Experience of a tutor centric model for sonography training of emergency department registrars in an Australian urban emergency department 2009–2012

Purpose: To assess the impact of a regular sonographer proctored training program for emergency medicine trainees in the use of Emergency Department bedside ultrasound Methods: Emergency Department (ED) Registrars in the Swan District Hospital ED were provided with proctored instruction in bedside ultrasound in performance of extended focused assessment sonography in trauma (eFAST) and abdominal aortic aneurysm (AAA) detection. Training was conducted by credentialed sonographers for individual trainees in a 1:1 or 1:2 setting for 1 hour on a weekly basis. Registrars who trained in the Department between Jan 2009 to Dec 2012 were invited to participate in a survey conducted between June-August 2013 designed to assess the impact of training on their confidence and use of bedside sonography. Results: Registrars reported increased perception of their skill level in AAA and eFAST post-training. High levels of confidence in their ability to adjust machine settings for image optimization, recognition of free fluid in the abdomen and ability to recognise an AAA were also reported. The participants that completed at least 10 hours of training and at least 20 scans showed significantly greater improvement in their perception of skill and confidence levels than those with less time. Registrars reported training was of significant benefit, improving their confidence in obtaining good quality images and their understanding of the equipment, which contributed to them obtaining accreditation. Benefits were ongoing and 50% of participants reported using ultrasound in clinical practice at least 3 times per week and a further 30% at least weekly after leaving ED. Conclusion: Proctored training in the clinical context for ED registrars resulted in improvement in skills, confidence and willingness to maintain skills through practice in the clinical context over the long-term

Pulmonary arterial hypertension outcomes upon endothelin-1 receptor antagonist switch to macitentan

Objectives: To assess whether switching patients with suboptimally controlled pulmonary arterial hypertension from bosentan or ambrisentan to macitentan would improve six-minute walk test (6MWT) distance and World Health Organization functional class. Methods: This was a retrospective cohort analysis of 37 patients from a single center. Patients were separated into three heterogeneous treatment groups and followed for 18 months: switch group (n¼14): patients switched to macitentan from bosentan/ambrisentan; added group (n¼11): patients who began macitentan as de novo therapy (n¼5) or who added macitentan to an existing sildenafil regimen (n¼6); and control group (n¼12): patients for whom sildenafil and/or bosentan/ambrisentan therapy was unchanged. Results: Mortality was observed in two patients (one each, switch and added groups). Patients in the control group had one hospital admission and 100% survival. There was significant improvement in functional class for the switch and added groups. Statistically significant improvement was observed in 6MWT distance in the added group alone. Overall, 92% of patients continued macitentan throughout the study. Conclusion: Macitentan was well tolerated. For bosentan/ambrisentan-treated patients with suboptimally controlled pulmonary arterial hypertension, switching to macitentan may facilitate an improvement in functional class

Moral Masculinities: Ethical Self-fashionings of Professional Chinese Men in London

Through qualitative interviews and examination of textual sources, this essay investigates the gendered, class and cultural subjectivities of transnational, highly-educated Chinese men living and working in London. Narrative analysis of the interviews of two participants suggests that they exhibit hybrid “bricolage masculinities,” which incorporate elements from Western educational and corporate cultures, and also appropriate concepts and practices from the Confucian tradition of moral self-cultivation. A discussion of contemporary texts that support the revival of Confucian masculinities illuminates the discursive context in which the participants’ ethical self-fashionings take place. The study argues that the cosmopolitan yet culturally embedded masculinities of the participants are suggestive of how professional Chinese men, as they step onto the world stage, seek to insert themselves more advantageously into local and global power relations of gender, class and nation

Externalising, sharing and comparing perceptions in design

There is a need for organisations and the leaders within them to explore, recognise, build and exploit new capabilities. Some of this ‘new’ capability could be better utilisation of the resources already at their disposal. For example, highly skilled designers and engineers. This paper explores the notion of knowledge models in design with two driving motivations. Firstly, a new urgency in the light of the forth industrial revolution, from a digitisation perspective: can we integrate designer’s thoughts with AI. Secondly, a longer-standing concern, from the point of view of the inherent need to communicate and express and model clearly in achieve the objective of design. An analysis of the role of models in design is presented before a potential new approach is proposed

White-collar men and masculinities in contemporary urban China

This work investigates the characteristics of masculinity that are at the symbolic heart of China’s economic success, and of which the figure of the white-collar man is emblematic. Based on fieldwork observations, interview and media publications, it examines the gendered practices, aspirations and attitudes of men who identify with or aspire to white-collar status alongside discursive representations of the Chinese white-collar man, interrogating the links between practice and discourse. Drawing on various approaches to theorizing subjectivity, it argues that white-collar masculinity is performed in ways that suggest both radical shifts and continuities in understandings of gender, which challenge the prevalent teleological narrative of China’s modernization. The first chapter sets the scene for white-collar masculinity in the reform era and discusses fieldwork methodologies. Chapter two sets out the theoretical framework adopted to analyse the gendered white-collar subject, and examines academic literature on masculinities in China. Chapter three examines the ‘body culture’ of informants, and how they ‘bring themselves’ to white-collar discourse through attention to their bodies in areas of daily life such as dress, movement and hygiene. Chapters four and five look respectively at the production of corporate masculinity both inside and outside the office, through an exploration of business and leisure practices, and their overlap. Chapter six takes a close look at the young white-collar man as (heterosexual) boyfriend and husband and the final chapter investigates sexualisations of young urban middle-class males, and comments on their transformative possibilities

Xi Jinping’s Family Values

Xi Jinping has been variously termed an ‘alpha male’ in (and out of) a bromance with Donald Trump; a macho, Putin-like aggressor covetous of neighbouring territories; and one of several national leaders exhibiting chauvinistic ‘straight-man cancer’ (zhinan ai). Looking at Xi through the lens of gender reveals vital clues about his reshaping of Chinese gender relations and in particular family roles. Xi's gender identity has been constructed through the acts of female ‘others’, such as his wife’s passive adulation and his mother’s selfless care. This vision of masculinity fits a growing neo-familism in Chinese society. Whether one considers Xi the benevolent father of the nation, a hetero-patriarchal oppressor of women and sexual minorities, or somewhere in between, his enactment of masculinity and vision of gender hierarchies are helping transform gender relations in China