Individual sensorimotor adaptation characteristics are independent across orofacial speech movements and limb reaching movements.

Sensorimotor adaptation is critical for human motor control but shows considerable interindividual variability. Efforts are underway to identify factors accounting for individual differences in specific adaptation tasks. However, a fundamental question has remained unaddressed: Is an individual's capability for adaptation effector system specific or does it reflect a generalized adaptation ability? We therefore tested the same participants in analogous adaptation paradigms focusing on distinct sensorimotor systems: speaking with perturbed auditory feedback and reaching with perturbed visual feedback. Each task was completed once with the perturbation introduced gradually (ramped up over 60 trials) and, on a different day, once with the perturbation introduced suddenly. Consistent with studies of each system separately, visuomotor reach adaptation was more complete than auditory-motor speech adaptation (80% vs. 29% of the perturbation). Adaptation was not significantly correlated between the speech and reach tasks. Moreover, considered within tasks, 1) adaptation extent was correlated between the gradual and sudden conditions for reaching but not for speaking, 2) adaptation extent was correlated with additional measures of performance (e.g., trial duration, within-trial corrections) only for reaching and not for speaking, and 3) fitting individual participant adaptation profiles with exponential rather than linear functions offered a larger benefit [lower root mean square error (RMSE)] for the reach task than for the speech task. Combined, results suggest that the ability for sensorimotor adaptation relies on neural plasticity mechanisms that are effector system specific rather than generalized. This finding has important implications for ongoing efforts seeking to identify cognitive, behavioral, and neurochemical predictors of individual sensorimotor adaptation.NEW & NOTEWORTHY This study provides the first detailed demonstration that individual sensorimotor adaptation characteristics are independent across articulatory speech movements and limb reaching movements. Thus, individual sensorimotor learning abilities are effector system specific rather than generalized. Findings regarding one effector system do not necessarily apply to other systems, different underlying mechanisms may be involved, and implications for clinical rehabilitation or performance training also cannot be generalized.

Multiracial Patient Experiences With Racial Microaggressions in Health Care Settings.

PURPOSE: Illuminating patients' experiences of microaggressions in health care settings can help practitioners develop care that is more culturally responsive. While much of the literature on health care disparities focuses on minority groups generally, we sought to identify and to describe the ways in which racial microaggressions manifest for multiracial individuals and families specifically. METHODS: Using a combination of interviews and focus groups, we conducted 15 interviews and 3 focus groups. Eligible participants self-identified as more than one race and/or they self-identified as part of an interracial family, and they and/or someone they considered to be part of their family received health care in the past 12 months. We performed a content analysis to describe the dominant ways racial microaggressions presented in health care interactions. RESULTS: A total of 31 participants shared their experiences in health care settings, including their experiences with racism, racial bias, and microaggressions. Based on their experiences, we describe 6 prevalent microaggressions: mistaken identity, mistaken relationships, fixed forms, entitled examiner, pervasive stereotypes, and intersectionality. Many acknowledged their experiences with racial microaggressions in health care were similar to those they experienced in everyday settings; however, the power dynamics differed in health care. CONCLUSIONS: Understanding patient perspectives about racial microaggressions suggests opportunities to improve patient-provider communication. For multiracial individuals and families, racial microaggressions may have implications for patient engagement in health care. Findings of this study highlight implications for theory and research as well as opportunities to facilitate systematic improvements in the provision of culturally responsive health care services.