Benefits and challenges of multi-level learner rural general practices – an interview study with learners, staff and patients

Background: General practices vary in the provision of training and education. Some practices have training as a major focus with the presence of multi-level learners and others host single learner groups or none at all. This study investigates the educational benefits and challenges associated with 'multi-level learner' practices. Methods: This paper comprised three case studies of rural general practices with multiple levels of learners. Qualitative data were collected from 29 interviews with learners (n = 12), staff (n = 12) and patients (n = 5). Interviews were initially analyzed using open and axial coding and thematic analysis. Results: Thematic analysis showed 'multi-level learning' in general practices has benefits and challenges to learners and the practice. Learner benefits included knowledge exchange, the opportunity for vertical peer learning, a positive learning environment and the development of a supportive network. The presence of multi-level learners promoted sharing of knowledge with all staff, a sense of community, an increase in patient services and enthused supervisors. Challenges for learners included perception of decreased access to supervisors, anxiety with peer observation, reduced access to patient presentations and patient reluctance to be seen by a learner. Practice challenges were administration requirements, high learner turnover, infrastructure requirements and the requirement for supervisors to cater to a range of learner level needs. Conclusions: The presence of medical students, interns and registrars in general practice has educational benefits to the learners extending to the other stakeholders (staff and patients). Multi-level learners present challenges to the learners and the practice by increasing pressures on resources, staff (administrative and supervisors) and infrastructure

Magnetospectroscopy of symmetric and anti-symmetric states in double quantum wells

The experimental results obtained for the magneto-transport in the InGaAs/InAlAs double quantum wells (DQW) structures of two different shapes of wells are reported. The beating-effect occurred in the Shubnikov-de Haas (SdH) oscillations was observed for both types of the structures at low temperatures in the parallel transport when magnetic field was perpendicular to the layers. An approach to the calculation of the Landau levels energies for DQW structures was developed and then applied to the analysis and interpretation of the experimental data related to the beating-effect. We also argue that in order to account for the observed magneto-transport phenomena (SdH and Integer Quantum Hall effect), one should introduce two different quasi-Fermi levels characterizing two electron sub-systems regarding symmetry properties of their states, symmetric and anti-symmetric ones which are not mixed by electron-electron interaction.Comment: 20 pages, 20 figure

Race, Socioeconomic Status, and Age: Exploring Intersections in Preterm Birth Disparities among Teen Mothers

Few studies have examined disparities in adverse birth outcomes and compared contributingsocioeconomic factors specifically between African-American and White teen mothers. Thisstudy examined intersections between neighborhood socioeconomic status (as defined by censustractmedian household income), maternal age, and racial disparities in preterm birth (PTB)outcomes between African-American and White teen mothers in North Carolina. Using a linkeddataset with state birth record data and socioeconomic information from the 2010 US Census,disparities in preterm birth outcomes for 16,472 teen mothers were examined through bivariateand multilevel analyses. African-American teens had significantly greater odds of PTB outcomesthan White teens (OR = 1.38, 95% CI 1.21, 1.56). Racial disparities in PTB rates significantlyvaried by neighborhood income; PTB rates were 2.1 times higher for African-American teens inhigher income neighborhoods compared to White teens in similar neighborhoods. Disparities inPTB did not vary significantly between teens younger than age 17 and teens ages 17–19,although the magnitude of racial disparities was larger between younger African-American andWhite teens. These results justify further investigations using intersectional frameworks to testthe effects of racial status, neighborhood socioeconomic factors, and maternal age on birthoutcome disparities among infants born to teen mothers

Nano-Particle Enhanced Polymer Materials for Space Flight Applications

Recent advances in materials technology both in polymer chemistry and nano-materials warrant development of enhanced structures for space flight applications. This work aims to develop spacecraft structures based on polymer matrix composites (PMCs) that utilize these advancements.. Multi-wall carbon nano-tubes (MWCNTs) are expected to increase mechanical performance, lower coefficient of thermal expansion (CTE), increase electrical conductivity (mitigate electrostatic charge), increase thermal conductivity, and reduce moisture absorption of the resultant space structures. In this work, blends of MWCNTs with PETI-330 were prepared and characterized. The nano-reinforced resins were then resin transfer molded (RTM) into composite panels using M55J carbon fabric and compared to baseline panels fabricated from a cyanate ester (RS-3) or a polyimide (PETI-330) resin containing no MWCNTs. In addition, methods of pre-loading the fabric with the MWCNTs were also investigated. The effects of the MWCNTs on the resin processing properties and on the composite end-use properties were also determined

Influence of history on saccade countermanding performance in humans and macaque monkeys

AbstractThe stop-signal or countermanding task probes the ability to control action by requiring subjects to withhold a planned movement in response to an infrequent stop signal which they do with variable success depending on the delay of the stop signal. We investigated whether performance of humans and macaque monkeys in a saccade countermanding task was influenced by stimulus and performance history. In spite of idiosyncrasies across subjects several trends were evident in both humans and monkeys. Response time decreased after successive trials with no stop signal. Response time increased after successive trials with a stop signal. However, post-error slowing was not observed. Increased response time was observed mainly or only after cancelled (signal inhibit) trials and not after noncancelled (signal respond) trials. These global trends were based on rapid adjustments of response time in response to momentary fluctuations in the fraction of stop signal trials. The effects of trial sequence on the probability of responding were weaker and more idiosyncratic across subjects when stop signal fraction was fixed. However, both response time and probability of responding were influenced strongly by variations in the fraction of stop signal trials. These results indicate that the race model of countermanding performance requires extension to account for these sequential dependencies and provide a basis for physiological studies of executive control of countermanding saccade performance

Overgeneralized autobiographical memory and future thinking in combat veterans with posttraumatic stress disorder

a b s t r a c t Background: Studies show that individuals with Posttraumatic Stress Disorder (PTSD) tend to recall autobiographical memories with decreased episodic specificity. A growing body of research has demonstrated that the mechanisms involved in recalling autobiographical memories overlap considerably with those involved in imagining the future. Although shared autobiographical deficits in remembering the past and imagining the future have been observed in other clinical populations, this has yet to be examined in PTSD. This study examined whether, compared to combat trauma-exposed individuals without PTSD, those with combat-related PTSD would be more likely to generate overgeneralized autobiographical memories and imagined future events. Method: Operation Enduring/Iraqi Freedom (OEF/OIF) veterans with and without PTSD were presented with neutral word cues and were instructed to generate memories or imagine future autobiographical events. Responses were digitally recorded and were coded for level of episodic specificity and content related to combat trauma. Results: Individuals with PTSD were more likely to generate overgeneral autobiographical memories and future events than individuals without PTSD, and were more likely to incorporate content associated with combat when remembering the past or thinking about the future. Limitation: Limitations of the study include a cross-sectional design, precluding causality; the lack of a non-trauma exposed group, relatively small sample, and almost all-male gender of participants, limiting the generalizability to other populations. Conclusion: These findings suggest that individuals with PTSD show similar deficits when generating personal past and future events, which may represent a previously unexamined mechanism involved in the maintenance of PTSD symptoms

Antibiotic or silver versus standard ventriculoperitoneal shunts (BASICS): a multi-centre, single-blinded, randomised trial and economic evaluation

Background Insertion of a ventriculoperitoneal shunt for hydrocephalus is one of the commonest neurosurgical procedures worldwide. Infection of the implanted shunt affects up to 15% of these patients, resulting in prolonged hospital treatment, multiple surgeries, and reduced cognition and quality of life. Our aim was to determine the clinical and cost-effectiveness of antibiotic (rifampicin and clindamycin) or silver shunts compared with standard shunts at reducing infection. Methods In this parallel, multicentre, single-blind, randomised controlled trial, we included patients with hydrocephalus of any aetiology undergoing insertion of their first ventriculoperitoneal shunt irrespective of age at 21 regional adult and paediatric neurosurgery centres in the UK and Ireland. Patients were randomly assigned (1:1:1 in random permuted blocks of three or six) to receive standard shunts (standard shunt group), antibiotic-impregnated (0·15% clindamycin and 0·054% rifampicin; antibiotic shunt group), or silver-impregnated shunts (silver shunt group) through a randomisation sequence generated by an independent statistician. All patients and investigators who recorded and analysed the data were masked for group assignment, which was only disclosed to the neurosurgical staff at the time of operation. Participants receiving a shunt without evidence of infection at the time of insertion were followed up for at least 6 months and a maximum of 2 years. The primary outcome was time to shunt failure due the infection and was analysed with Fine and Gray survival regression models for competing risk by intention to treat. This trial is registered with ISRCTN 49474281. Findings Between June 26, 2013, and Oct 9, 2017, we assessed 3505 patients, of whom 1605 aged up to 91 years were randomly assigned to receive either a standard shunt (n=536), an antibiotic-impregnated shunt (n=538), or a silver shunt (n=531). 1594 had a shunt inserted without evidence of infection at the time of insertion (533 in the standard shunt group, 535 in the antibiotic shunt group, and 526 in the silver shunt group) and were followed up for a median of 22 months (IQR 10–24; 53 withdrew from follow-up). 32 (6%) of 533 evaluable patients in the standard shunt group had a shunt revision for infection, compared with 12 (2%) of 535 evaluable patients in the antibiotic shunt group (cause-specific hazard ratio [csHR] 0·38, 97·5% CI 0·18–0·80, p=0·0038) and 31 (6%) of 526 patients in the silver shunt group (0·99, 0·56–1·74, p=0·96). 135 (25%) patients in the standard shunt group, 127 (23%) in the antibiotic shunt group, and 134 (36%) in the silver shunt group had adverse events, which were not life-threatening and were mostly related to valve or catheter function. Interpretation The BASICS trial provides evidence to support the adoption of antibiotic shunts in UK patients who are having their first ventriculoperitoneal shunt insertion. This practice will benefit patients of all ages by reducing the risk and harm of shunt infection. Funding UK National Institute for Health Research Health Technology Assessment programme

2006 AAPP Monograph American Series

The African American Professors Program (AAPP) at the University of South Carolina is proud to publish the sixth edition of its annual monograph series. The program recognizes the significance of offering its scholars a venue for engaging actively in research and for publishing papers related thereto. Parallel with the publication of their refereed manuscripts is the opportunity to gain visibility among scholars throughout institutions worldwide. Scholars who have contributed manuscripts for this monograph are to be commended for adding this additional responsibility to their academic workloads. Writing across disciplines adds to the intellectual diversity of these papers. From neophytes, relatively speaking, to an array of very experienced individuals, the chapters have been researched and comprehensively written. Founded in 1997 through the Department of Educational Leadership and Policies in the College of Education, AAPP was designed to address the underrepresentation of African American professors on college and university campuses. Its mission is to expand the pool of these professors in critical academic and research areas. Sponsored by the University of South Carolina, the W.K. Kellogg Foundation, and the South Carolina General Assembly, the program recruits doctoral students for disciplines in which African Americans currently are underrepresented among faculty in higher education. The continuation of this monograph series is seen as responding to a window of opportunity to be sensitive to an academic expectation of graduates as they pursue career placement and, at the same time, one that allows for the dissemination of AAPP products to a broader community. The importance of this monograph series has been voiced by one of our 2002 AAPP graduates, Dr. Shundele LaTjuan Dogan, a former Program Officer for the Southern Education Foundation, Atlanta, Georgia, a former Administrative Fellow at Harvard University, and currently a Senior Program Officer with the Arthur M. Blank Foundation, focusing on the Pathways to Success Initiative. Dr. Dogan wrote: One thing in particular that I want to thank you for is having the African American Professors Program scholars publish articles for the monograph. I have to admit that writing the articles seemed like extra work at the time. However, in my recent interview process, organizations have asked me for samples of my writing. Including an article from a published monograph helped to make my portfolio much more impressive. You were \u27right on target\u27 in having us do the monograph series. {AAPP 2003 Monograph, p xi) The African American Professors Program offers this 2006 publication as a contribution to its readership and hopes that you will be inspired by this select group of manuscripts. John McFadden, Ph.D. The Benjamin Elijah Mays Professor Director, African American Professors Program University of South Carolinahttps://scholarcommons.sc.edu/mcfadden_monographs/1008/thumbnail.jp