Thesis (Ph. D.)--University of Washington, 1998. / Vita. Includes bibliographical references (leaves [81]-85).

Recently, attentional focus studies involving force production have demonstrated that when participants focused externally motor units were recruited more efficiently and muscular communication was enhanced. When participants focused internally, however, increased "noise" was incorporated into the neuromuscular system resulting in energy waste. The present study explored the effects of an external or internal focus of attention in the isometric wall sit endurance test. Since motor unit recruitment is more efficient under an external focus, it was hypothesized that participants (n = 23) would have a higher endurance time when they focused externally (ex. I want you to focus on pretending like you are sitting in a chair through the duration of the trial) rather than internally (ex. I want you to focus on keeping your knee at 90 degrees through the duration of the trial). Results revealed when participants focused externally they had a significantly higher endurance time (68.41 ± 34.12 sec) than when they focused internally (60.22 ± 34.54 sec). Participants also adopted the correct attentional focus in a majority of the endurance trials (70% and 69% for the external and internal conditions, respectively). This was the first study to demonstrate the benefits of an external focus over an internal focus in an isometric wall sit endurance test. Future studies should use biomechanical analyses such as EMG and kinematic measures and perceived force measures such as RPE to explore the reasons why an external focus provided performance benefits.

In two experiments, groups of children received interest money contingent upon their savings; yoked control subjects received identical interest irrespective of their savings. In the first experiment, interest was paid every 3 days by parents for the average savings of the period. In Experiment II, interest was paid on a daily basis and control subjects received instructions concerning the lack of a relationship between interest and their savings. In both experiments savings and magnitude of expenditures increased systematically across the research phases for contingent and non-contingent interest subjects alike. Neither interest nor subject wealth was found to relate to subject savings, or expenditures in Experiment I. Contingent-interest subjects' frequency of expenditures, during the interest and reversal phases was reduced relative to that of baseline and the expenditures of yoked controls. Additionally, an increase in the conditional probability of an expenditure at longer inter-expenditure intervals developed during the interest phase and was maintained into the reversal phase. The contingent interest procedures of Experiment II differentially reinforced longer times between expenditures without affecting savings. Control subjects who received instructions regarding the absence of a relation between savings and interest did not alter the time between their expenditures.

<p> Different instructions for associating concrete nouns were given in a paired-associate learning situation. Material was varied to produce different types of interference against which to evaluate the effectiveness of the different instructions.</p> <p> The major findings were: (1) Specific instructions for association produced fewer errors than no specific instructions on the first list a subject learned. (2) After the first list, only the instructions which asked the learner to produce a logical scene from the nouns produced fewer errors than non-specific instructions. (3) Specific instructions did not interact with material.</p> <p> Little evidence was found that the significant instructional effects were due to the specific characteristics of the learners' mediations. These effects were more plausibly attributed to such general mechanisms as either giving the mediations during learning or having learning time occupied with irrelevant activity.</p> / Thesis / Master of Arts (MA)

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Previous research has demonstrated that judicial instructions on the law are not well understood by jurors tasked with applying the law to the facts of a case. The past research has also shown that jurors are often confused by the instructions used in the sentencing phase of a capital trial. Social scientists have used two different methods to improve juror understanding of legal instructions, psycholinguistic rewrites and bias-reduction techniques. Psycholinguistic rewrites of legal instructions have been shown consistently to improve juror comprehension of general legal instructions and instructions used in the sentencing phase of a capital trial, however, there has been a call in the literature to not only improve the clarity of judicial instructions but to address comprehension biases that interfere with jurors? ability to understand the instructions. Because a bias-reduction approach has received limited empirical testing and has never been tested on capital-sentencing instructions, this research sought to test the effectiveness of a bias-reduction approach with those instructions. Participants were randomly assigned to hear either Florida's pattern instructions used in the penalty phase of a capital trial or the same instructions with additional statements that mentioned and refuted biases thought to be associated with established areas of miscomprehension. After participants heard the judicial instructions, their understanding of the law on capital punishment decision-making was assessed. Additionally, the participants were asked to render a verdict in a hypothetical case. The results revealed that comprehension was higher for participants exposed to the bias-refutation statements than for participants who were exposed to only the pattern instructions. Among all participants, greater understanding of capital sentencing instructions was associated with an increased likelihood that mock jurors recommended a life sentence, but this observed association was not statistically significant when examining capital-juror eligible participants. The results of this study suggest that efforts should be undertaken to improve specific areas of Florida's capital sentencing instructions.

Designing for older adults often takes the form of design for declining sensory, motor orcognitive ability. Instead of starting from disabilities this thesis aims to explore theproblems older adults experience in relation to information technology from theperspective of the older adult. Through the use of situational analysis data from fiveinterviews and five observations were analysed in order to find what problems, if any,the older adults gave voice to. This resulted in a study focused on three such problems:the instructions older adults receive when learning how to use information technology,the role of the surrounding of the older adults, and the feelings those interactions create.The result is a mix of different ways to view ageing along with a proposition that showsone possible way to reconfigure this interplay between older adults, the surrounding andinformation technology in order to lessen the impact of those problems.

Read-Modify-Write (RMW) operations, or atomics, have widespread application in (a) synchronization, where they are used as building blocks of various synchronization constructs like locks, barriers, and lock-free data structures (b) supervised memory systems, where every memory operation is effectively an RMW that reads and modifies metadata associated with memory addresses and (c) profiling, where RMW instructions are used to increment shared counters to convey meaningful statistics about a program. In each of these scenarios, the RMWs pose a bottleneck to performance and scalability. We observed that the cost of RMWs is dependent on two major factors – the memory ordering enforced by the RMW, and contention amongst processors performing RMWs to the same memory address. In the case of both synchronization and supervised memory systems, the RMWs are expensive due to the memory ordering enforced due to the atomic RMW operation. Performance overhead due to contention is more prevalent in parallel programs which frequently make use of RMWs to update concurrent data structures in a non-blocking manner. Such programs also suffer from a degradation in fairness amongst concurrent processors. In this thesis, we study the cost of RMWs in the above applications, and present solutions to obtain better performance and scalability from RMW operations. Firstly, this thesis tackles the large overhead of RMW instructions when used for synchronization in the widely used x86 processor architectures, like in Intel, AMD, and Sun processors. The x86 processor architecture implements a variation of the Total-Store-Order (TSO) memory consistency model. RMW instructions in existing TSO architectures (we call them type-1 RMW) are ordered like memory fences, which makes them expensive. The strong fence-like ordering of type-1 RMWs is unnecessary for the memory ordering required by synchronization. We propose weaker RMW instructions for TSO consistency; we consider two weaker definitions: type-2 and type-3, each causing subtle ordering differences. Type-2 and type-3 RMWs avoid the fence-like ordering of type-1 RMWs, thereby reducing their overhead. Recent work has shown that the new C/C++11 memory consistency model can be realized by generating type-1 RMWs for SC-atomic-writes and/or SC-atomic-reads. We formally prove that this is equally valid for the proposed type-2 RMWs, and partially for type-3 RMWs. We also propose efficient implementations for type-2 (type-3) RMWs. Simulation results show that our implementation reduces the cost of an RMW by up to 58.9% (64.3%), which translates into an overall performance improvement of up to 9.0% (9.2%) for the programs considered. Next, we argue the case for an efficient and correct supervised memory system for the TSO memory consistency model. Supervised memory systems make use of RMW-like supervised memory instructions (SMIs) to atomically update metadata associated with every memory address used by an application program. Such a system is used to help increase reliability, security and accuracy of parallel programs by offering debugging/monitoring features. Most existing supervised memory systems assume a sequentially consistent memory. For weaker consistency models, like TSO, correctness issues (like imprecise exceptions) arise if the ordering requirement of SMIs is neglected. In this thesis, we show that it is sufficient for supervised instructions to only read and process their metadata in order to ensure correctness. We propose SuperCoP, a supervised memory system for relaxed memory models in which SMIs read and process metadata before retirement, while allowing data and metadata writes to retire into the write-buffer. Our experimental results show that SuperCoP performs better than the existing state-of-the-art correct supervision system by 16.8%. Finally, we address the issue of contention and contention-based failure of RMWs in non-blocking synchronization mechanisms. We leverage the fact that most existing lock-free programs make use of compare-and-swap (CAS) loops to access the concurrent data structure. We propose DyFCoM (Dynamic Fairness and Contention Management), a holistic scheme which addresses both throughput and fairness under increased contention. DyFCoM monitors the number of successful and failed RMWs in each thread, and uses this information to implement a dynamic backoff scheme to optimize throughput. We also use this information to throttle faster threads and give slower threads a higher chance of performing their lock-free operations, to increase fairness among threads. Our experimental results show that our contention management scheme alone performs better than the existing state-of-the-art CAS contention management scheme by an average of 7.9%. When fairness management is included, our scheme provides an average of 3.4% performance improvement over the constant backoff scheme, while showing increased fairness values in all cases (up to 43.6%).

Discharge instructions provided to patients discharged from the emergency department (ED) are often provided in a way that is neither clear nor concise. Patients are often discharged home without a clear understanding of their diagnosis, medications, reasons to return to the ED, follow-up instructions, or how to manage their care at home during their illness. Therefore, a guideline needed to be developed in order to help the ED staff provide clear and concise discharge instructions to patients discharged from the ED. The Ace Star Model of Knowledge Transformation was the foundation for the development of the evidence-based guideline. A formative group of 7 individuals was created to critique the initial draft of the guideline, and a final version of the guideline was then distributed to 10 medical professionals to aid in the approval and determination of the quality of the guideline. The data analysis from the formative group questionnaire, and the appraisal of guidelines for research and evaluation tool led to the recommendations for a guideline on the delivery of evidence-based discharge instructions. This project has implications for social change in practice by (a) increasing the awareness among medical professionals about the importance of their communication style on patient discharge and (b) allowing for more efficient communication to occur between them and their patients. The use of an evidence-based practice guideline for providing discharge instructions to patients discharged from the ED will allow improved quality of care to patients, efficient communication between the healthcare providers and patients, a positive impact for social change in practice, and a consistent and reliable method for patients to understand their discharge instructions in a way that is clear and concise.

Discharge instructions and medication directions can be overwhelming for older adults, which can lead to potential medication errors, noncompliance, readmissions, and patient safety concerns. At a specialty lung clinic, the goal is to improve patient safety and to decrease the chance of errors by standardizing the discharge process via a Teach-Back education policy and protocol. Without consistency, there is a potential for mistakes and misunderstandings. The Agency for Healthcare Research and Quality (AHRQ) and the Institute for Healthcare Improvement (IHI) considers the Teach-Back discharge method as best practice and should be considered universal practice among health care workers. Using the Always Use Teach-Back Toolkit for education and evaluation provided strategies and resources for the project. Five nurse practitioners and a physician assistant, who are responsible for discharge instructions, participated in the study by viewing an online teaching module and completing written surveys. The Conviction and Confidence Tool revealed 100% of the clinicians agreed that Teach-Back education was '10-Very Important' and were '10-Very Confident' in their abilities to apply the Teach-Back methods using a 1-10 Likert scale. Likewise, the practitioners showed significant improvements when comparing the pre-implementation and one-month, post-policy implementation, as indicated in the paired t test of the second part of the Conviction and Confidence Teach-Back Tool. Nursing plays a pivotal role in positive social change by using an evidence-based education method, which improves patient care through medication compliance and decreased readmission rates, thus showing significant transformation in chronic health management.