Student-directed learning in a LIC:How do they find it? An exploration into the medical students' perceptions of the utility of the self-directed component ('white space') of the Longitudinal Integrated Clerkship in the ScotGEM curriculum

Background: Scottish Graduate Entry Medicine (ScotGEM) is a new four-year graduate entry medical programme. During the third year, students undertake a Longitudinal Integrated Clerkship (LIC) where they are integrated into one General Practice for two and a half days a week. The remaining time is 'white space', allowing students to undertake placements and portfolio work; while directing their learning.Aims: To explore the students' perceptions of the utility of the 'white space' of the ScotGEM LIC. Secondary aims were to explore the positive aspects of this space, the challenges of utilising this space and to explore any difference in the 'white space' between LIC regions.Methods: An explorative case study methodology was utilised and semi-structured interviews were conducted with third and fourth-year students. 13 interviews were transcribed for inductive thematic analysis.Findings: Four themes were established: the students' usage of the 'white space'; the tools they used to guide learning in this space; regional variations in LIC experiences and they offered suggestions to improve the utility of this space.Discussion and conclusion: The findings are detailed and integrated with relevant literature to inform recommendations for future LIC practice and suggestions for future research are offered.</p

Student-directed learning in a LIC:How do they find it? An exploration into the medical students' perceptions of the utility of the self-directed component ('white space') of the Longitudinal Integrated Clerkship in the ScotGEM curriculum

Background: Scottish Graduate Entry Medicine (ScotGEM) is a new four-year graduate entry medical programme. During the third year, students undertake a Longitudinal Integrated Clerkship (LIC) where they are integrated into one General Practice for two and a half days a week. The remaining time is 'white space', allowing students to undertake placements and portfolio work; while directing their learning.Aims: To explore the students' perceptions of the utility of the 'white space' of the ScotGEM LIC. Secondary aims were to explore the positive aspects of this space, the challenges of utilising this space and to explore any difference in the 'white space' between LIC regions.Methods: An explorative case study methodology was utilised and semi-structured interviews were conducted with third and fourth-year students. 13 interviews were transcribed for inductive thematic analysis.Findings: Four themes were established: the students' usage of the 'white space'; the tools they used to guide learning in this space; regional variations in LIC experiences and they offered suggestions to improve the utility of this space.Discussion and conclusion: The findings are detailed and integrated with relevant literature to inform recommendations for future LIC practice and suggestions for future research are offered.</p

Concept design of a fast sail assisted feeder container ship

A fast sail assisted feeder container ship concept has been developed for the 2020 container market in the South East Asian and Caribbean regions.The design presented has met the requirements of an initial economic study, with a cargo capacity of 1270 twenty-foot equivalent unit containers, meeting the predictions of container throughput derived from historical data. In determining suitable vessel dimensions, account has also been taken for port and berthing restrictions, and considering hydrodynamic performance. The vessel has been designed for a maximum speed of 25 knots, allowing it to meet the demand for trade whilst reducing the number of ships operating on the routes considered.The design development of the fast feeder concept has involved rigorous analyses in a number of areas to improve the robustness of the final design. Model testing has been key to the development of the concept, by increasing confidence in the final result. This is due to the fact that other analysis techniques are not always appropriate or accurate. Two hull forms have been developed to meet requirements whilst utilising different propulsor combinations. This has enabled evaluation of efficiency gains resulting from different hydrodynamic phenomena for each design. This includes an evaluation of the hydrodynamic performance when utilising the sail system. This has been done using a combination of model test results and data from regression analysis. The final propulsor chosen is a contra-rotating podded drive arrangement. Wind tunnel testing has been used to maximise the performance of a Multi-wing sail system by investigating the effects of wing spacing, stagger and sail-container interactions. This has led to an increase in lift coefficient of 32% from initial predictions. The savings in power requirement due to the sail system are lower than initially predicted. However, another benefit of their installation, motion damping, has been identified. Whilst this has not been fully investigated, additional fuel savings are possible as well as improved seakeeping performance.The design is shown to be environmentally sustainable when compared to existing vessels operating on the proposed routes. This is largely due to the use of low-carbon and zero-sulphur fuel (liquefied natural gas) and improvements in efficiency regarding operation. This especially relates to cargo handling and scheduling. Green house gas emissions have been predicted to fall by 42% and 40% in the two regions should the design be adopted. These savings are also due to the use of the Multi-wing sail system, which contributes to reductions in power requirement of up to 6% when the vessel operates at its lower speed of 15 knots. It is demonstrated that the fast feeder is also economically feasible, with predicted daily cost savings of 27% and 33% in the South East Asian and Caribbean regions respectively. Thus the fast feeder container ship concept is a viable solution for the future of container transhipment. <br/

Concept design of a fast sail assisted feeder container ship

An environmentally sustainable fast sail-assisted feeder-container ship concept, with a maximum speed of 25 knots, has been developed for the 2020 South East Asian and Caribbean container markets. The use of low-carbon and zero-sulphur fuel (liquefied natural gas) and improvements in operational efficiency (cargo handling and scheduling) mean predicted Green house gas emissions should fall by 42% and 40% in the two selected operational regions. The adoption of a Multi-wing sail system reduces power requirement by up to 6% at the lower ship speed of 15 knots. The predicted daily cost savings are respectively 27% and 33% in South East Asian and the Caribbean regions.Two hull forms with a cargo capacity of 1270TEU utilising different propulsion combinations were initially developed to meet operational requirements. Analysis &amp; tank testing of different hydrodynamic phenomena has enabled identification of efficiency gains for each design. The final propulsion chosen is a contra-rotating podded drive arrangement. Wind tunnel testing improved Multi-wing sail performance by investigating wing spacing, wing stagger and sail-container interactions. The associated lift coefficient was increased by 32%. Whilst savings in sail-assisted power requirement are lower than initially predicted an unexpected identified benefit was motion damping.The fast feeder-container ship is a proposed as a viable future method of container transhipment

Performance of Slabs with varying Reinforcement Configurations

The subject of ductility of suspended slabs constructed with Class L mesh as primary reinforcement led to widespread industry discussion over recent years which led to the current provisions in Australian Standard 3600 - Concrete Structures (2009) [1] which outlines the analysis, design and detailing of such slabs. The aim of this research program was to examine the behaviour – in terms of ultimate strength and ductility parameters - of simply supported one way reinforced concrete slabs with differing reinforcement types with relatively consistent tensile steel reinforcing ratios of the order of 0.4%. Eight slabs were constructed with a range of reinforcing including (i) class L mesh only, (ii) class N reinforcing bar only, (iii) combination of L class mesh and N class bar or (iv) reinforcing consisting of two layers of class L mesh. The classification of the reinforcing is in accordance to Australian and New Zealand Standard 4671 – Steel Reinforcing Materials (2001) [2]. The behaviour of slabs reinforced with L class mesh and steel fibre reinforced concrete was also investigated. This paper presents the test data for 8 test slabs. Four of the slabs were duplicate tests; Control 1 and Control 2 had the same reinforcing arrangement consisting of mesh SL 102; and CS2 and N10 slabs both had 4 N10-220 in both directions ofslab. The testing of duplicate tests enabled an assessment of the variability of test data and sensitivity of the ductility parameter W1/W0

Fostering innovation across aerospace supplier networks

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering; and, (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2002.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections."June 2002." Page 187 blank.Includes bibliographical references (p. 180-184).by Aaron L. Kirtley.S.M

ADVANCES IN UPPER LIMB MODELLING: IMPLICATIONS FOR TESTING CRICKET BOWLING ACTIONS

This study investigates the effect of glenohumeral joint centre (GHJ) mislocation on elbow flexion-extension kinematics and outlines the development and validation of functionally based 2DoF upper-limb model that is proposed to more accurately measure elbow flexion-extension angles. The findings suggest that a new regression equation be adopted to calculate the GHJ centre used in the definition of the upper arm anatomical coordinate system. The research also proposes that a 2DoF mean finite helical axis model (HAM) be used to describe upper limb motion as it more accurately measures flexion-extension angles when compared with traditional anatomically based models as validated against a mechanical arm moving through known ranges and angles. The HAM model also eliminated cross-talk on elbow flexion-extension kinematics

Development of outbred CD1 mouse colonies with distinct standardized gut microbiota profiles for use in complex microbiota targeted studies.

Studies indicate that the gut microbiota (GM) can significantly influence both local and systemic host physiologic processes. With rising concern for optimization of experimental reproducibility and translatability, it is essential to consider the GM in study design. However, GM profiles can vary between rodent producers making consistency between models challenging. To circumvent this, we developed outbred CD1 mouse colonies with stable, complex GM profiles that can be used as donors for a variety of GM transfer techniques including rederivation, co-housing, cross-foster, and fecal microbiota transfer (FMT). CD1 embryos were surgically transferred into CD1 or C57BL/6 surrogate dams that varied by GM composition and complexity to establish four separate mouse colonies harboring GM profiles representative of contemporary mouse producers. Using targeted 16S rRNA amplicon sequencing, subsequent female offspring were found to have similar GM profiles to surrogate dams. Furthermore, breeding colonies of CD1 mice with distinct GM profiles were maintained for nine generations, demonstrating GM stability within these colonies. To confirm GM stability, we shipped cohorts of these four colonies to collaborating institutions and found no significant variation in GM composition. These mice are an invaluable experimental resource that can be used to investigate GM effects on mouse model phenotype

Fluoroscopy‐guided Umbilical Venous Catheter Placement in Infants with Congenital Heart Disease

ObjectiveThe objective of this study was to (1) describe the technical aspects of fluoroscopy‐guided umbilical venous catheter placement (FGUVCP); and (2) determine the procedural success rate, factors contributing to procedural failure, and risks of the procedure.BackgroundUmbilical venous catheters are advantageous compared with femoral venous access, but can be difficult to place at the bedside.Materials and MethodsThis was a retrospective chart review from a single tertiary care referral institution.ResultsFGUVCP was successful in 138 of 180 patients (76.7%) over a seven‐year period. Patients in whom FGUVCP was successful were younger at the time of procedure compared with patients in whom FGUVCP was unsuccessful (median 18.2 vs. 22.2 hours, P = .03). The optimal age cutoff to predict FGUVCP success was 20 hours with a high positive predictive value (82.4%) but low negative predictive value (32.5%). No other variables were associated with procedural failure, though functional univentricular heart and older gestational age trended toward statistical significance. Median radiation time, contrast exposure, and blood loss were 3.2 minutes, 1 mL, and 1 mL, respectively. A total of 10 complications in 10 patients were associated with FGUVCP.ConclusionsFGUVCP is a safe and highly successful way to obtain central venous access in neonates with congenital heart disease. Older age at the time of procedure is associated with procedural failure, but utilization of an age cutoff may not be clinically useful.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/113170/1/chd12233.pd

Anatomic Femoral and Tibial Tunnel Placement During Anterior Cruciate Ligament Reconstruction: Anteromedial Portal All-Inside and Outside-In Techniques

Tunnel malposition is one of the most common technical reasons for anterior cruciate ligament reconstruction failure. Small changes in tunnel placement can result in significant differences in outcome. More anatomic placement of the tunnels can lead to greater knee stability and a more accurate reproduction of native knee kinematics. This Technical Note describes 2 tibial tunnel–independent methods to obtain anatomic femoral tunnel placement. The all-inside anteromedial portal technique requires only minimal surgical incisions but allows precise femoral tunnel placement. However, hyperflexion of the knee is required, adequate surgical assistance is necessary, and this technique may be susceptible to graft-tunnel mismatch. The outside-in technique may be more beneficial in obese patients, skeletally immature patients, or revision cases. On the downside, it does require an additional 2-cm surgical incision. This article also provides surgical pearls to fine-tune tibial tunnel placement