Beyond 'health and safety':The challenges facing students asked to work outside of their comfort, qualification level or expertise on medical elective placement

Background: On elective students may not always be clear about safeguarding themselves and others. It is important that placements are safe, and ethically grounded. A concern for medical schools is equipping their students for exposure to and response to uncomfortable and/or unfamiliar requests in locations away from home, where their comfort and safety, or that of the patient, may be compromised. This can require legal, ethical, and/or moral reasoning on the part of the student. The goal of this article is to establish what students actually encounter on elective, to inform better preparing students for safe and ethical medical placements. We discuss the implications of our findings, which are arguably applicable to other areas of graduate training, e.g. first medical roles post-qualification.Method: An anonymised survey exploring clinical and ethical dilemmas on elective was issued across 3 years of returning final year elective medical students. Questions included the prevalence and type of potentially unsafe scenarios encountered, barriers to saying 'no' in unsafe situations, perceived differences between resource poor and developed world settings and the degree to which students refused or consented to participation in events outside of the 'norms' of their own training experience.Results: Three hundred seventy-nine students participated. 45% were asked to do something "not permissible" at home. 27% were asked to do something they felt "uncomfortable" with, often an invasive clinical task. Half asked to do something not usually permissible were "comfortable". 48% felt it more acceptable to bypass guidelines in developing settings. 27% refused an offer outside their experience.Conclusion: Of interest are reasons for "going along with" uncomfortable invitations, e.g. "emergency", self-belief in 'capability' and being 'more qualified' than host-personnel. This "best pair of hands available" merits scrutiny. Adverse scenarios were not exclusive to developing settings. We discuss preparing students for decision-making in new contexts, and address whether 'home' processes are too inflexible to prepare students for 'real' medical life? Ethical decision-making and communicating reluctance should be included in elective preparation.</p

Multi-messenger astronomy of gravitational-wave sources with flexible wide-area radio transient surveys

We explore opportunities for multi-messenger astronomy using gravitational waves (GWs) and prompt, transient low-frequency radio emission to study highly energetic astrophysical events. We review the literature on possible sources of correlated emission of gravitational waves and radio transients, highlighting proposed mechanisms that lead to a short-duration, high-flux radio pulse originating from the merger of two neutron stars or from a superconducting cosmic string cusp. We discuss the detection prospects for each of these mechanisms by low-frequency dipole array instruments such as LWA1, LOFAR and MWA. We find that a broad range of models may be tested by searching for radio pulses that, when de-dispersed, are temporally and spatially coincident with a LIGO/Virgo GW trigger within a \usim 30 second time window and \usim 200 \mendash 500 \punits{deg}^{2} sky region. We consider various possible observing strategies and discuss their advantages and disadvantages. Uniquely, for low-frequency radio arrays, dispersion can delay the radio pulse until after low-latency GW data analysis has identified and reported an event candidate, enabling a \emph{prompt} radio signal to be captured by a deliberately targeted beam. If neutron star mergers do have detectable prompt radio emissions, a coincident search with the GW detector network and low-frequency radio arrays could increase the LIGO/Virgo effective search volume by up to a factor of \usim 2. For some models, we also map the parameter space that may be constrained by non-detections.Comment: 31 pages, 4 figure

Observations of Giant Pulses from Pulsar PSR B0950+08 using LWA1

We report the detection of giant pulse emission from PSR B0950+08 in 24 hours of observations made at 39.4 MHz, with a bandwidth of 16 MHz, using the first station of the Long Wavelength Array, LWA1. We detected 119 giant pulses from PSR B0950+08 (at its dispersion measure), which we define as having SNRs at least 10 times larger than for the mean pulse in our data set. These 119 pulses are 0.035% of the total number of pulse periods in the 24 hours of observations. The rate of giant pulses is about 5.0 per hour. The cumulative distribution of pulse strength $S$ is a steep power law, $N(>S)\propto S^{-4.7}$, but much less steep than would be expected if we were observing the tail of a Gaussian distribution of normal pulses. We detected no other transient pulses in a dispersion measure range from 1 to 90 pc cm$^{-3}$, in the beam tracking PSR B0950+08. The giant pulses have a narrower temporal width than the mean pulse (17.8 ms, on average, vs. 30.5 ms). The pulse widths are consistent with a previously observed weak dependence on observing frequency, which may be indicative of a deviation from a Kolmogorov spectrum of electron density irregularities along the line of sight. The rate and strength of these giant pulses is less than has been observed at $\sim$100 MHz. Additionally, the mean (normal) pulse flux density we observed is less than at $\sim$100 MHz. These results suggest this pulsar is weaker and produces less frequent giant pulses at 39 MHz than at 100 MHz.Comment: 27 pages, 12 figures, typos correcte

Children’s particulate matter exposure characterization as part of the new hampshire birth cohort study

As part of the New Hampshire Birth Cohort Study, children 3 to 5 years of age participated in a personal PM2.5 exposure study. This paper characterizes the personal PM2.5 exposure and protocol compliance measured with a wearable sensor. The MicroPEM™ collected personal continuous and integrated measures of PM2.5 exposure and compliance data on 272 children. PM2.5, black carbon (BC), and brown carbon tobacco smoke (BrC-ETS) exposure was measured from the filters. We per-formed a multivariate analysis of woodstove presence and other factors that influenced PM2.5, BC, and BrC exposures. We collected valid exposure data from 258 of the 272 participants (95%). Children wore the MicroPEM for an average of 46% of the 72-h period, and over 80% for a 2-day, 1-night period (with sleep hours counted as non-compliance for this study). Elevated PM2.5 exposures oc-curred in the morning, evening, and overnight. Median PM2.5, BC, and BrC-ETS concentrations were 8.1 μg/m3, 3.6 μg/m3, and 2.4 μg/m3. The combined BC and BrC-ETS mass comprised 72% of the PM2.5. Woodstove presence, hours used per day, and the primary heating source were associated with the children’s PM2.5 exposure and air filters were associated with reduced PM2.5 concentrations. Our findings suggest that woodstove smoke contributed significantly to this cohort’s PM2.5 expo-sure. The high sample validity and compliance rate demonstrated that the MicroPEM can be worn by young children in epidemiologic studies to measure their PM2.5 exposure, inform interventions to reduce the exposures, and improve children’s health

Predictive validity of the UK clinical aptitude test in the final years of medical school:a prospective cohort study

Peer reviewedPublisher PD

The Bolocam Galactic Plane Survey: Survey Description and Data Reduction

We present the Bolocam Galactic Plane Survey (BGPS), a 1.1 mm continuum survey at 33" effective resolution of 170 square degrees of the Galactic Plane visible from the northern hemisphere. The survey is contiguous over the range -10.5 < l < 90.5, |b| < 0.5 and encompasses 133 square degrees, including some extended regions |b| < 1.5. In addition to the contiguous region, four targeted regions in the outer Galaxy were observed: IC1396, a region towards the Perseus Arm, W3/4/5, and Gem OB1. The BGPS has detected approximately 8400 clumps over the entire area to a limiting non-uniform 1-sigma noise level in the range 11 to 53 mJy/beam in the inner Galaxy. The BGPS source catalog is presented in a companion paper (Rosolowsky et al. 2010). This paper details the survey observations and data reduction methods for the images. We discuss in detail the determination of astrometric and flux density calibration uncertainties and compare our results to the literature. Data processing algorithms that separate astronomical signals from time-variable atmospheric fluctuations in the data time-stream are presented. These algorithms reproduce the structure of the astronomical sky over a limited range of angular scales and produce artifacts in the vicinity of bright sources. Based on simulations, we find that extended emission on scales larger than about 5.9' is nearly completely attenuated (> 90%) and the linear scale at which the attenuation reaches 50% is 3.8'. Comparison with other millimeter-wave data sets implies a possible systematic offset in flux calibration, for which no cause has been discovered. This presentation serves as a companion and guide to the public data release through NASA's Infrared Processing and Analysis Center (IPAC) Infrared Science Archive (IRSA). New data releases will be provided through IPAC IRSA with any future improvements in the reduction.Comment: Accepted for publication in Astrophysical Journal Supplemen