The role of the smartphone in the transition from medical student to foundation trainee: a qualitative interview and focus group study

Background The transition from medical student to junior doctor is one of the most challenging in medicine, affecting both doctor and patient health. Opportunities to support this transition have arisen from advances in mobile technology and increased smartphone ownership. Methods This qualitative study consisted of six in-depth interviews and two focus groups with Foundation Year 1 Trainees (intern doctors) and final year medical students within the same NHS Trust. A convenience sample of 14 participants was recruited using chain sampling. Interviews and focus groups were recorded, transcribed verbatim, analysed in accordance with thematic analysis and presented below in keeping with the standards for reporting qualitative research. Results Participants represented both high and low intensity users. They used their smartphones to support their prescribing practices, especially antimicrobials through the MicroGuide™ app. Instant messaging, via WhatsApp, contributed to the existing bleep system, allowing coordination of both work and learning opportunities across place and time. Clinical photographs were recognised as being against regulations but there had still been occasions of use despite this. Concerns about public and colleague perceptions were important to both students and doctors, with participants describing various tactics employed to successfully integrate phone use into their practices. Conclusion This study suggests that both final year medical students and foundation trainees use smartphones in everyday practice. Medical schools and healthcare institutions should seek to integrate such use into core curricula/training to enable safe and effective use and further ease the transition to foundation training. We recommend juniors are reminded of the potential risks to patient confidentiality associated with smartphone use

Influence of fly ash blending on hydration and physical behavior of Belite-Alite-Ye'elimite cements

A cement powder, composed of belite, alite and ye’elimite, was blended with 0, 15 and 30 wt% of fly ash and the resulting lended cements were further characterized. During hydration, the presence of fly ash caused the partial inhibition of both AFt degradation and belite reactivity, even after 180 days. The compressive strength of the corresponding mortars increased by increasing the fly ash content (68, 73 and 82 MPa for mortars with 0, 15 and 30 wt% of fly ash, respectively, at 180 curing days), mainly due to the diminishing porosity and pore size values. Although pozzolanic reaction has not been directly proved there are indirect evidences.This work is part of the Ph.D. of D. Londono-Zuluaga funded by Beca Colciencias 646—Doctorado en el exterior and Enlaza Mundos 2013 program grant. Cement and Building materials group (CEMATCO) from National University of Colombia is acknowledged for providing the calorimetric measurements. Funding from Spanish MINECO BIA2017-82391-R and I3 (IEDI-2016-0079) grants, co-funded by FEDER, are acknowledged

Stability and Purity of \u3cem\u3eEpichloë\u3c/em\u3e Endophyte Infection in New Zealand Ryegrass Pastures

Perennial ryegrass (Lolium perenne) in New Zealand pastures is typically infected with the mutualist Epichloë fungal endophyte, which assists the plant in resisting biotic and abiotic stresses. Ryegrass that has naturalised in New Zealand is highly infected with the ‘Standard’ strain of endophyte. This strain provides good protection from a range of invertebrate pests but negatively impacts livestock productivity and health in the warmer seasons of the year. Grass-endophyte associations have been developed between elite perennial ryegrass cultivars and selected endophyte strains to provide protective properties to the host plant and lessen or eliminate the negative effects on animals. While Epichloë-ryegrass associations have been intensively monitored in experimental trials, little has been measured and reported from dairy pastures grazed in commercial settings, particularly with regards to ingress of Standard endophyte. Here we report on presence of endophyte infection and endophyte strain in ryegrass tillers from dairy pastures sampled for up to 7 years in regions of the North and South Islands. In general, infection levels were high (mean 86%). The sown, selected endophytes were the dominant endophyte strains present and these were stable over time. This demonstrates that the industry has been successfully delivering ryegrasses infected with selected endophytes on to dairy farms. The frequency of non-sown endophytes was greater in the North (mean 8%, and mostly Standard endophyte) than the South Island (2%), and Standard endophyte increased over time. There were some notable exceptions to these general effects. Of 23 pastures, two failed to achieve the 70% minimum infection for endophyte to effectively protect against invertebrate pests, and three out of 23 developed high levels of contamination from Standard endophyte. In two cases, the management practices could have contributed to the poor outcome but otherwise the drivers for the low infection or increases in Standard endophyte are unknown

Local Austenite grain size distribution in hot bar rolling of AISI 4135 Steel

In this paper, the local distribution of austenite grain size (AGS) was experimentally determined by conducting single round-oval and square-diamond pass hot bar rolling experiments of AISI4135 steel. The rolling experiments were carried out using the laboratory mill. The local distribution of AGS was also determined numerically. In order to predict AGS distribution, the AGS evolution model was combined with three dimensional non-isothermal finite element analyses by adopting a modified additivity rule. AGS evolution model was experimentally determined from hot torsion test according to Hodgson\u27s model. The predicted results were in a reasonably good agreement with experimental results.<br /