Should an intercalated degree be compulsory for undergraduate medical students?

Undertaking an intercalated year whilst at medical school involves taking time out of the medicine undergraduate programme in order to pursue a separate but related degree. It is widely seen as a challenging but rewarding experience, with much to be gained from the independent project or research component of most additional degrees. However, whilst intercalating is encouraged at many universities and is incorporated into some undergraduate curricula, it is by no means compulsory for all students. The literature would suggest that those who have intercalated tend to do better academically, both for the remainder of medical school and after graduating. Despite this, the issue of making intercalation mandatory is one of considerable debate, with counter-arguments ranging from the detrimental effect time taken out of the course can have to the lack of options available to cater for all students. Nonetheless, the research skills developed during an intercalated year are invaluable and help students prepare for taking a critical evidence-based approach to medicine. If intercalated degrees were made compulsory for undergraduates, it would be a step in the right direction. It would mean the doctors of tomorrow would be better equipped to practise medicine in disciplines that are constantly evolving

Scanning the visual world: a study of patients with homonymous hemianopia.

Published versio

Resolved Multi-element Stellar Chemical Abundances in the Brightest Quiescent Galaxy at z ∼ 2

Measuring the chemical composition of galaxies is crucial to our understanding of galaxy formation and evolution models. However, such measurements are extremely challenging for quiescent galaxies at high redshifts, which have faint stellar continua and compact sizes, making it difficult to detect absorption lines and nearly impossible to spatially resolve them. Gravitational lensing offers the opportunity to study these galaxies with detailed spectroscopy that can be spatially resolved. In this work, we analyze deep spectra of MRG-M0138, a lensed quiescent galaxy at z = 1.98, which is the brightest of its kind, with an H-band magnitude of 17.1. Taking advantage of full spectral fitting, we measure [Mg/Fe] = 0.51 ± 0.05, [Fe/H] = 0.26 ± 0.04, and, for the first time, the stellar abundances of six other elements in this galaxy. We further constrained, also for the first time in a z ~ 2 galaxy, radial gradients in stellar age, [Fe/H], and [Mg/Fe]. We detect no gradient in age or [Mg/Fe] and a slightly negative gradient in [Fe/H], which has a slope comparable to that seen in local early-type galaxies. Our measurements show that not only is MRG-M0138 very Mg-enhanced compared to the centers of local massive early-type galaxies, it is also very iron rich. These dissimilar abundances suggest that even the inner regions of massive galaxies have experienced significant mixing of stars in mergers, in contrast to a purely inside-out growth model. The abundance pattern observed in MRG-M0138 challenges simple galactic chemical evolution models that vary only the star formation timescale and shows the need for more elaborate models

Evaluation of two mobile health apps in the context of smoking cessation: qualitative study of cognitive behavioral therapy (CBT) versus non-CBT-based digital solutions.

BACKGROUND: Mobile health (mHealth) apps can offer users numerous benefits, representing a feasible and acceptable means of administering health interventions such as cognitive behavioral therapy (CBT). CBT is commonly used in the treatment of mental health conditions, where it has a strong evidence base, suggesting that it represents an effective method to elicit health behavior change. More importantly, CBT has proved to be effective in smoking cessation, in the context of smoking-related costs to the National Health Service (NHS) having been estimated to be as high as £2.6bn in 2015. Although the evidence base for computerized CBT in mental health is strong, there is limited literature on its use in smoking cessation. This, combined with the cost-effectiveness of mHealth interventions, advocates a need for research into the effectiveness of CBT-based smoking cessation apps. OBJECTIVE: The objective of this study was, first, to explore participants' perceptions of 2 mHealth apps, a CBT-based app, Quit Genius, and a non-CBT-based app, NHS Smokefree, over a variety of themes. Second, the study aimed to investigate the perceptions and health behavior of users of each app with respect to smoking cessation. METHODS: A qualitative short-term longitudinal study was conducted, using a sample of 29 smokers allocated to one of the 2 apps, Quit Genius or Smokefree. Each user underwent 2 one-to-one semistructured interviews, 1 week apart. Thematic analysis was carried out, and important themes were identified. Descriptive statistics regarding participants' perceptions and health behavior in relation to smoking cessation are also provided. RESULTS: The thematic analysis resulted in five higher themes and several subthemes. Participants were generally more positive about Quit Genius's features, as well as about its design and information engagement and quality. Quit Genius users reported increased motivation to quit smoking, as well as greater willingness to continue using their allocated app after 1 week. Moreover, these participants demonstrated preliminary changes in their smoking behavior, although this was in the context of our limited sample, not yet allowing for the finding to be generalizable. CONCLUSIONS: Our findings underscore the use of CBT in the context of mHealth apps as a feasible and potentially effective smoking cessation tool. mHealth apps must be well developed, preferably with an underlying behavioral change mechanism, to promote positive health behavior change. Digital CBT has the potential to become a powerful tool in overcoming current health care challenges. The present results should be replicated in a wider sample using the apps for a longer period so as to allow for generalizability. Further research is also needed to focus on the effect of greater personalization on behavioral change and on understanding the psychological barriers to the adoption of new mHealth solutions

Theory of Mind and Emotion Regulation Difficulties in Adolescents With Borderline Traits

Objective: Dysfunctions in both emotion regulation and social cognition (understanding behavior in mental state terms, theory of mind or mentalizing) have been proposed as explanations for disturbances of interpersonal behavior in borderline personality disorder (BPD). This study aimed to examine mentalizing in adolescents with emerging BPD from a dimensional and categorical point of view, controlling for gender, age, Axis I and Axis II symptoms, and to explore the mediating role of emotion regulation in the relation between theory of mind and borderline traits. Method: The newly developed Movie for the Assessment of Social Cognition (MASC) was administered alongside self-report measures of emotion regulation and psychopathology to 111 adolescent inpatients between the ages of 12 to 17 (mean age = 15.5 years; SD = 1.44 years). For categorical analyses borderline diagnosis was determined through semi-structured clinical interview, which showed that 23% of the sample met criteria for BPD. Results: Findings suggest a relationship between borderline traits and "hypermentalizing" (excessive, inaccurate mentalizing) independent of age, gender, externalizing, internalizing and psychopathy symptoms. The relation between hypermentalizing and BPD traits was partially mediated by difficulties in emotion regulation, accounting for 43.5% of the hypermentalizing to BPD path. Conclusions: Results suggest that in adolescents with borderline personality features the loss of mentalization is more apparent in the emergence of unusual alternative strategies (hypermentalizing) than in the loss of the capacity per se (no mentalizing or undermentalizing). Moreover, for the first time, empirical evidence is provided to support the notion that mentalizing exerts its influence on borderline traits through the mediating role of emotion dysregulation. J. Am. Acad. Child Adolesc. Psychiatry, 2011;50(6): 563-573

Resolving Quiescent Galaxies at z≳2: I. Search for Gravitationally Lensed Sources and Characterization of their Structure, Stellar Populations, and Line Emission

Quiescent galaxies at z ≳ 2 are compact and have weak or absent emission lines, making it difficult to spatially resolve their kinematics and stellar populations using ground-based spectroscopy. Gravitationally lensed examples provide a promising route forward, but such objects are very rare. We describe a search in the fields of 232 galaxy clusters that has uncovered five bright (H AB < 20) lensed galaxies with red near-infrared colors. These include MRG-M0138, which is the brightest lensed galaxy known in the near-infrared. Analysis of near-infrared spectra and multiband photometry confirms that all are quiescent galaxies at z = 1.95–2.64 with stellar ages of 0.5–1.4 Gyr (corresponding to formation epochs z form ≃ 3–4) and stellar masses of 10^11.6-12.8 µ^-1 Mʘ, where μ is the magnification. In three cases, we derive lens models and reconstruct the source structure; these galaxies are massive (M ≳ 10^11.10 Mʘ) and follow the mass–size relation defined by unlensed samples. In two of these three galaxies, the main structural component is an inclined disk. Weak emission lines are detected in four of five galaxies with high ratios [NII]/Hα ≃ 2–6 that are inconsistent with a star formation origin. Based on the line ratios, the Hα equivalent widths, and the distribution and kinematics of the gas, we infer that shocks are likely to be present in at least two galaxies and could be present in all of the line emitters. We speculate that these could be analogs of local galaxies in which AGN jet-driven outflows are thought to heat the interstellar medium and suppress star formation. In further papers, we will present spatially resolved measurements of the stellar populations and kinematics of this unique sample

Resolving Quiescent Galaxies at z≳2: II. Direct Measures of Rotational Support

Stellar kinematics provide insights into the masses and formation histories of galaxies. At high redshifts, spatially resolving the stellar kinematics of quiescent galaxies is challenging due to their compact sizes. Using deep near-infrared spectroscopy, we have measured the resolved stellar kinematics of four quiescent galaxies at z = 1.95–2.64, introduced in Paper I, that are gravitationally lensed by galaxy clusters. Analyses of two of these have previously been reported individually by Newman et al. and Toft et al., and for the latter, we present new observations. All four galaxies show significant rotation and can be classified as "fast rotators." In the three systems for which the lensing constraints permit a reconstruction of the source, we find that all are likely to be highly flattened (intrinsic ellipticities of ≈0.75–0.85) disk-dominated galaxies with rapid rotation speeds of V max = 290–352 km s−1 and predominantly rotational support, as indicated by the ratio (V/σ)Re = 1.7-2.3. Compared to coeval star-forming galaxies of similar mass, the quiescent galaxies have smaller V/σ. Given their high masses, Mdyn ≳ 2 x 10^11 Mⵙ, we argue that these galaxies are likely to evolve into "slow rotator" elliptical galaxies whose specific angular momentum is reduced by a factor of 5–10. This provides strong evidence for merger-driven evolution of massive galaxies after quenching. Consistent with indirect evidence from earlier morphological studies, our small but unique sample suggests that the kinematic transformations that produced round, dispersion-supported elliptical galaxies were not generally coincident with quenching. Such galaxies probably emerged later via mergers that increased their masses and sizes while also eroding their rotational support

Grand Challenges: Improving HIV Treatment Outcomes by Integrating Interventions for Co-Morbid Mental Illness.

In the fourth article of a five-part series providing a global perspective on integrating mental health, Sylvia Kaaya and colleagues discuss the importance of integrating mental health interventions into HIV prevention and treatment platforms. Please see later in the article for the Editors' Summary

The extent to which education interventions have been studied and the range of effects typically observed.

!e EEF’s education database is comprised of thousands of education research studies from across the globe, all focused on measuring the impact of education interventions on students’ outcomes. !e studies in the database have been coded to enable analysis and searching across a range of factors, including country, pupil age and type of intervention. Rather than simply focusing on the impact of interventions, the database also records information about the delivery of interventions (such as the frequency and intensity of the intervention) and detailed quantitative impact data, such as variations in e#ects based on subject or delivery mechanism (such as whether an intervention is delivered by a quali"ed teacher or a classroom assistant). Impact is translated from standardised e#ect sizes to ‘months of learning’ for ease of communication and to aid discussion around the impact of interventions. Months of learning, communicated as a headline "gure for each approach, however, can hide important variation caused by duration of intervention, group size and the test measures used. Building the database containing all of this data allows researchers to examine which factors are driving the impact behind the overall average to "nd the signal amongst the noise. It is this detailed data which makes this education database unique. It will signi"cantly reduce the time and e#ort needed to review the impact of di#erent types of interventions, and to analyse the factors that increase or reduce e#ectivenes

On-demand semiconductor single-photon source with near-unity indistinguishability

Single photon sources based on semiconductor quantum dots offer distinct advantages for quantum information, including a scalable solid-state platform, ultrabrightness, and interconnectivity with matter qubits. A key prerequisite for their use in optical quantum computing and solid-state networks is a high level of efficiency and indistinguishability. Pulsed resonance fluorescence (RF) has been anticipated as the optimum condition for the deterministic generation of high-quality photons with vanishing effects of dephasing. Here, we generate pulsed RF single photons on demand from a single, microcavity-embedded quantum dot under s-shell excitation with 3-ps laser pulses. The pi-pulse excited RF photons have less than 0.3% background contributions and a vanishing two-photon emission probability. Non-postselective Hong-Ou-Mandel interference between two successively emitted photons is observed with a visibility of 0.97(2), comparable to trapped atoms and ions. Two single photons are further used to implement a high-fidelity quantum controlled-NOT gate.Comment: 11 pages, 11 figure