Cognitive Strategies Research Articles

The impact of unfolding case studies combined with think-aloud strategies on the clinical reasoning and self-directed learning abilities of postgraduate students: A mixed methods study

AimTo conduct unfolding case studies and test their effectiveness in improving clinical reasoning, teamwork and self-directed learning among postgraduate students. BackgroundPostgraduate students, as advanced nursing professionals in clinical settings, are the driving force behind the rapid development of the nursing profession. Effective clinical reasoning is a fundamental nursing skill that postgraduate students must cultivate, having a direct impact on patient health outcomes. The development and usation of unfolding case studies, which reflect the evolving conditions of patients, combined with think-aloud teaching methods, can enhance postgraduate students' clinical reasoning abilities and foster communication and self-reflection, thereby achieving this goal. DesignMixed methods design. MethodsThe Nurses' Clinical Reasoning Scale and the Nursing Students' Self-Directed Learning Ability Scale were used to evaluate the clinical reasoning and self-directed learning abilities of nursing students. A qualitative exploratory design with a think-aloud interview technique was employed to explore the clinical reasoning process of nursing students in unfolding cases. Twenty-one nursing students completed the questionnaire survey. Data analysis was conducted using Wilcoxon signed-rank tests, Spearman correlations, regressions and inductive content analysis. ResultsAfter implementing the case study, there was a statistically significant improvement in students' clinical reasoning, self-directed learning and teamwork abilities. Think-aloud analysis revealed that the cognitive strategies most employed by students in clinical reasoning were 'Making choices', 'Forming relationships', 'Searched for information' and 'Drawing conclusions'. ConclusionUnfolding case studies combined with think-aloud strategies provide a conducive learning environment for postgraduate students, effectively enhancing their clinical reasoning and self-directed learning abilities.

A - 29 Support for Use of Cognitive Rehabilitation Strategies to Enhance Accessibility of Medications for Opioid Use Disorder Treatment: a Qualitative Secondary Data Analysis

Abstract Objective Despite cognitive rehabilitation paradigms gaining support as adjunctive interventions to opioid use disorder treatments, limited research details strategies that medical providers who prescribe medications for opioid use disorder (MOUD) employ to attend to patient cognitive limitations. We conducted a secondary data analysis to explore this gap in the literature. Method The parent study included individual interviews with 23 MOUD treatment providers from New Mexico and Washington state, and the interview guide centered barriers and facilitators to equitable implementation. A deductive thematic analysis was utilized to identify sources, solutions, and strategies that MOUD providers identified for patients experiencing cognitive impairments. Results Regarding sources of cognitive dysfunction, history of stroke, overdose, severe mental illness, and traumatic brain injury were emphasized. Low health literacy was also identified as a justification to modify approach. Strategies providers utilized fell under five subthemes: visual aids; communication (e.g., repetition; open questions); engaging caregivers; leveraging peer support; and increasing visit frequency. Though less common, some providers emphasized only focusing on substance use and safety. Conclusions There have been calls to better attend to cognitive functioning as a potential moderator of MOUD treatment outcomes; however, existing personalized care guidelines do not address this adequately. The present study revealed variability in clinical decision-making that may exacerbate health inequities among individuals seeking MOUD treatment –a population disproportionately impacted by social determinants of health (e.g., housing; access to healthcare; quality of education). Greater focus on equitable MOUD implementation is needed to explore methods of personalizing care for individuals seeking MOUD treatment presenting with cognitive dysfunction.

Mediating effect of cognitive appraisal and coping on anticipatory grief in family caregivers of patients with cancer: a Bayesian structural equation model study

BackgroundAnticipatory grief is common among family caregivers of cancer patients and may be related to caregiver burden, family resilience, psychological capital, cognitive appraisal, and coping strategies. The purpose of this study was to examine the mediating role of cognitive appraisal and coping strategies in the relationship between caregiver burden, family resilience, psychological capital, and anticipatory grief among caregivers of cancer patients.MethodsThis study surveyed from January to September 2023 among 265 caregivers of lung and breast cancer patients in two public hospitals. They completed measures of caregiver burden, family resilience, psychological capital, cognitive appraisal, coping, and anticipatory grief. AMOS software was used to model the data with Bayesian structural equation modeling.ResultsBayesian structural equation modeling results showed that caregiver burden had a direct effect on anticipatory grief. The chain mediating effects for cognitive appraisal tendency and coping tendency between caregiver burden, family resilience, psychological capital, and anticipatory grief, respectively. Coping tendency acted as a mediator between psychological capital and anticipatory grief.ConclusionsThe relationships between caregiver burden, family resilience, and psychological capital with anticipatory grief are embedded in the mediating effects of cognitive appraisal and coping. Early identification and intervention for caregiver burden, family resilience, psychological capital, cognitive appraisal, and coping methods may prevent anticipatory grief in caregivers of cancer patients.

Neural adaptation of the reward system in primary dysmenorrhea.

Introduction: The brain's reward system (RS) reacts differently to pain and its alleviation. This study examined the correlation between RS activity and behavior during both painful and pain-free periods in individuals with primary dysmenorrhea (PDM) to elucidate their varying responses throughout the menstrual cycle. Methods: Ninety-two individuals with PDM and 90 control participants underwent resting-state functional magnetic resonance imaging (rsfMRI) scans during their menstrual and peri-ovulatory phases. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) analyses were used to evaluate RS responses. Psychological evaluations were conducted using the McGill Pain Questionnaire and the Pain Catastrophizing Scale. Results: ReHo analysis showed higher values in the left putamen and right amygdala of the PDM group during the peri-ovulatory phase compared to the menstrual phase. ALFF analysis revealed lower values in the putamen of the PDM group compared to controls, regardless of phase. ReHo and ALFF values in the putamen, amygdala, and nucleus accumbens were positively correlated with pain scales during menstruation, while ALFF values in the ventral tegmental area inversely correlated with pain intensity. Those with severe PDM (pain intensity ≥7) displayed distinct amygdala ALFF patterns between pain and pain-free phases. PDM participants also had lower ReHo values in the left insula during menstruation, with no direct correlation to pain compared to controls. Discussion: Our study highlights the pivotal role of the RS in dysmenorrhea management, exhibiting varied responses between menstrual discomfort and non-painful periods among individuals with PDM. During menstruation, the RS triggers mechanisms for pain avoidance and cognitive coping strategies, while it transitions to processing rewards during the peri-ovulatory phase. This demonstrates the flexibility of the RS in adapting to the recurring pain experienced by those with PDM.

A cognitive communication jamming strategy based on Transformer and Deep Reinforcement Learning

The advent of sophisticated communication technologies, such as cognitive radio and anti-jamming techniques, has significantly elevated the challenge of disrupting enemy communications. Nevertheless, the inherent openness of wireless communications remains a vulnerability that can be exploited to interfere with them. Some contemporary Reinforcement Learning (RL)-based jamming strategies examine methods for rapidly identifying the optimal jamming strategy for a specific modulated signal. However, such algorithms lack the flexibility and responsiveness required to effectively counter the enemy’s evolving communication strategies. To address this issue, we propose a Transformer and Deep Reinforcement Learning (DRL)-based jamming strategy that can be trained to identify jamming methods for multiple digital and analog signals. In particular, the Transformer Encoder is employed as a network for DRL to process the state information pertaining to the enemy communication. Subsequently, the decision module of the Double Deep Q Network (DDQN) is utilized to select the jamming action based on the processed information. Furthermore, we have devised a reward function and constructed an invalid jamming list, with the objective of selecting an action that requires low power consumption and enhances the convergence speed of the algorithm. The experimental results demonstrate that the algorithm proposed in this paper exhibits notable performance advantages in comparison to other networks and DRL algorithms.

Teachers matter: linking teachers and students’ self-regulated learning

ABSTRACT Teachers play an essential role in supporting students to become self-regulated learners. It is assumed that teachers’ professional competence in self-regulated learning (SRL) influences their promotion of SRL, which in turn influences students’ acquisition of SRL skills. However, the links between teachers’ SRL competences, SRL promotion, and students’ SRL have not yet been the subject of extensive research. In a multilevel analysis with 167 lower secondary teachers and their 2,785 students, we examined the relationships between teachers’ professional competences (own SRL skills, mindsets, pedagogical content knowledge about SRL, self-efficacy, and attainment values), teachers’ self-reported and students’ perceived SRL promotion, and students’ SRL skills (metacognitive, motivational, and cognitive strategies, and metacognitive strategy knowledge). The results highlight the importance of teachers’ self-efficacy for their self-reported SRL promotion. Furthermore, SRL promotion was positively related to students’ metacognitive, motivational, and cognitive strategies but not to their metacognitive strategy knowledge. The analyses of indirect effects showed that teachers’ own SRL as self-regulated learners and their self-efficacy as agents of SRL were indirectly related to students’ SRL through the promotion of SRL. Focusing on teachers’ SRL competences as both learners and agents could help to understand better why teachers do or do not promote SRL, thereby explaining the development of students’ SRL.

Characterization of neural networks involved in transdiagnostic emotion dysregulation from a pilot randomized controlled trial of a neurostimulation-enhanced behavioral intervention

BackgroundEmotional dysregulation is a serious and impairing mental health problem. We examined functional activity and connectivity of neural networks involved in emotional dysregulation at baseline and following a pilot neurostimulation-enhanced cognitive restructuring intervention in a transdiagnostic clinical adult sample. MethodsNeuroimaging data were analyzed from adults who scored 89 or higher on the Difficulties with Emotion Regulation (DERS) scale and had at least one DSM-5 diagnosis. These participants were part of a pilot randomized, double-blind, placebo-controlled trial combining a single therapeutic session of cognitive restructuring with active or sham transcranial magnetic stimulation over the dorsolateral prefrontal cortex. During the study, participants engaged in an emotional regulation task using personalized autobiographical stressors while undergoing functional magnetic resonance imaging (fMRI) before and after the pilot intervention. The fMRI task required participants to either experience the emotions associated with the memories or apply cognitive restructuring strategies to reduce their distress. ResultsWhole-brain fMRI results during regulation at baseline revealed increased activation in the dorsal frontoparietal network but decreased activation in the supplementary motor area, cingulate cortex, insula, and ventrolateral prefrontal cortex (vlPFC). Emotion dysregulation was associated with greater vmPFC and amygdala activation and functional connectivity between these regions. The strength of functional connectivity between the dlPFC and other frontal regions was also a marker of emotional dysregulation. Preliminary findings from a subset of participants who completed the follow-up fMRI scan showed that active neurostimulation improved behavioral indices of emotion regulation more than sham stimulation. A whole-brain generalized psychophysiological interaction analysis indicated that active neurostimulation selectively increased occipital cortex connectivity with both the insula and the dlPFC. Region-of-interest functional connectivity analyses showed that active neurostimulation selectively increased dlPFC connectivity with the insula and orbitofrontal cortex (OFC). ConclusionInsufficient neural specificity during the emotion regulation process and over-involvement of frontal regions may be a marker of emotional dysregulation across disorders. OFC, vlPFC, insula activity, and connectivity are associated with improved emotion regulation in transdiagnostic adults. In this pilot study, active neurostimulation led to neural changes in the emotion regulation network after a single session; however, the intervention findings are preliminary, given the small sample size. These functional network properties can inform future neuroscience-driven interventions and larger-scale studies.

Cognitive Emotional Regulation Strategies, Fear, and Anger in Children from GuanajuatoAfter the Confinement Due to the Pandemic COVID-19

Cognitive Emotional Regulation Strategies, Fear, and Anger in Children from GuanajuatoAfter the Confinement Due to the Pandemic COVID-19

How do high-achieving students learn languages online?

The impact of language learning strategy use on achievement has been extensively researched in the traditional foreign language classroom. However, little is known about this topic in the context of online learning. In addition, previous research has focused primarily on English as a foreign or second language. This study fills these gaps by investigating the use of language learning strategies by students taking a beginner-level online course in a foreign language other than English at a Swedish university. The study examined the extent to which students used language learning strategies, whether age was related to the use of language learning strategies, and whether language learning strategy use increased the likelihood of foreign language achievement, operationalised as receiving the highest final course grade. Participants (n= 108), aged 19–76 years (M = 37.6), completed the Strategy Inventory for Language Learning (Oxford, 1990). Three main findings emerged from the study. First, the students used metacognitive strategies most frequently, which could be explained by the fact that the online format requires great learner autonomy. Second, age was negatively but weakly related to the use of memory and affective strategies. Third, the use of cognitive strategies significantly increased the likelihood of foreign language achievement almost tenfold. Thus, this category of strategies appeared to be a strong predictor of achievement among the study participants.

Clutaxis: an information-driven source search method balancing exploration and exploitation in turbulent environments

Locating unknown emission sources in turbulent environments is a challenging yet crucial task, particularly in emergency response scenarios. Existing studies have developed information-theoretic approaches to fuse intermittent information collected by mobile sensors regarding the sources. This fused information is then used to support source-term estimation (STE) in various search algorithms. Among these, the cognitive strategy—a promising information-driven search algorithm—leverages a reward-based action selection mechanism to balance exploration and exploitation during each search step. However, this mechanism is hampered by a high computational load and rigid search trajectories, limiting its application in real-world systems. To address these issues, this paper proposes a novel information-driven search method called Clutaxis, based on a global exploration and exploitation tradeoff principle. Specifically, a particle filter is leveraged to maintain the STE. After projecting the particle filter samples onto a 2D search scene, the density-based spatial clustering of applications with noise (DBSCAN) algorithm is used to extract the density information of the samples, which is then used to construct a belief source area (BSA). By leveraging the uncertainty of the BSA, Clutaxis adopts explorative or exploitative actions with no restrictions on motion direction. Through dedicated simulations, the experimental results demonstrate the robustness of Clutaxis to key parameters and its advantages in computational complexity and search performance compared to two state-of-the-art algorithms (Infotaxis and Entrotaxis) and two Clutaxis variants (Clutaxis_ER and Clutaxis_EI).

Feasibility of a nurse-initiated brief cognitive behavioral strategy intervention program for symptom clusters experienced by patients with advanced non-small cell lung cancer

BackgroundA nurse-initiated brief cognitive behavioral Strategy (CBS) intervention program has shown alleviation effects of single symptoms. However, the feasibility of the brief CBS for symptoms included in the Pain and Fatigue symptom clusters in patients with advanced nonsmall cell lung cancer (NSCLC) has not been evaluated. ObjectiveTo evaluate the feasibility of application of the nurse-initiated brief CBS intervention program focusing on pain and fatigue symptoms among the Pain and Fatigue/anorexia symptom clusters experienced by patients with advanced NSCLC. MethodsIn this one-group pretest-posttest design, participants were 15 outpatients with NSCLC undergoing medical treatment (UMIN 000026996). After expressing consent to the study participation, the participants completed a baseline questionnaire and were given a booklet explaining brief cognitive behavioral therapies (relaxation, problem-solving strategies for symptom relief), exercise therapy, and tools. We provided follow-up calls five times and evaluated the retention and changes in symptom severities till the 10th week after the intervention. ResultsOf 15 participants, 10 (66.7%) completed the program. For pain relief strategies, 87% chose deep breathing for relaxation, and 80% fatigue relief with exercises. The median symptom severities (at the baseline and Wk10) showed downward tendencies: pain (2.00, 1.00), sadness (1.00, 0.00), and anxiety (1.00, 0.50). Implications for practiceWe need a randomized controlled trial to further test the effectiveness of the intervention in alleviating symptom and improving QOL of this population. ConclusionsThe nurse-initiated brief CBS intervention program is clinically practical in this population. Nurses may provide useful support for patient symptom management by brief CBS.

Exploring the Impact of Math Anxiety and Task Difficulty on Pupil Dilation in Adults and Young Children.

We investigated the relations between self-reported math anxiety, task difficulty, and pupil dilation in adults and very young children during math tasks of varying difficulty levels. While task difficulty significantly influenced pupillary responses in both groups, the association between self-reported math anxiety and pupil dilation differed across age cohorts. The children exhibited resilience to the effects of math anxiety, hinting at additional influential factors such as formal math education experiences shaping their relations to mathematics and their impact on cognitive processes over time. Contrary to expectations, no significant association between self-reported math anxiety and pupil dilation during task anticipation was found in either group. In adults, math anxiety influenced pupil dilation exclusively during the initial phase of task processing indicating heightened cognitive load, but this influence diminished during sustained task processing. Theoretical implications emphasize the need for exploring individual differences, cognitive strategies, and the developmental trajectory of math anxiety in very young children.

A Systematic Review of the Effectiveness of Rehabilitation Programmes or Strategies to Treat People With Persistent Knee Pain Following a Total Knee Replacement.

Persistent high levels of knee pain after a total knee replacement have been estimated to affect 5%-10% of people and this is related to dissatisfaction with surgery, reduced function and reduced quality of life. This systematic review aims to evaluate the effectiveness of rehabilitation programs or strategies to reduce persistent pain and improve function and quality of life in people following a total knee replacement. The systematic review was conducted following PRISMA guidelines with a search of relevant online databases up to 17 July 2024. The search criteria included English language randomised controlled trials of rehabilitation programs or strategies in any setting to treat people with persistent knee pain more than 3 months after a total knee replacement. Rehabilitation could include exercise, education, cognitive strategies and self-management programs and excluded medication trials, procedural techniques and complementary therapies. After removal of duplicates, there were 468 abstracts screened for eligibility with 23 remaining for full-text screening and finally, one study meeting the eligibility criteria. This study's interventions were pain neuroscience education alone and pain neuroscience education plus neuromuscular exercise. There were no statistically significant between-group differences for pain reduction or functional improvement. The evidence examining the value of rehabilitation programs or strategies for pain reduction and functional improvement in people with persistent pain following total knee replacement is deficient. Given the high number of people affected annually, further research concerning both prevention and management of persistent pain after knee replacement is warranted.

Next-Level Healthcare Leadership Begins with Self-Leadership

There are so many ways that healthcare administrators, leaders, and managers can work on ramping up their leadership to the next level that it can be hard to know where to start. This article argues that the best way to begin your own development program is with self-leadership. It defines self-leadership and provides a brief history of the concept and a description of its theoretical underpinnings. It describes 10 practical benefits of self-leadership and the challenging obstacles leaders are most likely to encounter as they work on developing their self-leadership. This article then offers 15 practical cognitive and behavioral self-leadership strategies and explores the best ways to develop a next-level mindset. Finally, this article explains the 8 C’s of Self-Leadership model and suggests how leaders can assess their self-leadership so they become the best versions of themselves.

Critical thinking abilities, cognitive reading strategies, and task-based language learning among Chinese EFL learners

Critical thinking abilities, cognitive reading strategies, and task-based language learning among Chinese EFL learners

Is the Unified Protocol for Children Effective for the Transdiagnostic Treatment of Children’s Emotional Disorders? A Randomized Controlled Trial

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) aims to reduce internalizing symptoms in children by addressing fundamental mechanisms that underlie emotional disorders through a combination of cognitive, emotional, and behavioral strategies. This study, the largest randomized controlled trial (RCT) to date of UP-C efficacy and the first one conducted outside the U.S., assesses the efficacy of UP-C compared to an active control group. A total of 153 children (6–13 years old; 58.8% girls) with at least one emotional disorder as a primary diagnosis and their parents (88.2% mothers) were randomly assigned to either the UP-C condition (n = 77) or an active control condition (n = 76; receiving a psychoeducational intervention, the ABC of Emotions). Participants completed self-report questionnaires at pretreatment, midtreatment, posttreatment, and at the 3-month follow-up, assessing children’s internalizing symptoms and their interference with the child and family functioning. Clinicians assessed the severity of the child’s symptoms and monitored clinical improvement throughout the study. Descriptive statistics, comparative tests and Linear Mixed Models were used. Results showed greater satisfaction, lower dropout rates, and better adherence in the UP-C condition, with a reduced need for additional interventions posttreatment compared to the control group. The UP-C demonstrated significantly greater efficacy in reducing internalizing symptoms, with a large effect size, including anxiety and depression, as well as in reducing the interference and severity of child symptoms and in improving clinical gains compared to the control group. These findings provide strong support for UP-C as a feasible, acceptable, and effective treatment for childhood emotional disorders, reinforcing its status as an evidence-based treatment.

The Role of Personality Features and Cognitive Avoidance Strategies in Cigarette Smoking Behavior

The Role of Personality Features and Cognitive Avoidance Strategies in Cigarette Smoking Behavior

Flexibility predicts chronic anxiety and depression during the first year of the COVID-19 pandemic-A longitudinal investigation of mental health trajectories.

The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to adapt to changing contextual demands by employing various emotional, cognitive, and behavioral strategies, may significantly contribute to coping with long-term stressors such as COVID-19. Cognitive and coping flexibility domains and longitudinal trajectories of anxiety and depression were assessed at three-time points across 13 months in 571 Israelis. Analyses revealed four different trajectories for anxiety: resilient (66%), chronic (22%), emerging (7%), and improving (6%), and two trajectories for depression: resilient (87%) and chronic (13%). Individuals in the chronic trajectory group (for both anxiety and depression) exhibited lower cognitive flexibility and coping flexibility levels than individuals in the resilient trajectory group. Across time, anxiety and depression were linked to clinically significant posttraumatic stress disorder-like symptoms. Low cognitive and coping flexibility are linked to the probability of experiencing chronic mental health problems, making them a potential target for prevention and treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Effectiveness of Cognitive Activation Strategy in Developing Oral Classical Arabic Communication Competency Among Omani Students’ Courses

The Effectiveness of Cognitive Activation Strategy in Developing Oral Classical Arabic Communication Competency Among Omani Students’ Courses

Potential Mechanisms Underlying Reappraisal Strategies: An Exploratory Study

Reappraisal strategies are vital for our psychological well-being. The way people feel, behave and react in different stressful situations, depends to a degree on the reappraisal strategies they use to manage their emotional states and to cope with a given situation. In this paper, we assess the types of reappraisal strategy described in the scientific literature from the point of view of a focus on specific cognitive strategies. Adopting a mixed research design, we used inductive content analysis in order to identify potential underlying mechanisms relating to qualitative patterns of thinking used in efficient reappraisal. Eight anger and anxiety eliciting situations where used to stimulate emotional responses and the use of reappraisal strategies. Based on our exploratory approach we identified four additional specific reappraisal strategies (justification, responsibly assumption, normality check, and non-justified acceptance) which can be used as specific intervention techniques. Awareness and core beliefs are cognitive processes that contribute to the understanding of inter-individual differences in the efficacy of the reappraisal process. Research areas for future studies are identified.