The academic backbone: longitudinal continuities in educational achievement from secondary school and medical school to MRCP(UK) and the specialist register in UK medical students and doctors

Background: Selection of medical students in the UK is still largely based on prior academic achievement, although doubts have been expressed as to whether performance in earlier life is predictive of outcomes later in medical school or post-graduate education. This study analyses data from five longitudinal studies of UK medical students and doctors from the early 1970s until the early 2000s. Two of the studies used the AH5, a group test of general intelligence (that is, intellectual aptitude). Sex and ethnic differences were also analyzed in light of the changing demographics of medical students over the past decades. Methods: Data from five cohort studies were available: the Westminster Study (began clinical studies from 1975 to 1982), the 1980, 1985, and 1990 cohort studies (entered medical school in 1981, 1986, and 1991), and the University College London Medical School (UCLMS) Cohort Study (entered clinical studies in 2005 and 2006). Different studies had different outcome measures, but most had performance on basic medical sciences and clinical examinations at medical school, performance in Membership of the Royal Colleges of Physicians (MRCP(UK)) examinations, and being on the General Medical Council Specialist Register. Results: Correlation matrices and path analyses are presented. There were robust correlations across different years at medical school, and medical school performance also predicted MRCP(UK) performance and being on the GMC Specialist Register. A-levels correlated somewhat less with undergraduate and post-graduate performance, but there was restriction of range in entrants. General Certificate of Secondary Education (GCSE)/O-level results also predicted undergraduate and post-graduate outcomes, but less so than did A-level results, but there may be incremental validity for clinical and post-graduate performance. The AH5 had some significant correlations with outcome, but they were inconsistent. Sex and ethnicity also had predictive effects on measures of educational attainment, undergraduate, and post-graduate performance. Women performed better in assessments but were less likely to be on the Specialist Register. Non-white participants generally underperformed in undergraduate and post-graduate assessments, but were equally likely to be on the Specialist Register. There was a suggestion of smaller ethnicity effects in earlier studies. Conclusions: The existence of the Academic Backbone concept is strongly supported, with attainment at secondary school predicting performance in undergraduate and post-graduate medical assessments, and the effects spanning many years. The Academic Backbone is conceptualized in terms of the development of more sophisticated underlying structures of knowledge ('cognitive capital’ and 'medical capital’). The Academic Backbone provides strong support for using measures of educational attainment, particularly A-levels, in student selection

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates

The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students

Trends in long-term prescribing of dependence forming medicines

Using patient-level primary care data to estimate the extent to which antidepressant medicines are prescribed to people continuously for long periods of time. Aim This descriptive research used patient-level primary care data to estimate the extent to which antidepressant medicines are prescribed to people continuously for long periods of time. The study also drew on survey data and data on the number of prescriptions dispensed. Findings - The number of antidepressant prescriptions dispensed each year in England doubled between 2008 and 2018 - Survey data show that the proportion of adults reporting use of antidepressants in the past year increased in the 1990s, and again between 2007 and 2014 - The average length of time that antidepressants are continuously prescribed to people for has increased over time. - Some types of antidepressants (for example, tricyclics and other antidepressants) tend to be prescribed for longer periods than other types (such as SSRIs). - In 2014, one in twelve prescribing periods for tricyclics and other antidepressants lasted for three years or more Methods The analyses in this report are descriptive and show the overall prevalence of long-term prescribing in each year. We used a sample of around 50,000 patients prescribed at least one antidepressant medicine between 2000 and 2017. This was drawn from the Clinical Practice Research Datalink (CPRD). The CPRD contains data about prescriptions issued by GPs (including the length and size of prescription) and characteristics of the patients prescribed to (such as their age, sex, and area where they live). Medicines were grouped for analysis into: tricyclics, selective serotonin reuptake inhibitors (SSRIs), and other ADMs. The length of individual prescriptions and continuous prescribing periods were derived using information on consultation dates, the quantity of tablets prescribed, and the numeric daily dose

Is the Health Care System Working for Adolescents? Perspectives From Providers in Boston, Denver, Houston, and San Francisco

Assesses healthcare system services for adolescents in four urban areas. Includes provider perspectives on how health insurance, managed care, and other factors facilitate or impede access. Discusses innovative programs, and offers recommendations

MECHANICAL DAMPING SYSTEM FOR STRUCTURES

A mechanical damping system for a structure is provided. The mechanical damping system comprises a tubular impact frame secured to the structure. A support frame is secured to the structure with the support frame spaced from the impact frame. An elongated member is provided having a first end and a second end. The first end is secured within the support frame and the second end is free from connection and extends into the impact frame. At least one impact mass is secured to the second end of the elongated member, the impact mass movable within and contactable with the impact frame

Using Pattern Languages in Participatory Design

In this paper, we examine the contribution that pattern languages could make to user participation in the design of interactive systems, and we report on our experiences of using pattern languages in this way. In recent years, there has been a growing interest in the use of patterns and pattern languages in the design of interactive systems. Pattern languages were originally developed by the architect, Christopher Alexander, both as a way of understanding the nature of building designs that promote a ‘humane’ or living built environment; and as a practical tool to aid in participatory design of buildings. Our experience suggests that pattern languages do have considerable potential to support participatory design in HCI, but that many pragmatic issues remain to be resolved

Book Review: Cora DuBois: Anthropologist, Diplomat, Agent

Review of Cora DuBois: Anthropologist, Diplomat, Agent (Critical Studies in the History of Anthropology) by Susan C. Seymour. University of Nebraska Press. 2015

Utilizing Color Preferences in Teaching Materials for an Adolescent with Autism

Students on the autism spectrum frequently have a more challenging time learning new skills, such as identifying sight words, than their neurotypical peers. This study attempted to utilize color preferences in creating teaching materials with the aim of increasing the acquisition rate of learning sight words with a 15 year old Hispanic male student with a diagnosis of autism and the identified need for an increase in sight word identification. Using an AB method, the use of highlighting the target word with the students’ preferred color was evaluated. Due to the specific students’ learning profile and challenges, specifically inattention and needing a longer period of time to learn new skills, this intervention did not show an increase in sight word identification. Future studies should utilize intensive 1:1 instruction, individualized motivational systems, and color preference, to attempt to increase acquisition rate when teaching new sight words

Mental Health of Children and Young People in England, 2017: Trends and characteristics

This survey series provides England’s best source of data on trends in child mental health. Emotional, behavioural, hyperactivity, and other types of mental disorder were assessed in 5 to 15 year olds in 1999, 5 to 16 year olds in 2004, and 5 to 19 year olds in 2017. One in eight (12.8%) 5 to 19 year olds had a mental disorder when assessed in 2017. Rates were similar in boys and girls. Data for 5 to 15 year olds show a slight upward trend over time in the prevalence of emotional disorders.Rates for behavioural, hyperactivity and other disorders have remained broadly stable