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Motivating rodents to perform cognitive tasks often relies on the application of aversive stimuli. The Vibration Actuating Search Task (VAST) is a novel open-field task in which gradient floor vibration provides motivation for the rodent to navigate in the direction of diminishing vibration to an unmarked target destination. Using floor vibration as a motivational stimulus may overcome several of the potential confounds associated with stimuli used in other tasks. In a series of three experiments, we determined whether (1) rats exhibit place preference for floor vibration over other aversive stimuli (i.e., water, foot shock, and bright light), (2) exposure to floor vibration is associated with a lower corticosterone response than exposure to these other stimuli, (3) rats successfully acquire the VAST, and (4) VAST performance is sensitive to 6 h of sleep deprivation (SD). Our results showed that rats exhibited place preference for vibration over water, foot shock, and bright light environments, and that corticosterone levels were lower in rats exposed to vibration than those exposed to water. VAST performance also significantly improved over two days of testing for some metrics, and SD impaired VAST performance. Overall, we conclude that (1) rats exhibit place preference for vibration over other stimuli commonly used to motivate task performance, (2) the vibrations employed by the VAST produce lower concentrations of circulating corticosterone than forced swimming, (3) rats can learn to use gradient floor vibration as a mode of performance feedback within two days of testing, and (4) VAST performance is substantially impaired by SD. Thus, the VAST is an effective and practical testbed for studying the mechanisms by which SD causes deficits in feedback-dependent decision making.

Practical skills training is an essential part of medical education. An important example is the training of Basic Life Support (BLS) skills, which are key to improve patient outcomes in life-threatening situations. However, despite practical training, BLS performance is often sub-optimal even among healthcare professionals and medical students. Finding more effective training methods is therefore of high importance. A promising method to enhance learning outcomes is reflective practice. The goal of the present study was to evaluate whether a short reflective practice intervention following standard BLS training (Peyton's 4-step approach) improves BLS training outcomes, reflected in higher BLS performance and higher self-confidence to perform BLS. 287 first-year medical students were randomly assigned to one of two BLS training conditions: 1) standard BLS training (ST), 2) ST followed by a 15-minute reflective practice exercise. Outcome parameters included objective BLS performance data assessed by a resuscitation manikin, and students' self-reported confidence in their BLS skills. Outcomes were assessed directly after the training (T0) and re-assessed one week later (T1). A two-way mixed model analysis of variance (ANOVA) was conducted to examine the effect of the intervention on BLS performance and self-reported confidence. Significance was determined by two-sided 95% confidence intervals. The intervention group performed significantly more effective compressions at T1 and began significantly faster with performing their first chest compression at T0 and T1, in comparison to the control group. No significant differences between study groups regarding their self-reported confidence to perform BLS were observed. This research shows that standard BLS training accompanied with a simple, cost-effective reflective practice exercise can improve learners' BLS skill acquisition and retention. This shows that reflective practice has the potential to enhance practical skills training in medicine; yet, more empirical studies are needed to examine its broader applicability.

The current paper explores adult friendship and its relation to satisfaction with life and loneliness during established adulthood and midlife. The sample ( n  = 124) consisted of 59 established adults (30–45 years) and 65 midlifers (46–65 years), with the majority of participants characterized as White, middle-income, and female. Participants completed the Network of Relationships-BSV scale (Furman and Buhrmester, International Journal of Behavioral Development 33:470–478, 2009) to measure friendship quality, the Satisfaction with Life Scale (Diener et al., Journal of Personality Assessment 49:71–75, 1985) to measure one’s global sense of life satisfaction, and the UCLA Loneliness Scale (Russell, Journal of Personality Assessment 66:20–40, 1996) to measure participants’ level of loneliness. Results suggest that friendship plays a more central part in the lives of those in midlife compared to those in established adulthood and that loneliness is higher in established adulthood than in midlife. There were no significant differences in satisfaction with life for the two groups. Implications of the findings are discussed with regard to the middle adult years as two distinct age frames.

Background As the COVID-19 pandemic swept across the globe at the beginning of 2020, healthcare systems were forced to rapidly adapt and expand to meet the sudden surge in demand for intensive care services. This study is the first systematic analysis of the strategies employed by German hospitals to recruit personnel and expand bed capacities during the first wave of the pandemic, and to evaluate the effectiveness of those recruitment measures. Methods 152 German hospitals with intensive care capacities were selected and invited to participate in an online-based retrospective survey. Factors like the geographic distribution, individual COVID burden and level of care were considered for inclusion in the sample. The data were analyzed descriptively. Results A total of 41 hospitals participated in the survey. The additional demand for intensive care beds was met primarily by activating intensive care beds that were previously considered as non-operational in existing intensive care units (81% of respondents) and by upgrading recovery rooms (73%). The physician staffing requirements were met at approximately 75%, while the nursing staffing requirements were only met by about 45%. Staffing needs were met through reallocations/transfers (85%), staff recruitment from parental leave or retirement (49%), increased hours worked by internal staff (49%), new staff hiring (44%) and increased use of temporary staff (32%). Staff reallocations/transfers to critical care within a hospital were rated as the most effective measure. In this context, specialized personnel mostly from anesthesiology departments were appointed to intensive care medicine. Conclusions Despite multiple recruitment efforts, the pandemic has exacerbated the nursing staff shortage. The reallocation of existing staff within hospitals was a key element in covering the staffing needs. However, additional measures and efforts are required in order to ensure that critically ill patients can be cared for without compromise. The results of this study may have important implications for healthcare providers and policymakers, offering an evidence-based foundation for responding to future public health emergencies with agility, efficiency, and success.

Background Direct laryngoscopy (DL) is a crucial skill and continues to be indispensable. While the superiority of video laryngoscopy (VL) has been demonstrated regarding the rate of first attempt successful intubations, its application as a teaching tool for DL remains largely unexplored. We hypothesised a higher first-pass success and shorter durations of conventional intubation after video laryngoscopy supported training (VLF = video-laryngoscopy based feedback) compared to students trained without VL (DLF = direct-laryngoscopy based feedback). Methods All 211 medical students (DLF: 92/ VLF:119) trained conventional intubation, using a manikin in an airway course during their anaesthesiology rotation in fourth year of medical school. The study period was October 2023 to August 2024. In the DLF group, the tutor could only provide feedback via an intermittent direct view of the larynx during intubation whereas in the VLF group, the tutor had a continuous view via the monitor. Students of the VLF group did not get a view of the monitor and performed laryngoscopy via direct view. The main outcome measures were the first-pass success, time for intubation, Cormack-Lehane Score, occurrence of tooth damage, a difficulty score and a self-confidence score. Results Both groups achieved a high rate of first-pass success (DLF 97,8% vs. VLF 100%, p  = 0.081). Nevertheless, we found a significant difference concerning duration of intubation (DLF 21,49s ± 7,421 vs. VLF 24,75s ± 10,371, p  = 0.008). DLF group demonstrated a higher reduction in a subjective difficulty score ( p  = 0.018). Both groups demonstrated enhanced confidence regarding airway management following training favouring DLF group (difference between the groups: p  = 0.039). Conclusions Teaching direct laryngoscopy by using the video laryngoscope monitor as a teaching tool for the tutor seems to give students more detailed feedback and a more realistic rating of the difficulty level, which is reflected in the students spending more time on the task, a smaller decrease in the difficulty value and a more realistic self-assessment. Furthermore, a higher first-pass success in our assessment with direct laryngoscopy is reached after video-laryngoscopy based feedback training. We assume that this method holds great chances for teaching practice. Trial registration DRKS00032815 https://drks.de/search/de/trial/DRKS00032815 .

Abstract Study Objectives The time-on-task (TOT) effect and total sleep deprivation (TSD) have similar effects on neurobehavioral functioning, including increased performance instability during tasks requiring sustained attention. The TOT effect is exacerbated by TSD, suggesting potentially overlapping mechanisms. We probed these mechanisms by investigating genotype–phenotype relationships on psychomotor vigilance test (PVT) performance for 3 a-priori selected genes previously linked to the TOT effect and/or TSD: dopamine active transporter 1 (DAT1), catechol-O-methyltransferase (COMT), and tumor necrosis factor alpha (TNFα). Methods N = 82 healthy adults participated in 1 of 3 laboratory studies. A 10-min PVT was administered repeatedly during 38 h of TSD. We assessed changes in response time (RT) across each minute of the PVT as a function of time awake and genotype. Additionally, cumulative relative RT frequency distributions were constructed to examine changes in performance from the first to the second 5 min of the PVT as a function of genotype. Results DAT1, COMT, and TNFα were associated with differences in the build-up of the TOT effect across the 10-min PVT. DAT1 additionally modulated the interaction between TSD and the TOT effect. Subjects homozygous for the DAT1 10-repeat allele were relatively protected against TOT deficits on the PVT during TSD compared to carriers of the 9-repeat allele. Conclusions DAT1 is known to regulate dopamine reuptake and is highly expressed in the striatum. Our results implicate striatal dopamine in mechanisms involved in performance instability that appear to be common to TSD and the TOT effect. Furthermore, DAT1 may be a candidate biomarker of resilience to the build-up of performance impairment across TOT due to TSD.

As part of an institutional effort to develop an atmosphere of communication and encourage mutual appreciation of respective viewpoints, we used a cross-sectional survey to investigate the perceptions of emergency (EM) and internal medicine (IM) residents and faculty, particularly, their attitudes about collaboration, mutual respect, and mistreatment. This cross-sectional survey was administered to the EM and IM faculty and residents of a county, academic hospital with a Level 1 Trauma Center to evaluate each specialty's current perception of professional behavior and observations of unprofessional behavior in order to identify areas for improvement. The survey items were answered using a 5-point Likert scale and was analyzed using the unpaired t-test. A total of 68 residents and faculty completed the survey, 32 (59.4% residents) from EM and 36 (94.4% residents) from IM. Among all EM and IM clinicians, 48.6% felt that there was a culture of clinical collaboration. Approximately half of the respondents (51.5%) felt that the state of professionalism between the two departments was below that of other departments. About 10% (11.8%) of all respondents reported experiencing unprofessional behaviors from the other department at least once a month. Challenges identified by EM faculty and residents included time to consult, recommendations, and disposition. Challenges identified by IM included difficulty contacting EM providers and lack of communication regarding patient's clinical status changes. Both specialties emphasized the importance of improved patient care transitional processes. This study is an important first look at the prevalence of negative attitudes and misperceptions between EM and IM providers. These perspectives can occur due to breakdown of communication and differing expectations. Such asynchronies can cause a toxic workplace environment, diminished performance, and poor patient outcomes.

This study was conducted to assess whether friendship quality and gender moderate the association between peer victimization and internalizing distress. Third-, fourth-, and fifth-grade children (N = 670; 315 girls, 355 boys) completed self-report measures of friendship quality, relational and overt physical victimization, anxiety, and depression. Results indicated that several aspects of positive friendship quality, including help and security, serve as effective buffers against both relational and overt victimization. These results were found for girls only and for both anxiety and depression. Results highlight the importance of positive friendship features as protective factors in the link between victimization and internalizing distress.

My research explores Maya perspectives on neo-traditional farming as a source of metabolic health and resilience to the global epidemic of type-two diabetes. This article is based on long-term ethnographic research and interviews in Maya Mountains Reservation (MMR) communities in southern Belize, an area with low diabetes prevalence relative to national and global populations. Research participants see lower rates of diabetes in the MMR as the result of neo-traditional peasant and subsistence farming on ancestral lands. Good metabolic health represents the embodiment of food systems that routinize healthy material and social relationships to the landscape. This research suggests that diabetes is endemic to modern food systems and proposes neo-traditional food ways as a societal antidote to nutritional disease. My research demonstrates and responds to a need for further disaggregated data on diabetes prevalence in Indigenous communities, contributes to the social scientific literature on the importance of small-scale agricultural models for community health, and provides a case study of success in diabetes prevention. I engage Maya perspectives with anthropological literature on embodiment and small-scale agriculture to suggest neo-traditional food ways as healthier alternatives to capitalist agricultural development.