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The present study had two aims. First, we set out to evaluate the structure of processing speed in children by comparing five alternative models: two conceptual models (a unitary model, a complexity model) and three methodological models (a stimulus material model, an output response model, and a timing modality model). Second, we then used the resulting models to predict multiple types of reading, a highly important developmental outcome, using other well-known predictors as covariates. Participants were 844 children enrolled in third through fifth grade in urban public elementary schools who received 16 measures of processing speed that varied in the above dimensions. A two-factor complexity model that differentiated between simple and complex processing speed was the preferred model and fit the data well. Both types of PS predicted reading fluency, and complex (but not simple) PS predicted single word reading and comprehension. Results offer insight to the structure of processing speed, its relation to closely related concepts (such as executive function), and provide nuance to the understanding of the way processing speed influences reading.

Purpose: Exercise prescriptions for chronic low back pain (CLBP) often utilize reductionistic, trunk‐focused exercise aimed at addressing proposed pain mechanisms. It is unknown if the use of these trunk‐focused exercises imply beliefs to people with CLBP about the rationale for their use (e.g., etiology), even without concurrent biomedical narratives. This study aimed to explore people's perceptions of specific and general exercise without an accompanying narrative when experiencing CLBP. Methods: An anonymous online survey was distributed. Mixed methods were utilized for analysis. Six‐point Likert scales categorized people's beliefs about individual exercises. Open‐ended questions were used to gather further beliefs which were then coded into themes. Results: People with CLBP perceived specific exercise as more beneficial than general exercise. Eight themes and five subthemes were defined. A high volume of positive beliefs were centered around strengthening the low back and abdominal musculature, emphasizing the importance of correct technique. Negative beliefs were held against spinal flexion and external load. Both positive and negative beliefs were underpinned by spinal/pelvic stability being important as well as certain exercises being achievable or not. Conclusion: This study demonstrated that people with CLBP consider specific exercises to be more beneficial than general exercises for CLBP. Specific exercises irrespective of an accompanying narrative can imply meaning about the intent of an exercise. Understanding this requires practitioners to be mindful when prescribing and communicating exercise. [ABSTRACT FROM AUTHOR]

Background: In South Africa, the doctrine of informed consent (introduced by the South African courts, Cape Provincial Division) dictates that all reasonable patients be told of material risks and alternative options before consenting to medical treatment or procedural interventions. The reasonable patient standard requires that a patient be told of all material risks that would influence a reasonable person in determining whether or not to consent to the treatment. Regional anaesthesia, including peripheral nerve blocks (PNBs), provides a plethora of benefits to patients undergoing surgery but, due to potential risks involved, also requires informed consent. Studies have shown that South African anaesthetists do not regularly obtain adequate informed consent for these procedures. We implemented a quality improvement project to facilitate and enhance documented informed consent in our setting. Methods: A prospective quality improvement project was established at Groote Schuur Hospital, Cape Town, including all PNBs performed in two-week blocks before and after the introduction of a standardised regional anaesthesia informed consent form. The primary outcome, comparing the incidence of documented informed consent between the two groups, was assessed with the McNemar's test for differences in proportions. Regression analysis was used to explore the effect of prespecified confounders (such as documented consent taken, benefits discussed, alternatives discussed, complications discussed and whether autonomy was documented). Results: In total, 39 and 43 patients were included in the pre- and post-intervention groups, respectively. In our setting, anaesthetists were 4.16 times (95% confidence interval (CI) -6.67 to -2.98, p < 0.001) more likely to take documented informed consent when provided with a standardised form. The incidence of documented informed consent improved from 7.7% to 60.5%. Regression analysis showed that these confounders influenced the recall of the PNB consent and discussed benefits and complications. Overall, recall was mostly influenced when benefits were discussed with patients (95%CI -20.023 to -14.64, p < 0.001). Conclusion: Documentation of informed consent for PNBs in our setting is poor. A standardised consent form can facilitate the documentation of consent significantly. Patient recollection of the consent process also improved, specifically when benefits were discussed. [ABSTRACT FROM AUTHOR]

Background: Clinical registries are pivotal for advancing patient care and clinical research. The prospective Point of Care Ultrasound Registry (PURE) is a unique, pioneering initiative that aims to accumulate essential ultrasound data through a dedicated collection tool. This study investigates user satisfaction with the implementation of PURE, a first-of-its-kind registry, focusing on a spectrum of implementation outcomes. Methods: Using a cross-sectional survey approach, this study evaluated diverse implementation metrics such as acceptability, appropriateness, adoption, accessibility, feasibility, efficacy and efficiency. Statistical analyses were conducted to determine the overall user satisfaction with the implementation of this novel registry. Results: The study yielded a mean implementation score (IS) of 3.83 (95% CI 3.59-4.07). Effectiveness (E) had a mean score of 1.93 (95% CI 1.80-2.05) and Cumulative Implementation Factor (A) averaged 1.90 (95% CI 1.78-2.03). Notably, 11 of the 30 participants achieved an IS above 4, with a predominant 21 of 30 surpassing an IS of 3.8. Nevertheless, the scores for efficiency and feasibility, registered at 0.392/0.625 and 0.165/0.250, respectively, indicate areas for improvement. Conclusion: While PURE represents an innovative step forward in point-of-care ultrasound (POCUS) data collection, its initial implementation did not fully resonate with user satisfaction expectations. Significant possibilities for enhancement lie particularly within the efficiency and feasibility sectors. To improve its utility, measures such as optimising the data collection tool, bolstering training programmes, merging with existing systems, and implementing thorough evaluation and feedback processes are recommended. A nuanced understanding of the time pressure faced by anaesthetists during data input can provide valuable insights into further areas of potential refinement. [ABSTRACT FROM AUTHOR]