Mental health and emotional well-being of students in further education - a scoping study

This study aimed to explore how FE colleges in England are engaging with and addressing the mental health needs of their young students (aged 16-19), both in terms of promoting positive mental health and emotional well-being and in responding to identified mental health problems

Medical graduate views on statistical learning needs for clinical practice: a comprehensive survey

BACKGROUND: This paper seeks to contribute to a reputable evidence base for required competencies across different topics in statistics and probability (statistical topics) in preparing medical graduates for clinical practice. This is in order to inform the prioritization of statistical topics within future undergraduate medical curricula, while exploring the need for preparing tomorrow's doctors to be producers, and not merely consumers, of statistics. METHODS: We conducted a comprehensive online survey from July 2013 to August 2014 for a target group of 462 medical graduates with current or prior experience of teaching undergraduate medical students of the University of Edinburgh of whom 278 (60.2%) responded. Statistical topics were ranked by proportion of respondents who identified the practice of statistics, performing statistical procedures or calculations using appropriate data, as a required competency for medical schools to provide in preparing undergraduate medical students for clinical practice. Mixed effects analyses were used to identify potential predictors for selection of the above competency and to compare the likelihood of this selection for a range of statistical topics versus critical appraisal. RESULTS: Evidence was gleaned from medical graduates' experiences of clinical practice for the need for, not only a theoretical understanding of statistics and probability but also, the ability to practice statistics. Nature of employment and statistical topic were highly significant predictors of choice of the practice of statistics as a required competency ((F = 3.777, p < 0.0005) and (F = 45.834, p < 0.0005), respectively). The most popular topic for this competency was graphical presentation of data (84.3% of respondents) in contrast to cross-over trials for the competency understanding the theory only (70.5% of respondents). Several topics were found to be more popular than critical appraisal for competency in the practice of statistics. CONCLUSIONS: The model of medical graduates as mere consumers of statistics is oversimplified. Contrary to what has been suggested elsewhere, statistical learning opportunities in undergraduate medicine should not be restricted to development of critical appraisal skills. Indeed, our findings support development of learning opportunities for undergraduate medical students as producers of statistics across a wide range of statistical topics

Local atomic and magnetic structure of dilute magnetic semiconductor (Ba,K)(Zn,Mn)2_2As2_2

We have studied the atomic and magnetic structure of the dilute ferromagnetic semiconductor system (Ba,K)(Zn,Mn)$_2$As$_2$ through atomic and magnetic pair distribution function analysis of temperature-dependent x-ray and neutron total scattering data. We detected a change in curvature of the temperature-dependent unit cell volume of the average tetragonal crystallographic structure at a temperature coinciding with the onset of ferromagnetic order. We also observed the existence of a well-defined local orthorhombic structure on a short length scale of $\lesssim 5$ \AA, resulting in a rather asymmetrical local environment of the Mn and As ions. Finally, the magnetic PDF revealed ferromagnetic alignment of Mn spins along the crystallographic $c$-axis, with robust nearest-neighbor ferromagnetic correlations that exist even above the ferromagnetic ordering temperature. We discuss these results in the context of other experiments and theoretical studies on this system

Linking the formation and fate of exo-Kuiper belts within solar system analogues

Abstract Escalating observations of exo-minor planets and their destroyed remnants both passing through the solar system and within white dwarf planetary systems motivate an understanding of the orbital history and fate of exo-Kuiper belts and planetesimal discs. Here we explore how the structure of a 40 − 1000 au annulus of planetesimals orbiting inside of a solar system analogue that is itself initially embedded within a stellar cluster environment varies as the star evolves through all of its stellar phases. We attempt this computationally challenging link in four parts: (1) by performing stellar cluster simulations lasting 100 Myr, (2) by making assumptions about the subsequent quiescent 11 Gyr main-sequence evolution, (3) by performing simulations throughout the giant branch phases of evolution, and (4) by making assumptions about the belt’s evolution during the white dwarf phase. Throughout these stages, we estimate the planetesimals’ gravitational responses to analogues of the four solar system giant planets, as well as to collisional grinding, Galactic tides, stellar flybys, and stellar radiation. We find that the imprint of stellar cluster dynamics on the architecture of ≳ 100 km-sized exo-Kuiper belt planetesimals is retained throughout all phases of stellar evolution unless violent gravitational instabilities are triggered either (1) amongst the giant planets, or (2) due to a close (≪103 au) stellar flyby. In the absence of these instabilities, these minor planets simply double their semimajor axis while retaining their primordial post-cluster eccentricity and inclination distributions, with implications for the free-floating planetesimal population and metal-polluted white dwarfs

Direct Observation of Dynamic Symmetry Breaking above Room Temperature in Methylammonium Lead Iodide Perovskite

Lead halide perovskites such as methylammonium lead triiodide (MAPI) have outstanding optical and electronic properties for photovoltaic applications, yet a full understanding of how this solution processable material works so well is currently missing. Previous research has revealed that MAPI possesses multiple forms of static disorder regardless of preparation method, which is surprising in light of its excellent performance. Using high energy resolution inelastic X-ray (HERIX) scattering, we measure phonon dispersions in MAPI and find direct evidence for another form of disorder in single crystals: large amplitude anharmonic zone-edge rotational instabilities of the PbI_6 octahedra that persist to room temperature and above, left over from structural phase transitions that take place tens to hundreds of degrees below. Phonon calculations show that the orientations of the methylammonium couple strongly and cooperatively to these modes. The result is a non-centrosymmetric, instantaneous local structure, which we observe in atomic pair distribution function (PDF) measurements. This local symmetry breaking is unobservable by Bragg diffraction, but can explain key material properties such as the structural phase sequence, ultra low thermal transport, and large minority charge carrier lifetimes despite moderate carrier mobility.Comment: 30 pages, 11 figure

Finding binaries from phase modulation of pulsating stars with Kepler: V. Orbital parameters, with eccentricity and mass-ratio distributions of 341 new binaries

The orbital parameters of binaries at intermediate periods (102–103 d) are difficult to measure with conventional methods and are very incomplete. We have undertaken a new survey, applying our pulsation timing method to Kepler light curves of 2224 main-sequence A/F stars and found 341 non-eclipsing binaries. We calculate the orbital parameters for 317 PB1 systems (single-pulsator binaries) and 24 PB2s (double-pulsators), tripling the number of intermediate-mass binaries with full orbital solutions. The method reaches down to small mass ratios q ≈ 0.02 and yields a highly homogeneous sample. We parametrize the mass- ratio distribution using both inversion and Markov-Chain Monte Carlo forward-modelling techniques, and find it to be skewed towards low-mass companions, peaking at q ≈ 0.2. While solar-type primaries exhibit a brown dwarf desert across short and intermediate periods, we find a small but statistically significant (2.6σ ) population of extreme-mass-ratio companions (q 0.1, we measure the binary fraction of current A/F primaries to be 15.4 per cent ± 1.4 per cent, though we find that a large fraction of the companions (21 per cent ± 6 per cent) are white dwarfs in post-mass-transfer systems with primaries that are now blue stragglers, some of which are the progenitors of Type Ia supernovae, barium stars, symbiotics, and related phenomena. Excluding these white dwarfs, we determine the binary fraction of original A/F primaries to be 13.9 per cent ± 2.1 per cent over the same parameter space. Combining our measurements with those in the literature, we find the binary fraction across these periods is a constant 5 per cent for primaries M1 < 0.8 M , but then increases linearly with log M1, demonstrating that natal discs around more massive protostars M1 2: 1M become increasingly more prone to fragmentation. Finally, we find the eccentricity distribution of the main-sequence pairs to be much less eccentric than the thermal distribution

Prevalence and causes of prescribing errors: the prescribing outcomes for trainee doctors engaged in clinical training (PROTECT) study

Objectives Study objectives were to investigate the prevalence and causes of prescribing errors amongst foundation doctors (i.e. junior doctors in their first (F1) or second (F2) year of post-graduate training), describe their knowledge and experience of prescribing errors, and explore their self-efficacy (i.e. confidence) in prescribing. Method A three-part mixed-methods design was used, comprising: prospective observational study; semi-structured interviews and cross-sectional survey. All doctors prescribing in eight purposively selected hospitals in Scotland participated. All foundation doctors throughout Scotland participated in the survey. The number of prescribing errors per patient, doctor, ward and hospital, perceived causes of errors and a measure of doctors' self-efficacy were established. Results 4710 patient charts and 44,726 prescribed medicines were reviewed. There were 3364 errors, affecting 1700 (36.1%) charts (overall error rate: 7.5%; F1:7.4%; F2:8.6%; consultants:6.3%). Higher error rates were associated with : teaching hospitals (p&#60;0.001), surgical (p = &#60;0.001) or mixed wards (0.008) rather thanmedical ward, higher patient turnover wards (p&#60;0.001), a greater number of prescribed medicines (p&#60;0.001) and the months December and June (p&#60;0.001). One hundred errors were discussed in 40 interviews. Error causation was multi-factorial; work environment and team factors were particularly noted. Of 548 completed questionnaires (national response rate of 35.4%), 508 (92.7% of respondents) reported errors, most of which (328 (64.6%) did not reach the patient. Pressure from other staff, workload and interruptions were cited as the main causes of errors. Foundation year 2 doctors reported greater confidence than year 1 doctors in deciding the most appropriate medication regimen. Conclusions Prescribing errors are frequent and of complex causation. Foundation doctors made more errors than other doctors, but undertook the majority of prescribing, making them a key target for intervention. Contributing causes included work environment, team, task, individual and patient factors. Further work is needed to develop and assess interventions that address these.</p

Prescribing competency assessment for Canadian medical students: a pilot evaluation

Background: The knowledge and ability to prescribe safely and effectively is a core competency for every graduating medical student. Our previous research suggested concerns about medical student prescribing abilities, and interest in a standardized assessment process. Methods: A multi-year cross-sectional study evaluating the feasibility, acceptability, and discriminative ability of an online prescribing competency assessment for final year Canadian medical students was conducted. Students at nine sites of four Ontario medical schools were invited to participate in an online one-hour exam of eight domains related to prescribing safely. Student feedback on perceived fairness, clarity, and ease of use formed the primary outcome. Exam performance and parity between schools were the secondary outcome.  Results: A total of 714 students completed the assessment during spring final review courses between 2016 and 2018. Student feedback was more favourable than not for appropriateness of content (53.5% agreement vs 18.3% disagreement), clarity of questions (65.5% agreement vs 11.6% disagreement), question layout and presentation (70.8% agreement vs 12.2% disagreement), and ease of use of online interface (67.1% agreement vs 13.6% disagreement). Few (23.6% believed their course work had prepared them for the assessment. Mean total exam score was 70.0% overall (SD 10.4%), with 47.6% scoring at or above the pass threshold of 70%. Conclusion: Our prescribing competency assessment proved feasible, acceptable, and discriminative, and indicated a need for better medical school training to improve prescribing competency. Further evaluation in a larger sample of medical schools is warranted

Sporadic sampling, not climatic forcing, drives observed early hominin diversity.

Paleoanthropologists have long been intrigued by the observed patterns of human evolution, including species diversity, and often invoked climatic change as the principal driver of evolutionary change. Here, we investigate whether the early hominin fossil record is of suitable quality to test these climate-forcing hypotheses. Specifically, we compare early hominin diversity to sampling metrics that quantify changes in fossil preservation and sampling intensity between 7 and 1 million years ago. We find that observed diversity patterns are governed by sporadic sampling and do not yield a genuine evolutionary signal. Many more fossil discoveries are required before existing hypotheses linking climate and evolution can be meaningfully tested.The role of climate change in the origin and diversification of early hominins is hotly debated. Most accounts of early hominin evolution link observed fluctuations in species diversity to directional shifts in climate or periods of intense climatic instability. None of these hypotheses, however, have tested whether observed diversity patterns are distorted by variation in the quality of the hominin fossil record. Here, we present a detailed examination of early hominin diversity dynamics, including both taxic and phylogenetically corrected diversity estimates. Unlike past studies, we compare these estimates to sampling metrics for rock availability (hominin-, primate-, and mammal-bearing formations) and collection effort, to assess the geological and anthropogenic controls on the sampling of the early hominin fossil record. Taxic diversity, primate-bearing formations, and collection effort show strong positive correlations, demonstrating that observed patterns of early hominin taxic diversity can be explained by temporal heterogeneity in fossil sampling rather than genuine evolutionary processes. Peak taxic diversity at 1.9 million years ago (Ma) is a sampling artifact, reflecting merely maximal rock availability and collection effort. In contrast, phylogenetic diversity estimates imply peak diversity at 2.4 Ma and show little relation to sampling metrics. We find that apparent relationships between early hominin diversity and indicators of climatic instability are, in fact, driven largely by variation in suitable rock exposure and collection effort. Our results suggest that significant improvements in the quality of the fossil record are required before the role of climate in hominin evolution can be reliably determined