Medical students' perceptions in relation to ethnicity and gender: A qualitative study

Background The British medical student population has undergone rapid diversification over the last decades. This study focuses on medical students' views about their experiences in relation to ethnicity and gender during their undergraduate training within the context of the hidden curriculum in one British medical school as part of a wider qualitative research project into undergraduate medical education. Method We interviewed 36 undergraduate medical students in one British Medical School, across all five years of training using a semi-structured interview schedule. We selected them by random and quota sampling, stratified by sex and ethnicity and used the whole medical school population as a sampling frame. Data analyses involved the identification of common themes, reported by means of illustrative quotations and simple counts. Results The students provided information about variations patterned by gender in their motivation and influences when deciding to study medicine. Issues in relation to ethnicity were: gaining independence from parents, perceived limitations to career prospects, incompatibility of some religious beliefs with some medical practices and acquired open-mindedness towards students and patients from different ethnic backgrounds. Despite claiming no experiences of gender difference during medical training, female and male students expressed gender stereotypes, e.g. that women bring particularly caring and sympathetic attitudes to medicine, or that surgery requires the physical strength and competitiveness stereotypically associated with men that are likely to support the continuation of gender differentiation in medical careers. Conclusion The key themes identified in this paper in relation to ethnicity and to gender have important implications for medical educators and for those concerned with professional development. The results suggest a need to open up aspects of these relatively covert elements of student culture to scrutiny and debate and to take an explicitly wider view of the influence of what has sometimes been called the hidden curriculum upon the training of medical professionals and the practice of medicine

Space shuttle engineering and operations support. Separation operational limits for ALT free flights 1 through 5

The orbiter/SCA separation operational limits for the current target conditions of ALT free flights 1 through 5 are analyzed. The separation operational limits are used to verify that no separation design constraints are violated. The operational limits represent the acceptable dispersions in attainment of separation target conditions which assure safe separation. Safe separation is based on satisfying all specified separation design criteria except orbiter altitude at ALT interface airspeed. Separation operational limits are defined for each of the five orbiter tailcones on ALT free flight missions based upon preflight aerodynamics. The effect of carrier pilot steering compensation due to off-nominal flight conditions is determined to be within the separation operational limits

CARICOM Bilateral Trade: A Preliminary Analysis Using the Gravity Model

This paper investigates the determinants of intra-CARICOM bilateral trade and the CARICOM member's trade with the North American and European countries using the gravity model. Seventeen annual cross-sections are estimated for the period 1980 through 1996. Overall, the empirical results indicate that the gravity model has considerable potential to explain intra-CARICOM bilateral trade as well as trade between CARICOM members and non-members. The evidence suggests that both the importer's GDP per capita and the exporter's GDP per capita exert strong positive effects on CARICOM trade levels. Since these effects are found to be statistically the same, we conclude that the gravity model is symmetric with respect to GDP per capita. Further, sharing a common language, colonial ties, or membership in the CARICOM all significantly contribute to larger volumes of bilateral trade, while geographic distance has the opposite effect. Both the exporting and the importing countries' populations have a positive effect on trade levels, indicating that larger economies have a wider production base and thus export and import more than would smaller economies.Caribbean economies, CARICOM, FTAA, gravity model, regional integration, International Relations/Trade,

Observations and Analysis of Ground Motion and Pore Pressure at the Nees Instrumented Geotechnical Field Sites

The Garner Valley and Wildlife sites are producing a large data set that includes very interesting observations from earthquakes in the magnitude 4 to 7 range, with peak accelerations of ~10%g, at the threshold where nonlinear effects start to become important. In addition, hundreds of smaller earthquakes are recorded each month that provide the control data representing the linear behavior of the site. With the larger motions, we begin to see pore pressure build up on the liquefaction array at both the NEES Garner Valley Array site and at the NEES Wildlife Liquefaction Array site. We present the results of simulated pore pressure generation using the observed ground motions and a nonlinear anelastic hysteretic finite difference model of the soil response. We are able to reproduce this onset of pore pressure generation that occurs under the moderate strain levels associated with these ground motions. Additional work to be completed for this conference includes the development of an empirical model to predict pore pressure generation based on observed ground motions within a saturated soil column using data from the GVDA and WLA field sites. Correlations between pore pressure data and various ground motion parameters derived from accelerometers within the vertical arrays will be shown. Continuing studies on these unique data sets are improving our understanding of the physical process that drives liquefaction

Immunisation for refugees in Australia: a policy review and analysis across all States and Territories.

OBJECTIVE: Although people of refugee background are likely to be under-immunised before and after resettlement, no study to date has evaluated refugee specific immunisation policies in Australia. We developed a framework to analyse immunisation policies across Australia to highlight the strengths and gaps so as to inform development of more effective refugee specific immunisation policies. METHODS: We sourced publicly available immunisation policy documents from state and territory government websites. Content analysis of seven policy documents was undertaken using a developed framework comprising crucial policy determinants. RESULTS: Immunisation policy differed substantially across the jurisdictions. While most policies did not highlight the importance of data collection on immunisation for refugees and the public funding of vaccines for refugees, policy determinants such as accessibility and obligations were fulfilled by most jurisdictions. CONCLUSION: Our findings indicate stark differences in immunisation policy for people of refugee background across Australia. Highlighted gaps demonstrate the need to revise current policies so that they are aligned with their intended outcome of enhancing uptake of vaccines and improving immunisation coverage among resettled refugees in Australia. Implications for public health: Immunisation policy development for refugees needs to be robust enough to ensure equitable health services to this group

Analysis of Site Effects at the Garner Valley Downhole Array Near the San Jacinto Fault

The Garner Valley downhole array is located in the geologically complicated and seismologically active San Jacinto fault zone. The choice of the site and the potential for a large earthquake there are discussed. The equipment is described in detail. The data recorded through the end of 1 April 1990 are summarized. Two large events at different locations are discussed in some detail and analyzed for amplification of the signal at the surface

Quick look analysis of an emergency separation for ALT captive-inert flight 1

Emergency separation capability for the landing configuration of ALT Captive Inert Flight Number One was investigated. The quick look analysis confirms emergency separation capability under nominal conditions for the ALT landing configuration. The recommended emergency separation procedure under those conditions is not applicable to all ALT configurations

What Families, Clinicians and Payors Need to Know About Transitional Rehabilitation

When a person sustains a traumatic brain injury (TBI), he and his family are thrust into a health care system that is unfamiliar and difficult to navigate. Too often, patients do not have access to the full continuum of treatment - especially transitional rehabilitation (TR). This article addresses why that is so and ways to change it

Short Communication: A qualitative assessment of food security in an internally displaced persons camp in Kenya

The 2007/08 post-election violence in Kenya resulted in the displacement of an estimated 600 000 people. Current published research suggests that many of these internally displaced persons (IDPs) continue to have issues accessing basic needs, including food and water, impacting morbidity and mortality. This study aimed to assess food security and access to cooking fuel and water within an internally displaced persons’ (IDP) camp in Kenya. It was designed as a descriptive, qualitative study involving semi-structured interviews with members of households residing in the IDP camp. Participants were recruited through respondent-driven sampling using a network of coupons. Semi-structured interviews were utilised to determine key issues associated with the attainment of food security, access to cooking fuel and water among resident IDPs, targeting male household heads. Interview structure was based on framework for assessment of food security provided by the International Federation of the Red Cross. Recorded interviews then underwent thematic analysis using NVivo 10 (QSR International, Melbourne, Victoria). A total of 15 semi-structured interviews were completed with men at the camp, aged between 18 and 53. Thematic analysis shows that key elicited concerns regarding food security included lack of capital for agriculture, lack of dietary diversity, seasonal insecurity and anxiety about the future. Access to water was limited to a single borehole located within the camp. Few reliable and safe sources could be identified for cooking fuel. Thus, internally displaced persons residing at this camp continue to experience significant food insecurity. Despite being allocated land for agriculture, they lack capital for investment in agriculture and access to local food markets. Access to water and cooking fuel is limited and a source of significant concern. Initiatives to improve food security delivered through government and non-government programs are necessary to minimise the significant impact of such food insecurity on mental health and disease profiles as reported in other IDP settings.Key words: Internally displaced persons, Kenya, Food security, Qualitative study, Nutritio

The Pendulum Has Swung: How Do We Ensure a Life Course Approach to Immunisation in Australia?

Rather than concentrating primarily on children and adolescents, there has been a shift in the discourse around immunisation to encompass a whole-of-life approach. Despite this acknowledgement and ongoing high burdens of vaccine preventable diseases in adults, coverage for some adult risk groups remains sub-optimal. This study aimed to explore key informant's and stakeholder's perceptions of factors impacting provision of immunisation programs for Australian adults and to identify strategies to promote acceptance and uptake. Semi-structured telephone interviews were undertaken with people involved in adult immunisation program delivery, advocacy, policy or research between September 2020 and June 2021. Transcripts were inductively analysed, with the resulting themes categorised into the five influences on vaccination gaps that have informed program planning in other countries: Access, Affordability, Awareness, Acceptance and Activation. Participants spoke of improvements in the provision of vaccines to adults, however, ongoing challenges persisted. Participants agreed that the focus or emphasis of policies and the promotion/communication strategies has been on childhood vaccination in Australia, however there is a sense that the “pendulum has swung.” These included understanding of eligibility amongst the Australian population and the reluctance of some health providers to dedicate time to exploring immunisation needs with adult patients. In comparison to the childhood vaccination program, there has been a lack of data available on coverage for adult vaccines on the national immunisation program. This has contributed to the ongoing challenges of identifying and promoting certain vaccines. At a government level, questions were raised about why the Australian government has never set an aspirational target for adult vaccination (i.e., influenza or pneumococcal) coverage. While significant improvements have been made in adult immunisation uptake, there are still gaps across the program. While the system remains under stress because of the COVID-19 pandemic, it is not appropriate to implement any additional programs. There needs to be strong commitment to establish the value of adult vaccination in the eyes of community members, policy makers and healthcare professionals. Having a national adult immunisation strategic plan would help advance action