Verbal Requests Research Articles

Infants Produce Optimally Informative Points to Satisfy the Epistemic Needs of Their Communicative Partner.

Pragmatic theories assume that during communicative exchanges humans strive to be optimally informative and spontaneously adjust their communicative signals to satisfy their addressee's inferred epistemic needs. For instance, when necessary, adults flexibly and appropriately modify their communicative gestures to provide their partner the relevant information she lacks about the situation. To investigate this ability in infants, we designed a cooperative task in which 18-month-olds were asked to point at the target object they wanted to receive. In Experiment 1, we found that when their desired object was placed behind a distractor object, infants appropriately modified their prototypical pointing to avoid mistakenly indicating the distractor to their partner. When the objects were covered, and their cooperative partner had no information (Experiment 2) or incorrect information (Experiment 3) about the target's location - as opposed to being knowledgeable about it - infants pointed differentially more often at the target and employed modified pointing gestures more frequently as a function of the amount of relevant information that their partner needed to retrieve their desired object from its correct location. These findings demonstrate that when responding to a verbal request in a cooperative task 18-month-old infants can take into account their communicative partner's epistemic states and when necessary provide her with the relevant information she lacks through sufficiently informative deictic gestures. Our results indicate that infants possess an early emerging, species-unique cognitive adaptation specialized for communicative mindreading and pragmatic inferential communication which enable the efficient exchange of relevant information between communicating social partners in cooperative contexts.

Knowledge and Attitudes of Medical and Pharmacy Graduates about Opioids Prescription and Dispensation in 2022 in Bamako, Mali

Opioids are medications with analgesic properties used primarily as painkillers. Nowadays, off-label uses (non-medical use, prolonged use, misuse and use without a medical supervision) are common inducing drug dependence with harmful consequences including substance-induced psychosis or pharmacopsychosis. In a cross-sectional study from February to June 2021, we used a questionnaire to collect information on the knowledge of interns and doctors trained in the Faculty of Medicine and Dental Medicine and the Faculty of Pharmacy at the University of Sciences, Bamako Techniques and Technologies (USTTB) on opioids in eight (8) public health facilities (5 university hospitals and 3 district hospitals) in Bamako. We analyzed the data with SPSS software version 25.0. A total of 400 health workers participated in the study with 62.5% of medical students (250/400), 31.0% of pharmacy students (124/400) and 6.5% of general practitioners (26/400). More than 70.0% of our respondents were aware that there is a regulatory framework for prescribing and dispensing opioids in Mali. Level 2 opioids were dispensed in 29.0% of cases at the patient’s verbal request and 30.6% by telephone. However, level 3 opioids were dispensed in 0.8% of cases at the patient’s verbal request and in 3.2% of cases by telephone call. Medical students in 60.0%, pharmacy students in 64.5% and general practitioners in 50.0% had very good knowledge about the risks of opioid use. For 23.0%, general practitioners had at least a good knowledge of opioid indications. Participants had a good understanding of the risks and benefits of opioids. Keywords: Attitudes, Knowledge, Opioïds, Mali

Surgeon perspectives on preference cards and environmental stewardship.

Refinement of surgical preference cards may reduce waste from surgery. This study aimed to characterize surgeon perceptions and practices regarding preference card maintenance, identify barriers to updating preference cards, and explore whether opinions on environmental stewardship relate to preference card maintenance. This was a mixed methods survey performed at a single tertiary academic medical center. Surgeons completed questions on accuracy, frequency of updates, and perceived environmental impact of their preference cards. Responses were compared between early career and mid-to late-career surgeons using Kruskal-Wallis, chi-squared, and Fisher's exact tests. The response rate was 46.4% (n=89/192). Among respondents, 46.1% (n=41/89) rarely or never updated preference cards. Nearly all (98.9%, n=87/88) said some of their cases had unused items on their cards. Most (87.6%, n=78/89) made updates via verbal requests. Unfamiliar processes (83.7%, n=72/86) and effort required (64.0%, n=55/86) were viewed as barriers to card maintenance. Most agreed that more frequent updates would reduce waste (80.5%, n=70/87), but respondents did not feel knowledgeable about the environmental impact of items on their cards (62.1%, n=54/87). Mid-to late-career surgeons were less likely to update their cards annually or more often compared to early career surgeons (18.9%, n=7/37 vs. 57.1%, n=24/42, p<0.001). No other responses varied significantly between early career and mid-to late-career surgeons. Surgeons acknowledged the utility of preference card maintenance in environmental stewardship, but unfamiliar systems and perceived effort hindered preference card review. Greater attention to preference card maintenance would promote environmentally sustainable practices in surgery.

Patients’ Reasons to Consider and Their Attitudes toward Complementary and Alternative Medicine

Purpose. In recent years, decision-making between conventional medicine, complementary medicine (CM), and alternative medicine (AM) has been studied. The purpose of this study is to take a closer look at patients’ thoughts regarding AM and CM and, if possible, to identify differences. Patients and Methods. Ten cancer patients were recruited to participate in a guided semistructured interview. Recruitment was via verbal request during counseling sessions for complementary healing methods. The main recruiting criterion was their interest in or use of AM or CM. In the following face-to-face interviews, demographic data, previous experience with alternative medicine and conventional medicine, doctor-patient communication, role of the family, and sources of information were determined. The interviews were conducted in a semistructured manner using a guide and were recorded anonymously. The recordings were subsequently transcribed. Results. The number of patients was 10, of which eight were female and seven could show higher educational status. In most of the cases, poor communication was mentioned, both in past situations and at the time of diagnosis. Patients described a lack of emotion in the communication of their diagnosis and paternalistic discussions. They complained that they did not receive an overview of the therapy and that they were hardly involved in the decision-making process. Especially, the demanding content as well as the scarcity of conversation time played an important role for the doctor-patient relationship and the resulting trust toward the doctor. A fundamentally dismissive attitude toward CM, AM, and CAM procedures led to a more fragile trust base. Most frequently used sources were the Internet, support organizations, and books. Conclusion. The first point of contact for cancer patients is usually the conventional physician. Commonly, he is one of the most important sources. If the patient is satisfied with the atmosphere of the conversation and the information regarding CAM received, he will probably follow the doctor’s recommendations. Only in the case of dissatisfaction do patients seek advice from alternative medicine. Good training of conventional physicians in communication and complementary therapy options could, therefore, be of great importance.

Enabling people with intellectual and other disabilities to make verbal requests using cardboard chips with mini objects or pictures and a smartphone.

This study aimed to help six participants with intellectual disability combined with sensory and motor impairments to make verbal requests through the use of a technology system involving cardboard chips and a smartphone. The participants were divided into two groups of three based on whether they did or did not have visual skills. Each group was exposed to the intervention with the technology system according to a non-concurrent multiple baseline across participants design. During the 20 min intervention sessions, the participants were provided with a smartphone and nine cardboard chips each of which had a picture or object (i.e., a mini object replica or raised object contour) and several radio frequency identification tags attached to it. To make a request, the participants were to bring a cardboard chip in contact with the smartphone. This read the tags attached to the cardboard and verbalized the request related to that cardboard. During the baseline (without cardboard chips and smartphone), the participants' mean frequency of independent requests (all non-verbal requests) varied between zero and near 1.5 per session. During the intervention (with cardboard chips and smartphone), the participants' mean frequency of independent requests (all verbal requests) varied between over 4.5 and about 10 per session. The results suggest that the system might be useful to help participants like the ones included in this study to make verbal requests with simple responses.

Mothers’ communicative cues and the development of infants’ helping: Linking participation and problem solving in the first year of life

AbstractThere is an ongoing debate on the role of socialization in the development of infants’ helping. Although opportunities for the socialization of early helping are rare in problem solving (bystander intervention), there are many opportunities for socialization in participation (working alongside others), and infants’ experiences of participation could socialize problem solving indirectly. The present study links participation and problem solving conceptually by drawing on a Hebbian concept of indirect learning and through a study examining mothers’ communicative cues in both forms of helping. Forty mother‐infant dyads engaged in two semi‐structured helping tasks, a participation task and a problem‐solving task at five, eight, and ten months of age. Mothers’ communicative cues and infants’ return of the object were examined using coding schemes adapted from prior research. Mothers used similar communicative cues (reaches, give‐me gestures, and verbal requests) in both tasks, and more maternal scaffolding contributed to greater object handover. Infants showed higher object handover in participation tasks. The findings, framed in Tomasello's neo‐Vygotskian account of prosocial development, offer a synthesis of the debate on the role of socialization where prosocial behavior emerges first between people, and then becomes individualized.

Bir Üniversite Hastanesinde Sözel İstem Alma Süreci, Kontrolü ve Sonuçlarının Değerlendirilmesi

In hospitals, the immediate administration of the treatment recommended by the physician is important for the patient safety, quality patient care, not prolonging the hospitalization length and expense. When considering near-miss/happened medication administration error in patient safety, it is discovered that verbal requests also play a role. Aim: This study was conducted in a university hospital using a standardized verbal request process, control and result evaluation to identify problems that develop throughout the implementation process and to offer solutions. Design/Method: The study was carried out by retrospectively assessing verbal requests given between January and December 2019 in accordance with the standard of taking verbal request used in a 110-bed university hospital. The data were analyzed based on the department, the status of requests within and outside of working hours, the presence of the physician's signature on the form, academic staff, and the physician’s full-time/contracted job status. The SPSS 24 software was used to analyze the data. Results: It was established that a total of 2033 verbal requests were put in the hospital where this study was conducted; with medicine accounting for 51.6% (n=1048) of the verbal requests. It was determined that 53% (n=57) of the doctors who put in verbal requests were contracted, 47% (n=51) were permanent employees, and 50.6% (n=531) of the requests were given during working hours and 49.4% (n=517) were given outside of working hours. Conclusion: Considering the research results, it was detected that the number of signed verbal requests is low; that, despite the institution’s large number of contracted doctors, their own staff physicians use many verbal requests and do not sign the forms; and that more verbal requests are given during working hours.

An Evaluation of Ethnicity-Matching for Caregiver Telehealth Training in India.

Telehealth has become an increasingly viable service delivery option for function-based treatment of problem behavior (Lindgren et al., 2016). However, few applications have occurred with participants outside the United States and little research exists evaluating the role that culture plays in service delivery. In the current study, we compared functional analyses and functional communication training delivered via telehealth by ethnically matched and ethnically distinct trainers to six participants in India. We measured the effectiveness using a multiple baseline design while collecting supplemental measures of sessions to criterion, cancellations, treatment fidelity, and social validity. We directly assessed preference for the ethnically matched and ethnically distinct trainers using a concurrent chains arrangement. Sessions with both trainers were effective in reducing problem behavior and increasing functional verbal requests for participating children, and treatment fidelity was high across training modalities. There were no major differences in sessions-to-criterion or cancellations across trainers. However, all six caregivers demonstrated greater preference for sessions with the ethnically matched trainer.

The Socio-economic Evaluation of the MGNREGS in Punjab

The present study aimed to evaluate the impact of MGNREGS on rural households' socio-economic status. The results revealed that the beneficiaries were well aware of the MGNREGS whose work was either meant for poor or scheduled caste households. The assets created under the scheme were considered helpful by most beneficiaries. The beneficiaries mostly follow a verbal request, paying no charges for job card preparation. The majority of respondents had custody of their job cards. The results revealed a significant rise in income and expenditure of sample households. The MGNREGS beneficiaries' food and non-food expenses increased after joining MGNREGS. Thus MGNREGS had facilitated the improvement of their socio-economic status.

0509 Behavioral Topography of Bedtime Resistance in Younger and Older Toddlers

Abstract Introduction Sleep issues in young children are common, however little is known about bedtime resistance across development in toddlers. Thus, the aims of this study were to (1) assess the prevalence of bedtime resistance in younger and older toddlers and (2) examine differences in behavioral topography across groups. Methods 318 mothers of toddlers (12-36 mos; M =23.1 mos) completed an online questionnaire addressing bedtime resistance, as well as the Brief Infant Sleep Questionnaire–Revised (BISQ-R). The sample included both younger (n=162, 12-23mos) and older (n=156, 24-36mos) toddlers. Results Overall, 61.3% endorsed bedtime stalling/fighting/resisting, with no age difference (57.4% younger vs 65.4% older), p &amp;gt; .05. Bedtime resistance commonly occurred after lights out (60% of those who resisted). Resistance also occurred during the bedtime routine (55.9%) and with announcement of bedtime (36.9%). Older toddlers were more likely to resist at announcement of bedtime (51.0% vs. 21.5%, p&amp;lt; .001), with no other age differences for resistance timing. Of the 21 resistant behaviors assessed, younger toddlers were most likely to cry/tantrum (68.8% vs 48.0%) and climb (or attempt) out of the crib (28.0% vs 12.7%), p &amp;lt; .01. Older toddlers were more likely to engage in 16 behaviors, including these most common: wanting a snack/drink (19.4% vs. 57.8%), adult to hug/snuggle/lie down (23.7% vs 53.9%), more time doing a bedtime activity (19.4% vs 49.0%), or a specific item (19.4% vs. 46.1%), getting out of bed (25.8% vs 46.1%), or watching electronics (24.7% vs 42.2%), p &amp;lt; .01. Conclusion Most mothers (61%) reported that their toddler resisted in some way at bedtime. No differences in the prevalence of bedtime resistance were found between younger and older toddlers, however the behavioral presentation of resistance differed. Whereas younger toddlers were more likely to cry and attempt climbing out of the crib, older toddlers were more likely to make specific verbal requests and requesting specific activities. These differences likely stem from developing language, motor, and cognitive skills. Ways to help caregivers manage these common bedtime behaviors need to be age and developmentally-based, aligning with presenting behavioral difficulties. Support (If Any) Johnson &amp; Johnson Consumer Inc., Skillman, NJ, USA

Artificial intelligence-based voice assistant for BIM data management

Existing systems that employ Automatic Speech Recognition (ASR) technology to retrieve information from the BIM model fail to provide remote interaction, retrieve a wide range of data, and automate the entire process. This is particularly a problem for users with disabilities. The paper offers a two-way, automated, and agnostic solution to this theoretical and methodological gap. A ‘Proof of Concept’ prototype was developed using Amazon Alexa – as the AI voice assistant platform – to test the applicability. The outcome shows that the created and the retrieved information is valid. Furthermore, there is a high level of interoperability among the components of the proposed solution, including the AI voice assistant interface and mediation environment to convert verbal requests and retrieve information to CSV files. Future research will extend the created solution to retrieve and access information from a BIM cloud model.

Depression and suicidality as evolved credible signals of need in social conflicts

Mental health professionals generally view major depression and suicidality as pathological responses to stress that elicit aversive responses from others. An alternative hypothesis grounded in evolutionary theory contends that depression and suicidality are honest signals of need in response to adversity that can increase support from reluctant others when there are conflicts of interest. To test this hypothesis, we examined responses to emotional signals in a preregistered experimental vignette study involving claims of substantial need in the presence of conflicts of interest and private information about the signaler's true level of need. In a sample of 1240 participants recruited from Amazon Mechanical Turk, costlier signals like depression and suicidality increased perceptions of need, reduced perceptions of manipulativeness, and increased likelihood of support compared to simple verbal requests and crying without further symptoms. The effect of signaling on likelihood of support was largely mediated by the effect of signaling on participants' belief that the signaler was genuinely in need. Our results support the hypothesis that depression and suicidality, apparent human universals, are credible signals of need that elicit more support than verbal requests, sad expressions, and crying when there are conflicts of interest.

Effect of verbal messages with reminders to communicate driving situations to alter driver behavior in conditional driving automation

In conditionally automated driving, drivers are relieved of steering (hands-off), accelerating, and braking actions as well as of continuous monitoring of driving situations and the system operation status (eyes off). This enables continuously engagement in non-driving-related activities. Managing the allocation of a driver’s attention to the surrounding environment and automation status presents a major challenge in human–machine system design. In this study, we propose a verbal message with a reminder (monitoring request) to divert the driver’s attention from non-driving-related activities to peripheral monitoring under conditionally automated driving. When the system encounters events related to weather, traffic, and road geometry, it provides a verbal message pertaining to the road surroundings (e.g., “It is foggy outside”) to the driver. After three seconds, the system provides a reminder message (i.e., “Did you confirm it?”) to the driver. We explore two questions: (1) how does the message with the reminder affect the driver’s attention allocation, and (2) how does the message with the reminder affect the driver behavior in response to a request to intervene (RTI). With a driving simulator, we designed a repeated measures mixed design with a between-participant factor of “Driving condition” and within-participant factors of “Event type” and “Measurement time”. Three driving conditions were established as follows: no messages, messages without reminders, and messages with reminders. Twenty-seven drivers participated as participants in the driving simulator experiment. Results showed that the reminder message was effective in allocating the participants’ attention to the surrounding environment, and the participants took over the driving task after spending more time understanding the take-over situation in the condition of messages with reminders compared to those in the condition of no messages. We conclude that the proposed reminder message can direct drivers’ attention to the road surroundings during conditionally automated driving. In the future, we plan to design adaptive verbal monitoring requests to adjust the reminder message according to the situation.

Relational aspects of regulating clinical work: examining electronic and in-person compliance mechanisms

BackgroundClinical documentation quality is an important way to facilitate clinical communication, improve patient safety metrics and optimise hospital coding and public reporting. However, the monitoring of clinicians by external individuals...

Community pharmacists' management of minor ailments in developing countries: A systematic review of types, recommendations, information gathering and counselling practices.

To conduct a systematic review of the management of minor ailments by community pharmacists in developing countries, and to identify the specific minor ailments encountered, the medications recommended or requested and the information gathering and counselling practices. Observational studies from developing countries published in English language from inception to 2019 and report the management of minor ailments by community pharmacists were systematically searched in PubMed, ScienceDirect and Cochrane Library. Thirty full-text studies, out of 7876 retrieved and screened, were included in the systematic review. Minor ailment-induced encounters by patients with community pharmacists are generally pervasive and involve mainly verbal request for specific medicines by name (60%). The most frequent minor ailments reported were respiratory, gastrointestinal and musculoskeletal conditions, and the most common medicines recommended or requested for were cough/cold preparations, antimotility and oral rehydration preparation, and analgesic/antipyretic. Inappropriate recommendation of antibiotics were reported for acute diarrhoea and cough/colds (40%) (10/25). Community pharmacists encountered 11-30 customers with minor ailments per day, with an average of about 4.8 (1.3-20.5) minutes per encounter. None of the studies reported the availability and/or use of a specific protocol to guide the management of minor ailments. There was wide variation in the type and depth of information gathered and used for the management of minor ailments; and the counselling information provided by community pharmacists, and there was no evidence of the documentation activities related to the management of minor ailments. Community pharmacists' encounter with and management of minor ailments appear extensive in developing countries and probably present an opportunity to contribute significantly to reduce disease burden and enhance public health. However, the management process is currently unstructured, unguided by a specific protocol and vary in the quality of recommendations, information gathering and counselling practices.

Huntington’s Disease Complicated by Traumatic Subarachnoid Bleeding and Subdural Hematoma

Though Huntington’s Disease (HD) is frequently complicated by falls and consecutive Traumatic Brain Injury (TBI) with Subdural Hematoma (SDH), traumatic Subarachnoid Bleeding (SAB) has not been reported as a complication of HD. A 67yo female with HD due to a CAG-repeat expansion of 43 repeats, diagnosed 18 months earlier, was admitted after a fall with a Glasgow-Coma Scale (GCS) score of 3. Cerebral CT on admission revealed bilateral SDH and SAB. No aneurysm could be detected on conventional angiography. After extubation, she was non-responsive to verbal requests and typical choreatic movement recurred. Tiaprid, olanzapine, and tetrabenazine were of limited effect. This case shows that falls in HD may not only cause SDH but rarely traumatic SAB. TBI in HD may worsen the phenotype and may increase the risk of a poor outcome.

Providing support is easier done than said: Support providers' perceptions of touch and verbal support provision requests

Although researchers strive to optimize support exchanges, support providers' experiences have largely been overlooked. To identify optimal support from the perspective of the support provider, the current research compared support providers' perceptions of touch and verbal support provision. In Experiment 1, participants were less stressed when they imagined their spouses requesting touch support (versus verbal support). This effect was explained by support providers' perceptions that touch support is less difficult and less likely to produce unintended negative consequences than verbal support and their greater self-efficacy to provide touch support. In Experiment 2, participants who imagined providing touch support (versus verbal or no support) in response to their partner's request anticipated less stress and greater relationship quality while providing support. Greater anticipated security and perceptions that touch support is less difficult and less likely to produce negative consequences explained these effects. Experiment 3 compared requests for touch support, general verbal support, and specific verbal support to test whether the benefits of touch support are explained by specificity. Participants viewed touch support as less difficult to provide and felt particularly special and secure when imagining providing touch support, which indirectly contributed to greater motivation to provide support, less anticipated stress, and greater anticipated relationship quality. Despite support provision deficits among insecurely attached participants, findings were consistent across attachment orientation. This research highlights support providers' experiences and adds to the literature demonstrating benefits of interpersonal touch.

Improving Inpatient Consult Communication Through a Standardized Tool.

To increase the number of essential consult elements (ECEs) included in initial inpatient consultation requests between pediatric residents and fellows through implementation of a novel consult communication tool. Literature review and previous needs assessment of pediatric residents and fellows were used to identify 4 specific ECEs. From February to June 2018, fellows audited verbal consult requests at a medium-sized, quaternary care children's hospital to determine the baseline percentage of ECE components within consults. A novel consult communication tool containing all ECEs was then developed by using a modified situation-background-assessment-recommendation (SBAR) format. The SBAR tool was implemented over 3 plan-do-study-act cycles. Adherence to SBAR, inclusion of ECEs, and consult question clarity were tracked via audits of consult requests. A pre- and postintervention survey of residents and fellows was used to examine perceived miscommunication and patient care errors and overall satisfaction. The median percentage of consults containing ≥3 ECEs increased from 50% preintervention to 100% postintervention with consult question clarity increasing from 52% to 92% (P < .001). Overall perception of consult miscommunication frequency decreased (52% vs 18%; P < .01), although there was no significant change in resident- or fellow-reported patient errors. SBAR maintained residents' already high consult satisfaction (96% vs 92%; P = .39) and increased fellows' consult satisfaction (51% vs 91%; P < .001). Implementation of a standardized consult communication tool resulted in increased inclusion of ECEs. Use of the tool led to greater consult question clarity, decreased perceived miscommunication, and improved overall consult satisfaction.

The Effects of a Dohsa-hou Intervention Package on the Shaping of Verbal Requests of a Child with Autism

The Effects of a Dohsa-hou Intervention Package on the Shaping of Verbal Requests of a Child with Autism

The Effects of Dohsa-hou Intervention Package on the Shaping of Verbal Request of a Child with Autism Spectrum Disorder

The Effects of Dohsa-hou Intervention Package on the Shaping of Verbal Request of a Child with Autism Spectrum Disorder