Procedural skills such as riding a bicycle and playing a musical instrument play a central role in daily life. Such skills are learned gradually and are retained throughout life. The present study investigated one-year retention of procedural skill in a version of the widely used serial reaction time task (SRTT) in young and older motor-skill experts and older controls in two experiments. The young experts were college-age piano and action video-game players, and the older experts were piano players. Previous studies have reported sequence-specific skill retention in the SRTT as long as two weeks but not at one year. Results indicated that both young and older experts and older non-experts revealed sequence-specific skill retention after one year with some evidence that general motor skill was retained as well. These findings are consistent with theoretical accounts of procedural skill learning such as the procedural reinstatement theory as well as with previous studies of retention of other motor skills. KeywordsImplicit learning; sequence learning; aging; motor skill expertise; piano players; video-game players Over time, people acquire a wide range of implicit skills including riding a bicycle, playing a musical instrument, and displaying fluency in language. A prominent characteristic of such skills is that they are learned only gradually through extended experience, but once learned, they are retained throughout life. This property of skill learning has both practical and theoretical significance. The practical interest stems from the fact that rehabilitation following neurological damage or brain insult, such as stroke, often requires re-learning basic life skills such as walking and speaking (e.g., Boyd, Vidoni, & Daly, 2007), and expertise in specialties such as laparoscopic surgery is developed in part through procedural learning (Stefanidis, Korndorffer, Sierra, Touchard, Dunne, & Scott, 2005). The theoretical interest derives from contemporary multi-system theories that posit that distinct brain regions support nondeclarative learning, which occurs without awareness, and declarative learning, which occurs with awareness. The non-declarative procedural memory system, viewed as engaging corticostriatial circuits, is often contrasted with the medial temporal lobe-dependent declarative Correspondence concerning this article should be addressed to Jennifer C. Romano, Statistical Research Division, US Census Bureau, 4600 Silver Hill Rd, Washington, DC 20233. jennifer.c.romano@gmail.com. Jennifer C. Romano is now at the Statistical Research Division, US Census Bureau, Washington, DC. NIH Public Access Author ManuscriptMemory. Author manuscript; available in PMC 2011 May 1. Published in final edited form as:Memory. 2010 May ; 18(4): 427-441. doi:10.1080/09658211003742680. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript system, which acquires new information quickly and flexibly but is less long-lived (Clark, Manns, & Squire, 2002;Poldrack & Packard, 2003;Reber & Squire, 1998;...

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Implicit learning is thought to underlie the acquisition of many skills including reading. Previous research has shown that some forms of implicit learning are reduced in individuals with dyslexia (e.g., sequence learning) whereas other forms are spared (e.g., spatial context learning). However, it has been proposed that dyslexia-related motor dysfunction may have contributed to the implicit sequence learning deficits reported earlier. To assess implicit sequence learning in the absence of a motor sequence, 16 young adults diagnosed with dyslexia (20.6 ± 1.5 years) and 18 healthy controls (20.8 ± 2.0 years) completed a triplet frequency learning task (TRIP) that involved learning a sequential regularity in which the location of certain events followed a repeating pattern but motor responses did not. Participants also completed the spatial contextual cueing task (SCCT), which involved learning a spatial regularity in which the location of distractors in some visual arrays predicted the target location. In addition, neuropsychological tests of real-word and pseudo-word reading were administered. TRIP task analyses revealed no between-group differences in pattern learning, but a positive correlation between individual learning scores and reading ability indicated that poor readers learned less well than did good readers. Thus, earlier reports of reduced implicit sequence learning in dyslexics cannot be entirely accounted for by motor sequencing deficits. No significant correlations or group differences in learning were found for SCCT. These findings offer additional evidence for a link between poor reading and impaired implicit sequence learning.

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Background: Understanding the impact of the COVID-19 pandemic on paediatric non-COVID-19-related care, as well as patient and caregiver concerns and stressors, is critical for informing healthcare delivery. It was hypothesised that high care disruptions and psychological stress would be observed among paediatric and adult CHD patients in the early phase of the pandemic. Methods: A cross-sectional, international, electronic survey study was completed. Eligible participants included parents of children with acquired or CHD, adults with CHD, or caregivers of adults with CHD. Results: A total of 1220 participants from 25 countries completed the survey from 16 April to 4 May, 2020. Cardiac care disruption was significant with 38% reporting delays in pre-pandemic scheduled cardiac surgeries and 46% experiencing postponed cardiac clinic visits. The majority of respondents (75%) endorsed moderate to high concern about the patient with heart disease becoming ill from COVID-19. Worry about returning for in-person care was significantly greater than worry of harm to patient due to postponed care. Clinically significant psychological stress was high across the sample including children (50%), adults with CHD (42%), and caregivers (42%). Conclusions: The early phase of the COVID-19 pandemic contributed to considerable disruptions in cardiac care for patients with paediatric and adult CHD. COVID-19-related fears are notable with potential to impact willingness to return to in-person care. Psychological stress is also very high necessitating intervention. Further study of the impact of delays in care on clinical outcomes is warranted.

As our specialty faces unprecedented challenges to the delivery of care to congenital heart disease patients secondary to the COVID-19 pandemic, we offer guidance for crisis management.

We have applied and adapted conceptual framework and methodology related to composite quality measures across other fields to congenital heart surgery. The composite quality metric created is inclusive of both morbidity and mortality, and expands our view of quality in this patient population.