42 (37%)). In the same period, no publications have reported level of expertise in Journal of Hand Surgery (American Volume). Documenting level of expertise may provide readers with additional information for incorporation of novel techniques into their practices. It may identify procedures that require a baseline level of expertise for effective performance. Further evaluation of level of expertise criteria may improve the reliability of the numeric scale, while widespread adoption of this scale will allow future outcome analysis by level of expertise.

Lung sonography can improve the specificity of determination of left-sided double-lumen tracheal tube position in both novices and experts: a randomised prospective study

Objective

Lung sonography can be helpful to determine the position of a left-sided double-lumen tube (DLT). However, clinical experience is required for correct assessment. We investigated whether lung sonography can improve the diagnostic efficacy of determining the DLT position in novices and experts.

Methods

In this randomised prospective clinical study, 88 patients were allocated to two groups using auscultation or lung sonography for initial assessment of the DLT position. In each group, two repeated assessments were performed; the first was performed by a novice, and the second was performed by an expert. The final DLT position was confirmed by fibre-optic bronchoscopy. The primary outcome was the diagnostic efficacy (including overall accuracy, sensitivity, and specificity) in confirming the DLT position.

Results

In both the novices and experts, the specificity of determining the DLT position was significantly higher with lung sonography than auscultation (60.0% vs. 21.7% and 66.7% vs. 37.5%, respectively). Additionally, the predictability of an incorrect position was similar between the novices and experts using lung sonography (area under the curve of 0.665 and 0.690, respectively).

Conclusions

Lung sonography can improve the diagnostic efficacy of detecting an incorrect DLT position in both novices and experts.

Kinetics of stone tool production among novice and expert tool makers

OBJECTIVES

As is the case among many complex motor tasks that require prolonged practice before achieving expertise, aspects of the biomechanics of knapping vary according to the relative experience/skill level of the practitioner. In archaeological experiments focused on the production of Plio-Pleistocene stone tools, these skill-mediated biomechanical differences have bearings on experimental design, the interpretation of results, and lithic assemblage analysis. A robust body of work exists on variation in kinematic patterns across skill levels but less is known about potential kinetic differences. The current study was undertaken to better understand kinetic patterns observed across skill levels during "Oldowan," freehand stone tool production.

MATERIALS AND METHODS

Manual pressure data were collected from 23 novice and 9 expert stone tool makers during the production of simple stone flakes using direct hard hammer percussion.

RESULTS

Results show that expert tool makers experienced significantly lower cumulative pressure magnitudes and pressure-time integral magnitudes compared with novices. In expert knappers, digits I and II experienced similarly high pressures (both peak pressure and pressure-time integrals) and low variability in pressure relative to digits III-V. Novices, in contrast, tended to hold hammerstones such that pressure patterns were similar across digits II-V, and they showed low variability on digit I only.

DISCUSSION

The similar and consistent emphasis of the thumb by both skill groups indicates the importance of this digit in stabilizing the hammerstone. The emphasis placed on digit II is exclusive to expert knappers, and so this digit may offer osteological signals diagnostic of habitual expert tool production.

Experiences and mentoring needs of novice nurse educators at a public nursing college in the Eastern Cape

Background

When novice nurse educators enter academia, they are expected to demonstrate and implement knowledge in the clinical and classroom environment. However, when one enters academia without proper guidance and support, these expectations create lack of role models. Although mentorship has proved to make the transition easier, there is a lack of mentoring in most nursing schools and/or departments at higher education institutions in South Africa because of scarcity of mentoring programmes for novice nurse educators.

Aim

The aim of this study was to explore and describe the experiences and mentoring needs of novice (newly qualified) nurse educators at a public nursing college in the Eastern Cape, to make recommendations for the mentoring of novice nurse educators.

Setting

Urban and rural public nursing college campuses and sub-campuses in the Eastern Cape.

Methods

Qualitative research approach and exploratory, descriptive, contextual and phenomenological designs were used. Sampling was purposive, data were collected by using semi-structured individual interviews and analysed using Tesch’s method.

Results

Five themes emerged from this study. Findings indicated that novice nurse educators experienced lack of theoretical and clinical mentoring and lack of orientation and resources. Participants also provided recommendations to optimise the experience and performance of novice nurse educators.

Conclusion

Lack of mentoring causes difficult transition by novice nurse educators from the nursing role into the nurse educator role. The implementation of the recommendations on mentoring of novice nurse educators would optimise the experience and performance of the novice nurse educators, thus enhance their smooth transition into academia.

[Forensic medical examination in the context of expanding the possibility of competitiveness realization in criminal proceedings]

The involvement of special knowledge in criminal proceedings has always created the problem of assessing the reliability of conclusions formulated on the basis of their application. At the beginning of the 20th century, one of the ways to solve this problem was the expansion of competition between the parties. For a long time, in criminal proceedings, competition has not been actively developed due to the particular historical development of society and the state. In the same period, it became a separate medical profession and the formation of a domestic forensic medical examination took place. With the adoption in 2001 of the current Code of Criminal Procedure, competition as a principle returned to the domestic criminal proceedings (Article 15 of the Code of Criminal Procedure of Russian Federation. Competition of the parties). In the practice of forensic medical examination, little has changed, since, on the one hand, the involvement of an expert's opponent in the process was difficult to implement, and on the other hand, his participation in criminal proceedings for several reasons had little effect on the outcome of case. At the same time, forensic medical examination remained an unshakable pillar in cases of crimes against health and life (and in other categories of cases whose corpus delicti provides for harm to health). The situation began to change rapidly from April 2017 after the coming into force of a number of federal laws that significantly simplified the organization of opposing an expert in criminal proceedings and created the conditions for a more critical assessment of an expert opinion. The purpose of the work is to analyze the consequences of federal laws for forensic expert practice.

A Phenomenographic Approach to Understanding the Expertise of Perioperative Nurses

Understanding the ways that perioperative nurses view the acquisition of expertise may provide foundational information for perioperative nurse educators. Our study aimed to evaluate specific types of expertise exhibited by experienced perioperative nurses and identify how nurses perceived these areas of expertise. We interviewed 20 perioperative nurses working in a university hospital in Korea. We extracted six themes regarding perioperative nursing expertise: sticking to principles, using available resources in complex situations, paying close attention to details, seeing the whole picture, prioritizing actions according to patients' conditions, and organizing a team to maximize efficiency. These findings may help perioperative educators develop practical educational strategies for novice perioperative nurses by providing a common language regarding the areas of expertise exhibited by experienced perioperative nurses.

Outcome Bias in Clinical Negligence Medico-legal Cases

Independent medical experts provide reports in clinical negligence claims brought against doctors and other health care professionals. They are asked to provide an opinion on whether the doctor has breached their duty of care to the patient, commonly described as the "Bolam Principle". By the time a patient litigates against a health care professional, the clinical sequence and outcome are known. Experts provide their opinions with the benefit of this knowledge. To determine whether knowledge of the outcome affects the expert's opinion, 42 independent general practice experts were asked to indicate whether a general practitioner had breached their duty of care in six clinical case scenarios. 21 were told the clinical outcome. Experts who knew the outcome were less likely to support the general practitioner's course of action, although this did not reach statistical significance. General practitioners demonstrated considerable "dove" or "hawk" variability when giving opinions on the same scenario.

Comparison of still image quality between traditional 35 mm digital and GoPro cameras in a surgical setting

Intraoperative photography is used to obtain images for both education and research purposes, but poses challenges due concerns regarding aseptic technique. Waterproof digital cameras have sterilisable cases that can be used by the surgeon for intraoperative photography. We compared the quality of still intraoperative images obtained by a non-scrubbed observer using a 35 mm single lens reflex (SLR) camera to images obtained by the surgeon using a GoPro camera in a sterilised case. Image quality was scored using a 4 point Likert scale by 3 groups of end users with differing experience: faculty surgeons, surgical residents, and 3rd year veterinary students. Mean ± SEM overall image quality scores were higher for the traditional 35 mm digital SLR camera when compared to the GoPro (3.25 ± 0.08 vs. 2.0 ± 0.08, p < .0001), as were scores for each image characteristic (brightness, colour, sharpness, and contrast). Image quality scores for each camera also differed significantly between user groups, with expert users (faculty and residents) giving lower quality scores when compared to scores from novices (students). Findings suggest that GoPro cameras provide lower intraoperative image quality than digital SLR cameras, although lower quality images may be more accepted by novices than by experienced users.

Oxytocin Facilitates Social Learning by Promoting Conformity to Trusted Individuals

There is considerable interest in the role of the neuropeptide oxytocin in promoting social cohesion both in terms of promoting specific social bonds and also more generally for increasing our willingness to trust others and/or to conform to their opinions. These latter findings may also be important in the context of a modulatory role for oxytocin in improving the efficacy of behavioral therapy in psychiatric disorders. However, the original landmark studies claiming an important role for oxytocin in enhancing trust in others, primarily using economic game strategies, have been questioned by subsequent meta-analytic approaches or failure to reproduce findings in different contexts. On the other hand, a growing number of studies have consistently reported that oxytocin promotes conformity to the views of groups of in-group individuals. Most recently we have found that oxytocin can increase acceptance of social advice given by individual experts without influencing their perceived trustworthiness per se, but that increased conformity in this context is associated with how much an expert is initially trusted and liked. Oxytocin can also enhance the impact of information given by experts by facilitating expectancy and placebo effects. Here we therefore propose that a key role for oxytocin is not in facilitating social trust per se but in conforming to, and learning from, trusted individuals who are either in-group members and/or perceived experts. The implications of this for social learning and use of oxytocin as an adjunct to behavioral therapy in psychiatric disorders are discussed. Interpersonal trust within social groups is of key importance for social interactions, bonds, cooperation and learning and trust between different groups can also help ensure a stable and peaceful co-existence as well as mutually beneficial co-operation and trade. Trust is generally considered to be critical for co-operation and reciprocity in social and economic interactions but importantly trust also involves risk of potential injury if misplaced or broken and we have a natural aversion to taking such risks (Hardin, 2002; Ostrom and Walker, 2003). Indeed, an important factor influencing our trust behavior is that we are strongly motivated to avoid others betraying our trust (Bohnet and Zeckhauser, 2004; Bohnet et al., 2008). Trust can potentially be influenced by our assessment of the level of risk that trusting others might have and also by increased sensitivity to physical and/or other cues for detecting trustworthiness. It is therefore of great importance to identify both behavioral and physiological factors which can act to enhance trust, particularly in situations where individuals have impaired trust and therefore find it hard to interact socially with others and learn from them and/or to benefit optimally from cognitive and behavioral therapeutic strategies.

Connectivity Analysis Using Functional Brain Networks to Evaluate Cognitive Activity during 3D Modelling

Modelling 3D objects in CAD software requires special skills which require a novice user to undergo a series of training exercises to obtain. To minimize the training time for a novice user, the user-dependent factors must be studied. we have presented a comparative analysis of novice/expert information flow patterns. We have used Normalized Transfer Entropy (NTE) and Electroencephalogram (EEG) to investigate the differences. The experiment was divided into three cognitive states i.e., rest, drawing, and manipulation. We applied classification algorithms on NTE matrices and graph theory measures to see the effectiveness of NTE. The results revealed that the experts show approximately the same cognitive activation in drawing and manipulation states, whereas for novices the brain activation is more in manipulation state than drawing state. The hemisphere- and lobe-wise analysis showed that expert users have developed an ability to control the information flow in various brain regions. On the other hand, novice users have shown a continuous increase in information flow activity in almost all regions when doing drawing and manipulation tasks. A classification accuracy of more than 90% was achieved with a simple K-nearest neighbors (k-NN) to classify novice and expert users. The results showed that the proposed technique can be used to develop adaptive 3D modelling systems.

Protocol for a systematic evaluation of pediatric pharmacy development and pediatric pharmacy experts' research area in China

BACKGROUND

The pediatric pharmacy research status of children's hospitals in China is still unknown. Our previous findings suggest the regional differences in academic level in tertiary (grade III level A) children's hospitals in China.

METHODS

This systemic evaluation described in this protocol will be conducted to follow the Cochrane Handbook. We will perform a systemic literature search of relevant databases including Chinese databases (CNKI, Wanfang Data, VIP Paper Check System) and English databases (Medline, EMbase, Cochrane Library) from inception to December 31, 2018. The search strategy will be enacted according to the guidance offered from the Cochrane Handbook. Two rounds of searches will be conducted to prevent the omission of relevant literature. A pre-set grading standard will be used to give calculation weight (W) to evaluate the quality of each article. Data synthesis will be performed using STATA software (version 13.1, Statacorp, College Station, Texas). Pediatric pharmacy development index (PPDI) of each hospital will be used to evaluate the pediatric pharmacy development in each tertiary children's hospitals. The cumulative calculation weight (∑W) and annual calculation weight (∑yearW) will be used to evaluate the academic level of pharmaceutical departments in different tertiary children's hospitals. Subgroup analysis will be performed to compare the number of different types of articles published between different hospitals base on different research areas such as policy research, basic research, and clinical research.

RESULTS

In this article, we will evaluate pediatric pharmacy development and the research area of pediatric pharmacy experts in China. Based on the results from this research, we will analyze the professional backgrounds of pediatric pharmacy experts from 23 tertiary children's hospitals in China. According to the contents and research directions of literature published by the pediatric pharmacy experts in these 23 hospitals, we will determine the professional field of pediatric pharmacy experts and establish an expert database. In the process of formulating the related national or local policies in the future, the expert database will be selected accurately to reach the expert consensus.

CONCLUSION

Our study will provide a comprehensive picture of pediatric pharmacy development in China. The pediatrics pharmacy expert's database constructed by this study will be used to build consensus on pediatric pharmacology in the future.

Hippocrates to Nightingale: Converging or Diverging Concepts in Patient Management and Decision Making

Although medicine and nursing are complementary and equally important, paradoxically the relationship can appear adversarial at times. Physicians and nurses work concurrently and conjointly in hospitals where patients are admitted for round-the-clock nursing care to help cure or attenuate diseases. Roles are further obscured for advanced practice nurses and physicians when they perform the same function, such as in the practice of anesthesia. Regarding physician-nurse relationships, the following questions become apparent:Why do these professions compete over the right to take care of patients? Where and when did this conflict originate? Answers are complicated and multifactorial. This commentary briefly reviews the history of the establishment of medicine and nursing, discusses gender roles, and summarizes differences in education and training between the two disciplines.

Evaluation of the quality of transesophageal echocardiography images and verification of proficiency

Various metrics have been used in curriculum-based transesophageal echocardiography (TEE) training programs to evaluate acquisition of proficiency. However, the quality of task completion, that is the final image quality, was subjectively evaluated in these studies. Ideally, the endpoint metric should be an objective comparison of the trainee-acquired image with a reference ideal image. Therefore, we developed a simulator-based methodology of preclinical verification of proficiency (VOP) in trainees by tracking objective evaluation of the final acquired images. We utilized geometric data from the simulator probes to compare image acquisition of anesthesia residents who participated in our structured longitudinal simulator-based TEE educational program vs ideal image planes determined from a panel of experts. Thirty-three participants completed the study (15 experts, 7 postgraduate year (PGY)-1 and 11 PGY-4). The results of our study demonstrated a significant difference in image capture success rates between learners and experts (χ² = 14.716, df = 2, P < 0.001) with the difference between learners (PGY-1 and PGY-4) not being statistically significant (χ² = 0, df = 1, P = 1.000). Therefore, our results suggest that novices (i.e. PGY-1 residents) are capable of attaining a level of proficiency comparable to those with modest training (i.e. PGY-4 residents) after completion of a simulation-based training curriculum. However, professionals with years of clinical training (i.e. attending physicians) exhibit a superior mastery of such skills. It is hence feasible to develop a simulator-based VOP program in performance of TEE for junior anesthesia residents.

Creative Processes in the Shaping of a Musical Interpretation: A Study of Nine Professional Musicians

Various studies have been conducted to understand the role of mental representation when musicians practice or perform music (Lehman and Ericsson, 1997; Sloboda, 2005) and the work steps required for a musician to prepare a concert (Chaffin et al., 2003). More recent studies examine creativity in the shaping of a musical interpretation (Lisboa et al., 2011; Payne, 2016; Barros et al., 2017; Wise et al., 2017). However, none of these studies answers the following questions: Why do expert musicians working from the same score create different musical interpretations? During individual practice sessions, what happens that allows each musician to produce significantly different interpretive results? To answer these questions, we instructed nine expert musicians to record their individual practice sessions, verbalize their actions and thoughts, and answer a self-reflection questionnaire. A third-party observer also described what happened during the practice sessions. We conducted interviews in order to gather additional information about the contents of the individual practice sessions; the musicians' usual work habits; and their beliefs, values, and ideas regarding the role of the musician in the creative process. Based on the methodology of Analyse par théorisation ancrée¹ (Paillé, 1994), we were able to take into account a diverse data set and identify aspects of the creative process that were specific to each individual as well as elements that all musicians shared. We found that the context in which the creative process takes place—the musician (e.g., his or her values and knowledge); the musical work (e.g., style, technical aspects, etc.); and the external constraints (e.g., deadlines, public expectations, etc.)—impacted the strategies used. The participants used reflection, extramusical supports, emotions, body reactions, intuition, and other tools to generate new musical ideas and evaluate the accuracy of their musical interpretations. We identified elements related to those already discussed in the literature, including the creative process as an alternation between divergent and convergent thinking (Guilford, 1950), creative associations (Lubart, 2015), and artistic appropriation (Héroux and Fortier, 2014; Héroux, 2016).

Moving from Novice to Expertise and Its Implications for Instruction

Objective: To address the stages of expertise development, what differentiates a novice from an expert, and how the development and differences impact how we teach our classes or design the curriculum. This paper will also address the downside of expertise and discuss the importance of teaching expertise relative to domain expertise. Summary: Experts develop through years of experience and by progressing from novice, advance beginner, proficient, competent, and finally expert. These stages are contingent on progressive problem solving, which means individuals must engage in increasingly complex problems, strategically aligned with the learner's stage of development. Thus, several characteristics differentiate experts from novices. Experts know more, their knowledge is better organized and integrated, they have better strategies for accessing knowledge and using it, and they are self-regulated and have different motivations.

Phronesis: practical wisdom the role of professional practice knowledge in the clinical reasoning of Bobath instructors

RATIONALE, AIMS, AND OBJECTIVES

Clinical reasoning is an essential aspect of clinical practice, however is largely ignored in the current rehabilitation sciences evidence base. Literature related to clinical reasoning and clinical expertise has evolved concurrently although rehabilitation reasoning frameworks remain relatively generic. The purpose of this study was to explicate the clinical reasoning process of Bobath instructors of a widely used neuro-rehabilitation approach, the Bobath concept.

METHODS

A qualitative interpretive description approach consisting of stimulated recall using video-recorded treatment sessions and in-depth interviews. Purposive sampling was used to recruit members of the International Bobath Instructors Training Association (IBITA). Interview transcripts were transcribed verbatim providing the raw data. Data analysis was progressive, iterative, and inductive.

RESULTS

Twenty-two IBITA instructors from 7 different countries participated. Ranging in clinical experience from 12 to 40 years, and instructor experience from 1 to 35 years. Three themes were developed, (a) a Bobath clinical framework, (b) person-centered, and (c) a Bobath reasoning approach, highlighting the role of practical wisdom, phronesis in the clinical reasoning process. In particular the role of visuospatial-kinesthetic perception, an element of technical expertise, was illuminated as an integral aspect of clinical reasoning in this expert group.

CONCLUSIONS

This study provides an interpretive understanding of the clinical reasoning process used by IBITA instructors illustrating an inactive embodied view of clinical reasoning, specifically the role of phronesis, requiring further investigation in nonexpert Bobath therapists, as well as in novice and experienced therapists in other specialty areas.

The Neural System of Postdecision Evaluation in Rostral Frontal Cortex during Problem-solving Tasks

Little attention has been paid to the postdecision processing in fMRI studies with task paradigms in which there was no explicit feedback. Although late-onset BOLD responses were previously observed in the lateral frontopolar cortex after the familiar-novel decision on visually presented words, the nature of neural activations that caused the late-onset BOLD responses remained elusive. We here found, in human experts conducting complicated problem-solving tasks in their expertise domain, that the rostral frontal cortex, including the lateral frontopolar cortex, along with the anterior inferior parietal lobule, was activated only during the postdecision period, although there was no feedback. That is, these areas showed late-onset BOLD responses, and fitting of the BOLD responses with different models indicates that they were caused by neural activations that occurred after the decision. However, there was no response after performing a sensory-motor control task, and the magnitude of postdecision activations was correlated with the degree of uncertainty about the preceding decision, which suggests that the postdecision neural activations were associated with the preceding decision procedure. Furthermore, the same set of areas was more strongly activated when the subject explicitly rethought the preceding problem. These results suggest that the rostral frontal cortex, together with anterior inferior parietal lobule, comprises a network for uncertainty monitoring and exploration of alternative resolutions in postdecision evaluation. The present results thus introduce a new aspect of the functional gradient along the rostrocaudal axis in the frontal cortex.

Fingerprint identification: advances since the 2009 National Research Council report

This paper will discuss the major developments in the area of fingerprint identification that followed the publication of the National Research Council (NRC, of the US National Academies of Sciences) report in 2009 entitled: Strengthening Forensic Science in the United States: A Path Forward. The report portrayed an image of a field of expertise used for decades without the necessary scientific research-based underpinning. The advances since the report and the needs in selected areas of fingerprinting will be detailed. It includes the measurement of the accuracy, reliability, repeatability and reproducibility of the conclusions offered by fingerprint experts. The paper will also pay attention to the development of statistical models allowing assessment of fingerprint comparisons. As a corollary of these developments, the next challenge is to reconcile a traditional practice dominated by deterministic conclusions with the probabilistic logic of any statistical model. There is a call for greater candour and fingerprint experts will need to communicate differently on the strengths and limitations of their findings. Their testimony will have to go beyond the blunt assertion of the uniqueness of fingerprints or the opinion delivered ispe dixit.

Perception of chemesthetic stimuli in groups who differ by food involvement and culinary experience

In the English language, there is generally a limited lexicon when referring to the sensations elicited by chemesthetic stimuli like capsaicin, allyl isothiocyanate, and eugenol, the orally irritating compounds found in chiles, wasabi, and cloves, respectively. Elsewhere, experts and novices have been shown to use language differently, with experts using more precise language. Here, we compare perceptual maps and word usage across three cohorts: experts with formal culinary education, naïve individuals with high Food Involvement Scale (FIS) scores, and naïve individuals with low FIS scores. We hypothesized that increased experience with foods, whether through informal experiential learning or formal culinary education, would have a significant influence on the perceptual maps generated from a sorting task conducted with chemesthetic stimuli, as well as on language use in a descriptive follow-up task to this sorting task. The low- and highFIS non-expert cohorts generated significantly similar maps, though in other respects the highFIS cohort was an intermediate between the lowFIS and expert cohorts. The highFIS and expert cohorts generated more attributes but used language more idiosyncratically than the lowFIS group. Overall, the results from the expert group with formal culinary education differed from the two naïve cohorts both in the perceptual map generated using MDS as well as the mean number of attributes generated. Present data suggest that both formal education and informal experiential learning result in lexical development, but the level and type of learning can have a significant influence on language use and the approach to a sorting task.

Models of care for musculoskeletal health: a cross-sectional qualitative study of Australian stakeholders' perspectives on relevance and standardised evaluation

BACKGROUND

The prevalence and impact of musculoskeletal conditions are predicted to rapidly escalate in the coming decades. Effective strategies are required to minimise 'evidence-practice', 'burden-policy' and 'burden-service' gaps and optimise health system responsiveness for sustainable, best-practice healthcare. One mechanism by which evidence can be translated into practice and policy is through Models of Care (MoCs), which provide a blueprint for health services planning and delivery. While evidence supports the effectiveness of musculoskeletal MoCs for improving health outcomes and system efficiencies, no standardised national approach to evaluation in terms of their 'readiness' for implementation and 'success' after implementation, is yet available. Further, the value assigned to MoCs by end users is uncertain. This qualitative study aimed to explore end users' views on the relevance of musculoskeletal MoCs to their work and value of a standardised evaluation approach.

METHODS

A cross-sectional qualitative study was undertaken. Subject matter experts (SMEs) with health, policy and administration and consumer backgrounds were drawn from three Australian states. A semi-structured interview schedule was developed and piloted to explore perceptions about musculoskeletal MoCs including: i) aspects important to their work (or life, for consumers) ii) usefulness of standardised evaluation frameworks to judge 'readiness' and 'success' and iii) challenges associated with standardised evaluation. Verbatim transcripts were analysed by two researchers using a grounded theory approach to derive key themes.

RESULTS

Twenty-seven SMEs (n = 19; 70.4 % female) including five (18.5 %) consumers participated in the study. MoCs were perceived as critical for influencing and initiating changes to best-practice healthcare planning and delivery and providing practical guidance on how to implement and evaluate services. A 'readiness' evaluation framework assessing whether critical components across the health system had been considered prior to implementation was strongly supported, while 'success' was perceived as an already familiar evaluation concept. Perceived challenges associated with standardised evaluation included identifying, defining and measuring key 'readiness' and 'success' indicators; impacts of systems and context changes; cost; meaningful stakeholder consultation and developing a widely applicable framework.

CONCLUSIONS

A standardised evaluation framework that includes a strong focus on 'readiness' is important to ensure successful and sustainable implementation of musculoskeletal MoCs.

Emotionally excited eyeblink-rate variability predicts an experience of transportation into the narrative world

Collective spectator communications such as oral presentations, movies, and storytelling performances are ubiquitous in human culture. This study investigated the effects of past viewing experiences and differences in expressive performance on an audience’s transportive experience into a created world of a storytelling performance. In the experiment, 60 participants (mean age = 34.12 years, SD = 13.18 years, range 18–63 years) were assigned to watch one of two videotaped performances that were played (1) in an orthodox way for frequent viewers and (2) in a modified way aimed at easier comprehension for first-time viewers. Eyeblink synchronization among participants was quantified by employing distance-based measurements of spike trains, D^spike and D^interval (Victor and Purpura, 1997). The results indicated that even non-familiar participants’ eyeblinks were synchronized as the story progressed and that the effect of the viewing experience on transportation was weak. Rather, the results of a multiple regression analysis demonstrated that the degrees of transportation could be predicted by a retrospectively reported humor experience and higher real-time variability (i.e., logarithmic transformed SD) of inter blink intervals during a performance viewing. The results are discussed from the viewpoint in which the extent of eyeblink synchronization and eyeblink-rate variability acts as an index of the inner experience of audience members.

Can taking the perspective of an expert debias human decisions? The case of risky and delayed gains

In several previously reported studies, participants increased their normative correctness after being instructed to think hypothetically, specifically taking the perspective of an expert or researcher (Beatty and Thompson, 2012; Morsanyi and Handley, 2012). The goal of this paper was to investigate how this manipulation affects risky or delayed payoffs. In two studies, participants (n = 193) were tested online (in exchange for money) using the adjusting procedure. Individuals produced certain/immediate equivalents for risky/delayed gains. Participants in the control group were solving the problem from their own perspective, while participants in the experimental group were asked to imagine "what would a reliable and honest advisor advise them to do." Study 1 showed that when taking the perspective of an expert, participants in experimental group became more risk aversive compared to participants in the control group. Additionally, their certain equivalents diverged from the expected value to a greater extent. The results obtained from the experimental group in Study 2 suggest that participants became less impulsive, which means they tried to inhibit their preferences. This favors the explanation, which suggests that the perspective shift forced individuals to override their intuitions with the social norms. Individuals expect to be blamed for impatience or risk taking thus expected an expert to advise them to be more patient and risk aversive.