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Studying texts constitutes a significant part of student learning in health professions education. Key to learning from text is the ability to effectively monitor one's own cognitive performance and take appropriate regulatory steps for improvement. Inferential cues generated during a learning experience typically guide this monitoring process. It has been shown that interventions to assist learners in using comprehension cues improve their monitoring accuracy. One such intervention is having learners to complete a diagram. Little is known, however, about how learners use cues to shape their monitoring judgments. In addition, previous research has not examined the difference in cue use between categories of learners, such as good and poor monitors. This study explored the types and patterns of cues used by participants after being subjected to a diagram completion task prior to their prediction of performance (PoP). Participants' thought processes were studied by means of a think-aloud method during diagram completion and the subsequent PoP. Results suggest that relying on comprehension-specific cues may lead to a better PoP. Poor monitors relied on multiple cue types and failed to use available cues appropriately. They gave more incorrect responses and made commission errors in the diagram, which likely led to their overconfidence. Good monitors, on the other hand, utilized cues that are predictive of learning from the diagram completion task and seemed to have relied on comprehension cues for their PoP. However, they tended to be cautious in their judgement, which probably made them underestimate themselves. These observations contribute to the current understanding of the use and effectiveness of diagram completion as a cue-prompt intervention and provide direction for future research in enhancing monitoring accuracy.

Many bilinguals switch languages in daily-life conversations. Although this usually happens within sentence context and with another speaker, most research on the cognitive mechanisms underlying the production of language switches has studied individual words. Here, we examined how context influences both switching frequency and the temporal cost associated with it. Sixty Bulgarian-English bilinguals named pictures in their language of choice without any context, in a sentence context, and in interaction with another (recorded) bilingual. Switching frequency was lower, and costs higher, when bilinguals switched languages with context than without context. This suggests switching costs were not an artifact of tasks without context. Furthermore, both switching frequency and costs correlated across the tasks. In addition, we examined the potential influence of sentence context and the conversation partner. Predictability in sentence context has previously been argued to reduce language competition, which in turn could influence switching. We therefore compared sentences with a predictable or unpredictable target word. As hypothesized, bilinguals were less likely to switch languages when a word was predictable in its sentence context, potentially because words in the other language were less active. The conversation partner's overall switching behaviour had little impact on a bilingual's general switching rate, showing relatively low global alignment. However, local alignment was observed as switching was influenced by the partner's switching in the immediately preceding utterance. Together, these findings show that while production tasks without context can reliably measure switching costs, studying effects of context is necessary to better capture a bilingual's language-switching behavior.

A central question in multilingualism research is how multiple languages interact. Most studies have focused on first (L1) and second language (L2) effects on a third language (L3), but a small number of studies dedicated to the opposite transfer direction have suggested stronger L3 influence on L2 than on L1 in postpuberty learners. In our study, we provide further support for stronger L3-to-L2 than L3-to-L1 influence and show that it extends to (a) phonetics and the lexicon and (b) childhood learners. Fifty Spanish-Basque-English trilingual adults who had acquired Spanish from birth and Basque between 2 to 4 years of age through immersion participated in a speeded trilingual switching task measuring production of voice onset time and lexical intrusions. Participants experienced more phonetic and lexical crosslinguistic influence from L3 English during L2-Basque production than during L1-Spanish production. These findings show that even highly proficient early bilinguals experience differential influence from a classroom-taught L3 to L1 and to L2.

Accurately monitoring one's learning processes during self-regulated learning depends on using the right cues, one of which could be perceived mental effort. A meta-analysis by Baars et al. (2020) found a negative association between mental effort and monitoring judgments (r = -0.35), suggesting that the amount of mental effort experienced during a learning task is usually negatively correlated with learners' perception of learning. However, it is unclear how monitoring judgments and perceptions of mental effort relate to learning outcomes. To examine if perceived mental effort is a diagnostic cue for learning outcomes, and whether monitoring judgments mediate this relationship, we employed a meta-analytic structural equation model. Results indicated a negative, moderate association between perceived mental effort and monitoring judgments ([beta] = -0.19), a positive, large association between monitoring judgments and learning outcomes ([beta] = 0.29), and a negative, moderate indirect association between perceived mental effort and learning outcomes ([beta] = -0.05), which was mediated by monitoring judgments. Our subgroup analysis did not reveal any significant differences across moderators potentially due to the limited number of studies included per moderator category. Findings suggest that when learners perceive higher levels of mental effort, they exhibit lower learning (confidence) judgments, which relates to lower actual learning outcomes. Thus, learners seem to use perceived mental effort as a cue to judge their learning while perceived mental effort only indirectly relates to actual learning outcomes.

Distinguishing easily confusable categories requires learners to detect their predictive differences. Interleaved sequences -- switching between categories -- help learners to detect such differences. Nonetheless, learners prefer to block -- switching within a category -- to detect commonalities. Across two 2 × 2-factorial experiments, we investigated why learners scarcely engage in interleaving when learning confusable categories. In Experiment 1 (N = 190), we investigated the role of the utility value of being able to distinguish confusable mushroom doubles on their spontaneous study sequence choices and of the conditional knowledge component that for distinguishing, the detection of differences (between the doubles) matters. In Experiment 2 (N = 134), we again investigated the role of the latter and additionally of the conditional knowledge component that interleaving highlights differences. Results showed that combining two factors -- increasing the utility value of distinguishing and informing learners that for distinguishing, the detection of differences matters -- fostered learners' use of interleaving. In conclusion, learners are more aware that interleaving highlights differences than previously thought. Nonetheless, learners prefer blocking because they do not recognize the utility value of distinguishing, and they lack the conditional knowledge that distinguishing requires finding predictive differences. Their blocked study sequence choices reflect a deliberate investment of effort to find commonalities rather than just avoiding effort. To make learners shift their effort allocation from finding commonalities to finding differences and engage them in spontaneous interleaving, we recommend highlighting the utility value of distinguishing and informing learners about the importance of finding differences for distinguishing.

Abrocitinib, an oral, once-daily, Janus kinase (JAK) 1-selective inhibitor, is approved for the treatment of adults and adolescents with moderate-to-severe atopic dermatitis (AD). Abrocitinib has shown rapid and sustained efficacy in phase 3 trials and a consistent, manageable safety profile in long-term studies. Rapid itch relief and skin clearance are more likely to be achieved with a 200-mg daily dose of abrocitinib than with dupilumab. All oral JAK inhibitors are associated with adverse events of special interest and laboratory changes, and initial risk assessment and follow-up monitoring are important. Appropriate selection of patients and adequate monitoring are key for the safe use of JAK inhibitors. Here, we review the practical use of abrocitinib and discuss characteristics of patients who are candidates for abrocitinib therapy. In general, abrocitinib may be used in all appropriate patients with moderate-to-severe AD in need of systemic therapy, provided there are no contraindications, e.g., in patients with active serious systemic infections and those with severe hepatic impairment, as well as pregnant or breastfeeding women. For patients aged ≥ 65 years, current long-time or past long-time smokers, and those with risk factors for venous thromboembolism, major adverse cardiovascular events, or malignancies, a meticulous benefit-risk assessment is recommended, and it is advised to start with the 100-mg dose, when abrocitinib is the selected treatment option.

Recent research has suggested that students prefer restudying over retrieval practice when learning difficult materials, despite the latter being a more effective learning strategy. The current study investigated whether an instructional intervention can improve the use of retrieval practice for both easy and difficult materials. In Experiment 1, after initial learning of each item, participants rated their perceived mental effort (PME) and judgment of learning (JOL) for each item. Then, participants chose whether to restudy or take retrieval practice for that item. The results showed that participants chose to take retrieval practice less frequently for difficult items compared to easy ones. Furthermore, participants' ratings of PME and JOL sequentially mediated the relationship between item difficulty and their learning strategy choices. Specifically, difficult items resulted in higher levels of PME, which in turn led to lower JOL, ultimately reducing the likelihood of choosing retrieval practice. In Experiment 2, half of the participants received an instructional intervention, which revealed that while students prefer restudying for difficult items, retrieval practice benefits both easy and difficult items in long-term retention. The remaining half did not receive such intervention and were designated as the control group. The results indicated that, compared to the control group, students who received the intervention increased the odds of choosing retrieval practice for both types of materials after the intervention. The findings of this study suggest that students can be supported to use retrieval practice regardless of item difficulty.

Abstract Despite advances in gut health research, the variability of important gut markers within individuals over time remains underexplored. We investigated the intra-individual variation of various faecal gut health markers using an optimised processing protocol aimed at reducing variability. Faecal samples from ten healthy adults over three consecutive days demonstrated marker-specific intra-individual coefficients of variation (CV%), namely: stool consistency (16.5%), water content (5.7%), pH (3.9%), total SCFAs (17.2%), total BCFAs (27.4%), total bacteria and fungi copies (40.6% and 66.7%), calprotectin and myeloperoxidase (63.8% and 106.5%), and untargeted metabolites (on average 40%). For thirteen microbiota genera, including Bifidobacterium and Akkermansia, variability exceeded 30%, whereas microbiota diversity was less variable (Phylogenetic Diversity 3.3%, Inverse Simpson 17.2%). Mill-homogenisation of frozen faeces significantly reduced the replicates CV% for total SCFAs (20.4–7.5%) and total BCFAs (15.9–7.8%), and untargeted metabolites compared to faecal hammering only, without altering mean concentrations. Our results show the potential need for repeated sampling to accurately represent specific gut health markers. We also demonstrated the effectiveness of optimised preprocessing of human stool samples in reducing overall analytical variability.

For decades, there has been growing advocacy and policy reform to provide an inclusive education for students with disabilities which has since been specified as their human right under the Convention on the Rights of Persons with Disabilities. Teachers play an essential role in implementing inclusive education, yet they describe inadequate support to ensure its success. This study aims to identify and synthesise research examining teachers' perceived support needs for implementing inclusive education in classrooms that were published between 2007 and 2020. A systematic procedure was used to identify articles which resulted in the selection of 25 studies for the review. Results revealed that teachers often advocate for appropriate teacher professional learning, improved availability of teaching assistants and sufficiency in resourcing. Teachers also noted the importance of being able to appropriately modify and adapt the curriculum, as well as to collaborate with other teachers, and being given adequate time to plan and to teach in smaller classes.

Music education involves elements of inquiry, discovery, explicit instruction and self-driven designerly ways of thinking that can lead to mastery and expertise. COVID-19 forced lecturers and teachers within a Higher Education music conservatorium to creatively adapt delivery with students for much of 2020. This qualitative study examined responses from (N = 32) participants including (n = 25 students and n = 7 teachers). The authors utilised questionnaires and extended responses to investigate innovative pedagogies and delivery modes that evolved during the pandemic in Victoria, Australia. Graduate teaching programmes shifted to fully online delivery for 20 months, one of the longest periods of societal isolation mandated worldwide. Data identified how teachers reinterpreted curricula and repositioned methods of teaching and assessment, fostering new learning experiences, creativity, self-reflection and problem-solving skills. Recommendations point to adaptive delivery and student engagement innovations. The authors outline how teachers can approach personal, collective and socio-cultural pedagogic approaches that enculturate students towards adaptable, creative and interdisciplinary thinking.

In this study, we investigated the perceptions of beginning teachers regarding their preparation for becoming inclusive educators. Our aim was to explore what they considered facilitators and barriers to becoming inclusive educators upon transitioning into the profession. The research was informed by the three apprenticeships model encompassing the cognitive, practical and moral dimensions of teaching that is the knowledge, skills and beliefs required to practice as an inclusive educator. We collected interview data from eight beginning teachers who transitioned into the profession in 2020 or 2021 and undertook a thematic analysis of these conversations. Our analysis identified that beginning teachers perceived that their teacher education at university did not prepare them sufficiently with (1) Strong professional inclusive education terminology and knowledge; (2) Practical and evidence-based skills for instruction and assessment; or (3) The opportunity to work with people with disabilities in inclusive contexts in order to become effective inclusive educators across all three domains. Findings are discussed and future directions for research are outlined.

Feedback is a powerful influence on learning and achievement in the instrumental music lesson, though this impact may render positive as well as negative implications to learning. The impact of feedback is thus foundational to the ways music teachers impart knowledge, skill, planning, reflection, and student motivation. This article provides an analysis of feedback- feed up-feed forward concepts through a musical instruction lens, and reviews evidence related to the impact of feedback given on student learning and achievement. A qualitative investigation of Australian instrumental music teachers working in secondary schools, this study analyses cohorts of novice, developing and expert level teachers, progressing through initial theory-practice constructs, towards development and expertise of personalised and experientially dynamic feedback episodes. Expert level teachers reflect on a wider palette of approaches, with wisdom, passion, and the capacity for accommodating diverse learners and differentiated strategies. Discursive analysis of constructivist and student-centred approaches that infuse with explicit instruction are used to offer implications to how feedback can be used to enhance enduring learning and teaching in instrumental music studios and classrooms. It provides insights into teacher growth, knowledge, and development of instrumental music teachers in the profession across the lifespan.

During category learning, students struggle to create an optimal study order: They often study one category at a time (i.e., blocked practice) instead of alternating between different categories (i.e., interleaved practice). Several interventions to improve self-study of categorical learning have been proposed, but these interventions have only been tested in learning tasks where students "did not" create the study order themselves. Instead, they decided which type of study order to follow. This pre-registered experiment examined whether an intervention that combines refutations and metacognitive prompts can enhance students' engagement in interleaved practice, specifically when they organize the learning materials themselves. Ninety-one undergraduate students were randomized into the intervention and control condition and learned visual categories. Prior to the intervention, students used more blocked practice. After the intervention, the use of interleaved practice significantly increased in both immediate and delayed-transfer tasks. More interleaved practice was associated with better classification performance. Our findings indicate that refutations and metacognitive prompts form a strong intervention that corrects students' erroneous beliefs and increases their engagement in interleaved practice.