What advice is given to newly qualified doctors on Twitter? An analysis of #TipsForNewDocs tweets

Context: Twitter is a social media platform on which users post very brief messages that can be rapidly communicated across wide geographical areas and audiences. Many doctors use Twitter for personal as well as professional communications and networking. The #TipsForNewDocs hashtag is used on Twitter to give advice to newly qualified doctors as they commence their careers. This study explores the nature and focus of such advice. Methods: An analysis of Twitter activity containing the #TipsForNewDocs hashtag was performed using Symplur health care analytics software. Tweets sent during a peak 48‐hour period in 2016 (immediately preceding the first day of work for newly qualified UK doctors) were studied. The geographical locations and professional backgrounds of participants were categorised and the content of tweets was subjected to thematic analysis. During 1 and 2 August 2016, 661 unique #TipsForNewDocs tweets were posted. A total of 621 (94.0%) were posted by people in the UK; 522 (79.0%) were posted by doctors, and the remainder by allied health care professionals and patients. Results: The majority of included tweets focused on aspects of professional development, improving personal or professional knowledge, particularly tacit knowledge, and developing ‘know‐how’. These aspects of professional knowledge have previously been described as fundamental to professional education and training. However, a significant subset of tweets focused on accelerating socialisation into the profession, an essential step in joining a professional community. The tweets relating to socialisation were often humorous and colloquial in nature. Conclusions: Despite their brief and often jocular nature, #TipsForNewDocs tweets provided meaningful advice for newcomers to the profession, often focusing on tacit learning and professional socialisation. Hashtag‐driven enquiries can be a valuable and time‐efficient way of accessing and sharing tacitly held knowledge. Social media content analysis can provide valuable insights into key educational issues

Exploring Pre-practicum Site-Based Experiential Learning in School Counselor Preparation

In this study, participation in a pre-practicum site-based experiential learning assignment was examined. First semester pre-service school counselors who were enrolled in an introductory school counseling course, engaged in observation, counseling, and academic support with students and clients at community and school sites. Qualitative data was collected across three cohort groups and examined through phenomenological inquiry. Participants shared common themes, including that they: (a) Recognized inequities while they expanded their worldview; (b) Preferred a structured experience; (c) Valued relationships; and (d) Drew connections to the classroom and the field

Immersive virtual reality as a pedagogical tool in education:a systematic literature review of quantitative learning outcomes and experimental design

The adoption of immersive virtual reality (I-VR) as a pedagogical method in education has challenged the conceptual definition of what constitutes a learning environment. High fidelity graphics and immersive content using head-mounted-displays (HMD) have allowed students to explore complex subjects in a way that traditional teaching methods cannot. Despite this, research focusing on learning outcomes, intervention characteristics, and assessment measures associated with I-VR use has been sparse. To explore this, the current systematic review examined experimental studies published since 2013, where quantitative learning outcomes using HMD based I-VR were compared with less immersive pedagogical methods such as desktop computers and slideshows. A literature search yielded 29 publications that were deemed suitable for inclusion. Included papers were quality assessed using the Medical Education Research Study Quality Instrument (MERSQI). Most studies found a significant advantage of utilising I-VR in education, whilst a smaller number found no significant differences in attainment level regardless of whether I-VR or non-immersive methods were utilised. Only two studies found clear detrimental effects of using I-VR. However, most studies used short interventions, did not examine information retention, and were focused mainly on the teaching of scientific topics such as biology or physics. In addition, the MERSQI showed that the methods used to evaluate learning outcomes are often inadequate and this may affect the interpretation of I-VR’s utility. The review highlights that a rigorous methodological approach through the identification of appropriate assessment measures, intervention characteristics, and learning outcomes is essential to understanding the potential of I-VR as a pedagogical method

Colouring the workplace green: considering the shade employees see

Sustainability, such as green initiatives, may be considered from two perspectives: (1) social marketing whereby societal value is a priority and (2) financial viability wherein stakeholder value is a concern. However, equally important to companies who seek to colour the workplace green is employee buy-in. This research, set in Dubai, UAE, sought answers about the support for green measures in the workplace. It was guided by three objectives: (1) to what extent are employees willing to contribute to an energy and/or environmentally friendly workplace; (2) to what extent do employees perceive company commitment towards a green workplace, and (3) what initiatives, if any, would encourage employees to participate in green activities. The empirical findings indicate that employees are critiquing company actions. They suggest that more may be done including education activities such as workshops and seminars for information as well as competitions across departments. Monetary rewards were preferred by those youngest and oldest in the workplace. The contribution to knowledge is made more significant given that the UAE scores exceptionally high on carbon footprint per capita ratings. The focus of the study was kept intentionally broad for data interpretation to identify potential issues which could further the research beyond this exploratory stage. Respondents were approached at various venues, including some in their workplace presenting some limitations due to sample size. Future research may pursue the opportunity for companies to use internal marketing activities if they seek to colour the workplace a deeper shade of green

The influence of transition metal solutes on dislocation core structure and values of Peierls stress and barrier in tungsten

Several transition metals were examined to evaluate their potential for improving the ductility of tungsten. The dislocation core structure and Peierls stress and barrier of $1/2$ screw dislocations in binary tungsten-transition metal alloys (W$_{1-x}$TM$_{x}$) were investigated using first principles electronic structure calculations. The periodic quadrupole approach was applied to model the structure of $1/2$ dislocation. Alloying with transition metals was modeled using the virtual crystal approximation and the applicability of this approach was assessed by calculating the equilibrium lattice parameter and elastic constants of the tungsten alloys. Reasonable agreement was obtained with experimental data and with results obtained from the conventional supercell approach. Increasing the concentration of a transition metal from the VIIIA group, i.e. the elements in columns headed by Fe, Co and Ni, leads to reduction of the $C^\prime$ elastic constant and increase of elastic anisotropy A=$C_{44}/C^\prime$. Alloying W with a group VIIIA transition metal changes the structure of the dislocation core from symmetric to asymmetric, similar to results obtained for W$_{1-x}$Re$_{x}$ alloys in the earlier work of Romaner {\it et al} (Phys. Rev. Lett. 104, 195503 (2010))\comments{\cite{WRECORE}}. In addition to a change in the core symmetry, the values of the Peierls stress and barrier are reduced. The latter effect could lead to increased ductility in a tungsten-based alloy\comments{\cite{WRECORE}}. Our results demonstrate that alloying with any of the transition metals from the VIIIA group should have similar effect as alloying with Re.Comment: 12 pages, 8 figures, 3 table

Unravelling anomalous mass transport in miscible liquids

The dissolution dynamics between miscible liquids play a key role in many industrial, biological and environmental processes, including solvent-induced phase transformations such as the formation of polymer membranes or antisolvent crystallisation. The “common” current intuition that guides the design of diffusion processes in miscible liquids is rooted in Fick’s law. This hypothesis generally holds when the system is close to equilibrium and behaves like an ideal mixture. However, Fickian diffusion has limited applicability far from equilibrium, and many systems display “anomalous” behaviours such as uphill diffusion [1] or the Ouzo effect [2]. Despite the importance of diffusion processes, the mechanisms underlying anomalous mass transfer are still poorly understood [3]. This work provides a direct microscopic view into highly localized anomalous pathways that can occur during the mixing of miscible fluids. Results will be presented for a model system of glycine-water-ethanol that represents a typical antisolvent crystallisation process where anomalous mass transport can have significant impacts on the critical quality attributes of the resulting crystalline product. We have deployed a novel experimental setup that includes a microfluidic flow cell that is monitored using a confocal Raman microscope, enabling the measurement of spectral maps of the mixing of the solution and antisolvent streams. These maps allow for the evolution of the composition of the multicomponent fluid to be determined as mixing progresses. From the measured spectral maps, the equilibration trajectories of the mixing solution and antisolvent streams can be determined, providing information on what regions of the phase diagrams are accessed during the mixing process, while also revealing the conditions that lead to surprising diffusive behaviours. This work provides new insight into the underlying mechanisms of anomalous mass transport and a better understanding of the equilibration pathways that can occur during antisolvent crystallization. References [1] R. Krishna; Uphill diffusion in multicomponent mixtures, Chem. Soc. Rev., 44, 2812-2836 (2015). [2] S. A. Vitale, and J. L. Katz; Liquid droplet dispersions formed by homogeneous liquid-liquid nucleation: “the ouzo effect”, Langmuir, 19, 4105-4110 (2003) [3] A. Vorobev: Dissolution dynamics of miscible liquid/liquid interfaces, Curr. Opin. Colloid Interface Sci., 19, 300-308 (2014)

Intravenous Iron to Treat Anaemia following Critical care (INTACT): A protocol for a feasibility randomised controlled trial

Background: Anaemia is common in patients who survive critical illness and is associated with high levels of fatigue and poor quality of life. In non-critically ill patients, treating anaemia with intravenous iron has resulted in meaningful improvements in quality of life, but uncertainties regarding the benefits, risks, timing and optimal route of iron therapy in survivors of critical illness remain.Methods / Design: INtravenous Iron to Treat Anaemia following CriTical care (INTACT) is an open-label, feasibility, parallel group, randomised controlled trial with 1:1 randomisation to either intravenous iron (1000 mg ferric carboxymaltose) or usual medical care. The primary objective is to assess the feasibility of a future, multicentre randomised controlled trial. Participants will be followed up for up to 90 days post-randomisation. The primary outcome measures, which will be used to determine feasibility, are recruitment and randomisation rates, protocol adherence and completeness of follow-up. Secondary outcome measures include collecting clinical, laboratory, health-related quality of life and safety data to inform the power calculations of a future definitive trial.Conclusion: Improving recovery from critical illness is a recognised research priority. Whether or not correcting anaemia, with intravenous iron, improves health-related quality of life and recovery requires further investigation. If so, it has the potential to become a rapidly translatable intervention. Prior to embarking on a phase III multicentre trial, a carefully designed and implemented feasibility trial is essential

Diagnosis of common health conditions among autistic adults in the UK: evidence from a matched cohort study

Background: Autistic people are disproportionately likely to experience premature mortality and most mental and physical health conditions. We measured the incidence of diagnosed conditions accounting for the most disability-adjusted life years in the UK population according to the Global Burden of Disease study (anxiety, depression, self-harm, harmful alcohol use, substance use, migraine, neck or back pain, and gynaecological conditions). Methods: Participants were aged 18 years or above and had an autism diagnosis recorded in the IQVIA Medical Research Database between 01/01/2000 and 16/01/2019. We included 15,675 autistic adults without intellectual disability, 6437 autistic adults with intellectual disability, and a comparison group matched (1:10) by age, sex, and primary care practice. We estimated crude incidences and incidence rate ratios (IRRs) adjusted for age and sex. Findings: Autistic adults without intellectual disability experienced a higher incidence (IRR, 95% CI) of self-harm (2.07, 1.79–2.40), anxiety (1.91, 1.76–2.06), depressive disorders (1.79, 1.67–1.92), and substance use (1.24, 1.02–1.51) relative to comparison participants. Incidences of harmful alcohol use (1.01, 0.85–1.18), migraine (0.99, 0.84–1.17), and gynaecological conditions (1.19, 0.95–1.49) did not differ. Neck or back pain incidence was lower (0.88, 0.82–0.95). Autistic adults with intellectual disability experienced a higher incidence of self-harm (2.08, 1.69–2.56). Incidences of anxiety (1.14, 1.00–1.30), gynaecological conditions (1.22, 0.93–1.62), and substance use (1.08, 0.80–1.47) did not differ, and lower incidences were found for depressive disorders (0.73, 0.64–0.83), harmful alcohol use (0.65, 0.50–0.84), migraine (0.55, 0.42–0.74), and neck or back pain (0.49, 0.44–0.55). Interpretation: Although our findings cannot be directly compared to previous prevalence studies, they contrast with the higher frequency of mental and physical health conditions in autistic adults reported in studies that directly assessed and/or surveyed autistic people about co-occurring conditions. The present findings may suggest under-diagnosis of common conditions in autistic people, particularly those with intellectual disability. Improved detection should be a clinical and policy priority to reduce health inequalities. Funding: Dunhill Medical Trust, Economic and Social Research Council, National Institute of Health and Care Research