Problem-based learning case writing by students based on early years clinical attachments: a focus group evaluation.

To evaluate the perception of medical students of the new approach to problem-based learning which involves students writing their own problem-based learning cases based on their recent clinical attachment, and team assessment.Focus group interviews with students using purposive sampling. Transcripts of the audio recordings were analysed using thematic analysis.Imperial College School of Medicine, London.Medical students in the second year of the MBBS course, who attended the problem-based learning case writing session.To elicit the students views about problem-based learning case writing and team assessment.The following broad themes emerged: effect of group dynamics on the process; importance of defining the tutors role; role of summative assessment; feedback as a learning tool and the skills developed during the process.Overall the students found the new approach, writing problem-based learning cases based on patients seen during their clinical attachments, useful in helping them to gain a better understanding about the problem-based learning process, promoting creativity and reinforcing the importance of team work and peer assessment which are vital professional skills. Further tutor development and guidance for students about the new approach was found to be important in ensuring it is a good learning experience. We hope this evaluation will be of use to other institutions considering introducing students case writing to problem-based learning

Possibility of "magic" trapping of three-level system for Rydberg blockade implementation

The Rydberg blockade mechanism has shown noteworthy promise for scalable quantum computation with neutral atoms. Both qubit states and gate-mediating Rydberg state belong to the same optically-trapped atom. The trapping fields, while being essential, induce detrimental decoherence. Here we theoretically demonstrate that this Stark-induced decoherence may be completely removed using powerful concepts of "magic" optical traps. We analyze "magic" trapping of a prototype three-level system: a Rydberg state along with two qubit states: hyperfine states attached to a J=1/2 ground state. Our numerical results show that, while such a "magic" trap for alkali metals would require prohibitively large magnetic fields, the group IIIB metals such as Al are suitable candidates.Comment: 5 pages, 3 figure

Early recurrent ischemic stroke complicating intravenous thrombolysis for stroke: incidence and association with atrial fibrillation

<p><b>Background and Purpose:</b> Mechanisms of early neurologic deterioration after treatment with intravenous, recombinant, tissue-type plasminogen activator (IV rt-PA) include symptomatic intracerebral hemorrhage (SICH) and early recurrent ischemic stroke. We observed a number of cases of acute deterioration due to recurrent ischemic events.</p> <p><b>Methods:</b> We undertook a single-center, retrospective analysis of consecutive acute stroke patients treated with IV rt-PA between January 2006 and December 2008 to define the incidence of early neurologic deterioration (>= 4-point drop on the National Institutes of Health Stroke Scale within 72 hours) and its mechanism. Deterioration was attributed to SICH when associated with a PH1 or PH2 hemorrhage on postdeterioration computed tomography scans, to recurrent ischemic stroke when there was clinical and radiologic evidence of a new territorial infarction or new vessel occlusion, and otherwise to evolution of the incident stroke.</p> <p><b>Results:</b> Of 228 consecutive IV rt-PA-treated patients, 34 (15%) developed early neurologic deterioration, 18 (8%) secondary to incident strokes 10 (4.4%) due to SICH, and 6 (2.6%) due to early recurrent ischemic events, which were significantly associated with atrial fibrillation (present in 5 of 6 patients; 4 paroxysmal, 1 permanent). In 4 patients, sudden clinical deterioration developed during or shortly after IV rt-PA infusion, and in 2, deterioration developed 3 days later. All died 2 days to 2 weeks later. The single case without atrial fibrillation had a recurrent, contralateral, middle cerebral artery stroke during IV rt-PA infusion and multiple high-signal emboli detected by transcranial Doppler. Early recurrent ischemic stroke accounted for 5 of 12 (42%) cases of early neurologic deterioration in patients with atrial fibrillation.</p> <p><b>Conclusion:</b> In this single-center series, the incidence of early recurrent ischemic stroke after IV rt-PA was 2.6% and was associated with previous atrial fibrillation.</p&gt

Some applications of computing to number theory

This thesis describes the application of a computer to certain problems in number theory. Chapter 1 is a general description of the use of computers in this field. Chapter 2 contains the results of computations relating to certain non - congruence subgroups of the full modular group, while chapter 3 describes the use of variable precision arithmetic, mainly in connection with continued fraction expansions. The last chapter describes a small library of subroutines, the majority of which are written in Fortran. A computer - printed listing of these subroutines is given at the end of the thesis

Sounds mega : musical discourse in Black majority churches in London

This thesis explores congregational singing through the lens of the local and global in Black Majority Churches (BMCs) in the Royal London Borough of Greenwich, UK. The phenomenal growth of modern-day Pentecostalism is its ability to negotiate the local and the global, and a number of scholars agree that up-tempo, lively music is integral to the Black religious experience. However, there is a paucity of literature in the UK that analyses this area in a detailed and systematic manner. Methodologically, Nattiez’s model of musical discourse is employed within a framework of critical discourse analysis to interrogate his ‘esthesic’, ‘immanent’ and ‘poietic’ elements, - that is the experience by the receivers, the music itself and the perspective of the producers - at New Wine Church, (NWC), Woolwich as the primary case study. The perspective of a multimodal analysis has uncovered multiple meaning-making processes within the context of a neo- Pentecostal megachurch with an emphasis on prosperity gospel. Firstly, the esthesic perspective found that the songs popular in the global Christian music industry fulfilled their role as Pentecostal liturgy, whilst simultaneously supporting and reinforcing the tenets of a prosperity gospel. Secondly, the immanent (musicological) analysis revealed simple, easy songs that had been altered through a process of African American ‘Blackenizing’. Thirdly, the poietic, from the point of view of the producers, told the story of music in the church, signalling a shift in the musical identity. Further fieldwork confirmed the findings at NWC and similar processes in regard to an undermining and a silencing of African and Caribbean musical identities. The research concludes that the global Christian music industry and its supporting systems are not reflective of UK BMC congregations although these sounds dominated both the large and small churches in the research. These findings make problematic an understanding of the local and the global in congregational singing in BMCs and the privileging of white music forms with its concomitant economic benefits

Precision nanoscale domain engineering of lithium niobate via UV laser induced inhibition of poling

Continuous wave ultraviolet (UV) laser irradiation at lambda=244 nm on the +z face of undoped and MgO doped congruent lithium niobate single crystals has been observed to inhibit ferroelectric domain inversion. The inhibition occurs directly beneath the illuminated regions, in a depth greater than 100 nm during subsequent electric field poling of the crystal. Domain inhibition was confirmed by both differential domain etching and piezoresponse force microscopy. This effect allows the formation of arbitrarily shaped domains in lithium niobate and forms the basis of a high spatial resolution micro-structuring approach when followed by chemical etching

Why Are People's Decisions Sometimes Worse with Computer Support?

In many applications of computerised decision support, a recognised source of undesired outcomes is operators' apparent over-reliance on automation. For instance, an operator may fail to react to a potentially dangerous situation because a computer fails to generate an alarm. However, the very use of terms like "over-reliance" betrays possible misunderstandings of these phenomena and their causes, which may lead to ineffective corrective action (e.g. training or procedures that do not counteract all the causes of the apparently "over-reliant" behaviour). We review relevant literature in the area of "automation bias" and describe the diverse mechanisms that may be involved in human errors when using computer support. We discuss these mechanisms, with reference to errors of omission when using "alerting systems", with the help of examples of novel counterintuitive findings we obtained from a case study in a health care application, as well as other examples from the literature

Billy Elliot The Musical: visual representations of working-class masculinity and the all-singing, all-dancing bo[d]y

According to Cynthia Weber, ‘[d]ance is commonly thought of as liberating, transformative, empowering, transgressive, and even as dangerous’. Yet ballet as a masculine activity still remains a suspect phenomenon. This paper will challenge this claim in relation to Billy Elliot the Musical and its critical reception. The transformation of the visual representation of the human body on stage (from an ephemeral existence to a timeless work of art) will be discussed and analysed vis-a-vis the text and sub-texts of Stephen Daldry’s direction and Peter Darling’s choreography. The dynamics of working-class masculinity will be contextualised within the framework of the family, the older female, the community, the self and the act of dancing itself

Attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient units

Background In psychiatry, most of the focus on patient aggression has been in adolescent and adult inpatient settings. This behaviour is also common in elderly people with mental illness, but little research has been conducted into this problem in old age psychiatry settings. The attitudes of clinical staff toward aggression may affect the way they manage this behaviour. The purpose of this study was to examine the attitudes of clinical staff toward the causes and management of aggression in acute old age psychiatry inpatient settings. Methods A convenience sample of clinical staff were recruited from three locked acute old age psychiatry inpatient units in Melbourne, Australia. They completed the Management of Aggression and Violence Scale, which assessed the causes and managment of aggression in psychiatric settings. Results Eighty-five staff completed the questionnaire, comprising registered nurses (61.1%, n = 52), enrolled nurses (27.1%, n = 23) and medical and allied health staff (11.8%, n = 10). A range of causative factors contributed to aggression. The respondents had a tendency to disagree that factors directly related to the patient contributed to this behaviour. They agreed patients were aggressive because of the environment they were in, other people contributed to them becoming aggressive, and patients from certain cultural groups were prone to these behaviours. However, there were mixed views about whether patient aggression could be prevented, and this type of behaviour took place because staff did not listen to patients. There was agreement medication was a valuable approach for the management of aggression, negotiation could be used more effectively in such challenging behaviour, and seclusion and physical restraint were sometimes used more than necessary. However, there was disagreement about whether the practice of secluding patients should be discontinued. Conclusions Aggression in acute old age psychiatry inpatient units occurs occasionally and is problematic. A range of causative factors contribute to the onset of this behaviour. Attitudes toward the management of aggression are complex and somewhat contradictory and can affect the way staff manage this behaviour; therefore, wide-ranging initiatives are needed to prevent and deal with this type of challenging behaviour