Boundary extension is constrained by naturalistic image properties

Boundary extension (BE) is a classical memory illusion in which observers remember more of a scene than was presented. According to predictive accounts, BE reflects the integration of visual input and expectations of what is beyond the boundaries of a scene. Alternatively, according to normalization accounts, BE reflects one end of a normalization process towards the typically-experienced viewing distance of a scene, such that BE and boundary contraction (BC) are equally common. Here, we show that BE and BC depend on depth-of-field (DOF), as determined by the aperture settings on a camera. Photographs with naturalistic DOF led to the strongest BE across a large stimulus set, while BC was primarily observed for unnaturalistic DOF. The relationship between DOF and BE was confirmed in three controlled experiments that isolated DOF from co-varying factors. In line with predictive accounts, we propose that BE is strongest for scene images that resemble day-to-day visual experience.

Verbesserung allgemeiner ambulanter Palliativversorgung in Hausarztpraxen – Evaluation der Interventionsstudie ALLPRAX

Zusammenfassung Hintergrund Trotz eines hohen Bedarfs an allgemeiner ambulanter Palliativversorgung (AAPV) fehlt es an konkreten Lösungsansätzen für eine zielgerichtete Integration in Hausarztpraxen. Ziel dieser Arbeit ist die Evaluation von Maßnahmen zur Verbesserung der AAPV aus Sicht hausärztlicher Praxisteams. Methoden Qualitative Evaluation der Implementierungsstudie ALLPRAX mit sieben Praxisteams mittels der Normalization Process Theory. Ergebnisse Bedürfnisse von Palliativpatient*innen und ihren Angehörigen konnten mittels eines palliativmedizinischen Erstassessments und Krisenbogens besser identifiziert werden. Zu ihrer Beratung und Informationen wurde die Bereitstellung von Flyern als hilfreich bewertet. Demgegenüber gelang die Integration von Maßnahmen mit hohem Arbeitsaufwand selten. Schlussfolgerungen Maßnahmen zur Verbesserung der AAPV sollten leicht integrierbar sein und neben den Bedürfnissen von Palliativpatient*innen gezielt die Belastungen von Angehörigen berücksichtigen.

Music Does Not Facilitate Lexical Tone Normalization: A Speech-Specific Perceptual Process

Listeners utilize the immediate contexts to efficiently normalize variable vocal streams into standard phonology units. However, researchers debated whether non-speech contexts can also serve as valid clues for speech normalization. Supporters of the two sides proposed a general-auditory hypothesis and a speech-specific hypothesis to explain the underlying mechanisms. A possible confounding factor of this inconsistency is the listeners’ perceptual familiarity of the contexts, as the non-speech contexts were perceptually unfamiliar to listeners. In this study, we examined this confounding factor by recruiting a group of native Cantonese speakers with sufficient musical training experience and a control group with minimal musical training. Participants performed lexical tone judgment tasks in three contextual conditions, i.e., speech, non-speech, and music context conditions. Both groups were familiar with the speech context and not familiar with the non-speech context. The musician group was more familiar with the music context than the non-musician group. The results evidenced the lexical tone normalization process in speech context but not non-speech nor music contexts. More importantly, musicians did not outperform non-musicians on any contextual conditions even if the musicians were experienced at pitch perception, indicating that there is no noticeable transfer in pitch perception from the music domain to the linguistic domain for tonal language speakers. The findings showed that even high familiarity with a non-linguistic context cannot elicit an effective lexical tone normalization process, supporting the speech-specific basis of the perceptual normalization process.

Evaluation of dentists' stress and anxiety levels in the COVID-19 pandemic

Aim: Coronavirus disease 2019 (COVID-19) can cause stress, anxiety, and fear, especially in healthcare workers as it has a high risk of transmission. The aim of this study was to investigate the levels of stress and anxiety during the COVID-19 pandemic among dentists working in our country. Methodology: The study included 164 dentists. Sociodemographic data and the stress and anxiety levels of the individuals who participated in the study were recorded. The COVID-19 Stress Scale and the Perceived Stress Scale-10 were used for evaluation of the stress levels, and the Generalized Anxiety Disorder 7 was used to evaluate the anxiety levels. All data were considered statistically significant at p < 0.05. Results: Among those who participated in the study, 112 were women and 52 were men, and 50% of them were 20 to 30 years of age. Based on the information these dentists provided, 63% did not have any expertise and 66% had worked in the normalization process. Their scores in the COVID-19 Stress Scale, the Generalized Anxiety Disorder Scale 7, and Perceived Stress Scale-10 were 64.4 ± 25.2, 5.46 ± 4.8, and 18.8 ± 5.9, respectively, and there was a positive correlation between all scales. When evaluating the stress levels according to gender, it was observed that those of the female dentists were higher than those of the male dentists (p < 0.05). There was no significant difference in the anxiety levels between the male and female dentists. While there were no significant differences between the dentists who worked during the pandemic process and those who did not work (p > 0.05), the COVID-19 stress levels were found to be lower in the normalization process (p < 0.05). Conclusion: The COVID-19 pandemic has caused stress and anxiety in dentists and has affected female dentists more than male dentists. In addition, working during the pandemic process can benefit dentists by helping to reduce the stress caused by the pandemic. How to cite this article: Öncü E, Dinçer NN, Uçan Yarkaç F, Tekin Atay Ü. Evaluation of dentists' stress and anxiety levels in the COVID-19 pandemic. Int Dent Res 2021;11(Suppl.1):259-65. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.38 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Evaluation of normalization after implementation of the digital Dutch Obstetric Telephone Triage System: Mixed methods design (questionnaire and focus group discussion) (Preprint)

BACKGROUND The Dutch Obstetric Telephone Triage System (DOTTS) was developed to improve the quality of acute obstetric care. To achieve optimal effect, DOTTS should be adopted in the daily care process by triage staff. The outcome of implementation was evaluated in nine hospitals. OBJECTIVE The aim of this study was to gain insight into the degree of implementation (normalization) and to evaluate which lessons can be learned from the implementation of DOTTS that can help optimize current and new implementations. METHODS An evaluation study with a mixed methods design was performed. All triage staff in hospitals who implemented DOTTS before 1 September 2019 were invited to complete the Normalization MeAsure Development (NoMAD) questionnaire between December 2019 and July 2020. The questionnaire is based on the Normalization Process Theory. This self-report questionnaire gives insight into the work people do in order to integrate and embed new practice in routine care. Normalization Process Theory is based on four constructs: coherence, cognitive participation, collective action and reflexive monitoring. Within the questionnaire each construct is represented by 4-7 questions. Questions could be scored on a 5-point Likert scale. Descriptive statistics were used for analysis of questionnaire scores. Subsequently, analysis of questionnaires were discussed during a focus group. Template analysis following the four constructs of NPT was used for analyzing the results of the focus group. RESULTS In total 173 triage-staff members completed the NoMAD questionnaire. Ninety percent of the participants had used DOTTS for over six months. The digital application was used as much as possible or always by 79.1% of the participants (n=137). The overall Normalization Process Score was 3.77 (SD=0.36). The constructs Coherence and Cognitive Participation scored 4.01 (SD=0.47) and 4.05 (SD=0.45) respectively. Collective Action scored 3.5 (SD=0.45) and Reflexive Monitoring scored 3.72 (SD=0.47). Analysis of the focus group discussion showed that the added value of DOTTS was seen as a quality improvement for pregnant women. Dedication of the complete multidisciplinary implementation team, with specific support from the medical staff, as well as proper use by all disciplines involved in the triage is important for facilitating normalization. Participants appreciated training and evaluation and indicated a need for ongoing training and evaluation in relation to goal achievement. CONCLUSIONS The DOTTS has been integrated into normal care in daily practice. Evaluation by NoMAD-questionnaires gave a positive overall score. These results are in line or, in some aspects better, when compared to other evaluation studies. Key factors in the normalization process of the DOTTS in obstetric triage are the shared added value for stakeholders, the dedication of the complete multidisciplinary implementation team and implementation plans that are tailor made in the practical context of the hospital.

Impact of a health literacy intervention combining general practitioner training and a consumer facing intervention to improve colorectal cancer screening in underserved areas: protocol for a multicentric cluster randomized controlled trial

Background Colorectal cancer (CRC) is a leading cause of cancer burden worldwide. In France, it is the second most common cause of cancer death after lung cancer. Systematic uptake of CRC screening can improve survival rates. However, people with limited health literacy (HL) and lower socioeconomic position rarely participate. Our aim is to assess the impact of an intervention combining HL and CRC screening training for general practitioners (GPs) with a pictorial brochure and video targeting eligible patients, to increase CRC screening and other secondary outcomes, after 1 year, in several underserved geographic areas in France. Methods We will use a two-arm multicentric randomized controlled cluster trial with 32 GPs primarily serving underserved populations across four regions in France with 1024 patients recruited. GPs practicing in underserved areas (identified using the European Deprivation Index) will be block-randomized to: 1) a combined intervention (HL and CRC training + brochure and video for eligible patients), or 2) usual care. Patients will be included if they are between 50 and 74 years old, eligible for CRC screening, and present to recruited GPs. The primary outcome is CRC screening uptake after 1 year. Secondary outcomes include increasing knowledge and patient activation. After trial recruitment, we will conduct semi-structured interviews with up to 24 GPs (up to 8 in each region) and up to 48 patients (6 to 12 per region) based on data saturation. We will explore strategies that promote the intervention’s sustained use and rapid implementation using Normalization Process Theory. We will follow a community-based participatory research approach throughout the trial. For the analyses, we will adopt a regression framework for all quantitative data. We will also use exploratory mediation analyses. We will analyze all qualitative data using a framework analysis guided by Normalization Process Theory. Discussion Limited HL and its impact on the general population is a growing public health and policy challenge worldwide. It has received limited attention in France. A combined HL intervention could reduce disparities in CRC screening, increase screening rates among the most vulnerable populations, and increase knowledge and activation (beneficial in the context of repeated screening). Trial registration Registry: ClinicalTrials.gov. Trial registration number: 2020-A01687-32. Date of registration: 17th November 2020.

Evaluating Implementation Contexts, Mechanisms, and Outcomes: A Normalization Process Theory Coding Manual for Qualitative Research and Instrument Development

Background. Qualitative studies, especially those conducted by teams of researchers, may benefit from clearly structured, parsimonious, coding manuals. The process of creating rigorous and robust coding manuals for individual studies is rarely described, and generalizable coding manuals are rare. Normalization Process Theory (NPT) provides conceptual tools to facilitate understanding of the dynamics of adoption, implementation, and sustainment of socio-technical and organizational innovations. As a widely used theory, a generalizable coding manual would be of utility to implementation researchersObjectives. To make the application of NPT simple for the user, to describe the development of a coding manual for qualitative content analytic studies using NPT, and present this for wider use.Method. Concept Selection and Structuring. Qualitative Content Analysis of selected published papers and interview transcripts. Results. All identifiable theoretical concepts (n=149) embedded in papers and chapters that developed NPT between 2006 and 2020 were identified and extracted from their texts. Overlapping, ambiguous, and duplicate versions of concepts were eliminated, as were concepts derived from other theories. This left 38 core concept definitions. These were piloted in coding of qualitative transcripts collected in two implementation studies, and by collaboratively coding papers collected for a systematic review of implementation studies. At the end of this process, a further process of elimination of overlapping or ambiguous concepts was undertaken leaving 12 primary NPT concepts. Conclusion. The process of coding manual resulted in the presentation of NPT concepts according to the Context-Mechanism-Outcomes configuration of realist evaluation research. A coding manual for NPT that is in accordance with realistic evaluation research was successfully produced and is now freely available to researchers who wish to use NPT in primary and secondary research that employs qualitative methods.

Attention biases preferential choice by enhancing an option's value

Does attending to an option lead to liking it? Though attention induced valuation is often hypothesized, evidence for this causal link has remained elusive. We test this hypothesis across two studies by manipulating attention during a preferential decision and its perceptual analog. In a free-viewing task, we found attention biased choice and eye movement pattern in the preferential decision more than during the perceptual analog. In a controlled-viewing task, we again found attention had a larger effect on choice in the preferential decision than its perceptual analog. Computational modeling of the data reveals that attention impacted preference by discounting the unattended option’s value. These results support the attention-induced valuation hypothesis. We suggest that attention impacts preference via a normalization process where an option's representation is scaled by its spatial and temporal neighbors. Attention provides a gain modulation on this representation at the sensory and value processing levels.