Estimation of Groundwater Recharge to the Gulf Coast Aquifer in Texas, USA

Quantifying groundwater recharge is essential for managing water resources in aquifers. The objective of this study was to quantify spatial variability in recharge in the outcrop zones of the Gulf Coast aquifer in Texas. Regional recharge was estimated using the chloride mass balance approach applied to groundwater chloride data from the TWDB database in 10,530 wells, which represented the most recent samples from wells located in the region. Regional groundwater recharge was also estimated using streamflow hydrograph separation in 59 watersheds using USGS unregulated gage data. Recharge was also estimated by applying the chloride mass balance approach to unsaturated zone chloride data from 27 boreholes that represented a range of precipitation, land use, and soil texture settings in the central and southern Gulf Coast regions. Groundwater chloride concentrations generally decrease from the southern to the northern Gulf Coast, qualitatively indicating increasing recharge in this direction with increasing precipitation. Ratios of chloride to bromide are less than 150 to 200 throughout most of the Gulf Coast, suggesting a predominantly meteoric source for groundwater chloride. Recharge rates based on the chloride mass balance approach range from less than 0.1 in/yr in the south to 10 in/yr in the north, correlated with increasing precipitation. Streamflow ranges from ephemeral in parts of the southern Gulf Coast to perennial throughout the rest of the Gulf Coast based on flow duration curves. Hydrograph separation using Base-Flow Index (BFI) showed that recharge increased from south to north, similar to increases in recharge based on groundwater chloride data. Unsaturated zone profiles show high local variability in chloride concentrations, with mean concentrations below the root zone ranging from 7 to 10,200 mg/L. Resultant percolation rates below the root zone based on the chloride mass balance approach range from less than 0.1 to 6.8 in/yr. In some areas, variations in percolation rates are related to differences in soil texture, whereas in other regions, they are related to differences in land use. However, there is no systematic variation in percolation rates throughout the region, unlike the trends in recharge with regional precipitation from groundwater chloride data and stream hydrograph separation. Recharge rates based on groundwater chloride data can be considered to provide a conservative lower bound on actual recharge because many processes can add chloride to the system, resulting in lower recharge rates whereas there are no processes that can remove chloride from the system in the Gulf Coast. Stream hydrograph separation provides recharge rates in contributing basins that do not cover the entire Gulf Coast region. Recharge estimates from the chloride mass balance applied to groundwater and perennial stream hydrograph separation are highly correlated (r = 0.96), and differences between these two sets of recharge estimates can be used to evaluate uncertainties in recharge rates in contributing basins to the stream gages. Recharge rates from groundwater chloride and streamflow hydrograph separation can be used to provide a range of recharge rates for future groundwater models of the Gulf Coast aquifer.Bureau of Economic Geolog

MBRRACE in simulation: an evaluation of a multi-disciplinary simulation training for medical emergencies in obstetrics (MEmO)

he majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as ‘indirect deaths’. The MBRRACE report identified serious gaps in clinicians’ human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Employing a mixed methods design, this study evaluated the educational impact of this training programme on the healthcare staff (n = 140), including the medical doctors (n = 91) and the midwives (n = 49). The training improved participants’ clinical management of medical deterioration in pregnancy (p=.003) alongside improving their human factors skills (p=.004). Furthermore, participants reported the translation of these skills to their routine clinical practice. This flexible training is responsive to the changing national needs and contextualises the MBRRACE findings for healthcare staff. It is a promising avenue for reducing the rates of in-direct death in pregnancy. Impact statement What is already known on this subject? The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions. The management of medical conditions in pregnancy relies on a multi-professional approach. However, serious gaps in clinicians’ human factors skills, highlighted by the MBRRACE report, may contribute to maternal death. What do the results of this study add? This study evaluated the first multi-disciplinary, simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Training significantly improved participants’ management of medical deterioration in pregnancy and human factors skills, particularly in the areas of leadership, communication and teamwork. Moreover, the participants learning translated into their clinical practice. What are the implications of these findings for clinical practice and/or further research? The delivery of multi-disciplinary team training for all healthcare staff involved in the complex management of medical conditions in pregnancy can help develop a greater understanding of others’ professional roles, and demonstrate the importance of interprofessional teamwork. Furthermore, it provides the space to reflect on team working approaches, including the leadership and professional autonomy, and their potential impact on patient care. Future research should evaluate the impact of this training on the objective outcome measures of medical emergencies in pregnancy

Post graduate clinical placements: evaluating benefits and challenges with a mixed methods cross sectional design

Abstract Background Systematic evaluations of clinical placements are rare, especially when offered alongside academic postgraduate courses. An evidence-based approach is important to allow pedagogically-driven provision, rather than that solely governed by opinion or market demand. Our evaluation assessed a voluntary clinical placement scheme allied to a mental health course. Methods Data were collected over academic years 2010/11– 2013/14, from participating students (n = 20 to 58) and clinician supervisors (n = 10–12), using a mixed-methods cross-sectional design. Quantitative evaluation captured information on uptake, dropout, resource use, attitudes and experience, using standardized (the Placement Evaluation Questionnaire; the Scale To Assess the Therapeutic Relationship – Clinical version and the University of Toronto Placement Supervisor Evaluation) and bespoke questionnaires and audit data. Qualitative evaluation comprised two focus groups (5 clinicians, 5 students), to investigate attitudes, experience, perceived benefits, disadvantages and desired future developments. Data were analysed using framework analysis to identify a priori and emergent themes. Results High uptake (around 70 placements per annum), low dropout (2–3 students per annum; 5 %) and positive focus group comments suggested placements successfully provided added value and catered sufficiently to student demand. Students’ responses confirmed that placements met expectations and the perception of benefit remained after completion with 70 % (n = 14) reporting an overall positive experience, 75 % (n = 15) reporting a pleasant learning experience, 60 % (n = 12) feeling that their clinical skills were enhanced and 85 % (n = 17) believing that it would benefit other students. Placements contributed the equivalent of seven full time unskilled posts per annum to local health care services. While qualitative data revealed perceived ‘mutual benefit’ for both students and clinicians, this was qualified by the inherent limitations of students’ time and expertise. Areas for development included fostering learning around professionalism and students’ confidence on placement. Conclusions The addition of healthcare placements to academic postgraduate taught courses can improve their attractiveness to applicants, benefit healthcare services and enhance students’ perception of their learning experiences. Well-positioned and supported placement learning opportunities could become a key differentiator for academic courses, over potential competitors. However, the actual implications for student employability and achievement remain to be established

Post graduate clinical placements: evaluating benefits and challenges with a mixed methods cross sectional design.

BACKGROUND: Systematic evaluations of clinical placements are rare, especially when offered alongside academic postgraduate courses. An evidence-based approach is important to allow pedagogically-driven provision, rather than that solely governed by opinion or market demand. Our evaluation assessed a voluntary clinical placement scheme allied to a mental health course. METHODS: Data were collected over academic years 2010/11- 2013/14, from participating students (n = 20 to 58) and clinician supervisors (n = 10-12), using a mixed-methods cross-sectional design. Quantitative evaluation captured information on uptake, dropout, resource use, attitudes and experience, using standardized (the Placement Evaluation Questionnaire; the Scale To Assess the Therapeutic Relationship - Clinical version and the University of Toronto Placement Supervisor Evaluation) and bespoke questionnaires and audit data. Qualitative evaluation comprised two focus groups (5 clinicians, 5 students), to investigate attitudes, experience, perceived benefits, disadvantages and desired future developments. Data were analysed using framework analysis to identify a priori and emergent themes. RESULTS: High uptake (around 70 placements per annum), low dropout (2-3 students per annum; 5 %) and positive focus group comments suggested placements successfully provided added value and catered sufficiently to student demand. Students' responses confirmed that placements met expectations and the perception of benefit remained after completion with 70 % (n = 14) reporting an overall positive experience, 75 % (n = 15) reporting a pleasant learning experience, 60 % (n = 12) feeling that their clinical skills were enhanced and 85 % (n = 17) believing that it would benefit other students. Placements contributed the equivalent of seven full time unskilled posts per annum to local health care services. While qualitative data revealed perceived 'mutual benefit' for both students and clinicians, this was qualified by the inherent limitations of students' time and expertise. Areas for development included fostering learning around professionalism and students' confidence on placement. CONCLUSIONS: The addition of healthcare placements to academic postgraduate taught courses can improve their attractiveness to applicants, benefit healthcare services and enhance students' perception of their learning experiences. Well-positioned and supported placement learning opportunities could become a key differentiator for academic courses, over potential competitors. However, the actual implications for student employability and achievement remain to be established

Death and organization: Heidegger’s thought on death and life in organizations

Mortality has not been given the attention it deserves within organization studies. Even when it has been considered, it is not usually in terms of its implications for own lives and ethical choices. In particular, Heidegger’s writing on death has been almost entirely ignored both in writing on death and writing on organizational ethics, despite his insights into how our mortality and the ethics of existence are linked. In this paper, we seek to address this omission by arguing that a consideration of death may yield important insights about the ethics of organizational life. Most important of these is that a Heideggerian approach to death brings us up against fundamental ethical questions such as what our lives are for, how they should be lived and how we relate to others. Heideggerarian thought also reconnects ethics and politics, as it is closely concerned with how we can collectively make institutions that support our life projects rather than thwart or diminish them

After retrotopia? The future of organizing and the thought of Zygmunt Bauman

The main body of work of Zygmunt Bauman concerns his home discipline of sociology, but his insights have been influential also in the field of organization studies. In this text, we provide an overview of the extent of this influence, providing some additional context for positioning the other contributions to this special section. Afterwards, we explore in more detail two notions central for Bauman’s late thought: that of liquidity and retrotopia. The former constitutes the root metaphor for theorizing the current global predicament. In this text, we analyse how two modes of interpreting it, using the assumptions behind Kurt Lewin’s CATS model and the alchemical tradition underpinning Carl Gustav Jung’s conception of archetypes respectively, can help us theorize the alternative modes of organizing and managing encountered in a study of contemporary alternative organizations. These insights form the starting point for our second goal: to explore Bauman’s notion of retrotopia as a potentially fruitful starting point for discussing both the deficiencies of current visions of our future society, and the possibilities and vicissitudes of developing new forms of organizing and managing. Such new forms, both as practice and as theoretical constructs, are urgently needed if we are to face the numerous, and potentially catastrophic global challenges facing our society today

Assessing 'wicked competencies' at a distance

How do teachers assess collaborative work and research skills in a way that is both motivational and engaging for business studies students? This paper describes an approach at the Open University Business School that proved to be highly effective and engaging for both students and tutors

'The Diamond':a structure for simulation debrief

BACKGROUND: Despite debriefing being found to be the most important element in providing effective learning in simulation-based medical education reviews, there are only a few examples in the literature to help guide a debriefer. The diamond debriefing method is based on the technique of description, analysis and application, along with aspects of the advocacy-inquiry approach and of debriefing with good judgement. It is specifically designed to allow an exploration of the non-technical aspects of a simulated scenario. CONTEXT: The debrief diamond, a structured visual reminder of the debrief process, was developed through teaching simulation debriefing to hundreds of faculty members over several years. The diamond shape visually represents the idealised process of a debrief: opening out a facilitated discussion about the scenario, before bringing the learning back into sharp focus with specific learning points. Debriefing is the most important element in providing effective learning in simulation-based medical education reviews INNOVATION: The Diamond is a two-sided prompt sheet: the first contains the scaffolding, with a series of specifically constructed questions for each phase of the debrief; the second lays out the theory behind the questions and the process. IMPLICATION: The Diamond encourages a standardised approach to high-quality debriefing on non-technical skills. Feedback from learners and from debriefing faculty members has indicated that the Diamond is useful and valuable as a debriefing tool, benefiting both participants and faculty members. It can be used by junior and senior faculty members debriefing in pairs, allowing the junior faculty member to conduct the description phase, while the more experienced faculty member leads the later and more challenging phases. The Diamond gives an easy but pedagogically sound structure to follow and specific prompts to use in the moment