The results of a survey highlighting issues with feedback on medical training in the United Kingdom and how a Smartphone App could provide a solution

BACKGROUND: Feedback drives learning in medical education. Healthcare Supervision Logbook (HSL) is a Smartphone App developed at Sheffield Teaching Hospitals for providing feedback on medical training, from both a trainee's and a supervisor's perspective. In order to establish a mandate for the role of HSL in clinical practice, a large survey was carried out. METHODS: Two surveys (one for doctors undertaking specialty training and a second for consultants supervising their training) were designed. The survey for doctors-in-training was distributed to all specialty trainees in the South and West localities of the Health Education Yorkshire and the Humber UK region. The survey for supervisors was distributed to all consultants involved in educational and clinical supervision of specialty trainees at Sheffield Teaching Hospitals. RESULTS: The results confirm that specialty trainees provide feedback on their training infrequently-66 % do so only annually. 96 % of the specialty trainees owned a Smartphone and 45 % said that they would be willing to use a Smartphone App to provide daily feedback on the clinical and educational supervision they receive. Consultant supervisors do not receive regular feedback on the educational and clinical supervision they provide to trainees-56 % said they never received such feedback and 33 % said it was only on an annual basis. 86 % of consultants surveyed owned a Smartphone and 41 % said they would be willing to use a Smartphone App to provide feedback on the performance of trainees they were supervising. CONCLUSIONS: Feedback on medical training is recorded by specialty trainees infrequently and consultants providing educational and clinical supervision often do not receive any feedback on their performance in this area. HSL is a simple, quick and efficient way to collect and collate feedback on medical training to improve this situation. Good support and education needs to be provided when implementing this new technology

Site assessment of Douglas Shoal ship grounding in the Great Barrier Reef

The bulk carrier Shen Neng 1 ran aground on Douglas Shoal in the Great Barrier Reef Marine Park in April 2010. At over 40 hectares, this is the largest ship grounding scar known in the Great Barrier Reef, and possibly the largest reef-related grounding in the world. Challenges for assessment of the site included its large scale and the remote nature of Douglas Shoal coupled with its high exposure to wind, wave conditions and fauna that may pose safety hazards. Marine surveys used multiple and novel methods including sediment sampling combined with visual and acoustic survey techniques

Self-management in women with stress incontinence: strategies, outcomes and integration into clinical care

The objective of this review is to present and discuss up-to-date conservative treatment strategies for the management of stress urinary incontinence (SUI) in women. This review aims to provide an overview of the importance of initial self-management strategies and conservative management options for women with SUI and how these treatments can be integrated into clinical practice. The various treatment modalities available including pelvic floor physiotherapy, biofeedback, and neuromuscular electrical stimulation devices, in addition to lifestyle changes which can significantly affect symptoms, are discussed. The relevance and importance of individual assessment and training programs is highlighted in addition to additional adjuncts available to facilitate rehabilitation and symptom improvement. Expected outcomes for women with mild to moderate SUI who participate in targeted individualized conservative management programs are generally good, with a high likelihood of substantial improvement in symptoms

Rocks Associated With the Mississippian-Pennsylvanian Unconformity in Southwestern Indiana

The purpose of this field conference is to acquaint participants with strata that are associated with the Mississippian-Pennsylvanian unconformity in southwestern Indiana. Criteria which aid in distinguishing between Mansfield strata of Pottsville (early Pennsylvanian) age and classic formations of Chester (late Mississippian) age will receive considerable attention in discussions at evening meetings and on the outcrop. Inspection of limestone and sandstone quarries will afford an insight into the economic products of Chester and Mansfield rocks

A low-voltage retarding-field Mott polarimeter for photocathode characterization

Nuclear physics experiments at Thomas Jefferson National Accelerator Facility's CEBAF rely on high polarization electron beams. We describe a recently commissioned system for prequalifying and studying photocathodes for CEBAF with a load-locked, low-voltage polarized electron source coupled to a compact retarding-field Mott polarimeter. The polarimeter uses simplified electrode structures and operates from 5 to 30 kV. The effective Sherman function for this device has been calibrated by comparison with the CEBAF 5 MeV Mott polarimeter. For elastic scattering from a thick gold target at 20 keV, the effective Sherman function is 0.201(5). Its maximum efficiency at 20 keV, defined as the detected count rate divided by the incident particle current, is 5.4(2) x 10-4, yielding a figure-of-merit, or analyzing power squared times efficiency, of 1.0(1) x 10-5. The operating parameters of this new polarimeter design are compared to previously published data for other compact Mott polarimeters of the retarding-field type.Comment: 9 figure

Classical Cepheids: Yet another version of the Baade-Becker-Wesselink method

We propose a new version of the Baade--Becker--Wesselink technique, which allows one to independently determine the colour excess and the intrinsic colour of a radially pulsating star, in addition to its radius, luminosity, and distance. It is considered to be a generalization of the Balona approach. The method also allows the function F(CI) = BC + 10 log (Teff) for the class of pulsating stars considered to be calibrated. We apply this technique to a number of classical Cepheids with very accurate light and radial-velocity curves and with bona fide membership in open clusters (SZ Tau, CF Cas, U Sgr, DL Cas, GY Sge), and find the results to agree well with the reddening estimates of the host open clusters. The new technique can also be applied to other pulsating variables, e.g. RR Lyrae and RV Tauri.Comment: 6 pages, 2 figures, 1 table; Submitted to Astrophysical Bulletin, 201

Dynamics, stratospheric ozone, and climate change

Dynamics affects the distribution and abundance of stratospheric ozone directly through transport of ozone itself and indirectly through its effect on ozone chemistry via temperature and transport of other chemical species. Dynamical processes must be considered in order to understand past ozone changes, especially in the northern hemisphere where there appears to be significant low-frequency variability which can look “trend-like” on decadal time scales. A major challenge is to quantify the predictable, or deterministic, component of past ozone changes. Over the coming century, changes in climate will affect the expected recovery of ozone. For policy reasons it is important to be able to distinguish and separately attribute the effects of ozone-depleting substances and greenhouse gases on both ozone and climate. While the radiative-chemical effects can be relatively easily identified, this is not so evident for dynamics — yet dynamical changes (e.g., changes in the Brewer-Dobson circulation) could have a first-order effect on ozone over particular regions. Understanding the predictability and robustness of such dynamical changes represents another major challenge. Chemistry-climate models have recently emerged as useful tools for addressing these questions, as they provide a self-consistent representation of dynamical aspects of climate and their coupling to ozone chemistry. We can expect such models to play an increasingly central role in the study of ozone and climate in the future, analogous to the central role of global climate models in the study of tropospheric climate change

Pay-it-forward gonorrhea and chlamydia testing among men who have sex with men and male STD patients in China: the PIONEER pragmatic, cluster randomized controlled trial protocol

Background: Gonorrhea and chlamydia are the most common sexually transmitted diseases (STDs) among men who have sex with men (MSM) in China. Previous studies have shown pay-it-forward (PIF) interventions to be associated with a substantial increase in gonorrhea and chlamydia test uptake compared to standard-of-care. We propose a 'pay-it-forward' gonorrhea and chlamydia testing randomized controlled trial (PIONEER). The trial would evaluate the effectiveness of two pay-it-forward strategies in promoting testing uptake compared to the standard of care (in which men pay for their tests out-of-pocket) among MSM and male STD patients in China. Methods: PIONEER will be a three-armed, pragmatic cluster randomized controlled trial (RCT), conducted across 12 clinics (six MSM-led and six public STD clinics) to compare the effectiveness of three implementation strategies. Each facility will be randomized to a standard pay-it-forward intervention of gonorrhea/ chlamydia testing with minimal encouragement for testing, a community-engaged pay-it-forward arm, or a control arm where men pay for their tests out-of-pockets. The primary outcome will be dual gonorrhea/chlamydia test uptake. Secondary outcomes will include syphilis testing, amount donated in pay-it-forward, number of positive gonorrhea and chlamydia tests, and measures of antimicrobial resistance. A sequential transformative mixed methods design will be used to evaluate the implementation process in type 2 effectiveness-implementation hybrid design. Data sources will include survey on acceptability, and feelings and attitudes towards the interventions among participants; testing and treatment uptake data from clinic records, WeChat records, and qualitative data to gain insights into men's perceptions and attitudes towards the pay-it-forward, mechanisms driving uptake, and donating behaviors. Implementers and organizers will be interviewed about fidelity and adherence to protocol, sustainability of pay-it-forward intervention, and barriers and facilitators of implementing the intervention. Discussion: PIONEER will substantially increase gonorrhea/chlamydia testing among MSM in China, providing an innovative and new financial mechanism to sustain STD screening among sexual minorities in low- and middle-income countries. This study will answer compelling scientific questions about how best to implement pay-it-forward and the individual and organizational characteristics that moderate it. Trial registration: The study with identification number NCT05723263 has been registered on clinicaltrials.gov/

Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector

A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results

Jet size dependence of single jet suppression in lead-lead collisions at sqrt(s(NN)) = 2.76 TeV with the ATLAS detector at the LHC

Measurements of inclusive jet suppression in heavy ion collisions at the LHC provide direct sensitivity to the physics of jet quenching. In a sample of lead-lead collisions at sqrt(s) = 2.76 TeV corresponding to an integrated luminosity of approximately 7 inverse microbarns, ATLAS has measured jets with a calorimeter over the pseudorapidity interval |eta| < 2.1 and over the transverse momentum range 38 < pT < 210 GeV. Jets were reconstructed using the anti-kt algorithm with values for the distance parameter that determines the nominal jet radius of R = 0.2, 0.3, 0.4 and 0.5. The centrality dependence of the jet yield is characterized by the jet "central-to-peripheral ratio," Rcp. Jet production is found to be suppressed by approximately a factor of two in the 10% most central collisions relative to peripheral collisions. Rcp varies smoothly with centrality as characterized by the number of participating nucleons. The observed suppression is only weakly dependent on jet radius and transverse momentum. These results provide the first direct measurement of inclusive jet suppression in heavy ion collisions and complement previous measurements of dijet transverse energy imbalance at the LHC.Comment: 15 pages plus author list (30 pages total), 8 figures, 2 tables, submitted to Physics Letters B. All figures including auxiliary figures are available at http://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/HION-2011-02