Quality-improvement program for ultrasound-based fetal anatomy screening using large-scale clinical audit.

OBJECTIVE: A large-scale audit and peer review of ultrasound images may improve sonographer performance, but is rarely performed consistently as it is time-consuming and expensive. The aim of this study was to perform a large-scale audit of routine fetal anatomy scans to assess if a full clinical audit cycle can improve clinical image-acquisition standards. METHODS: A large-scale, clinical, retrospective audit was conducted of ultrasound images obtained during all routine anomaly scans performed from 18 + 0 to 22 + 6 weeks' gestation at a UK hospital during 2013 (Cycle 1), to build a baseline understanding of the performance of sonographers. Targeted actions were undertaken in response to the findings with the aim of improving departmental performance. A second full-year audit was then performed of fetal anatomy ultrasound images obtained during the following year (Cycle 2). An independent pool of experienced sonographers used an online tool to assess all scans in terms of two parameters: scan completeness (i.e. were all images archived?) and image quality using objective scoring (i.e. were images of high quality?). Both were assessed in each audit at the departmental level and at the individual sonographer level. A random sample of 10% of scans was used to assess interobserver reproducibility. RESULTS: In Cycle 1 of the audit, 103 501 ultrasound images from 6257 anomaly examinations performed by 22 sonographers were assessed; in Cycle 2, 153 557 images from 6406 scans performed by 25 sonographers were evaluated. The analysis was performed including the images obtained by the 20 sonographers who participated in both cycles. Departmental median scan completeness improved from 72% in the first year to 78% at the second assessment (P < 0.001); median image-quality score for all fetal views improved from 0.83 to 0.86 (P < 0.001). The improvement was greatest for those sonographers who performed poorest in the first audit; with regards to scan completeness, the poorest performing 15% of sonographers in Cycle 1 improved by more than 30 percentage points, and with regards to image quality, the poorest performing 11% in Cycle 1 showed a more than 10% improvement. Interobserver repeatability of scan completeness and image-quality scores across different fetal views were similar to those in the published literature. CONCLUSIONS: A clinical audit and a set of targeted actions helped improve sonographer scan-acquisition completeness and scan quality. Such adherence to recommended clinical acquisition standards may increase the likelihood of correct measurement and thereby fetal growth assessment, and should allow better detection of abnormalities. As such a large-scale audit is time consuming, further advantages would be achieved if this process could be automated. © 2018 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology

Double marking revisited

In 2002, the Qualifications and Curriculum Authority (QCA) published the report of an independent panel of experts into maintaining standards at Advanced Level (A-Level). One of its recommendations was for: ‘limited experimental double marking of scripts in subjects such as English to determine whether the strategy would signi-ficantly reduce errors of measurement’ (p. 24). This recommendation provided the impetus for this paper which reviews the all but forgotten literature on double marking and considers its relevance now

Coastal meroplanktonic larval stages of peninsula de Llevant natural reserve determined with light traps

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Performance of Baited Underwater Video: Does It Underestimate Abundance at High Population Densities?

Funding: This work was supported by a grant from the Spanish National Plan for Scientific and Technological Research and Innovation, the RECMARE project (CTM2012-36982 MAR) and by the SGP (Spanish Ministry of Agriculture, Environment and Fisheries) for the ERICOL project. The South Australian Research Institute provided inkind funding support.Abstract Video survey techniques are now commonly used to estimate animal abundance under the assumption that estimates relate to true abundance, a key property needed to make video a valid survey tool. Using the spiny lobster Palinurus elephas as our model organism, we evaluate the effectiveness of baited underwater video (BUV) for estimating abundance in areas with widely different population density. We test three BUV abundance metrics and compare the results with an independently obtained abundance index from trammel-net surveys (Trammel). Video metrics used to estimate relative abundance include a value for total number of individuals per recording (TotN), the traditional maximum number of fish observed in a single video frame (MaxN) and the recently suggested alternative, the average of the mean MaxN from 5-minute periods throughout the duration of the recording (MeanN). This is the first video study of a wild population to include an estimate for TotN. Comparison of TotN with the other two BUV relative abundance metrics demonstrates that both of the latter lack resolution at high population densities. In spite of this, the three BUV metrics tested, as well as the independent estimate Trammel, distinguished high density areas from low density areas. Thus they could all be used to identify areas of differing population density, but MaxN and MeanN would not be appropriate metrics for studies aimed at documenting increases in abundance, such as those conducted to assess marine protected area effectiveness, as they are prone to sampling saturation. We also demonstrate that time of first arrival (T1) is highly correlated with all of the abundance indices,suggesting T1 may be a potentially useful index of abundance. However, these relationships require further investigation as our data suggests T1 may also become sampling-saturated as lobster abundance increases.Publicad

Exploration of the inter-annual variability and multi-scale environmental drivers of European spiny lobster, Palinurus elephas (Decapoda: Palinuridae) settlement in the NW Mediterranean

Determining the drivers of key ecological processes of commercial marine species is important to acquire basic and essential knowledge for fisheries management and conservation. Here we report on a long-term monitoring of the settlement of the European spiny lobster, Palinurus elephas, the most commercially important spiny lobster species in the Mediterranean and north-eastern Atlantic. Densities of recently settled individuals (early benthic juveniles –EBJs) were recorded annually, as an approximation to annual settlement, from 2000 to 2016 (17 years) in three zones of the north-western Mediterranean: Catalonia (CAT), the Columbretes Islands (COL), and the Balearic Islands (BAL). Settlement, the end point that integrate most of the variability occurred during dispersion, is a complex ecological process governed by the interaction of biotic and abiotic factors that can be in turn influenced by the atmospheric and oceanographic conditions. Using linear regression of the size structure of EBJs, we demonstrate that settlement occurs synchronously in the three study zones. Densities of EBJs were handled as time series, and regression analysis revealed that CAT and COL covaried significantly, but none of them with BAL. Therefore, CAT and COL were analysed together using generalized linear model and much of their joint variability was explained by the mesoscale oceanographic index IDEA. Settlement in BAL showed a different pattern, explained by the joint effect of the atmospheric oscillations NAO and WEMO. Complexity of P. elephas settlement cannot be fully accounted neither for CAT-COL nor for BAL because settlement seems be driven by more complex unknown multi-factorial processes. Therefore, further studies are necessary to gain insight into other factors that allow short-or medium-term predictions of settlement. Expanding the study area across the Mediterranean would also allow establishing a complete knowledge of the ecology of the species applicable to the management of the fishery.Versión del edito

Using legume-based mixtures to enhance the nitrogen use efficiency and economic viability of cropping systems - Final report (LK09106/HGCA3447)

As costs for mineral fertilisers rise, legume-based leys are recognised as a potential alternative nitrogen source for crops. Here we demonstrate that including species-rich legume-based leys in rotations helps to maximise synergies between agricultural productivity and other ecosystem services. By using functionally diverse plant species mixtures, these services can be optimised and fine-tuned to regional and farm-specific needs. Replicated field experiments were conducted over three years at multiple locations, testing the performance of 12 legume species and 4 grass species sown in monocultures, as well as in a mixture of 10 of the legumes and all 4 grasses (called the All Species Mix, ASM). In addition, we compared this complex mixture to farmer-chosen ley mixtures on 34 sites across the UK. The trials showed that there is a large degree of functional complementarity among the legume species. No single species scored high on all evaluation criteria. In particular, the currently most frequently used species, white clover, is outscored by other legume species on a number of parameters such as early development and resistance to decomposition. Further complementarity emerged from the different responses of legume species to environmental variables, with soil pH and grazing or cutting regime being among the more important factors. For example, while large birdsfoot trefoil showed better performance on more acidic soils, the opposite was true for sainfoin, lucerne and black medic. In comparison with the monocultures, the ASM showed increased ground cover, increased above-ground biomass and reduced weed biomass. Benefits of mixing species with regard to productivity increased over time. In addition, the stability of biomass production across sites was greater in the ASM than in the legume monocultures. Within the on-farm trials, we further found that on soils low in organic matter the biomass advantage of the ASM over the Control ley was more marked than on the soils with higher organic matter content. Ecological modelling revealed that the three best multifunctional mixtures all contained black medic, lucerne and red clover. Within the long term New Farming Systems (NFS) rotational study, the use of a clover bi-crop showed improvement to soil characteristics compared to current practice (e.g. bulk density and water infiltration rate). Improvements in wheat yield were also noted with respect to the inclusion of a clover bi-crop in 2010, but there was evidence of a decline in response as the N dose was increased. Cumulatively, over both the wheat crop and the spring oilseed rape crop, the clover bi-crop improved margin over N. The highest average yield response (~9%) was associated with the ASM legume species mix cover cropping approach

Impact of shortened crop rotation of oilseed rape on soil and rhizosphere microbial diversity in relation to yield decline

Oilseed rape (OSR) grown in monoculture shows a decline in yield relative to virgin OSR of up to 25%, but the mechanisms responsible are unknown. A long term field experiment of OSR grown in a range of rotations with wheat was used to determine whether shifts in fungal and bacterial populations of the rhizosphere and bulk soil were associated with the development of OSR yield decline. The communities of fungi and bacteria in the rhizosphere and bulk soil from the field experiment were profiled using terminal restriction fragment length polymorphism (TRFLP) and sequencing of cloned internal transcribed spacer regions and 16S rRNA genes, respectively. OSR cropping frequency had no effect on rhizosphere bacterial communities. However, the rhizosphere fungal communities from continuously grown OSR were significantly different to those from other rotations. This was due primarily to an increase in abundance of two fungi which showed 100% and 95% DNA identity to the plant pathogens Olpidium brassicae and Pyrenochaeta lycopersici, respectively. Real-time PCR confirmed that there was significantly more of these fungi in the continuously grown OSR than the other rotations. These two fungi were isolated from the field and used to inoculate OSR and Brassica oleracea grown under controlled conditions in a glasshouse to determine their effect on yield. At high doses, Olpidium brassicae reduced top growth and root biomass in seedlings and reduced branching and subsequent pod and seed production. Pyrenochaeta sp. formed lesions on the roots of seedlings, and at high doses delayed flowering and had a negative impact on seed quantity and quality

The informatics challenges facing biobanks:a perspective from a United Kingdom biobanking network

The challenges facing biobanks are changing from simple collections of materials to quality-assured fit-for-purpose clinically annotated samples. As a result, informatics awareness and capabilities of a biobank are now intrinsically related to quality. A biobank may be considered a data repository, in the form of raw data (the unprocessed samples), data surrounding the samples (processing and storage conditions), supplementary data (such as clinical annotations), and an increasing ethical requirement for biobanks to have a mechanism for researchers to return their data. The informatics capabilities of a biobank are no longer simply knowing sample locations; instead the capabilities will become a distinguishing factor in the ability of a biobank to provide appropriate samples. There is an increasing requirement for biobanking systems (whether in-house or com-mercially sourced) to ensure the informatics systems stay apace with the changes being experienced by the biobanking community. In turn, there is a requirement for the biobanks to have a clear informatics policy and directive that is embedded into the wider decision making process. As an example, the Breast Cancer Campaign Tissue Bank in the UK was a collaboration between four individual and diverse biobanks in the UK, and an informatics platform has been developed to address the challenges of running a distributed network. From developing such a system there are key observations about what can or cannot be achieved by informatics in isolation. This article will highlight some of the lessons learned during this development process

My School? Critiquing the abstraction and quantification of education

This paper draws upon and critiques the Australian federal government's website My School as an archetypal example of the current tendency to abstract and quantify educational practice. Arguing in favour of a moral philosophical account of educational practice, the paper reveals how the My School website reduces complex educational practices to simple, supposedly objective, measures of student attainment, reflecting the broader 'audit' society/culture within which it is located. By revealing just how extensively the My School website reduces educational practices to numbers, the paper argues that we are in danger of losing sight of the 'internal' goods of Education which cannot be readily and simply codified, and that the teacher learning encouraged by the site marginalises more active and collective approaches. While having the potential to serve some beneficial diagnostic purposes, the My School website reinforces a view of teachers as passive consumers of information generated beyond their everyday practice

Temporal dynamics and role of benthic habitat for the Mediterranean slipper lobster Scyllarides latus in a National Park

Populations of large large decapods have diminished due to intense fishing pressure and habitat modification along the widely inhabited coast. During the last decade some of the well established marine protected areas (MPAs) in the Western Mediterranean have led to growing densities of one of the most sought after large decapods, the slipper lobster Scyllarides latus (Latreille, 1803). A four year monitoring study was conducted to assess seasonal dynamics and habitat preference of S. latus in the Cabrera Archipelago National Park. Sampling was carried out through underwater visual census on rocky habitats at 0 - 50 m depth. The species may be found in caves, under boulders, and on walls and slopes at depths of up to 35 m, showing a preference for caves at 5 to 20 m depth. These hábitats provide diverse shelter types that are used during the daily period of trophic inactivity. S latus has a marked seasonality with highest densities occurring in late spring, and they disappear almost entirely from rocky coastal habitats in mid-summer. Knowledge of the preferred habitats and spatial pattern of the species is needed for implementing appropriate management schemes to stimulate their recover