The current state of the surgical care team in the United Kingdom: Shall we ‘do a time out’?

The reduction of junior doctors’ working hours over the last two decades paved the way to non-medical practitioners providing care traditionally discharged by surgeons and other medics. These registered practitioners play a vital role in the care of patients in surgery and work within multi-disciplinary teams comprising surgical care practitioners, advanced clinical practitioners in surgery, and physician associates, with significant experience in nursing or allied health care professional practice. Health Education England and the Royal Colleges of Surgeons have invested considerably in developing the relevant educational frameworks to support and quality assure the training of non-medical practitioners. Notwithstanding, to ascertain whether advanced and extended practice have been developed appropriately, a wide critical stance is needed. This article aims to begin to analyse the status quo of the extended surgical team and of the associated pitfalls and challenges, making conservative comparisons between the roles with the international scene. The objective is to help students, trainees and all involved in surgical care to adopt an informed and critical viewpoint about the extended surgical team in the United Kingdom, in the hope that this can lead to improvement and forward planning in workforce design for the benefit of patients and their communities.

Context, attention, and the switch between habit and goal-direction in behavior

This article reviews recent findings from the author’s laboratory that may provide new insights into how habits are made and broken. Habits are extensively practiced behaviors that are automatically evoked by antecedent cues and performed without their goal (or reinforcer) “in mind.” Goal-directed actions, in contrast, are instrumental behaviors that are performed because their goal is remembered and valued. New results suggest that actions may transition to habit after extended practice when conditions encourage reduced attention to the behavior. Consistent with theories of attention and learning, a behavior may command less attention (and become habitual) as its reinforcer becomes well-predicted by cues in the environment; habit learning is prevented if presentation of the reinforcer is uncertain. Other results suggest that habits are not permanent, and that goal-direction can be restored by several environmental manipulations, including exposure to unexpected reinforcers or context change. Habits are more context-dependent than goal-directed actions are. Habit learning causes retroactive interference in a way that is reminiscent of extinction: It inhibits, but does not erase, goal-direction in a context-dependent way. The findings have implications for the understanding of habitual and goal-directed control of behavior as well as disordered behaviors like addictions.

The Effect of Instruction Differentiation in Preventive Classroom Management Strategies on Early Childhood and Elementary Preservice Teachers’ Selected Behaviors in a Music Integration Course

The purpose of this pilot study was to investigate the effect of instruction differentiation in preventive classroom management strategies on preservice teachers’ selected behaviors. Results indicated no significant main effect for treatment condition, and significant main effects for lesson type and microteaching session. Findings indicated that preservice teachers benefited from extended practice in preventive classroom management strategies; however, longer microteaching sessions might be needed to provide more occasions to implement such strategies. With opportunities to practically apply classroom management skills within a university course, preservice teachers might enter their careers with more of a focus on proactive behavior management.

A multi-representation approach to the contextual interference effect: effects of sequence length and practice

The present study investigated the long-term benefit of Random-Practice (RP) over Blocked-Practice (BP) within the contextual interference (CI) effect for motor learning. We addressed the extent to which motor sequence length and practice amount factors moderate the CI effect given that previous reports, often in applied research, have reported no long-term advantage from RP. Based on predictions arising from the Cognitive framework of Sequential Motor Behavior (C-SMB) and using the Discrete Sequence Production (DSP) task, two experiments were conducted to compare limited and extended practice amounts of 4- and 7-key sequences under RP and BP schedules. Twenty-four-hour delayed retention performance confirmed the C-SMB prediction that the CI-effect occurs only with short sequences that receive little practice. The benefit of RP with limited practice was associated with overnight motor memory consolidation. Further testing with single-stimulus as well as novel and unstructured (i.e., random) sequences indicated that limited practice under RP schedules enhances both reaction and chunking modes of sequence execution with the latter mode benefitting from the development of implicit and explicit forms of sequence representation. In the case of 7-key sequences, extended practice with RP and BP schedules provided for equivalent development of sequence representations. Higher explicit awareness of sequence structures was associated with faster completion of practiced but also of novel and unstructured sequences.

Practice Mediates Bidirectional Dual-Task Interference When Performing a Novel Sequential Nonword Repetition Task

Introduction The current study examined the extent to which practice amount mediates dual-task interference patterns associated with concurrent performance of a novel speech task and attention-demanding visuomotor task. Method A Sequential Nonword Repetition Task was used to examine the effect of practice on interference associated with concurrent performance of a Visuomotor Pursuit Task. Twenty-five young adult participants were assigned to either an Extended Practice Group or a Limited Practice Group and performed a novel Sequential Nonword Repetition Task in isolation and while performing a concurrent visuomotor pursuit rotor task. Results Participants in the Limited Practice Group who were afforded a limited amount of practice exhibited dual-task interference (i.e., dual-task performance reductions) for both the speech and visuomotor tasks (i.e., bidirectional dual-task interference). Conversely, participants in the Extended Practice Group who were afforded extended practice exhibited little-to-no observable dual-task interference on the nonword repetition task. Conclusion Data from the current investigation suggest that the amount of initial practice mediates the degree of dual-task interference observed when a novel speech production task is performed with an attention-demanding Visuomotor Pursuit Task. Supplemental Material https://doi.org/10.23641/asha.14608071

Mechanisms Used by Probiotics to Confer Pathogen Resistance to Teleost Fish

Probiotics have been defined as live microorganisms that when administered in adequate amounts confer health benefits to the host. The use of probiotics in aquaculture is an attractive bio-friendly method to decrease the impact of infectious diseases, but is still not an extended practice. Although many studies have investigated the systemic and mucosal immunological effects of probiotics, not all of them have established whether they were actually capable of increasing resistance to different types of pathogens, being this the outmost desired goal. In this sense, in the current paper, we have summarized those experiments in which probiotics were shown to provide increased resistance against bacterial, viral or parasitic pathogens. Additionally, we have reviewed what is known for fish probiotics regarding the mechanisms through which they exert positive effects on pathogen resistance, including direct actions on the pathogen, as well as positive effects on the host.

Preliminary results from the Scientific Researching project “Direct Fiscal cost – benefit for the Smoking in Cuba”

Background. The academic development becomes stronger by including the scientific results to the teaching process. The academic research project checking is a constant need from the university context. Objective. To value the behavior from the academic research project “Direct fiscal cost – benefit for the smoking in Cuba”. Materials and Methods. Was made a descriptive research from the result obtained by the academic research project “Cost – benefit direct fiscal from smoking in Cuba”. As theoric methods were used the historical – logical, the comparative and the inductive – deductive. As empiric method was used the bibliographic research. Results. The project had an extended scientific production. It is leasing the research about smoking economic benefits and it suggest make an extensive practice validation from the proposes in other health institutions where smoking is an important risk factor. Conclusions. The academic research project “Cost – benefit direct fiscal from smoking in Cuba” had obtained important results that show the smoking social costs in the researched population. However is leasing the description and accounting from the smoking economic benefits to estimate the cost – benefit relation. A closer relation with other health institutions might obtain present primary information and an extended practice validation.

Preliminary results from the scientific researching project “direct fiscal cost-benefit for the smoking in cuba”

Background. The academic development becomes stronger by including the scientific results to the teaching process. The academic research project checking is a constant need from the university context. Objective. To value the behavior from the academic research project “Direct fiscal cost – benefit for the smoking in Cuba”. Materials and Methods. Was made a descriptive research from the result obtained by the academic research project “Cost – benefit direct fiscal from smoking in Cuba”. As theoric methods were used the historical – logical, the comparative and the inductive – deductive. As empiric method was used the bibliographic research. Results. The Project had have an extended scientific production. It is leasing the research about smoking economic benefits and it suggest make an extensive practice validation from the proposes in other health institutions where smoking is an important risk factor. Conclusions. The academic research project “Cost – benefit direct fiscal from smoking in Cuba” had obtained important results that show the smoking social costs in the researched population. However is leasing the description and accounting from the smoking economic benefits to estimate the cost – benefit relation. A closer relation with other health institutions might obtain present primary information and an extended practice validation.