Individuals after anterior cruciate ligament reconstruction (ACLR) have a high rate of reinjury upon return to competitive sports. Deficits in motor control may influence reinjury risk and can be addressed during rehabilitation with motor learning strategies. When instructing patients in performing motor tasks after ACLR, an external focus of attention directed to the intended movement effect has been shown to be more effective in reducing reinjury risk than an internal focus of attention on body movements. While this concept is mostly agreed upon, recent literature has made it clear that the interpretation and implementation of an external focus of attention within ACLR rehabilitation needs to be better described. The purpose of this commentary is to provide a clinical framework for the application of attentional focus strategies and guide clinicians towards effectively utilizing an external focus of attention in rehabilitation after ACLR.
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The aim of the current study was twofold: (1) to validate the use of action sport cameras for quantifying focus of visual attention in sailing and (2) to apply this method to examine whether an external focus of attention is associated with better performance in upwind sailing. To test the validity of this novel quantification method, we first calculated the agreement between gaze location measures and head orientation measures in 13 sailors sailing upwind during training regattas using a head mounted eye tracker. The results confirmed that for measuring visual focus of attention in upwind sailing, the agreement for the two measures was high (intraclass correlation coefficient (ICC) = 0.97) and the 95% limits of agreement were acceptable (between -8.0% and 14.6%). In a next step, we quantified the focus of visual attention in sailing upwind as fast as possible by means of an action sport camera. We captured sailing performance, operationalised as boat speed in the direction of the wind, and environmental conditions using a GPS, compass and wind meter. Four trials, each lasting 1 min, were analysed for 15 sailors each, resulting in a total of 30 upwind speed trials on port tack and 30 upwind speed trials on starboard tack. The results revealed that in sailing - within constantly changing environments - the focus of attention is not a significant predictor for better upwind sailing performances. This implicates that neither external nor internal foci of attention was per se correlated with better performances. Rather, relatively large interindividual differences seem to indicate that different visual attention strategies can lead to similar performance outcomes.
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Musicians often play under circumstances in which pressure may lead to anxiety and performance deterioration. Theories suggest that a drop in performance is due to a shift in focus of attention towards task-irrelevant information. In this study, we asked music students to report what they think and where they focus attention in three situations: when they play under pressure (Study 1; n = 81), the moment just before choking under pressure and when they try to recover after a mistake (Study 2; n = 25). Focus of attention was examined using retrospective verbal reports and point-spread distributions. Besides a notable focus on music-related information (36.9%), music students reported a considerable number of worries and disturbing thoughts (26.1%) during playing under pressure (Study 1). Just before choking, they showed even more worries and disturbing thoughts (46.4%) at the cost of music-related focus (21.1%) (Study 2), as also confirmed by the point-spread distributions. During recovery after a mistake, attention was mainly focused on music-related information (53.0%) and less on thoughts that give confidence (18.5%) and physical aspects (16.6%). It is advisable to help music students with improving their performance, for example, by attentional control training or providing training with elevated levels of anxiety.
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Background: Given the demands posed by excessive practice quantities in modern dance, physical and mental health can be compromised. Therefore, there is a need to consider how quality of practice may be improved and possibly even reduce training times. Sports literature has shown that instructions and feedback given by coaches can have an effect on the quality of training and influence self-regulation and the performance of athletes. However, currently little is known about the use of instructions and feedback by dance teachers. The aim of the current study was, therefore, to examine the type of instructions and feedback given by dance teachers during various dance classes. Methods: A total of six dance teachers participated in this study. Video and audio recordings were made of six dance classes and two rehearsals at a contemporary dance university. The dance teacher’s coaching behavior was analyzed using the modified Coach Analysis and Intervention System (CAIS). Additionally, feedback and instructions were also examined in terms of their corresponding focus of attention. Absolute numbers, as well as times per minute (TPM) rates were calculated for each behavior before, during, and after an exercise. Absolute numbers were also used to calculate ratios of positive-negative feedback and open-closed questions. Results: Most feedback comments were given after an exercise (472 out of 986 total observed behaviors). Improvisation had the highest positive-negative feedback ratio (29) and open-closed questions ratio (1.56). Out of the focus of attention comments, internal focus of attention comments were used most frequently (572 out of 900). Discussion/conclusion: The results make clear that there is a large variability in instructions and feedback over teachers and classes. Overall, there is room for improvement toward a higher positive-negative feedback ratio, a higher open-closed question ratio and producing more comments eliciting an external focus of attention.
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Smart glasses were perceived to be potentially revolutionary for healthcare, however, there is only limited research on the acceptance and social implications of smart glasses in healthcare. This study aims to get a better insight into the theoretical foundations and the purpose was to identify themes regarding adoption, mediation, and the use of smart glasses from the perspective of healthcare professionals. A qualitative research design with focus groups was used to collect data. Three focus groups with 22 participants were conducted. Data were analyzed using content analysis. Our analysis revealed six overarching themes related to the anticipated adoption of smart glasses: knowledge, innovativeness, use cases, ethical issues, persuasion, and attitude. Nine themes were found related to anticipated mediation and use of smart glasses: attention, emotions, social influences, design, context, camera use, risks, comparisons to known products, and expected reaction and might influence the acceptance of smart glasses.
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Smart glasses were perceived to be potentially revolutionary for healthcare, however, there is only limited research on the acceptance and social implications of smart glasses in healthcare. This study aims to get a better insight into the theoretical foundations and the purpose was to identify themes regarding adoption, mediation, and the use of smart glasses from the perspective of healthcare professionals. A qualitative research design with focus groups was used to collect data. Three focus groups with 22 participants were conducted. Data were analyzed using content analysis. Our analysis revealed six overarching themes related to the anticipated adoption of smart glasses: knowledge, innovativeness, use cases, ethical issues, persuasion, and attitude. Nine themes were found related to anticipated mediation and use of smart glasses: attention, emotions, social influences, design, context, camera use, risks, comparisons to known products, and expected reaction and might influence the acceptance of smart glasses.
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Last year in Klagenfurt a poster was presented, in which a first attempt was made to combine institutional economic theory with organizational theory under the motto: transaction costs can be influenced! A framework of 4 theories was constructed of Social Capital theory, Attention Theory, Proactive Theory and Principal Agent Theory. This year we focus on attention theory. First a research conducted at Portaal (a housing corporation) is presented. Looking for a new way of dealing with its tenants, Portaal is supporting several initiatives that tenants undertake. These initiatives are used by Portaal to strengthen social cohesion and thereby reinforcing their relationship with tenants. Although most initiatives are more or less successful, the relationship between Portaal and its tenants did not really improve. In a secondary analysis an attempt has been made to find out why this is the case. This secondary analysis was done using a constructivistic approach on the basis of grounded theory. It appeared to us that the relationship can be characterized by misunderstanding and misinterpretation, that there are lot of different views, that there is a mutual lack of understanding, recognition and attention. Furthermore, we see that within Portaal employees have different views and ways of dealing with tenants, thus creating a situation in which working at cross purposes is the common situation. The general conclusion of what is going is that attention is suboptimal in both the internal and the external relationships. Then three theories are discussed in which "attention" plays an important role: Baart's theory of presence, Scharmer's Theory U, and Yalom's existential psychotherapy. It is concluded that the working principles that these theories furnish can very well be used to reshape internal relationships as well as external relationships. The overall conclusion of the article is that "attention" can very well be used to develop a new management concept. Of course a lot work has to be done yet
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Individuals in multiproblem situations frequently seek frontline legal support. The support by frontline legal professionals is limited by its focus on the legal issue instead of the underlying problems. A strong focus on client values – i.e. on the outcome that these services yield in the client’s perception – may lead to a more effective approach by targeting underlying problems. Through individual interviews with clients and professionals, the current study examines client values and services that may contribute to those client values. Besides functional client values that focus on resolving the problem situation, emotional client values, such as trust prove at least as important. Furthermore, client values are not only supported by the professional’s legal expertise, accessibility and ability to build a relationship, but also by the professional’s knowledge and skills relevant to multiproblem situations, such as his ability to empower the client, the willingness to work on concrete needs, and his ability to adopt an integrated approach. Research findings confirm the relevance of an integrated approach to multiproblem situations, with due attention to different client values. Similarly, it proves important to incorporate skills and knowledge that specifically address multiproblem situations in education and training programmes of frontline legal professionals. Nederlandse samenvatting: Mensen in multiprobleem situaties maken veelvuldig gebruik van eerstelijns rechtshulp. De ondersteuning door eerstelijns rechtshulp wordt beperkt door de focus op de voorliggende rechtsvraag, in plaats van de onderliggende problematiek. Een sterke focus op klantwaarden – de opbrengsten van de dienstverlening in de ogen van de cliënt – zou weleens tot een effectievere werkwijze kunnen leiden, omdat de achterliggende problemen worden aangepakt. Aan de hand van diepteinterviews onder cliënten en professionals is onderzocht welke klantwaarden voor deze doelgroep relevant zijn en welke dienstverleningsaspecten daaraan kunnen bijdragen. Naast functionele klantwaarden gericht op oplossingen voor de probleemsituatie, blijken emotionele klantwaarden als vertrouwen en ontzorging minstens zo relevant. Ook dragen niet alleen juridisch vakmanschap, bereikbaarheid en de vaardigheden om met de klant een relatie op te bouwen van de professional aan klantwaarden bij, maar ook specifieke kennis en vaardigheden gericht op multiproblematiek, zoals de vaardigheid om de klant te empoweren, de bereidheid om te werken aan concrete behoeften, en het werken met een geïntegreerde aanpak. De onderzoeksbevindingen onderstrepen de relevantie van een integrale aanpak bij multiproblematiek met aandacht voor diverse klantwaarden. Evenzo blijkt van belang dat vaardigheden en kennis die specifiek gericht zijn op multiproblematiek in de opleiding van eerstelijns rechtshulp professionals worden geïncorporeerd.
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The present study presents a process evaluation of a performance psychology intervention for transitioning elite and elite musicians. The goal of the intervention was to provide participants with an amalgamation of evidence-informed principles, aimed to improve their quality of practice and performance preparation. The intervention consisted of an educational session followed by four workshops. In total, eight transitioning elite and seven elite musicians participated. Process measures included quantitative and qualitative workshop evaluations, monitoring logs, and semi-structured interviews. Overall, the intervention was evaluated positively by the participants. However, differences were present between the groups, with the elite musicians typically evaluating the intervention more favorably compared to the transitioning elites. Specific positive outcomes included an increased awareness and re-examining of current practice strategies, more structured and goal-directed practice, increased practice efficiency and focus, a more proactive approach to performances, and increased attention for the physical aspects of playing. Moreover, a number of contextual considerations and implementation challenges became evident. Important implications for performance psychology interventions and practitioners in music are discussed.
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Introduction: The Netherlands does not have a national guideline for performing radiographic examinations on pregnant patients. Radiographic examination is a generic term for all examinations performed using ionizing radiation, including but not limited to radiographs, fluoroscopy and computed tomography. A pilot study amongst radiographers (Medical Radiation Technologists (MRTs)) showed that standardized practice of radiographic examinations on pregnant women is not evident between Radiology departments and that there is a need for a national guideline as the varying practice methods may lead to confusion and uncertainty amongst both patients and MRTs. Methods: Focus groups consisting of MRTs from several Radiology departments within the Netherlands were used to map ideas and requirements as to what should be included in the national guideline. Nine focus group sessions were organized with a total of 52 participants. Using a previous review (Wit, Fleur; Vroonland, Colinda; Bijwaard H. Pre-natal X-ray exposure and the risk of developing paediatric cancer; a systematic review of risk factors and a comparison of international guidelines. Health Physics 2021; 121 (3):225e233), the following key points were chosen as discussion topics for the focus group sessions: dose reduction, confirming pregnancy and risk communication. Results: Results showed that the participating MRTs did not agree on the use of lead aprons. That the national guideline should include standardized methods to adjust parameters to decrease radiation dose. Focus group participants find it difficult to ask a patient's pregnancy status, especially when dealing with relatively young and old (er) patients. When communicating the level of risk associated with a radiographic examination the participating MRTs would like to be able to use examples and comparisons, preferably by means of a multilingual website. Conclusion: A national guideline must include information on justification, available alternatives, dose reductions methods and confirmation of pregnancy requirements when fetal dose is a significant risk. Implications for practice: A national guideline ensures standardized practice can be implemented in Radiology departments, increasing clarity of the issues for both patients and MRTs.
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