Self-healing codes: How stable neural populations can track continually reconfiguring neural representations.

As an adaptive system, the brain must retain a faithful representation of the world while continuously integrating new information. Recent experiments have measured population activity in cortical and hippocampal circuits over many days and found that patterns of neural activity associated with fixed behavioral variables and percepts change dramatically over time. Such "representational drift" raises the question of how malleable population codes can interact coherently with stable long-term representations that are found in other circuits and with relatively rigid topographic mappings of peripheral sensory and motor signals. We explore how known plasticity mechanisms can allow single neurons to reliably read out an evolving population code without external error feedback. We find that interactions between Hebbian learning and single-cell homeostasis can exploit redundancy in a distributed population code to compensate for gradual changes in tuning. Recurrent feedback of partially stabilized readouts could allow a pool of readout cells to further correct inconsistencies introduced by representational drift. This shows how relatively simple, known mechanisms can stabilize neural tuning in the short term and provides a plausible explanation for how plastic neural codes remain integrated with consolidated, long-term representations.

A qualitative analysis of Swedish sport psychology practitioners' experience of a continued professional development program.

Although sport psychology practitioners and researchers acknowledge the importance of continued professional development (CPD) for professional effectiveness and excellence, few studies have explored the influence of CPD activities on the practitioners' practice and thinking. This study examined qualified Swedish sport psychology practitioners' experiences of engaging in a CPD program and how it impacted their professional development. The Swedish Sports Confederation offers a CPD program that targets performance enhancement services and psychotherapy for sport psychology practitioners. We explored the influence of this CPD program on the professional development of 13 graduates (five females; age in years: M = 41.2, SD = 8.3) via semi-structured interviews. Our stance involved a realist ontology and constructionist epistemology. We followed the six-step Reflexive Thematic Analysis procedures to analyze data. We identified four themes of CPD: (1) Critique (participants decided to do the CPD program because of perceived gaps in their knowledge and skills), (2) Change (participants discussed several changes as a result of the CPD program), (3) Context (participants discussed the aspects of the CPD program that promoted change), and (4) Challenge (participants mentioned issues related to having completed the program). The study provides insights into the value of CPD activities for sport psychology practitioners, advances current knowledge on practitioner maturation, and illustrates how CPD fits within a practitioner's lifelong learning. Future research could investigate the professional development of mid-career sport psychology practitioners engaging in other CPD programs to confirm or extend this work.

Beyond residency: 'The imperative of lifelong learning in medical practice'.

The CPD landscape is rapidly evolving and may be affecting patient outcomes. This also poses challenges to healthcare professionals, some of whom are experiencing a lot of stress leading to burnout. Medical and residency training are very structured and the importance of CPD occurring in a non-structured setting to prevent professional stagnation cannot be overemphasized. The need for lifelong learning post- residency, which encompasses a much longer period until retirement, is underscored hence the need for a cultural shift. Adult learning needs emphasis and a focus on addressing individual needs is required. Reasons for physician reluctance and inertia towards CPD such as lack of time, self-sufficiency, occasional journal reading, and skepticism need ongoing exploration. Comprehensive measures, including integrated EMR designs, personal learning projects, practice updates, reward systems, physician surveys, equal weight for formal and informal CPD, and promoting a learning mindset are proposed.

Innovative Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise (SPLICE) modules promote critical thinking skills, early clinical exposure, and contextual learning among first professional-year medical students.

Medical education is undergoing various transformations to promote a more personalized and contextual way of learning. In light of this, the innovative "Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise" (SPLICE) modules were designed, implemented, and evaluated for medical students in the first professional year as a strategy for early clinical exposure in a collaborative and self-directed way of learning. This is a mixed methods study involving first-year medical students. Students were divided randomly into the control and the intervention groups. Six SPLICE modules were administered to the intervention while the control group followed the traditional curricula. The educational outcome was compared using an end-of-module assessment. In addition, 13-item and 8-item questionnaires were administered to students to evaluate the SPLICE and plenary sessions on a 5-point Likert scale. Furthermore, students' feedback was obtained on a 10-point rating scale and in in-depth small-group interviews. The majority of students perceived that the SPLICE module improved their communication and encouraged meaningful, active learning. Students found the plenary sessions to be well organized, with sufficient interaction with professionals. Students also gave excellent scores for feedback on SPLICE modules, demonstrating the effectiveness of the innovation. In terms of test scores used in assessing learning outcomes, the intervention group outperformed the control group (P < 0.0001). The innovative SPLICE curriculum facilitated early clinical exposure and active self-directed learning. Students perceived SPLICE modules to be highly helpful in terms of promoting meaningful learning and the future application of knowledge.NEW & NOTEWORTHY The very essence of this innovative "Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise" (SPLICE) curriculum is the team-based learning of integrated pre-, para-, and clinical learning objectives right from the first professional year of study serving as an early clinical exposure. This unique way of learning creates a holistic educational environment by combining both academic and professional development thereby empowering the next generation of physician leaders to take autonomy of their own learning strategies and emerge as competent lifelong learners.

A scoping review of continuing education models and statutory requirements for pharmacists globally.

BACKGROUND: In the dynamic field of pharmacy amongst a diverse array of countries with disparate income levels, pharmacists play a pivotal role in integrating emerging scientific knowledge into their practice while adapting to evolving therapeutic interventions and expanding service delivery responsibilities. Lifelong Learning (LLL) is cultivated through continuing professional education (CPE) and continuing professional development (CPD), indispensable components ensuring sustained professional competence and heightened patient care quality. The global landscape witnesses diverse LLL activities tailored to pharmacists' learning needs and preferences. This scoping review maps and synthesises a comprehensive global perspective on the existing knowledge regarding CPE/CPD models, statutory requirements, and pharmacists' preferences for LLL activities. OBJECTIVE: To comprehensively investigate global models of CPE/CPD for pharmacists' and examine the statutory requirements governing pharmacists' registration and licensure. METHOD: A literature search of PubMed, Google Scholar, Web of Science, and the University of KwaZulu-Natal library search engine was undertaken for studies between January 2012 and February 2023. The article selection and reporting followed the recommendations made by PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) guidelines. The articles were tabulated based on their respective country's income level, continuing education models employed, country-specific statutory requirements, and pharmacists' preferences for LLL activities. RESULTS: Of the initial 3974 publications identified through the database search, 24 studies met the review criteria. The majority of the articles originated from high-income countries (HICs) (14/24, 58.3%), and most employed the mandatory CPD points system (21/24, 87.5%). However, in some HICs and upper-middle income countries (UMICs), the CPE/CPD is non-mandatory. While most countries (19/24, 79.2%) offer various LLL formats, the preference of pharmacists remains primarily face-to-face learning (13/24, 54.2%). However, workplace learning (3/24, 12.5%) and blended learning (7/24, 29.1%) are mentioned in some studies. CONCLUSION: Diverse models of CPE/CPD alongside statutory requirements persist globally and evolve, shaped by varied implementation experiences. HICs lead in CPD models, while the implementation in low- and middle-income countries (LMICs) and low-income countries (LICs) requires further exploration for inclusivity and effectiveness. A few UMICs are either initiating or in early stages of implementing the CPD models. Structured planning for LLL activities is increasingly a global requirement for pharmacists' licensure. The essential progression of pharmacy practice in developing healthcare systems necessitates a mandatory CPD model. Ongoing research is crucial to fortify the implementation, align and unify the CPD model with evolving pharmacy profession needs.

[First Senior Citizens University in Turkey-Empirical findings on the personal benefits of the programmes from the participants' perspective]. / Erste Seniorenuniversität in der Türkei ­ Empirische Befunde zum persönlichen Nutzen der Angebote aus der Perspektive der Teilnehmer/-innen.

The article reports on the evaluation of the programmes offered by the "60+Tazelenme Üniversitesi" (University of Antalya's Senior Citizens' University) from the users' perspective. 174 users (from a population of 6000 people) evaluated in a differentiated according to 18 characteristics their expectations of the programme before enrolling in the four-semester study programme and the personal benefits of the programme after completing it. The results show a highly differentiated picture of the benefits realized with regard to areas of competence and quality of life. The empirical study is placed in the broader context of geragogics and universities of the third age.

Capacity for Competence Development: Unlocking Potential for Lifelong Learning in Later Working Life.

The retention of older workers has become a key policy issue in European welfare states. Consequently, there is an increased focus on how lifelong learning, or continued competence development, can extend working life. This article explores the dynamics of competence development among employees aged 55 years and older regarding their learning practices and attitudes toward competence development, based on qualitative fieldwork conducted in nine governmental workplaces across Denmark. To gain a comprehensive understanding of the factors that influence willingness to participate in competence development, the article introduces the analytical framework "capacity for competence development" and highlights five factors that influence this capacity: time, economy, learning culture, energy, and purpose. The article argues that (non)participation in competence development is not static and is not solely the responsibility of employees or managers. Rather, it is co-produced by complex workplace dynamics, including policies, age stereotypes, as well as ways of organizing work and learning. In conclusion, the article emphasizes the potential for competence development and suggests that most employees aged 55 years and older want to participate but await the right circumstances. Their participation could be enhanced through an increased focus on the five identified factors in the capacity for competence development.

[EPIPEN INSTRUCTIONS FOR ANAPHYLAXIS PATIENTS DURING DISPENSING: FACTORS RELATED TO THE QUALITY OF PHARMACISTS' INSTRUCTIONS].

BACKGROUND AND AIM: We previously reported that pharmacists working in pharmacies don't have enough knowledge and enough experience teaching anaphylaxis (An) and EpiPen use. We administered a questionnaire survey to pharmacists with experience handling EpiPen prescriptions. We investigated the relationship between the questionnaire results and the factors in the pharmacists' background regarding the explanation and guidance to patients. RESULTS: The percentage of pharmacists working in pharmacies who provided guidance using visual information and demonstrations was insufficient. Moreover, this figure decreased after the second guidance session. Objective confirmation of patient understanding was also insufficient. The results indicated that self-examination and participation in drug information sessions were important background factors for pharmacists who provided detailed guidance to patients. DISCUSSION: For appropriate long-term management of their condition, An patients must master the EpiPen technique. Pharmacists' guidance plays a critical role in this regard. A support system should be established for proper instruction of pharmacy patients by improving pharmacists' self-education and other educational opportunities.

The effects of job characteristics on physicians' orientation toward lifelong learning.

With the rapidly growing body of medical knowledge, physicians must engage in lifelong learning. Physicians' orientation toward lifelong learning is of crucial importance. This study aimed to explore the effects of job characteristics on physicians' lifelong learning. A multicenter study collecting data from physicians from three medical centers in Taiwan was performed. A total of 321 physicians were surveyed with the Chinese version of the Job Content Questionnaire (C-JCQ) and the revised Jefferson Scale of Physician Lifelong Learning (JeffSPLL) to assess their job characteristics (i.e., job demands, job control, social support) and orientation toward lifelong learning. Exploratory factor analysis was employed to validate both questionnaires. Hierarchical regression was utilized to explore the relationship of job characteristics and predictors with physicians' lifelong learning. The results revealed that job demands (ß = 0.10), job control (ß = 0.19), social support from supervisors (ß = 0.16), the interaction of job demands × job control (ß = - 0.11) and the interaction of job demands × social support from colleagues (ß = 0.13) were significantly (p < .05, p < .001) related to lifelong learning. Moreover, physicians in the active group (high demand, high control) possessed a stronger orientation toward lifelong learning (mean = 3.57) than those in the low-strain group (mean = 3.42), high-strain group (mean = 3.39) and passive group (mean = 3.20). In conclusion, examining physicians' job demands, job control and social support helps us to understand their orientation toward lifelong learning and may provide insight to improve educational strategies.

Observations on strategies used by people with dementia to manage being assessed using validated measures: A pilot qualitative video analysis.

BACKGROUND: Analysis of video data was conducted of validated assessments with people with dementia as part of a feasibility control study comparing a lifelong learning service with other dementia services. OBJECTIVE: The aim was to provide a new perspective on what occurs during the assessment process when using validated measures in research and explore which strategies people with dementia use to manage their participation. DESIGN: Video recordings were made of pre- and postintervention assessments of people with dementia. An initial pilot analysis of 10 videos of the pre-assessments was conducted. SETTING: Lifelong learning services and other dementia services situated in six municipalities in Northern Denmark took part in this study, with 55 people with dementia participating. RESULTS: The themes identified were: 'State of mind' and 'Mental resources', showing how these aspects influenced the participants' reactions and the strategies they used. DISCUSSION: The results are discussed in relation to how individual personality traits influence the assessment process and the way a person with dementia will manage the situation. CONCLUSION: The assessment situation is complex and can be influenced by the strategies adopted by individuals with dementia as they try to manage the assessment process. PATIENT OR PUBLIC CONTRIBUTION: People with dementia supported the decision-making for the choice of validated measure used within this study.

A Longitudinal Assessment of a Physician Performance Enhancement Program Using Health Data, to Improve Quality of Care and Facilitate Lifelong Learning.

The Personal Quality Index (PQI) provides individual annual reports of benchmarked clinical data to inform practice development. This 5-year longitudinal retrospective study of PQI performance indicators also surveyed department members (n = 104) on utility, using t test, and Wilcoxon test. Technicity increased from 59% in 2014 to 72% in 2018 (P < 0.001). The vaginal birth after cesarean delivery rate did not improve, but the combined forceps/vacuum delivery rate decreased for sites and physicians (P < 0.001). Survey response was 35%. Most physicians (62%) found it valuable, and it informed professional development in 23% of cases. Nevertheless, 42% did not trust the data, and 39% found the process provoked anxiety.

A modeling framework for adaptive lifelong learning with transfer and savings through gating in the prefrontal cortex.

The prefrontal cortex encodes and stores numerous, often disparate, schemas and flexibly switches between them. Recent research on artificial neural networks trained by reinforcement learning has made it possible to model fundamental processes underlying schema encoding and storage. Yet how the brain is able to create new schemas while preserving and utilizing old schemas remains unclear. Here we propose a simple neural network framework that incorporates hierarchical gating to model the prefrontal cortex's ability to flexibly encode and use multiple disparate schemas. We show how gating naturally leads to transfer learning and robust memory savings. We then show how neuropsychological impairments observed in patients with prefrontal damage are mimicked by lesions of our network. Our architecture, which we call DynaMoE, provides a fundamental framework for how the prefrontal cortex may handle the abundance of schemas necessary to navigate the real world.

Thought Leader Perspectives on the Benefits, Barriers, and Enablers for Routinely Collected Electronic Health Data to Support Professional Development: Qualitative Study.

BACKGROUND: Hospitals routinely collect large amounts of administrative data such as length of stay, 28-day readmissions, and hospital-acquired complications; yet, these data are underused for continuing professional development (CPD). First, these clinical indicators are rarely reviewed outside of existing quality and safety reporting. Second, many medical specialists view their CPD requirements as time-consuming, having minimal impact on practice change and improving patient outcomes. There is an opportunity to build new user interfaces based on these data, designed to support individual and group reflection. Data-informed reflective practice has the potential to generate new insights about performance, bridging the gap between CPD and clinical practice. OBJECTIVE: This study aims to understand why routinely collected administrative data have not yet become widely used to support reflective practice and lifelong learning. METHODS: We conducted semistructured interviews (N=19) with thought leaders from a range of backgrounds, including clinicians, surgeons, chief medical officers, information and communications technology professionals, informaticians, researchers, and leaders from related industries. Interviews were thematically analyzed by 2 independent coders. RESULTS: Respondents identified visibility of outcomes, peer comparison, group reflective discussions, and practice change as potential benefits. The key barriers included legacy technology, distrust with data quality, privacy, data misinterpretation, and team culture. Respondents suggested recruiting local champions for co-design, presenting data for understanding rather than information, coaching by specialty group leaders, and timely reflection linked to CPD as enablers to successful implementation. CONCLUSIONS: Overall, there was consensus among thought leaders, bringing together insights from diverse backgrounds and medical jurisdictions. We found that clinicians are interested in repurposing administrative data for professional development despite concerns with underlying data quality, privacy, legacy technology, and visual presentation. They prefer group reflection led by supportive specialty group leaders, rather than individual reflection. Our findings provide novel insights into the specific benefits, barriers, and benefits of potential reflective practice interfaces based on these data sets. They can inform the design of new models of in-hospital reflection linked to the annual CPD planning-recording-reflection cycle.

A Perspective on Lifelong Open-Ended Learning Autonomy for Robotics through Cognitive Architectures.

This paper addresses the problem of achieving lifelong open-ended learning autonomy in robotics, and how different cognitive architectures provide functionalities that support it. To this end, we analyze a set of well-known cognitive architectures in the literature considering the different components they address and how they implement them. Among the main functionalities that are taken as relevant for lifelong open-ended learning autonomy are the fact that architectures must contemplate learning, and the availability of contextual memory systems, motivations or attention. Additionally, we try to establish which of them were actually applied to real robot scenarios. It transpires that in their current form, none of them are completely ready to address this challenge, but some of them do provide some indications on the paths to follow in some of the aspects they contemplate. It can be gleaned that for lifelong open-ended learning autonomy, motivational systems that allow finding domain-dependent goals from general internal drives, contextual long-term memory systems that all allow for associative learning and retrieval of knowledge, and robust learning systems would be the main components required. Nevertheless, other components, such as attention mechanisms or representation management systems, would greatly facilitate operation in complex domains.

New to health information, library or knowledge work .

Dissertations into Practice is changing. Details on how those new to health information, library and knowledge work can get involved coming shortly.

On Sequential Bayesian Inference for Continual Learning.

Sequential Bayesian inference can be used for continual learning to prevent catastrophic forgetting of past tasks and provide an informative prior when learning new tasks. We revisit sequential Bayesian inference and assess whether using the previous task's posterior as a prior for a new task can prevent catastrophic forgetting in Bayesian neural networks. Our first contribution is to perform sequential Bayesian inference using Hamiltonian Monte Carlo. We propagate the posterior as a prior for new tasks by approximating the posterior via fitting a density estimator on Hamiltonian Monte Carlo samples. We find that this approach fails to prevent catastrophic forgetting, demonstrating the difficulty in performing sequential Bayesian inference in neural networks. From there, we study simple analytical examples of sequential Bayesian inference and CL and highlight the issue of model misspecification, which can lead to sub-optimal continual learning performance despite exact inference. Furthermore, we discuss how task data imbalances can cause forgetting. From these limitations, we argue that we need probabilistic models of the continual learning generative process rather than relying on sequential Bayesian inference over Bayesian neural network weights. Our final contribution is to propose a simple baseline called Prototypical Bayesian Continual Learning, which is competitive with the best performing Bayesian continual learning methods on class incremental continual learning computer vision benchmarks.

The Relationship between Burnout and Wellbeing Using Social Support, Organizational Justice, and Lifelong Learning in Healthcare Specialists from Romania.

Background and objectives: The goal of this study was to evaluate the levels of organizational justice, social support, wellbeing, and lifelong learning associated with the level of burnout experienced by medical and non-medical staff from public and private medical units. Materials and Methods: A cross-sectional study was conducted on a sample of 497 healthcare professionals: 367 medical personnel (Mage = 43.75 ± 0.50), including 216 nurses, 97 physicians, and 54 respondents with other medical specialities such as biologists, psychologists, physical therapists, pharmacists, etc., and 130 non-medical staff respondents (Mage = 45.63 ± 0.80), including administrative personnel. The Maslach Burnout Inventory, the ECO System, the Multidimensional Scale of Perceived Social Support, the WHO Wellbeing Index, and the revised Jefferson Scale of Physician's Lifelong Learning were used. Results: Burnout was measured in terms of emotional exhaustion, depersonalization, and personal accomplishment. Medical personnel registered higher values of personal accomplishment (38.66 ± 0.39 vs. 35.87 ± 0.69), while non-medical personnel registered higher values of depersonalization (6.59 ± 0.52 vs. 4.43 ± 0.26) and emotional exhaustion (27.33 ± 1.24 vs. 19.67 ± 0.71). In terms of organizational justice, higher scores were observed for medical staff, while non-medical staff recorded lower values (24.28 ± 0.24 vs. 22.14 ± 0.38). For wellbeing, higher scores were also registered for medical staff (11.95 ± 0.21 vs. 10.33 ± 0.37). Conclusions: For lifelong learning and social support, no statistically significant differences were found. In the case of the proposed parallel moderated mediation model, the moderated mediation effects of organizational justice, lifelong learning, and burnout on the relationship between social support and wellbeing were valid for every dimension of burnout (emotional exhaustion, depersonalization, and personal accomplishment), but lifelong learning was not found to be a viable mediating variable, even if high levels of social support correspond to high levels of lifelong learning and wellbeing.

Back to the campus: Lifelong experience of older learners in a university setting.

This study focuses on older participants' experiences of and views on a lifelong learning program at the Hong Kong Polytechnic University in Hong Kong. As many third age adults tend not to have the opportunity to receive tertiary education when they were young, this program aims to fulfil their dream of studying at a university and boost their self-esteem and self-confidence. Using qualitative research methods, this research was conducted after the MiniU program (supported by the Institute of Active Aging of the Hong Kong Polytechnic University). Semi-structured interviews were conducted with 32 participants after the program. While participants had acquired knowledge and experience of university life from the Mini-U program, they also reported concerns and difficulties with participation including difficulties in memorizing course content and financial difficulties. The program has offered a unique opportunity for enhancing participants' interpersonal relationships and wellbeing. The research also further informs the development of creative lifelong learning programs aimed at improving the well-being of older people.

Using an age-friendly university lens to explore community member engagement during the pandemic.

The COVID-19 global pandemic forced institutions of higher education to adapt quickly to virtual connection platforms to maintain ties with their learners. After transitioning to virtual programming, the number of participants in our lifelong learning program more than quadrupled. As a member of the Age-Friendly University (AFU) global network, we saw this as an opportunity to continue expanding our age-inclusivity efforts and capitalized on this engagement by inviting attendees to participate in a brief online survey related to several of the AFU principles. Respondents requested, although not exclusively, continued virtual access to programming. Results emphasized the need for flexible and diverse access points, supported by age-inclusive campus infrastructure, for continuity in respondents engaging with the university post-pandemic. Our path forward is discussed, highlighting successful strategies by other AFU global partners.

The approaches and motivations to learning of student nurses: a phenomenological study.

This research study was undertaken to elicit a group of final-year student nurses' perceptions of their motivations and approaches to learning, and the implications of their views. It is important to explore this subject because students' motivations and approaches to learning can potentially impact patient care. This study was part of a larger research project. The sample consisted of 18 final-year student nurses at a large UK university. Students completed semi-structured interviews that used a qualitative constructivist approach to explore their educational experience. Students described what motivated them to learn, and how they approached their learning because of their understanding of which subjects they believed were and were not important. Students felt that clinical skills were the most important subjects, and topics such as health promotion, law and ethics, were less important and therefore they approached these subjects in a superficial way, learning just enough to pass their course. Clinical skills were perceived as more useful because they would be used directly in clinical practice. The findings of this study are significant to inform nurse educators as they plan curricula and provide an insight into what may potentially adversely affect patient care when students become registered nurses.