Ethnic differences in success at application for consultant posts among United Kingdom physicians from 2011 to 2019: a retrospective cross-sectional observational study

OBJECTIVES: To identify associations between success following application for consultant physician posts and demographic factors. DESIGN: Logistic regression analysis of nationwide survey data. SETTING: United Kingdom (UK) physicians with a recent certificate of completion of training (CCT). PARTICIPANTS: All UK trainee physicians who received a CCT between 2010 and 2019 were surveyed. Respondents were excluded if they had not applied for a consultant post or if application data were incomplete. MAIN OUTCOME MEASURES: The primary outcome measure was success over the entire consultant application process, i.e. shortlisted and offered the post following the first application. Secondary outcomes were: shortlisted following first application and offered a consultant post at first interview. RESULTS: From 7037 CCT holders surveyed, 50.7% responded. While 1198 (59.7%) respondents were white, 760 (37.9%) were from minority ethnic groups and 50 (3.5%) were of unknown ethnicity. Primary medical qualification (PMQ) country was the UK in 75.3% (n = 1512). On multivariable logistic regression analysis the independent negative associations with success were: minority ethnicity (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.43-0.71); p < 0.001) vs. white; PMQ from Europe (OR 0.47, 95% CI 0.28-0.79; p = 0.004) or Asia (OR 0.68, 95% CI 0.49-0.96; p = 0.027) vs. UK PMQ; year of CCT 2012 (OR 0.40, 95% CI 0.24-0.68; p = 0.001), 2013 (OR 0.39, 95% CI 0.23-0.65; p < 0.001), and 2014 (OR 0.26, 95% CI 0.15-0.43; p < 0.001) vs. 2019. Specialties associated with lower success rates included Cardiology, Endocrinology, Genitourinary medicine, Palliative care, Renal and Respiratory, compared to Acute medicine. CONCLUSIONS: Minority ethnic group candidates for consultant physician posts had lower success rates compared to white candidates after correction for important variables including specialty, time from and country of PMQ. This finding requires further evaluation to identify the causes for this variation

Neutral evolution: A null model for language dynamics

We review the task of aligning simple models for language dynamics with relevant empirical data, motivated by the fact that this is rarely attempted in practice despite an abundance of abstract models. We propose that one way to meet this challenge is through the careful construction of null models. We argue in particular that rejection of a null model must have important consequences for theories about language dynamics if modelling is truly to be worthwhile. Our main claim is that the stochastic process of neutral evolution (also known as genetic drift or random copying) is a viable null model for language dynamics. We survey empirical evidence in favour and against neutral evolution as a mechanism behind historical language changes, highlighting the theoretical implications in each case.Comment: 20 pages, 2 figures. To appear in a special issue of ACS - Advances in Complex Systems on language dynamic

Diagnostic yield from symptomatic lower gastrointestinal endoscopy in the UK: A British Society of Gastroenterology analysis using data from the National Endoscopy Database

\ua9 2024 The Authors. Alimentary Pharmacology &amp; Therapeutics published by John Wiley &amp; Sons Ltd.Background: The value of lower gastrointestinal endoscopy (LGIE; colonoscopy or sigmoidoscopy) relates to its ability to detect clinically relevant findings, predominantly cancers, preneoplastic polyps or inflammatory bowel disease. There are concerns that many LGIEs are performed on low-risk patients with limited benefit. Aims: To determine the diagnostic outcomes of LGIE for common symptoms. Methods: We performed a cross-sectional study of diagnostic LGIE between March 2019 and February 2020 using the UK National Endoscopy Database. We used mixed-effects logistic regression models, incorporating random (endoscopist) and fixed (symptoms, patient age, and sex) effects upon two dependent variables (large polyp [≥10 mm] and cancer diagnosis). Adjusted positive predictive values (aPPVs) were calculated. Results: We analysed 384,510 LGIEs; 33.2% were performed on patients aged under 50 and 53.6% on women. Regarding colonoscopies, the unadjusted PPV for cancer was 1.5% (95% CI: 1.4–1.5); higher for men than women (1.9% vs. 1.1%, p &lt; 0.01). The PPV for large polyps was 3.2% (95% CI: 3.1–3.2). The highest colonoscopy cancer aPPVs were in the over 50s (1.9%) and in those with rectal bleeding (2.5%) or anaemia (2.1%). Cancer aPPVs for other symptoms were &lt;1% despite representing 54.3% of activity. In patients under 50, aPPVs were 0.4% for cancer and 1.6% for large polyps. Results were similar for sigmoidoscopy. Conclusions: Most colonoscopies were performed on patients with low-risk symptoms, where cancer risk was similar to the general population. Cancer and large polyp yield was highest in elderly patients with rectal bleeding or anaemia, although still fell short of FIT-based screening yields

Language Structure Is Partly Determined by Social Structure

BACKGROUND: Languages differ greatly both in their syntactic and morphological systems and in the social environments in which they exist. We challenge the view that language grammars are unrelated to social environments in which they are learned and used. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a statistical analysis of >2,000 languages using a combination of demographic sources and the World Atlas of Language Structures--a database of structural language properties. We found strong relationships between linguistic factors related to morphological complexity, and demographic/socio-historical factors such as the number of language users, geographic spread, and degree of language contact. The analyses suggest that languages spoken by large groups have simpler inflectional morphology than languages spoken by smaller groups as measured on a variety of factors such as case systems and complexity of conjugations. Additionally, languages spoken by large groups are much more likely to use lexical strategies in place of inflectional morphology to encode evidentiality, negation, aspect, and possession. Our findings indicate that just as biological organisms are shaped by ecological niches, language structures appear to adapt to the environment (niche) in which they are being learned and used. As adults learn a language, features that are difficult for them to acquire, are less likely to be passed on to subsequent learners. Languages used for communication in large groups that include adult learners appear to have been subjected to such selection. Conversely, the morphological complexity common to languages used in small groups increases redundancy which may facilitate language learning by infants. CONCLUSIONS/SIGNIFICANCE: We hypothesize that language structures are subjected to different evolutionary pressures in different social environments. Just as biological organisms are shaped by ecological niches, language structures appear to adapt to the environment (niche) in which they are being learned and used. The proposed Linguistic Niche Hypothesis has implications for answering the broad question of why languages differ in the way they do and makes empirical predictions regarding language acquisition capacities of children versus adults

A simple view of linguistic complexity

Although a growing number of second language acquisition (SLA) studies take linguistic complexity as a dependent variable, the term is still poorly defined and often used with different meanings, thus posing serious problems for research synthesis and knowledge accumulation. This article proposes a simple, coherent view of the construct, which is defined in a purely structural way, i.e. the complexity directly arising from the number of linguistic elements and their interrelationships. Issues of cognitive cost (difficulty) or developmental dynamics (acquisition) are explicitly excluded from this theoretical definition and its operationalization. The article discusses how the complexity of an interlanguage system can be assessed based on the limited samples SLA researchers usually work with. For the areas of morphology, syntax and the lexicon, some measures are proposed which are coherent with the purely structural view advocated, and issues related to their operationalization are critically scrutinized

Utterance Selection Model of Language Change

We present a mathematical formulation of a theory of language change. The theory is evolutionary in nature and has close analogies with theories of population genetics. The mathematical structure we construct similarly has correspondences with the Fisher-Wright model of population genetics, but there are significant differences. The continuous time formulation of the model is expressed in terms of a Fokker-Planck equation. This equation is exactly soluble in the case of a single speaker and can be investigated analytically in the case of multiple speakers who communicate equally with all other speakers and give their utterances equal weight. Whilst the stationary properties of this system have much in common with the single-speaker case, time-dependent properties are richer. In the particular case where linguistic forms can become extinct, we find that the presence of many speakers causes a two-stage relaxation, the first being a common marginal distribution that persists for a long time as a consequence of ultimate extinction being due to rare fluctuations.Comment: 21 pages, 17 figure

Introduction

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69081/2/10.1177_0261927X99018001001.pd

Holistic corpus-based dialectology

This paper is concerned with sketching future directions for corpus-based dialectology. We advocate a holistic approach to the study of geographically conditioned linguistic variability, and we present a suitable methodology, 'corpusbased dialectometry', in exactly this spirit. Specifically, we argue that in order to live up to the potential of the corpus-based method, practitioners need to (i) abandon their exclusive focus on individual linguistic features in favor of the study of feature aggregates, (ii) draw on computationally advanced multivariate analysis techniques (such as multidimensional scaling, cluster analysis, and principal component analysis), and (iii) aid interpretation of empirical results by marshalling state-of-the-art data visualization techniques. To exemplify this line of analysis, we present a case study which explores joint frequency variability of 57 morphosyntax features in 34 dialects all over Great Britain

F2 slope as a perceptual cue for the front-back contrast in Standard Southern British English

Acoustic studies of several languages indicate that second-formant (F2) slopes in high vowels have opposing directions (independent of consonantal context): front [iː]-like vowels are produced with a rising F2 slope while back [uː]-like vowels are produced with a falling F2 slope. The present study first reports acoustic measurements that confirm this pattern for the English variety of Standard Southern British English (SSBE), where /uː/ has shifted from the back to the front area of the vowel space and is now realized with higher midpoint F2 values than several decades ago. Subsequently, we test whether the direction of F2 slope also serves as a reliable cue to the /iː/-/uː/ contrast in perception. The findings show that F2 slope direction is used as a cue (additional to midpoint formant values) to distinguish /iː/ from /uː/ by both young and older SSBE listeners: an otherwise ambiguous token is identified as /iː/ if it has a rising F2 slope and as /uː/ if it has a falling F2 slope. Furthermore, our results indicate that listeners generalize their reliance on F2 slope to other contrasts, namely /ɛ/-/ɒ/ and /æ/-/ɒ/, even though F2 slope is not employed to differentiate these vowels in production. This suggests that in SSBE, a rising F2 seems to be perceptually associated with an abstract feature such as [+front] while a falling F2 with an abstract feature such as [-front]