Episodic virtual care (EVC) offers patients rapid access to virtual primary care services but lacks relational continuity with a primary care clinician or team. We investigated patients’ experiences with EVC and examined differences based on access to a regular primary care clinician and self-reported complexity of medical needs. In this convergent parallel mixed methods study, we conducted a descriptive and exploratory survey of EVC users’ health service access, self-reported medical needs, EVC use, and demographics. Participants included adults (aged ≥ 18) living in Nova Scotia or New Brunswick who self-reported using EVC in the past year. We used descriptive statistics to summarize numeric and ordinal data of patient experience and stratified findings by having a regular primary care clinician and medical complexity. We conducted inductive content analysis of free-text survey responses. We integrated quantitative and qualitative data at the interpretation phase. We identified mixed experiences among EVC users, with quantitative data portraying virtual care experiences more favourably than free-text responses. Most users felt EVC met their health needs, although those without a regular primary care clinician and with greater medical complexity tended to rate experiences less favourably. In free-text responses, some participants expressed concerns with the technological aspects of virtual visits and voiced preferences for in-person care. Patients with a regular primary care clinician tended to access EVC for short-term health concerns, whereas those without a regular primary care clinician sought care for ongoing/chronic problems and prescription renewals. EVC is helping to address some gaps in access, particularly for patients without a regular primary care clinician, by providing care where there might otherwise be none. However, EVC often falls short of meeting ongoing and more comprehensive care needs, underscoring the importance of improving access to longitudinal primary care.

IntroductionChatbots are accessible and cost-effective tools that may be able to provide navigation support to people who lack access to conventional patient navigation services. To date, little is known about people's interest in using chatbots for patient navigation. It is also unclear what specific types of support people would like to see incorporated into patient navigation chatbots. The purpose of this study was to gain insight into these topics.MethodsParticipants were recruited through the Prolific research platform. They completed a cross-sectional survey that captured information on respondent characteristics, general interest in using a patient navigation chatbot, and interest in various navigation support functions. Data were analyzed using descriptive statistics and ANOVA and hierarchical regression statistical tests.ResultsA total of 276 participants (141 women; M age = 38.99 years, SD = 12.90) were included in the analysis. In general, participants were moderately interested in using a patient navigation chatbot. They had greater interest in functions related to care coordination, linkage to services and resources, and general education than functions related to needs assessment and treatment support. Interest varied by certain respondent characteristics, particularly demographic and personality factors.DiscussionThe findings from this study will help inform the design and marketing of patient navigation chatbots. The effective implementation of this technology may fill some of the accessibility gaps that characterize conventional patient navigation programs.

OBJECTIVE The objective of this review is to map the literature on the characteristics, barriers, and faciliators of patient navigation programs for people with dementia, their caregivers, and/or members of their care team across all settings. INTRODUCTION Patient navigation refers to a model of care that helps guide people through the health care system, matching their unmet needs to appropriate resources, services, and programs. Patient navigation may be beneficial to people with dementia because this is a population that frequently faces fragmented and uncoordinated care and has individualized care needs. INCLUSION CRITERIA This review will focus on patient navigation programs for people living with dementia, their caregivers, and/or members of their care team, while excluding programs that do not explicitly focus on dementia. It will include patient navigation across all settings, delivered in all formats, and administered by all types of navigators, as long as the program is aligned with this article's definition of patient navigation, while excluding case management. METHODS This review will be conducted in accordance with JBI methodology for scoping reviews. The MEDLINE, CINAHL, PsycINFO, Embase, and ProQuest Nursing and Allied Health databases will be searched for published articles. Two independent reviewers will screen articles for relevance against the inclusion criteria. The results will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews flow diagram and the extracted data will be presented in both tabular and narrative format.

Previous research has shown a link between attachment anxiety and the strength of the parasocial relationships that people form with their favorite media figures. The mechanism underlying this connection is unclear, although certain findings from the literature suggest that belongingness needs could play a role. In the current study, we assessed whether the association between attachment anxiety and parasocial relationship strength is mediated by belongingness needs. A sample of 200 online participants filled out measures of attachment anxiety and belongingness needs, reported their favorite TV figure, and completed a measure of the strength of their parasocial relationship with that figure. As expected, results showed a significant association between attachment anxiety and parasocial relationship strength. This association was mediated by belongingness needs. These results may help to explain why anxiously attached individuals tend to form stronger parasocial relationships with their favorite media figures than people with other attachment orientations. Public Policy Relevance Statement People with high levels of attachment anxiety may form strong bonds with their favorite media figures due to their elevated belongingness needs. Media figures might be used in a directed way to help satisfy the elevated belongingness needs of these individuals.

Two studies were carried out to determine how loneliness is related to the way that individuals interpret ambiguous situations. Study 1 involved participants from undergraduate psychology classes and Study 2 involved participants from the general population. Participants completed measures of loneliness, anxiety, and depression, as well as a measure of their interpretation of ambiguous situations. Pearson correlations were used to assess the relationship between three types of loneliness and the perceived pleasantness of ambiguous situations. Hierarchical regression analyses were used to determine whether the same types of loneliness predicted perceived pleasantness over and above the effects of depression, anxiety, and perceived vividness of ambiguous situations. Across both studies, there was a link between social loneliness and the way individuals interpret ambiguous situations. These results have implications for the treatment of loneliness, in particular social loneliness.

Anxiously attached individuals tend to report stronger parasocial relationships with their favorite media figures than people with other attachment orientations. Researchers have suggested that these individuals may be inclined to see their favorite media figures as safe and secure attachment figures. The purpose of the current study was to evaluate this possibility by assessing the qualities of people’s favorite media figures, particularly within a television context. A sample of 200 online participants filled out an attachment measure, reported their favorite television figure, and rated several aspects of the television figure’s personality. It was expected that anxiously attached individuals would be drawn to figures that are high in warmth, emotional stability, and sensitivity. Instead, results showed that these individuals preferred figures with greater anxious and insecure characteristics. These results suggest that anxiously attached individuals may not see their favorite media figures as safe and secure attachment figures as previously theorized. Exploratory analyses failed to show significant effects for the second attachment dimension, attachment avoidance, or for the interaction between anxiety and avoidance.

PURPOSE:Studies assessing intraoperative pain during surgery with wide-awake local anesthesia typically use a unidimensional pain scale, which provides a limited view of the pain experience. The present paper describes two studies that assessed qualitative aspects of intraoperative pain using a multidimensional pain measure. METHODS:The first study was a retrospective survey of 24 patients who received a variety of foot and ankle procedures under wide-awake local anesthesia. Patients completed a copy of the Short-Form McGill Pain Questionnaire (SF-MPQ) through the mail an average of six months following surgery. The second study was a prospective assessment of 40 patients receiving forefoot procedures under the same anesthesia. Patients completed a copy of the SF-MPQ directly after the surgery. RESULTS:Patients in the first study selected an average of 1.17 pain descriptors (SD = 3.02) on the SF-MPQ, whereas patients in the second study selected an average of 1.90 pain descriptors (SD = 1.82). In general, both studies found that sensory descriptors of pain (e.g., sharp, shooting, tender) were more common than affective descriptors. However, mean intensity ratings were low for all descriptors. CONCLUSION:The results of these studies provide a more comprehensive understanding of the patient experience during surgery with wide-awake local anesthesia.

PURPOSE:Patients receiving surgery with wide-awake local anesthesia typically report little or no intraoperative pain. However, self-report assessments of pain are susceptible to bias. In the present study, patient self-report ratings were supplemented with objective physiological measures of electrodermal activity. METHODS:Fifteen patients receiving forefoot surgery using wide-awake local anesthesia were recruited. Pain ratings and skin conductance responses were acquired during the initial anesthetic injection (into unanesthetized tissue), during a follow-up anesthetic injection (into anesthetized tissue), and during five intraoperative procedures. RESULTS:The highest ratings of self-reported pain coincided with the initial anesthetic injection, and pain ratings were similarly low at all remaining measurement points. Fourteen patients reported no pain beyond the initial injection, whereas one patient reported minimal pain during two intraoperative procedures. Skin conductance data were consistent with pain ratings such that responses to the initial injection were significantly larger than responses at any subsequent measurement point. CONCLUSION:These results provide further evidence that patients experience little or no pain during surgery with wide-awake local anesthesia.

Background: A recent case series suggested that surgery with wide-awake local anesthesia is tolerated well by most foot and ankle patients. However, patients were assessed retrospectively and there was no comparison group to show the relative efficacy of this approach. The present study was conducted to address these concerns. Methods: Perioperative pain and anxiety were assessed in 40 patients receiving forefoot surgery using either wide-awake local anesthesia or general anesthesia. Ratings were collected on the day of surgery using 11-point (0-10) numerical rating scales. Results: Patients in the two anesthesia groups reported no differences in preoperative pain (p = 0.500) or anxiety (p= 0.820). Patients who received wide-awake local anesthesia reported lower levels of postoperative pain (p < 0.001) and anxiety (p < 0.001) than patients who received general anesthesia. They also reported little pain (M=0.17, SD= 0.32) or anxiety (M=1.33, SD= 1.74) during the operation. Conclusions: Results indicate that surgery with wide-awake local anesthesia is tolerated well by most patients, and that it may have some benefit compared to surgery with general anesthesia. (C) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

BACKGROUND:The "wide-awake" approach to foot and ankle surgery is characterized by a surgeon-administered mixture of local anesthetic and epinephrine. No tourniquet, sedation, or general anesthesia are required for surgery. This paper describes a retrospective survey of the initial patients to undergo wide-awake foot and ankle surgery at our center.METHODS:Thirty former wide-awake patients were surveyed about their perioperative anxiety, pain, and satisfaction.RESULTS:Twenty-seven of 30 patients (90%) completed the survey. Patients received a variety of forefoot, hindfoot, and lower leg procedures. In general, they reported a decrease in anxiety over the course of the perioperative period (p=0.005). Pain fell from the preoperative to the intraoperative period, then rose to preoperative levels during recovery (p<0.001). Most patients said that the surgery was better than expected (83%); would choose wide-awake surgery for a subsequent procedure (87%); and would recommend wide-awake surgery to someone who required surgery (88%).CONCLUSIONS:Results indicate that the wide-awake approach to foot and ankle surgery causes little discomfort to patients who receive many common procedures. The removal of hindfoot hardware under local anesthesia is contraindicated.

Thermoregulatory influences on electrodermal and cardiovascular activity may interfere with the detection of concealed information using a polygraph. This possibility was assessed by means of a mock terrorism scenario. Seventy-two participants were assigned to either a guilty or an innocent role. They were given a polygraph test at one of three ambient temperatures: 10°C, 22°C, or 34°C. Among guilty participants, electrodermal and cardiovascular measures were least effective at 10°C. Electrodermal results were optimal at 22°C, whereas cardiovascular results were optimal at 34°C. Among innocent participants, the effectiveness of these same measures was not affected by ambient temperature. Temperature had no significant impact on respiration results within the guilty or the innocent groups. Taken together, these findings have implications for those who use polygraphs in uncontrolled testing environments.

The effect of situational factors on perceptions of items on the polygraph Comparison Question Test (CQT) was assessed. In an initial experiment, 86 students (30 men, 56 women; M age = 20.3 yr., SD = 4.0) imagined one of eight scenarios that varied by guilt or innocence, the commission of a real crime or mock crime, and interrogation by a police officer or a professor. They then rated generic CQT questions for importance and emotional concern. All participants rated crime-relevant questions as being more important than past-crime comparison questions. "Guilty" participants also rated these questions as being more emotionally concerning, but "innocent" participants showed no differences in their ratings of concern for the two question types. Interrogator or crime type did not affect the general pattern of responding. A second experiment involving 80 students (21 men, 58 women, 1 non-specified; M age = 22.5 yr., SD = 7.3) replaced the generic CQT questions with content-specific questions developed by the participant. Those imagining guilt showed no differencesin their ratings of relevant and comparison questions, whereas those imagining innocence rated comparison questions as more concerning. Again, interrogator type and crime type had little effect on results. Overall these findings indicated distinctions in cognitive and emotional appraisal for CQT questions, with the nature of emotional concern dependent on guilt/innocence status and the personal relevance of comparison questions. Evidence suggests that the CQT is robust to other situational factors, such as crime type and interrogator type.

Scientists use inscriptions, such as tables, graphs, and illustrations to provide readers with a visual representation of data. A sample of articles from the journal, Science was collected and a random selection of eight articles was drawn from each decade from inception to the present decade (2008 - 2010). Overall, we found different trends in the use of graphs, tables, and non-graph illustrations.

Effect size estimates are altered by many factors, including, and perhaps most importantly, the shapes of compared distributions. There have been many long time advocates of the necessity of graphing raw data to truly understand analysis. Though they were and remain correct, there is little evidence in the published literature in psychology that their recommendations have been followed. This paper argues their case, but with the advantage of the recent emphasis on effect sizes promoted by, amongst others, the American Psychological Association publication guide. Unlike Null Hypothesis Statistical Testing (NHST), effect size estimates are not robust to distributional deviations from normality. As a consequence of effect size sensitivity to distributional distortions from normality, it is all the more important to understand the qualities of the distributions from which estimates are derived. In this paper, we consider and simulate cases where graphical analyses reveal distortion in effect size estimates, and in doing so highlight the value of graphing data to interpret effect size estimates.