Precipitation and floodiness

There are a number of factors that lead to non-linearity between precipitation anomalies and flood hazard; this non-linearity is a pertinent issue for applications that use a precipitation forecast as a proxy for imminent flood hazard. We assessed the degree of this non-linearity for the first time using a recently developed global-scale hydrological model driven by the ERA-Interim Land precipitation reanalysis (1980–2010). We introduced new indices to assess large-scale flood hazard, or floodiness, and quantified the link between monthly precipitation, river discharge and floodiness anomalies at the global and regional scales. The results show that monthly floodiness is not well correlated with precipitation, therefore demonstrating the value of hydrometeorological systems for providing floodiness forecasts for decision-makers. A method is described for forecasting floodiness using the Global Flood Awareness System, building a climatology of regional floodiness from which to forecast floodiness anomalies out to two weeks

The benefits of being a near-peer teacher

Background: Near-peer teaching is used in anatomy education because of its benefits to the learner, teacher and faculty. Despite the range of reports focusing on the learner, the advantages for the teacher, which are thought to include communication skills, subject knowledge and employability, are only beginning to be explored. Method: A questionnaire was distributed to the teachers involved in anatomy near-peer teaching at the University of Southampton and Brighton and Sussex Medical School. This questionnaire was designed using 0-10 rating scales to assess teacher perspectives on their level of knowledge, teaching skills and enjoyment of teaching. Free text responses determined the teachers’ motivation and perceived benefits from the teaching. Results: Twenty-eight questionnaires were gathered (54.9% response rate) including 20 from Southampton and 8 from BSMS. Long term knowledge retention and better understanding of the material were rated 8.1 and 7.9 out of 10 respectively. Eight responses were from currently practising doctors, who rated how much they now use their teaching skills as doctors as 8.9 out of 10. Of the 8 doctors, 7 gained points for their foundation programme applications as a direct result of near-peer teaching. The most common motivator for engaging in teaching was to improve subject matter knowledge and the most common benefit was improved communication skills. Discussion: There are numerous advantages to being a near-peer teacher in medical school, which include knowledge improvement, transferrable professional skills and employability. These initial results support the hypothesised benefits to the teachers and provide a foundation for further longitudinal studies

Implementation of U.K. Earth system models for CMIP6

We describe the scientific and technical implementation of two models for a core set of experiments contributing to the sixth phase of the Coupled Model Intercomparison Project (CMIP6). The models used are the physical atmosphere-land-ocean-sea ice model HadGEM3-GC3.1 and the Earth system model UKESM1 which adds a carbon-nitrogen cycle and atmospheric chemistry to HadGEM3-GC3.1. The model results are constrained by the external boundary conditions (forcing data) and initial conditions.We outline the scientific rationale and assumptions made in specifying these. Notable details of the implementation include an ozone redistribution scheme for prescribed ozone simulations (HadGEM3-GC3.1) to avoid inconsistencies with the model's thermal tropopause, and land use change in dynamic vegetation simulations (UKESM1) whose influence will be subject to potential biases in the simulation of background natural vegetation.We discuss the implications of these decisions for interpretation of the simulation results. These simulations are expensive in terms of human and CPU resources and will underpin many further experiments; we describe some of the technical steps taken to ensure their scientific robustness and reproducibility

The 13th Southern Hemisphere Conference on the Teaching and Learning of Undergraduate Mathematics and Statistics

Ngā mihi aroha ki ngā tangata katoa and warm greetings to you all. Welcome to Herenga Delta 2021, the Thirteenth Southern Hemisphere Conference on the Teaching and Learning of Undergraduate Mathematics and Statistics. It has been ten years since the Volcanic Delta Conference in Rotorua, and we are excited to have the Delta community return to Aotearoa New Zealand, if not in person, then by virtual means. Although the limits imposed by the pandemic mean that most of this year’s 2021 participants are unable to set foot in Tāmaki Makaurau Auckland, this has certainly not stopped interest in this event. Participants have been invited to draw on the concept of herenga, in Te Reo Māori usually a mooring place where people from afar come to share their knowledge and experiences. Although many of the participants are still some distance away, the submissions that have been sent in will continue to stimulate discussion on mathematics and statistics undergraduate education in the Delta tradition. The conference invited papers, abstracts and posters, working within the initial themes of Values and Variables. The range of submissions is diverse, and will provide participants with many opportunities to engage, discuss, and network with colleagues across the Delta community. The publications for this thirteenth Delta Conference include publications in the International Journal of Mathematical Education in Science and Technology, iJMEST, (available at https://www.tandfonline.com/journals/tmes20/collections/Herenga-Delta-2021), the Conference Proceedings, and the Programme (which has created some interesting challenges around time-zones), by the Local Organizing Committee. Papers in the iJMEST issue and the Proceedings were peer reviewed by at least two reviewers per paper. Of the ten submissions to the Proceedings, three were accepted. We are pleased to now be at the business end of the conference and hope that this event will carry on the special atmosphere of the many Deltas which have preceded this one. We hope that you will enjoy this conference, the virtual and social experiences that accompany it, and take the opportunity to contribute to further enhancing mathematics and statistics undergraduate education. Ngā manaakitanga, Phil Kane (The University of Auckland | Waipapa Taumata Rau) on behalf of the Local Organising Committ

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Near peer teaching in medical curricula: integrating student teachers in pathology tutorials

Introduction: Due to increased cognitive and social congruence with their tutees, near peer teachers (NPTs) may be capable of more effectively delivering course material. This study examines NPTs as pathology tutors alongside more traditional teachers (e.g., consultants and registrars) to explore their acceptability, effectiveness, and years of ‘distance’ between tutors and tutees. Method: In total, 240 first- and second-year undergraduate medical students were taught set material in a pathology tutorial setting by NPTs (fourth-year medical students), registrars, or consultants. Learners were then asked to provide feedback using a 15-item, Likert-type scale. Results: On 11 of the 15 items, there were no significant differences in students’ median ratings. However, NPTs were perceived to be significantly more approachable than consultants, more aware of learning outcomes, more receptive to student input, and more invested in exam success. Compared with second-year students, first-year students showed a preference towards registrar tutors in terms of perceived gain of knowledge and use of time. In contrast, second-year students showed a preference towards NPTs, who provided more perceived knowledge gain and investment in exam success. No significant differences were found regarding consultant tutors. Discussion: Perhaps due to increased congruence with tutees, NPTs show promise as tutors within medical curricula. This provides advantages not only to tutees, but also to tutors – who may gain vital teaching experience and offer an effective supplement to ‘traditional’ faculty educators

Ten considerations for implementing effective and sustainable near-peer teaching in clinical anatomy education

This article was migrated. The article was marked as recommended.Near-peer teaching (NPT) is becoming increasing popular in medical education. The rationale and benefits of introducing such programs have been well documented and are usually described in terms of their advantages to the teacher, students and faculty. As a team that have successfully introduced two NPT anatomy programs in the last six years at the University of Southampton, we have taken a largely evidenced based approach in offering 10 considerations to ensure the implementation of a sustainable and effective NPT program in anatomical sciences. We have highlighted important aspects of NPT that will help maximise the benefit of such programs and emphasised particular areas where careful thought is necessary. We conclude that to safeguard sustainability and consistency of any given NPT program, faculty and student partnership is required, as is the maintenance of quality control and evaluative techniques

Identifying medical student perceptions on the difficulty of learning different topics of the undergraduate anatomy curriculum

Anatomy education research has identified neuroanatomy and pelvic anatomy as particularly challenging to medical students. However, perceptions of the whole undergraduate anatomy curriculum have not been properly determined. One hundred eighty-five second year medical student evaluations showed that neuroanatomy and head and neck and pelvic anatomy were rated significantly harder than the remainder of the curriculum (p &lt; 0.0001). However, students at the National Undergraduate Neuroanatomy Competition did not rate neuroanatomy harder than the other subjects. This study identifies topics which are perceived to be the most difficult to learn and targeting these will make the biggest differences in medical student learning experience.</p

The benefits of being a near-peer teacher

Background: Near-peer teaching is used in anatomy education because of its benefits to the learner, teacher and faculty members. Despite the range of reports focusing on the learner, the advantages for the teacher, which are thought to include communication skills, subject knowledge and employability, are only beginning to be explored.Method: A questionnaire was distributed to the teachers involved in anatomy near-peer teaching at the University of Southampton and Brighton and Sussex Medical School (BSMS). This questionnaire was designed using a rating scale of 0–10 to assess teacher perspectives on their level of knowledge, teaching skills and enjoyment of teaching. Free-text responses determined the teachers’ motivation and perceived benefits from the teaching.Results: Twenty-eight questionnaires were gathered (54.9% response rate), including 20 from Southampton and eight from BSMS. Long-term knowledge retention and better understanding of the material were rated 8.1 and 7.9 out of 10, respectively. Eight responses were from currently practising doctors, who rated how much they now use their teaching skills as doctors as 8.9 out of 10. Of the eight doctors, seven gained points for their foundation programme applications as a direct result of near-peer teaching. The most common motivator for engaging in teaching was to improve subject matter knowledge and the most common benefit was improved communication skill