Perceptions of the learning environment in higher specialist training of doctors: implications for recruitment and retention.

INTRODUCTION: Career choice, sense of professional identity and career behaviour are influenced, subject to change and capable of development through interaction with the learning environment. In this paper workplace learning discourses are used to frame ongoing concerns associated with higher specialist training. Data from the first stage of a multimethods investigation into recruitment into and retention in specialties in the West Midlands is used to consider some possible effects of the specialist learning environment on recruitment and retention. METHODS: The aim of the study was to identify issues, through interviews with 6 consultants and questionnaires completed by specialist registrars from specialties representing a range of recruitment levels. These would inform subsequent study of attributes and dispositions relevant to specialist practice and recruitment. The data were analysed using NVivo software for qualitative data management. RESULTS: Participants' perceptions are presented as bipolar dimensions, associated with: curriculum structure, learning relationships, assessment of learning, and learning climate. They demonstrate ongoing struggle between different models of workplace learning. CONCLUSION: Changes in the postgraduate education of doctors seem set to continue well into the future. How these are reflected in the balance between workplace learning models, and how they influence doctors' sense of identity as specialists suggests a useful basis for examination of career satisfaction and recruitment to specialties

An assessment of fluid flow and overpressure modelling m selected North Sea and Laramide basins

The occurrence of overpressure observed in petroleum bearing basins must be understood in terms of generation and distribution in order to build up a fluid flow history. Overpressure influences expulsion and migration of hydrocarbons from source rocks. This thesis details and interprets observations and results of a case study into aspects of overpressure distribution, fluid flow patterns, causative mechanisms, palaeo- pressure and subsequent pressure history, the surface expression of overpressure and the mechanical strength relationships of sealing rocks. One of the principle study areas was the Alwyn field in the Northern North Sea. The overpressure distribution over the field area was seen not to be uniform. Organic geochemical data indicated that the source of reservoired hydrocarbons and associated fluids was the Viking Graben depocentre. Fluid inclusion data recorded in specific diagenetic mineral phases interpreted fluid flow conditions of hydrocarbons into the reservoir under normal pressures but elevated temperatures. When combined with computer generated pressure models, these diagenetic events were exclusive of modelled overpressure periods. The greatest contribution of overpressure was modelled as being a result of compaction disequilibrium but withalikely contribution from the thermal cracking of oil to gas which would also account for the present day distribution of overpressure across the Alwyn field area. The Uinta Basin with its relatively simple burial and thermal history allowed the production of a model . : involving a temporal history of overpressure generation, fracture development, regional tectonism, hydrocarbon maturation and expulsion and the process of Gilsonite emplacement. It is inferred that initial hydraulically induced fracturing of the Green River and overlying formations was a result of combined overpressure due to disequilibrium and regional extension with a possible contribution from the maturation of the source rock. This study recognised that the hydrocarbon was emplaced under a high pressure regime with evidence provide. by the existence of forcibly injected hydrocarbon sills. Hydrocarbons fractionated in the pre-existing vertical fractures to leave residual highly viscous and immobile hydrocarbons in veins seen at the present day. The third major component of this study detailed results from an assessment of the mechanical capacity of sealing rocks with respect to specific composition and mineralogy. It was found that increasing organic carbon decreased the compressive strength of the tested shale specimens. This relationship was interpreted as a possible result of the interaction of alkaline fluids to produce a dispersant which acts to reduce the cohesion of the organic rich shale

Strategic Considerations in Leading an Innovation Ecosystem

The Georgia Institute of Technology has been a catalystfor economic growth in the Southeast United States since itsfounding in 1885. Over the past 30 years, it has become knownas one of the top technological universities in the world. As partof a strategic planning effort commenced in mid-2009, it soughtto strengthen its thought leadership and impact through thedevelopment and implementation of an innovation ecosystemstrategy. The Institute serves as the integrating focus within itsregion to promote (and provoke) disruptive thought, use-inspiredresearch, experimentation, and accelerated implementationthrough novel educational, research, and industry partnershipprograms. Since 2009, there has been a marked increase ineconomic development impact. This paper describes the guidingprinciples, strategy, innovative programs, benefits, and lessonslearned associated with a regional innovation ecosystem

Marine finfish and suspended shellfish aquaculture : water quality interactions and the potential for integrated aquaculture

The objective of this study was to quantitatively document the culture performance and tissue quality of commercially important deepwater shellfish species (i. e., Pacific oyster, Crassostrea gigas; and Japanese scallop, Patinopecten yessoensis) cultured adjacent to marine finfish aquaculture operations, and to determine (from a production viability and seafood safety perspective) whether integrated finfish-shellfish Multi- Trophic Aquaculture (MTA), or polyculture, is a viable option for the aquaculture industry of temperate regions. Two study sites were employed for this research, one comprising an Atlantic salmon production facility and the other a Pacific salmonf arm. A 2-year assessment program for these sites detailed: (i) oceanographic and physiographicc haracteristics;( ii) organic waste flux, composition and dispersion; (iii) shellfish uptake and contaminant persistence; and (iv) shellfish culture performance. Organic waste flux ranged from 17.11 g/m2/day to 18.35 g/m2/day at the study sites. Phosphorus, calcium, carbon, zinc, cadmium, and strontium were waste constituents that were found at elevated levels at the farm sites with significant declines in concentrations with distance downstream (maximum effect to 100-115 meters). A mass balancee stimation suggested that 85.1% of the organic material (feed) entering the cage was used for fish growth/respiration, 6.8% was lost as settlable solids to the seafloor, and the remaining 8.1% was retained in the water column and a fraction that could affect non-target species (e. g., polyculture candidates) either directly or indirectly. A similar mass balance evaluation for trace metal and chernotherepeutic constituents indicated that 12.9% of the zinc, and an estimated 98.6% of the oxytetracycline contained in feed (during treatment), was released to the water column for potential uptake by co-cultured shellfish. The shellfish monitoring component of this study revealed that trace metal constituents of the feed did become available to the shellfish, although the quantifiable accumulation of trace metals in these non-target species occurred only in close proximity to the cage system and only for the tested scallops (Patinopectin yessoensis). Uptake rates of OTC by shellfish ranged from 0.056 - 0.100 ug/g/day with an associated clearance rate of 0.016 - 0.109 ug/g/day for the respective treatment periods. The comparison of uptake-clearance dynamics suggested asignificant seasonal component to these processes. The physical and biological processes affecting contaminant uptake and clearance rates were identified as important considerations in the management of a proposed integrated-MTA system. A simple Probable Effects Duration (PED) model was developed on the basis of Uptake-Clearance-Persistence plots, illustrating the basis upon which temporal effects of water quality deterioration could be managed in such a system. Shellfish growth was neither impeded nor enhanced as a result of being cultured directly within the influences of a salmon aquaculture facility. An organoleptic test demonstrated that shellfish palatability was not negatively impacted as a consequence of culture proximity to a finfish aquaculture facility. Results of this research suggested that two options are available for developing MTA in coastal temperate waters, i. e., an integrated MTA system and/or an adjacent MTA system. A wide range of MTA social, technical and economic benefits were identified and discussed as a result of this research. It was concluded that the development of a balanced MTA could add measurable environmental benefits to existing aquaculture systemss, setting the stage for future production efficiencies and growth. Given a proper regulatory framework, including seafood (MTA products) and environmental quality surveillanc, the potential water quality impacts on the shellfish component of a finfish-shellfish MTA (identified in this research initiative), and the associated risks over seafood safety, could be effectively managed to support this aquaculture evolution

Like a Rolling Stone

How does it feel, how does it feel? To be without a home Like a complete unknown, like a rolling stone… -Bob Dylan 1965 2016 was the Year of Italian Innovation, Architecture & Design and marked a collaboration between the Italian Cultural Institute (ICI) Edinburgh and Edinburgh College of Art (ECA) and The University of Edinburgh. Stephen Bottomley, the then Head of Department of Jewellery and Silversmithing at ECA, was approached by ICI with a view to organising a series of events focusing on and celebrating gemmology and contemporary jewellery with events taking place between them.   Stephen Bottomley + Susan Cross invited three Italian Jewellery artists: Maria Rosa Franzin, Gigi Mariani and Gabi Vietalong side seven UK artists to explore themes of relocation, transplantation, camouflage, identity and materiality through mixed media work in their jewellery, using geology and geophysics and fieldwork in North Berwick, an area frequently visited by the Geologist James Hutton, as a backdrop to the political themes surrounding population displacement.   In the year following the Edinburgh workshop, the project has been developed in the artists home countries and exhibitions planned in Munich and Edinburgh over 2018 with support from the School of Jewellery, Birmingham City University

The direct impacts of an introduced seaweed Mazzaella japonica on benthic seaweed communities in Baynes Sound and possible interaction with the invasive seaweed Sargassum muticum.

Marine introduced algae have become established in coastal communities around the globe. There is great lack of understanding of how this trophic group in general impacts the habitats they are introduced to. Mazzaella japonica is an introduced, red seaweed that is thought to have been brought to Canada via the aquaculture trade as a hitch hiker with the Japanese oyster (Crassostrea gigas). While C. gigas and other hitch hikers (such as the brown seaweed Sargassum muticum) have become invasive all over the world, M. japonica has only been reported as introduced to Baynes Sound. As this species has never been previously studied it is essential to understand how its presence impacts the native seaweed communities of Baynes Sound. To understand the direct impact that M. japonica is having on its host ecosystem a long-term, in situ study was established in April, 2013. M. japonica was removed from half of the established experimental plots at two sites and the native seaweed recovery was quantified by over time and compared to control plots. Removal of M. japonica resulted in a significant community shift. Number of native species and percent cover of native species significantly increased over time. Perhaps the most interesting result is the establishment of another introduced seaweed Sargassum muticum in some of the removal plots where none had been previously recorded during the course of the experiment. It appears that the removal of this novel introduced species allows for a significant increase or recovery of native species indicating that it is having a negative impact on native seaweeds. Preliminary ecological and management implications will also be discussed

Protocol for a randomised control trial of methylnaltrexone for the treatment of opioid-induced constipation and gastrointestinal stasis in intensive care patients (MOTION)

Gastrointestinal dysmotility and constipation are common problems in intensive care patients. The majority of critical care patients are sedated with opioids to facilitate tolerance of endotracheal tubes and mechanical ventilation, which inhibit gastrointestinal motility and lead to adverse outcomes. Methylnaltrexone is a peripheral opioid antagonist that does not cross the blood-brain barrier and can reverse the peripheral side effects of opioids without affecting the desired central properties. This trial will investigate whether methylnaltrexone can reverse opioid-induced constipation and gastrointestinal dysmotility.This is a single-centre, multisite, double-blind, randomised, placebo-controlled trial. 84 patients will be recruited from 4 intensive care units (ICUs) within Imperial College Healthcare NHS Trust. Patients will receive intravenous methylnaltrexone or placebo on a daily basis if they are receiving opioid infusion to facilitate mechanical ventilation and have not opened their bowels for 48 hours. All patients will receive standard laxatives as per the clinical ICU bowel protocol prior to randomisation. The primary outcome of the trial will be time to significant rescue-free laxation following randomisation. Secondary outcomes will include tolerance of enteral feed, gastric residual volumes, incidence of pneumonia, blood stream and Clostridium difficile infection, and any reversal of central opioid effects.The trial protocol, the patient/legal representative information sheets and consent forms have been reviewed and approved by the Harrow Research Ethics Committee (REC Reference 14/LO/2004). An independent Trial Steering Committee and Data Monitoring Committee are in place, with patient representation. On completion, the trial results will be published in peer-reviewed journals and presented at national and international scientific meetings.2014-004687-37; Pre-results