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Abstract Introduction When performance data are provided as feedback to healthcare professionals, they may use it to significantly improve care quality. However, the question of how to provide effective feedback remains unanswered, as decades of evidence have produced a consistent pattern of effects—with wide variation. From a coaching perspective, feedback is often based on a learner's objectives and goals. Furthermore, when coaches provide feedback, it is ideally informed by their understanding of the learner's needs and motivation. We anticipate that a “coaching”‐informed approach to feedback may improve its effectiveness in two ways. First, by aligning feedback with healthcare professionals' chosen goals and objectives, and second, by enabling large‐scale feedback systems to use new types of data to learn what kind of performance information is motivating in general. Our objective is to propose a conceptual model of precision feedback to support these anticipated enhancements to feedback interventions. Methods We iteratively represented models of feedback's influence from theories of motivation and behavior change, visualization, and human‐computer interaction. Through cycles of discussion and reflection, application to clinical examples, and software development, we implemented and refined the models in a software application to generate precision feedback messages from performance data for anesthesia providers. Results We propose that precision feedback is feedback that is prioritized according to its motivational potential for a specific recipient. We identified three factors that influence motivational potential: (1) the motivating information in a recipient's performance data, (2) the surprisingness of the motivating information, and (3) a recipient's preferences for motivating information and its visual display. Conclusions We propose a model of precision feedback that is aligned with leading theories of feedback interventions to support learning about the success of feedback interventions. We plan to evaluate this model in a randomized controlled trial of a precision feedback system that enhances feedback emails to anesthesia providers.

Xylazine is in the unregulated drug supply at increasing rates, usually combined with fentanyl, necessitating understanding of its pharmacology. Despite commentary from politicians, and public health officials, it is unknown how xylazine impacts naloxone efficacy, and. few studies have examined it alone. Here, we examine the impact of xylazine alone and in combination with fentanyl on several behaviors in mice. Surprisingly, naloxone precipitates withdrawal from xylazine and fentanyl/xylazine coadministration, with enhanced sensitivity in females. Further, xylazine is a full agonist at kappa opioid receptors, a potential mechanism for its naloxone sensitivity. Finally, we demonstrate surprising effects of xylazine to kappa opioid antagonism, which are relevant for public health considerations. These data address an ongoing health crisis and will help inform critical policy and healthcare decisions. One-sentence summary: We present surprising new insights into xylazine and fentanyl pharmacology with immediate implications for clinical practice and frontline public health.

Objective The introduction of peer support in mental health teams creates opportunities and challenges for both peer and non-peer staff. However, the majority of research on mental health workers’ (MHWs) experiences with peer support comes from high-income countries. Using Peer Support In Developing Empowering Mental Health Services (UPSIDES) is an international multicentre study, which aims at scaling up peer support for people with severe mental illness in Europe, Asia and Africa. This study investigates MHWs experiences with UPSIDES peer support.Design Six focus groups with MHWs were conducted approximately 18 months after the implementation of the UPSIDES peer support intervention. Transcripts were analysed with a descriptive approach using thematic content analysis.Setting Qualitative data were collected in Ulm and Hamburg (Germany), Butabika (Uganda), Dar es Salaam (Tanzania), Be’er Sheva (Israel) and Pune (India).Participants 25 MHWs (19 females and 6 males) from UPSIDES study sites in the UPSIDES Trial (ISRCTN26008944) participated.Findings Five overarching themes were identified in MHWs’ discussions: MHWs valued peer support workers (PSWs) for sharing their lived experiences with service users (theme 1), gained trust in peer support over time (theme 2) and provided support to them (theme 3). Participants from lower-resource study sites reported additional benefits, including reduced workload. PSWs extending their roles beyond what MHWs perceived as appropriate was described as a challenge (theme 4). Perceptions about PSWs varied based on previous peer support experience, ranging from considering PSWs as equal team members to viewing them as service users (theme 5).Conclusions Considering local context is essential in order to understand MHWs’ views on the cooperation with PSWs. Especially in settings with less prior experience of peer support, implementers should make extra effort to promote interaction between MHWs and PSWs. In order to better understand the determinants of successful implementation of peer support in diverse settings, further research should investigate the impact of contextual factors (eg, resource availability and cultural values).Trial registration number ISRCTN26008944.

Objective. This study presents a Spanish version of the Cognitive Flexibility Scale (CFS), a subjective and brief instrument to measure Cognitive Flexibility (CF), and analyzes its psychometric characteristics. Method. The items of the scale’s original version were adapted to Spanish. An interview containing the adapted version of the CFS, the Adult Executive Functioning Inventory (ADEXI), the Interpersonal Reactivity Index (IRI), and sociodemographic data, was administered to an intentional sample of 369 Argentine adults, aged between 18 and 60, through an online platform. Results. The CFS’s internal consistency was high (α = .813). A two-factor model, Strengths and Difficulties in CF, showed the best fit for the data. The CFS shows a negative correlation with the executive deficit and a positive correlations with empathy dimensions. Discussion. The Spanish-adapted version of the CFS shows satisfactory psychometric properties in the Argentine adult population.

This paper describes a collaboration organized around exchanging data between two technological systems to support teachers' instructional decision-making. The goals of the collaboration among researchers, technology developers, and practitioners were not only to support teachers' instructional decision-making but also to document the challenges and opportunities associated with bringing together data from instruction- and assessment-focused technologies. The approach described in this paper illustrates the potential importance of anchoring data products that combine data between two systems in the needs of teachers as well as aligning the content that students learn and are assessed on between systems. The increasing presence of data standards has made sharing complex data increasingly more feasible. The example collaboration described in this paper demonstrates the role that nontechnical activities can play in supporting the exchange and use of learner event data.

Serotonin receptors are important targets for established therapeutics and drug development as they are expressed throughout the human body and play key roles in cell signaling. There are 12 serotonergic G protein-coupled receptor members encoded in the human genome, of which the 5-hydroxytryptamine (5-HT)5A receptor (5-HT5AR) is the least understood and lacks selective tool compounds. Here, we report four high-resolution (2.73-2.80 Å) structures of human 5-HT5ARs, including an inactive state structure bound to an antagonist AS2674723 by crystallization and active state structures bound to a partial agonist lisuride and two full agonists, 5-carboxamidotryptamine (5-CT) and methylergometrine, by cryo-EM. Leveraging the new structures, we developed a highly selective and potent antagonist for 5-HT5AR. Collectively, these findings both enhance our understanding of this enigmatic receptor and provide a roadmap for structure-based drug discovery for 5-HT5AR.

Abstract Background and Aims Scientific research continues to advance and improve the medical management of type 2 diabetes. However, the importance of lifestyle management remains invaluable in treatment and tertiary prevention of this disease. Day‐to‐day sedentariness is the fourth most important risk factor for mortality in France. Numerous studies have demonstrated that physical activity is beneficial to people with type 2 diabetes and various recommendations have been made to encourage it. However, it is universally agreed that interventions that promote physical activity, while they may enhance its practice in the short term, do not impact on it over longer periods. It therefore seems essential to focus interventions on an individual's capacity to persist with physical activity in the long term. By looking at the literature, the aim of this review is to synthesize group and supervised physical activity interventions for people with type 2 diabetes using variables based on the following levers: motivation and self‐efficacy. Methods The PRISMA (Preferred Reporting Items for Systematic reviews and Meta‐Analyses) methodology examined studies in English or French that are registered in the PubMed, PsycINFO, and SportDiscus databases and were published between 2005 and 2023, according to the following keywords: Motivation OR self‐efficacy AND physical activity AND type 2 diabetes AND intervention. Results and Conclusion Seven studies out of 1207 were included. Despite the pertinence of the concepts of motivation and self‐efficacy and their complementarity in physical activity management programs, few studies have yet proposed a combined intervention for people with type 2 diabetes.

IntroductionThe Impostor Phenomenon (IP) refers to a psychological experience characterized by unjustified feelings of intellectual and professional fraud, accompanied by the fear of not maintaining performance and of being exposed. IP is receiving increasing attention in the fields of psychological health at work and occupational psychology as well as among the general public, since it affects the functioning of both individuals and organizations. The aim of this scoping review is to map the range of interventions that have been conducted to address IP among individuals experiencing it in a professional context.MethodsThe search and selection process to identify relevant reports was conducted using the PRISMA-ScR methodology and JBI recommendations and resulted in the selection of 31 studies.ResultsThe results reported concerning the characteristics of the studies, the interventions described, and the effects identified are heterogeneous. More than half of the studies used research designs (experimental, pre-experimental, exploratory, etc.). Two major types of intervention emerge: training and counseling. The effectiveness of the interventions varies according to the evaluation methodology that was used, although most authors conclude that the proposed intervention is relevant.DiscussionIn light of these results, recognizing and educating individuals regarding the various manifestations of IP, as well as offering support in a group context, appear to be primary intervention levers. Future intervention proposals should explore psychosocial and educational influences as well as the impact of the immediate environment on IP-related beliefs.

Introduction The acute mountain sickness (AMS) prevalence increases with altitude; i.e.,10-25% at 2,500 m and 50-85% at ~5,000 m (Bärtsch & Swenson, 2013). Women are more likely affected by AMS than men (Richalet et al., 2012). AMS can affect exercise performance. However, the effects of the menstrual cycle (MC) on physiological responses to exercise and on tolerance to high-altitude (HA) remain underexplored. It has been reported that ovarian hormones stimulate ventilation in normoxic conditions (Saaresranta & Polo, 2002). Early findings suggest that running economy is lower in the mid-luteal (ML) compared to the early-follicular (EF) phase in normoxia (Goldsmith & Glaister, 2020). However, cycling efficiency at HA has not been explored yet. Thus, we investigated the effects of acute HA exposure on ventilatory responses at rest and during exercise in healthy females during two different phases of their MC. Methods Sixteen eumenorrheic women (age: 33 ± 7 yr; MC length: 27 ± 2 days; not taking any hormonal contraceptive) took part in this study. First, over a 6-month period, the participants’ MC were monitored using a calendar method. Then, they reached the Torino Hut (3,375 m) by cable car and spent one night at HA on two different MC phases; i.e., during the early-follicular (EF; MC day 4 ± 1) and the mid-luteal (ML; day 20 ± 2) phases. Each time, they underwent a submaximal (1.2 W/kg) test on a cycle ergometer ~17 h after arrival at HA. In addition to this, participants filled in two questionnaires, the Lake Louise AMS Score and the Groningen Sleep Quality Scale, ~16 h after arrival at HA. Results Resting ventilation was significantly higher during EF compared to ML (15.2 ± 1.9 vs. 13.2 ± 2.5 L/min, p = 0.039), while no differences were found for ventilation during exercise (53.9 ± 13.2 vs. 53.5 ± 13.4 L/min, p = 0.695), cycling efficiency (21.7 ± 0.0% vs. 19.8 ± 0.0%, p = 0.244), saturation at rest (92.4 ± 1.3 vs. 91.3 ± 3.2%, p = 0.142) and during exercise (87.2 ± 5.7 vs. 89.0 ± 4.0%, p = 0.528). Moreover, no differences in the Lake Louise AMS (2.2 ± 1.5 vs. 1.7 ± 1.5, p = 0.266) or Groningen (8.0 ± 3.3 vs. 7.5 ± 3.4, p = 0.668) scores were noted between the two MC phases. Discussion/Conclusion Despite a slightly higher resting ventilation during EF, when both oestrogens and progesterone are at their lowest levels, there were no differences in ventilatory responses to exercise and in AMS between the different phases of the MC. Consequently, there is currently very little evidence to aptly recommend a specific MC phase for mountaineering or any other HA activities (Burtscher et al., 2023). Further investigations are requested to assess whether other physiological responses to HA may be influenced by hormonal variations. References Bärtsch, P., & Swenson, E. R. (2013). Acute high-altitude illnesses. New England Journal of Medicine, 368, 2294–2302. https://doi.org/10.1056/NEJMcp1214870 Burtscher, J., Raberin, A., Brocherie, F., Malatesta, D., Manferdelli, G., Citherlet, T., Krumm, B., Bourdillon, N., Antero, J., Rasica, L., Burtscher, M. & Millet, G. P. (2023). Recommendations for women in mountain sports and hypoxia training/conditioning. Sports Medicine. Advance online publication. https://doi.org/10.1007/s40279-023-01970-6 Goldsmith, E., & Glaister, M. (2020). The effect of the menstrual cycle on running economy. The Journal of Sports Medicine and Physical Fitness, 60(4), 610–617. https://doi.org/10.23736/s0022-4707.20.10229-9 Richalet, J.-P., Larmignat, P., Poitrine, E., Letournel, M., & Canouï-Poitrine, F. (2012). Physiological risk factors for severe high-altitude illness: A prospective cohort study. American Journal of Respiratory and Critical Care Medecine, 185(2), 192–198. https://doi.org/10.1164/rccm.201108-1396OC Saaresranta, T., & Polo, O. (2002). Hormones and breathing. American College of Chest Physicians, 122(6), 2165–2182. https://doi.org/10.1378/chest.122.6.2165

Prerecorded video content in medical education has become more common. Increasingly accessible technology coupled with the COVID-19 pandemic and subsequent need for distanced learning has greatly increased the interest in and need for high-quality video content. The use of short educational videos to augment other teaching methods has been shown to improve learners' experiences, knowledge retention, and understanding of content. Multiple studies have demonstrated that video education can be a highly effective tool for learning, particularly for hard-to-visualize processes and for procedural education. Videos allow learners to view content at their own pace and revisit materials on demand. In addition, well-designed videos can be repurposed by educators, ultimately reducing time needed to create high-quality educational content. Currently available technology allows educators to create high-quality videos at minimal cost and with a modest investment of time. This article details practical tips for creating high-yield educational videos.

The quality of life of students at school is an increasingly topical issue in relation both to public health issues, made more acute by the pandemic and successive confinements, and to the technical nature of future jobs which means training has become an economic issue. There are therefore two issues, one linked to health and the other to school performance. A cross-sectional design was adopted. Questionnaires were administered to 470 volunteer student's seventh grade US to the first year of the Senior Technician Curriculum aged from 12 to 23 years (139 girls and 331 boys, mage = 15.7 years). Latent profiles analysis and the Games-Howell post hoc test were used. Analyses carried out with MPlus reveal three possible profiles. They also show that these profiles have a strong predictive power on motivation and perceived health.