Augmenting the Clinical Apprenticeship Model

The School of Medicine at The University of Notre Dame Australia (UNDA) has adopted a clinical apprenticeship model for the final two years of its MBBS course. In the context of real clinical settings, students observe experienced clinicians as they consult with real patients. Students are provided with opportunities to practice clinical skills under the watchful eye of these clinicians who provide constructive feedback and gradually relax their level of intervention as the students become more proficient. For the first time since the course commenced, UNDA medical students began their clinical apprenticeships in 2007 and participated in six three week rotations at a variety of hospital sites. Whilst literature on clinical apprenticeship suggests that this approach has the potential to provide rich learning opportunities, data gathered over the semester intimates that there were deficits in the learning environment. Students largely found the experience to be a positive one but problems with implementation of the clinical apprenticeship model across most sites resulted in ineffective learning. This paper presents the findings from this evaluation program and describes the features of an implementation framework that will be used to facilitate the management of the clinical apprenticeship model in subsequent years. It is hoped that this framework will augment the clinical apprenticeship model and enable its affordances to be realised through the active participation of both the clinicians and the students

Research capacity building in general practice: A new opportunity in Fremantle, WA

One of the great disappointments of primary care medicine has been the failure to develop a strong research tradition among general practitioners. This has happened despite the great legacy left by William Budd, James MacKenzie, and Will Pickles, and the clear acceptance that such research is necessary to improve patient care

Length-weight relationships of two conservation-concern mahseers (Teleostei: Cyprinidae: Tor) of the river Cauvery, Karnataka, India

Length-weight (LW) relationships are presented for two conservation-concern species of mahseer (Tor spp.) from southern India’s river Cauvery. Constructed from angler catch data, these are the first available LW relationships for the Critically Endangered Tor remadevii and the non-native and locally invasive Tor khudree. For T. remadevii, the value of b, the allometric parameter, was 2.94 (95% CI: 2.75–3.14) and was not significantly different from 3.0, indicating isometric growth (t = 0.61, P = 0.54). For T. khudree, b was greater at 3.18 (95% CI: 3.01–3.38), but with this also not significantly different from 3.0 (t = 1.91, P = 0.06). Outputs are discussed with reference to species conservation and recreational catch-and-release fisheries

Impulsivity in juvenile delinquency: Differences among early-onset, late-onset and non-offenders

The present research investigated differences in levels of impulsivity among early-onset, late-onset, and non-offending adolescents. 129 adolescents (114 males, 15 females), of whom 86 were institutionalised (M age=15.52 years) and 43 were regular school students (M age=15.40 years) participated. Each participant completed the Adapted Self-Report Delinquency Scale, Stroop Colour and Word Test, Time Perception task, Accuracy Game, Risk-Taking Game, and the Eysenck Impulsiveness Questionnaire. Results suggest that adolescents who display rapid cognitive tempo, poor mental inhibitory control, and high impulsivity are more likely to be early-onset offenders. Offender and non-offender groups showed significant differences on several measures of impulsivity, which may suggest that late-onset offenders acquire or exacerbate impulse-related problems through social mimicry of early-onset offender peers. Potentially important implications for our understanding of delinquency and the design and provision of prevention programs are highlighted

The effect of induced sadness and moderate depression on attention networks

This study investigates how sadness and minor/moderate depression influences the three functions of attention: alerting, orienting, and executive control using the attention network test. The aim of the study is to investigate whether minor to moderate depression is more similar to sadness or clinical depression with regards to attentional processing. It was predicted that both induced sadness and minor to moderate depression will influence executive control by narrowing spatial attention and in turn this will lead to less interference from the flanker items (i.e., less effects of congruency) due to a focused attentional state. No differences were predicted for alerting or orienting functions. The results from the two experiments, the first inducing sadness (Experiment 1) and the second measuring subclinical depression (Experiment 2), show that, as expected, participants who are sad or minor to moderately depressed showed less flanker interference compared to participants who were neither sad nor depressed. This study provides strong evidence, that irrespective of its aetiology, sadness and minor/moderate depression have similar effects on spatial attention

The Cluster-EAGLE project: global properties of simulated clusters with resolved galaxies

We introduce the Cluster-EAGLE (C-EAGLE) simulation project, a set of cosmological hydrodynamical zoom simulations of the formation of 30 galaxy clusters in the mass range of 1014 < M200/M⊙ < 1015.4 that incorporates the Hydrangea sample of Bahé et al. (2017). The simulations adopt the state-of-the-art EAGLE galaxy formation model, with a gas particle mass of 1.8 × 106 M⊙ and physical softening length of 0.7 kpc. In this paper, we introduce the sample and present the low-redshift global properties of the clusters. We calculate the X-ray properties in a manner consistent with observational techniques, demonstrating the bias and scatter introduced by using estimated masses. We find the total stellar content and black hole masses of the clusters to be in good agreement with the observed relations. However, the clusters are too gas rich, suggesting that the active galactic nucleus (AGN) feedback model is not efficient enough at expelling gas from the high-redshift progenitors of the clusters. The X-ray properties, such as the spectroscopic temperature and the soft-band luminosity, and the Sunyaev–Zel'dovich properties are in reasonable agreement with the observed relations. However, the clusters have too high central temperatures and larger-than-observed entropy cores, which is likely driven by the AGN feedback after the cluster core has formed. The total metal content and its distribution throughout the intracluster medium are a good match to the observations

Co-production of guidance and resources to implement principled participant information leaflets (PrinciPILs) [version 1; peer review: 2 approved with reservations]

Background: The way information about potential benefits and harms of trial is presented within participant information leaflets (PILs) varies widely and may cause unnecessary ‘nocebo’ effects. The Medical Research Council (MRC) funded a project that developed seven principles to reduce this variation. However, guidance has not been produced to facilitate the implementation of the principles. Stakeholder involvement is recommended to optimise the way these principles are disseminated and explained. To co-produce recommendations for developing: (1) user-friendly guidance for users of the principles; and (2) resources that support the implementation of the principles. Methods: We held a co-production workshop with representation from the following professional groups: the Health Research Authority (HRA), research ethics committee members, and trial managers. Two rounds of discussions focused on generating recommendations for guidance and resources that support the implementation of the seven principles. Extensive low inference style ethnographic notes were taken, and the data were analysed thematically using deductive codes. The data was collected on October 14, 2022. Results: 25 participants attended a hybrid workshop. Participants recommended that both researchers designing PILs and research ethics committee members should use the principles, and that that they should be simple, mention both benefits and harms explicitly, include examples of visual representations, and provide the evidence base for the principles. Conclusions: We were able to co-produce recommendations for developing and implementing the seven principles within PILs. These recommendations can now be implemented to reduce unexplained variation in the way potential benefits and harms are shared within PILs

Patient reported outcomes and recruitment rates following the introduction of principled patient information leaflets (PrinciPILs): Protocol for a meta-analysis

Background The way potential benefits and harms of trial interventions are shared within patient information leaflets (PILs) varies widely and may cause unnecessary harms (“nocebo effects”). The aim of this meta-analysis will be to evaluate the influence on recruitment rates and early effects on patient reported adverse events of principled patient information leaflets (PrinciPILs) compared with standard PILs. Methods Eligible studies will include those that report the effects on recruitment and patient reported adverse events of PrinciPILs compared to standard PILs. We will include in this meta-analysis all the standard PILs in studies within trials (SWATs) of PrinciPILs that were developed as part of the Medical Research Council (MRC) funded PrinciPIL project. By publishing this as a living meta-analysis, we will allow the meta-analysis to be updated with future SWATs of PrinciPILs. We will use the Cochrane Risk of Bias tool to evaluate the risk of bias for each outcome. We will report the total number of studies and participants analysed and the characteristics of included studies (including details of intervention, comparators, outcomes). For dichotomous data, we will calculate the risk difference and the risk ratio (RR) and 95% confidence intervals (CIs). For continuous outcomes we will use weighted mean differences with 95% CIs or standardized mean differences with 95% CIs. We will investigate heterogeneity by visually inspecting the forest plot and by considering the I2 test result. We will assess the certainty warranted for each outcome using the Grading of Recommendations Assessment Development and Evaluation (GRADE). Ethics approval is not applicable since no original data will be collected. The results will be disseminated through peer-reviewed publication and conference presentations. Discussion We will discuss the limitations of the meta-analysis including study risk of bias, inconsistency, heterogeneity, and imprecision. A general interpretation of the results and important implications will be provided

Mock galaxy redshift catalogues from simulations: implications for Pan-STARRS1

We describe a method for constructing mock galaxy catalogues which are well suited for use in conjunction with large photometric surveys. We use the semi-analytic galaxy formation model of Bower et al. implemented in the Millennium simulation. We apply our method to the specific case of the surveys soon to commence with PS1, the first of 4 telescopes planned for the Pan-STARRS system. PS1 has 5 photometric bands (grizy), and will carry out an all-sky 3pi survey and a medium deep survey (MDS) over 84 sq.deg. We calculate the expected magnitude limits for extended sources in the two surveys. We find that, after 3 years, the 3pi survey will have detected over 10^8 galaxies in all 5 bands, 10 million of which will lie at redshift z>0.9, while the MDS will have detected over 10^7 galaxies with 0.5 million lying at z>2. These numbers at least double if detection in the shallowest band, y is not required. We then evaluate the accuracy of photometric redshifts estimated using an off-the-shelf photo-z code. With the grizy bands alone it is possible to achieve an accuracy in the 3pi survey of Delta z/(1+z)~0.06 for 0.25<z<0.8, which could be reduced by about 15% using near infrared photometry from the UKIDDS survey, but would increase by about 25% for the deeper sample without the y band photometry. For the MDS an accuracy of Delta z/(1+z)~0.05 is achievable for 0.02<z<1.5 using grizy. A dramatic improvement in accuracy is possible by selecting only red galaxies. In this case, Delta z/(1+z)~0.02-0.04 is achievable for ~100 million galaxies at 0.4<z<1.1 in the 3pi survey and for 30 million galaxies in the MDS at 0.4<z<2. We investigate the effect of using photo-z in the estimate of the baryonic acoustic oscillation scale. We find that PS1 will achieve a similar accuracy in this estimate as a spectroscopic survey of 20 million galaxies.Comment: 23 pages, 18 figures, accepted by MNRA