Effect of mental rehearsal on team performance and non-technical skills in surgical teams: systematic review.

BACKGROUND: Simulation-based training in medical education has become a common method to develop both technical and non-technical skills in teams. Mental rehearsal (MR) is the cognitive act of simulating a task in our heads to pre-experience tasks imaginatively. It has been used widely to improve individual and collective performance in fields outside healthcare, and offers potential for more efficient training in time-pressured surgical and medical team contexts. This study aimed to review the available literature to determine the impact of MR on team performance and non-technical skills in healthcare. METHODS: MEDLINE, Embase, British Educational Index, CINAHL, Web of Science, PsycInfo and Cochrane databases were searched for the period 1994-2018. The primary outcome measure was improvement in team performance and non-technical skills. Study quality of RCTs was assessed using the Medical Education Research Quality Instrument. The reported impacts of MR in all included studies were mapped on to the Kirkpatrick framework for evaluation of educational interventions. RESULTS: Eight studies with 268 participants were identified that met the inclusion criteria, of which there were six randomized trials, one prospective pragmatic trial and one qualitative study. Three studies found MR to be effective in improving team non-technical skills. MR practices were varied and often poorly defined. MR benefited team non-technical skills when it was specifically designed to do so, but was not an automatic consequence of technical MR alone. The majority of studies demonstrated benefits of MR for technical performance, but only three showed positive impacts on teamwork. Overall the studies were of low quality and lacked sufficient discriminatory focus to examine impacts on teamwork dynamics. CONCLUSION: MR can improve technical performance, but the benefits on non-technical skills are less clear. Future research should look at longitudinal mixed-method evaluation designs and focus on real clinical teams

Imaging Oxygen Distribution in Marine Sediments. The Importance of Bioturbation and Sediment Heterogeneity

The influence of sediment oxygen heterogeneity, due to bioturbation, on diffusive oxygen flux was investigated. Laboratory experiments were carried out with 3 macrobenthic species presenting different bioturbation behaviour patterns:the polychaetes Nereis diversicolor and Nereis virens, both constructing ventilated galleries in the sediment column, and the gastropod Cyclope neritea, a burrowing species which does not build any structure. Oxygen two-dimensional distribution in sediments was quantified by means of the optical planar optode technique. Diffusive oxygen fluxes (mean and integrated) and a variability index were calculated on the captured oxygen images. All species increased sediment oxygen heterogeneity compared to the controls without animals. This was particularly noticeable with the polychaetes because of the construction of more or less complex burrows. Integrated diffusive oxygen flux increased with oxygen heterogeneity due to the production of interface available for solute exchanges between overlying water and sediments. This work shows that sediment heterogeneity is an important feature of the control of oxygen exchanges at the sediment–water interface

Single-neutron transfer from 11Be gs via the (p,d) reaction with a radioactive beam

The 11Be(p,d)10Be reaction has been performed in inverse kinematics with a radioactive 11Be beam of E/A = 35.3 MeV. Angular distributions for the 0+ ground state, the 2+, 3.37 MeV state and the multiplet of states around 6 MeV in 10Be were measured at angles up to 16 deg CM by detecting the 10Be in a dispersion-matched spectrometer and the coincident deuterons in a silicon array. Distorted wave and coupled-channels calculations have been performed to investigate the amount of 2+ core excitation in 11Be gs. The use of "realistic" 11Be wave functions is emphasised and bound state form factors have been obtained by solving the particle-vibration coupling equations. This calculation gives a dominant 2s component in the 11Be gs wave function with a 16% [2+ x 1d] core excitation admixture. Cross sections calculated with these form factors are in good agreement with the present data. The Separation Energy prescription for the bound state wave function also gives satisfactory fits to the data, but leads to a significantly larger [2 x 1d] component in 11Be gs.Comment: 39 pages, 12 figures. Accepted for publication in Nuclear Physics A. Added minor corrections made in proof to pages 26 and 3

ERS International Congress 2023:highlights from the Airway Diseases Assembly

In this review, early career and senior members of Assembly 5 (Airway Diseases, Asthma, COPD and Chronic Cough) present key recent findings pertinent to airway diseases that were presented during the European Respiratory Society International Congress 2023 in Milan, Italy, with a particular focus on asthma, COPD, chronic cough and bronchiectasis. During the congress, an increased number of symposia, workshops and abstract presentations were organised. In total, 739 abstracts were submitted for Assembly 5 and the majority of these were presented by early career members. These data highlight the increased interest in this group of respiratory diseases.</p

Climate Change and invasibility of the Antarctic benthos

Benthic communities living in shallow-shelf habitats in Antarctica (&lt;100-m depth) are archaic in their structure and function. Modern predators, including fast-moving, durophagous (skeleton-crushing) bony fish, sharks, and crabs, are rare or absent; slow-moving invertebrates are the top predators; and epifaunal suspension feeders dominate many soft substratum communities. Cooling temperatures beginning in the late Eocene excluded durophagous predators, ultimately resulting in the endemic living fauna and its unique food-web structure. Although the Southern Ocean is oceanographically isolated, the barriers to biological invasion are primarily physiological rather than geographic. Cold temperatures impose limits to performance that exclude modern predators. Global warming is now removing those physiological barriers, and crabs are reinvading Antarctica. As sea temperatures continue to rise, the invasion of durophagous predators will modernize the shelf benthos and erode the indigenous character of marine life in Antarctica

Artificial reefs: from ecological processes to fishing enhancement tools

info:eu-repo/semantics/publishedVersio

A systematic review and meta-synthesis of the impact of low back pain on people's lives

Copyright @ 2014 Froud et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Background - Low back pain (LBP) is a common and costly problem that many interpret within a biopsychosocial model. There is renewed concern that core-sets of outcome measures do not capture what is important. To inform debate about the coverage of back pain outcome measure core-sets, and to suggest areas worthy of exploration within healthcare consultations, we have synthesised the qualitative literature on the impact of low back pain on people’s lives. Methods - Two reviewers searched CINAHL, Embase, PsycINFO, PEDro, and Medline, identifying qualitative studies of people’s experiences of non-specific LBP. Abstracted data were thematic coded and synthesised using a meta-ethnographic, and a meta-narrative approach. Results - We included 49 papers describing 42 studies. Patients are concerned with engagement in meaningful activities; but they also want to be believed and have their experiences and identity, as someone ‘doing battle’ with pain, validated. Patients seek diagnosis, treatment, and cure, but also reassurance of the absence of pathology. Some struggle to meet social expectations and obligations. When these are achieved, the credibility of their pain/disability claims can be jeopardised. Others withdraw, fearful of disapproval, or unable or unwilling to accommodate social demands. Patients generally seek to regain their pre-pain levels of health, and physical and emotional stability. After time, this can be perceived to become unrealistic and some adjust their expectations accordingly. Conclusions - The social component of the biopsychosocial model is not well represented in current core-sets of outcome measures. Clinicians should appreciate that the broader impact of low back pain includes social factors; this may be crucial to improving patients’ experiences of health care. Researchers should consider social factors to help develop a portfolio of more relevant outcome measures.Arthritis Research U

Conceptualizing pathways linking women's empowerment and prematurity in developing countries.

BackgroundGlobally, prematurity is the leading cause of death in children under the age of 5. Many efforts have focused on clinical approaches to improve the survival of premature babies. There is a need, however, to explore psychosocial, sociocultural, economic, and other factors as potential mechanisms to reduce the burden of prematurity. Women's empowerment may be a catalyst for moving the needle in this direction. The goal of this paper is to examine links between women's empowerment and prematurity in developing settings. We propose a conceptual model that shows pathways by which women's empowerment can affect prematurity and review and summarize the literature supporting the relationships we posit. We also suggest future directions for research on women's empowerment and prematurity.MethodsThe key words we used for empowerment in the search were "empowerment," "women's status," "autonomy," and "decision-making," and for prematurity we used "preterm," "premature," and "prematurity." We did not use date, language, and regional restrictions. The search was done in PubMed, Population Information Online (POPLINE), and Web of Science. We selected intervening factors-factors that could potentially mediate the relationship between empowerment and prematurity-based on reviews of the risk factors and interventions to address prematurity and the determinants of those factors.ResultsThere is limited evidence supporting a direct link between women's empowerment and prematurity. However, there is evidence linking several dimensions of empowerment to factors known to be associated with prematurity and outcomes for premature babies. Our review of the literature shows that women's empowerment may reduce prematurity by (1) preventing early marriage and promoting family planning, which will delay age at first pregnancy and increase interpregnancy intervals; (2) improving women's nutritional status; (3) reducing domestic violence and other stressors to improve psychological health; and (4) improving access to and receipt of recommended health services during pregnancy and delivery to help prevent prematurity and improve survival of premature babies.ConclusionsWomen's empowerment is an important distal factor that affects prematurity through several intervening factors. Improving women's empowerment will help prevent prematurity and improve survival of preterm babies. Research to empirically show the links between women's empowerment and prematurity is however needed

Managing Critical Transition Zones

ABSTRACT Ecosystems that function as critical transition zones (CTZs) among terrestrial, freshwater, and marine habitats are closely connected to the ecosystems adjacent to them and are characterized by a rapid flux of materials and organisms. CTZs play various roles, including mediating water flows, accumulating sediments and organic matter, processing nutrients, and providing opportunities for recreation. They are particularly difficult to manage because they tend to be small, albeit important, components of large watersheds, and managers may not have control over the entire landscape. Moreover, they are often the focus of intensive human activity. Consequently, CTZs are critically important zones, and their preservation and protection are likely to require unique collaboration among scientists, managers, and stakeholders. Scientists can learn a great deal from the study of these ecosystems, taking advantage of small size and the importance of fluxes, but a good understanding of adaptive management strategies is needed to establish a dialogue with managers and stakeholders on technical and management issues. An understanding of risk analysis is also important to help set meaningful goals and establish logical strategies that include all of the interested parties. Successful restoration of a CTZ is the best test of the quality of knowledge about its structure and function. Much has already been learned about coastal CTZs through restoration projects, and the large number of such projects involving riparian CTZs in particular suggests that there is considerable opportunity for fruitful collaborations between scientists and managers

High environmental stress and productivity increase functional diversity along a deep‐sea hydrothermal vent gradient

peer reviewedProductivity and environmental stress are major drivers of multiple biodiversity facets and faunal community structure. Little is known on their interacting effects on early community assembly processes in the deep sea (>200 m), the largest environment on Earth. However, at hydrothermal vents productivity correlates, at least partially, with environmental stress. Here, we studied the colonization of rock substrata deployed along a deep‐sea hydrothermal vent gradient at four sites with and without direct influence of vent fluids at 1,700‐m depth in the Lucky Strike vent field (Mid‐Atlantic Ridge [MAR]). We examined in detail the composition of faunal communities (>20 μm) established after 2 yr and evaluated species and functional patterns. We expected the stressful hydrothermal activity to (1) limit functional diversity and (2) filter for traits clustering functionally similar species. However, our observations did not support our hypotheses. On the contrary, our results show that hydrothermal activity enhanced functional diversity. Moreover, despite high species diversity, environmental conditions at surrounding sites appear to filter for specific traits, thereby reducing functional richness. In fact, diversity in ecological functions may relax the effect of competition, allowing several species to coexist in high densities in the reduced space of the highly productive vent habitats under direct fluid emissions. We suggest that the high productivity at fluid‐influenced sites supports higher functional diversity and traits that are more energetically expensive. The presence of exclusive species and functional entities led to a high turnover between surrounding sites. As a result, some of these sites contributed more than expected to the total species and functional β diversities. The observed faunal overlap and energy links (exported productivity) suggest that rather than operating as separate entities, habitats with and without influence of hydrothermal fluids may be considered as interconnected entities. Low functional richness and environmental filtering suggest that surrounding areas, with their very heterogeneous species and functional assemblages, may be especially vulnerable to environmental changes related to natural and anthropogenic impacts, including deep‐sea mining