Medical students’ reactions to an experience-based learning model of clinical education

An experience-based learning (ExBL) model proposes: Medical students learn in workplaces by ‘supported participation’; affects are an important dimension of support; many learning outcomes are affective; supported participation influences students’ professional identity development. The purpose of the study was to check how the model, which is the product of a series of earlier research studies, aligned with students’ experiences, akin to the ‘member checking’ stage of a qualitative research project. In three group discussions, a researcher explained ExBL to 19 junior clinical students, who discussed how it corresponded with their experiences of clinical learning and were given a written précis of it to take away. One to 3 weeks later, they wrote 500-word reflective pieces relating to their subsequent experiences with ExBL. Four researchers conducted a qualitative analysis. Having found many instances of responses ‘resonating’ to the model, the authors systematically identified and coded respondents’ ‘resonances’ to define how they aligned with their experiences. 120 resonances were identified. Seventy (58 %) were positive experiences and 50 (42 %) negative ones. Salient experiences were triggered by the learning environment in 115 instances (96 %) and by learners themselves in 5 instances (4 %), consistent with a strong effect of environment on learning processes. Affective support was apparent in 129 of 203 statements (64 %) of resonances and 118 learning outcomes (58 %) were also affective. ExBL aligns with medical students’ experiences of clinical learning. Subject to further research, these findings suggest ExBL could be used to support the preparation of faculty and students for workplace learning

Mothers with attitude: how the Mumsnet parenting forum offers space for new forms of femininity to emerge online.

This paper investigates the motivations and online behaviour of the users of Mumsnet, a UK online parenting community. The Mumsnet discussion forum is characterised by its difference to other mothering websites in its language use, its celebration of confrontational, opinionated and well-informed debate, its tolerance of aggression and swearing and its focus on entertainment rather than support. Many of these attributes have previously been seen as male online behaviour, but it is argued that new forms of femininities are emerging and a clear-cut binary divide between male and female online behaviour can no longer be applied

Membership and activity in an online parenting community.

Recent studies have shown that British women, especially mothers of young children, spend a particularly large amount of time online. Many are logging on to parenting websites. This chapter investigates Mumsnet, a large British parenting site, and evaluates how members use and conceptualise the site. A combined method of a questionnaire survey with open and closed-ended questions, and discourse analysis of discussions on the site, was used to explore this. The analysis considers how membership and expertise are displayed and acknowledged in online groups, how people view their involvement with the site, how online and real life are segregated or integrated in various ways. The positioning of lurkers (those who read but do not post) and of trolls (those who post false information or fake identities) is explored within the context of how power is reproduced and challenged in the type of discourse produced in an online discussion forum

Preventing and lessening exacerbations of asthma in school-age children associated with a new term (PLEASANT) : Study protocol for a cluster randomised control trial

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedBackground: Within the UK, during September, there is a pronounced increase in the number of unscheduled medical contacts by school-aged children (4-16 years) with asthma. It is thought that that this might be caused by the return back to school after the summer holidays, suddenly mixing with other children again and picking up viruses which could affect their asthma. There is also a drop in the number of prescriptions administered in August. It is possible therefore that children might not be taking their medication as they should during the summer contributing to them becoming ill when they return to school. It is hoped that a simple intervention from the GP to parents of children with asthma at the start of the summer holiday period, highlighting the importance of maintaining asthma medication can help prevent increased asthma exacerbation, and unscheduled NHS appointments, following return to school in September.Methods/design: PLEASANT is a cluster randomised trial. A total of 140 General Practices (GPs) will be recruited into the trial; 70 GPs randomised to the intervention and 70 control practices of "usual care" An average practice is expected to have approximately 100 children (aged 4-16 with a diagnosis of asthma) hence observational data will be collected on around 14000 children over a 24-month period. The Clinical Practice Research Datalink will collect all data required for the study which includes diagnostic, prescription and referral data.Discussion: The trial will assess whether the intervention can reduce exacerbation of asthma and unscheduled medical contacts in school-aged children associated with the return to school after the summer holidays. It has the potential to benefit the health and quality of life of children with asthma while also improving the effectiveness of NHS services by reducing NHS use in one of the busiest months of the year. An exploratory health economic analysis will gauge any cost saving associated with the intervention and subsequent impacts on quality of life. If results for the intervention are positive it is hoped that this could be adopted as part of routine care management of childhood asthma in general practice. Trial registration: Current controlled trials: ISRCTN03000938 (assigned 19/10/12) http://www.controlled-trials.com/ISRCTN03000938/.UKCRN ID: 13572.Peer reviewe

A Lungfish survivor of the end-Devonian extinction and an Early Carboniferous dipnoan radiation.

Until recently the immediate aftermath of the Hangenberg event of the Famennian Stage (Upper Devonian) was considered to have decimated sarcopterygian groups, including lungfish, with only two taxa, Occludus romeri and Sagenodus spp., being unequivocally recorded from rocks of Tournaisian age (Mississippian, Early Carboniferous). Recent discoveries of numerous morphologically diverse lungfish tooth plates from southern Scotland and northern England indicate that at least ten dipnoan taxa existed during the earliest Carboniferous. Of these taxa, only two, Xylognathus and Ballgadus, preserve cranial and post-cranial skeletal elements and are yet to be described. Here we present a description of the skull of a new genus and species of lungfish, Limanichthys fraseri gen. et sp. nov. that hails from the very lowest Tournaisian from the Ballagan Formation of Burnmouth, southern Scotland. The new specimen represents the earliest definitive Tournaisian lungfish skull material thus providing valuable insight into the response of this group, and indeed, the Sarcopterygii as a whole, immediately following the Upper Devonian Hangenberg event. Phylogenetic analysis places Limanichthys fraseri within the Devonian ‘phaneropleurid-fleurantiid’ grade of lungfish and that the Carboniferous lungfish represent forms that have their origins deep in the Mid and Late Devonian as well as those from a unique Carboniferous radiation.This work was carried out with the aid of NERC consortium grants NE/J022713/1 (Cambridge), NE/J020729/1 (Leicester) and NE/J021091/1 (Southampton)

Early Mississippian sandy siltstones preserve rare vertebrate fossils in seasonal flooding episodes

Flood-generated sandy siltstones are under-recognised deposits that preserve key vertebrate (actinopterygians, rhizodonts, and rarer lungfish, chondrichthyans and tetrapods), invertebrate and plant fossils. Recorded for the first time from the lower Mississippian Ballagan Formation of Scotland, more than 140 beds occur throughout a 490 m thick core succession charac-terised by fluvial sandstones, palaeosols, siltstones, dolostone ‘cementstones’ and gypsum from a coastal–alluvial plain setting. Sandy siltstones are described as a unique taphofacies of the Ballagan Formation (Scotland, UK);they are matrix-supported siltstones with millimetre-sized siltstone and very fine sandstone lithic clasts. Common bioclasts include plants and mega-spores, fish, ostracods, eurypterids and bivalves. Fossils have a high degree of articulation compared with those found in other fossil-bearing deposits, such as conglomerate lags at the base of fluvial channel sandstones. Bed thickness and distribution varies throughout the formation, with no stratigraphic trend. The matrix sediment and clasts are sourced from the reworking of floodplain sediments including desiccated surfaces and palaeosols. Secondary pedogenic modification affects 30% of the sandy siltstone beds and most (71%) overlie palaeosols or desiccation cracks. Sandy siltstones are interpreted as cohesive debris flow deposits that originated by the over-bank flooding of rivers and due to localised floodplain sediment transport at times of high rainfall; their association with palaeosols and desiccation cracks indicates seasonally wet to dry cycles throughout the Tournaisian. Tetrapod and fish fossils derived from floodplain lakes and land surfaces are concentrated by local erosion and reworking, and are preserved by deposition into temporary lakes on the floodplain; their distribution indicates a local origin, with sediment transported across the floodplain in seasonal rainfall episodes. These deposits are significant new sites that can be explored for the preservation of rare non-marine fossil material and provide unique insights into the evolution of early terrestrial ecosystems

A new Mississippian tetrapod from Fife, Scotland, and its environmental context

The Visean stage of the Mississippian was a time of rapid tetrapod diversification which marks the earliest appearance of temnospondyls, microsaurs and the limbless aïstopods. Tetrapod finds from this stage are very rare and only a dozen sites are known worldwide. Here we announce the discovery of a new Visean site in Fife, Scotland, of Asbian age, and from it describe a new species of the baphetoid Spathicephalus. These specimens represent the oldest known baphetoid by three million years, yet belong to the most specialized members of the clade. Unlike typical baphetoids with large marginal teeth and palatal fangs characteristic of early tetrapods, spathicephalids had very broad flattened heads with a dentition consisting of a large number of small, uniform teeth. Spathicephalids were probably one of the earliest tetrapod groups to use suction feeding on small, aquatic prey. Palynological and sedimentological analysis indicates that the new fossil bed was deposited in a large, stratified, freshwater lake that became increasingly saline