Development and validation of the ACE tool: Assessing medical trainees' competency in evidence based medicine

BACKGROUND: While a variety of instruments have been developed to assess knowledge and skills in evidence based medicine (EBM), few assess all aspects of EBM - including knowledge, skills attitudes and behaviour - or have been psychometrically evaluated. The aim of this study was to develop and validate an instrument that evaluates medical trainees’ competency in EBM across knowledge, skills and attitude. METHODS: The ‘Assessing Competency in EBM’ (ACE) tool was developed by the authors, with content and face validity assessed by expert opinion. A cross-sectional sample of 342 medical trainees representing ‘novice’, ‘intermediate’ and ‘advanced’ EBM trainees were recruited to complete the ACE tool. Construct validity, item difficulty, internal reliability and item discrimination were analysed. RESULTS: We recruited 98 EBM-novice, 108 EBM-intermediate and 136 EBM-advanced participants. A statistically significant difference in the total ACE score was observed and corresponded to the level of training: on a 0-15-point test, the mean ACE scores were 8.6 for EBM-novice; 9.5 for EBM-intermediate; and 10.4 for EBM-advanced (p < 0.0001). Individual item discrimination was excellent (Item Discrimination Index ranging from 0.37 to 0.84), with internal reliability consistent across all but three items (Item Total Correlations were all positive ranging from 0.14 to 0.20). CONCLUSION: The 15-item ACE tool is a reliable and valid instrument to assess medical trainees’ competency in EBM. The ACE tool provides a novel assessment that measures user performance across the four main steps of EBM. To provide a complete suite of instruments to assess EBM competency across various patient scenarios, future refinement of the ACE instrument should include further scenarios across harm, diagnosis and prognosis

Nelson Fell: Eyewitness to the February Revolution

The following extracts from the diary and letters of Nelson Fell provide an insight into the revolutionary events taking place between February and May 1917 from the perspective of an overseas eyewitness. After detailing his visit to the Romanov family in Tsarskoe Tselo, Fell outlines the gradual unfolding of the events of the revolution as they took place on the streets of Moscow and, later, in Petrograd. One of his letters details his experience of train travel during his trip to Kazan in March 1917. In the final extract from May 1917, Fell considers the fate of Tsarism and the future prospects for further revolution in Russia

Women and Competition in State Socialist Societies: Soviet-era Beauty Contests

The phenomenon of the beauty contest did not find favour in the Soviet Union until the late 1980s, when Gorbachev was in office and perestroika was already under way. Before this time, beauty contests were condemned by socialist regimes as aspects of capitalist societies that degraded, sexualised and objectified women. Gorbachev’s policy of perestroika hailed a re-visioning of the role of women in Soviet society. Consequently, beauty contests were held in the Soviet Union’s regions and republics, as well as in a number of Eastern European countries, from the mid-1980s. It was, however, the first ever ‘Moscow Beauty’ contest, held in June 1988, that came to attract major international attention and was widely reported around the world. Before the collapse of the Soviet Union in 1991, three ‘Miss USSR’ competitions were organised and these events propelled the winners on to the global stage. The ‘Moscow Beauty’ and ‘Miss USSR’ beauty contests were accompanied also by a whole range of lower level competitions. An exploration of these Soviet beauty contests enables us to examine the notion of competition in state socialist societies from a number of different angles. These include: the adaptation of a Western model of competition to the Soviet cultural context; contested notions of beauty and femininity; and the role played by organisers, sponsors and agents in the international competitive arena. This study draws on contemporary Soviet newspaper and international press reports of the Soviet beauty contests and the widespread media coverage afforded to Soviet beauty queens around the world. It also makes use of the testimonies of some of the contestants themselves

The flux ratio of the [OIII] 5007,4959 lines in AGN: Comparison with theoretical calculations

By taking into account relativistic corrections to the magnetic dipole operator, the theoretical [OIII] 5006.843/4958.511 line intensity ratio of 2.98 is obtained. In order to check this new value using AGN spectra we present the measurements of the flux ratio of the [OIII] 4959,5007 emission lines for a sample of 62 AGN, obtained from the Sloan Digital Sky Survey (SDSS) Database and from published observations. We select only high signal-to-noise ratio spectra for which the line shapes of the [OIII] 4959,5007 lines are the same. We obtained an averaged flux ratio of 2.993 +/- 0.014, which is in a good agreement with the theoretical one.Comment: Accepted for publication in the MNRA

Self organized mode locking effect in superconductor / ferromagnet hybrids

The vortex dynamics in a low temperature superconductor deposited on top of a rectangular array of micrometer size permalloy triangles is investigated experimentally. The rectangular unit cell is such that neighboring triangles physically touch each other along one direction. This design stabilizes remanent states which differ from the magnetic vortex state typical of individual non-interacting triangles. Magnetic Force Microscopy images have revealed that the magnetic landscape of the template can be switched to an ordered configuration after magnetizing the sample with an in-plane field. The ordered phase exhibits a broad flux flow regime with relatively low critical current and a highly anisotropic response. This behavior is caused by the spontaneous formation of two separated rows of vortices and antivortices along each line of connected triangles. The existence of a clear flux flow regime even for zero external field supports this interpretation. The density of induced vortex-antivortex pairs is directly obtained using a high frequency measurement technique which allows us to resolve the discrete motion of vortices. Strikingly, the presence of vortex-antivortex rows gives rise to a self organized synchronized motion of vortices which manifests itself as field independent Shapiro steps in the current-voltage characteristics.Comment: 9 pages, 11 figure

Domain wall displacement in Py square ring for single nanometric magnetic bead detection

A new approach based on the domain wall displacement in confined ferromagnetic nanostructures for attracting and sensing a single nanometric magnetic particles is presented. We modeled and experimentally demonstrated the viability of the approach using an anisotropic magnetoresistance device made by a micron-size square ring of Permalloy designed for application in magnetic storage. This detection concept can be suitable to biomolecular recognition, and in particular to single molecule detection.Comment: 8pages, 3figure