Being the ‘med reg’: an exploration of junior doctors’ perceptions of the medical registrar role

The role of the medical registrar is a challenging one and is acknowledged as being a disincentive to a career in medicine for some junior doctors. We set out to build a broader understanding of the role through exploration of Foundation Doctors’ and Core Medical Trainees’ perceptions of the role. Data, gathered from focus groups, were analysed using a framework approach. Six key themes were identified, which were grouped under the headings ‘perceptions of the medical registrar role’ and ‘transition into the role’. Our work builds on existing literature to inform a deeper understanding of how junior doctors perceive the medical registrar role. In light of our findings we offer suggestions on possible training initiatives to tackle the issues identified. We also highlight positive perceptions of the role and emphasise the key ambassadorial role that current medical registrars have in relation to attracting tomorrows’ medical registrars to the specialty

Infantile spasms (West syndrome): update and resources for pediatricians and providers to share with parents

Background Infantile spasms (IS; West syndrome) is a severe form of encephalopathy that typically affects infants younger than 2 years old. Pediatricians, pediatric neurologists, and other pediatric health care providers are all potentially key early contacts for families who have an infant with IS. The objective of this article is to assist pediatric health care providers in the detection of the disease and in the counseling and guidance of families who have an infant with IS. Methods Treatment guidelines, consensus reports, and original research studies are reviewed to provide an update regarding the diagnosis and treatment of infants with IS. Web sites were searched for educational and supportive resource content relevant to providers and families of patients with IS. Results Early detection of IS and pediatrician referral to a pediatric neurologist for further evaluation and initiation of treatment may improve prognosis. Family education and the establishment of a multidisciplinary continuum of care are important components of care for the majority of patients with IS. The focus of the continuum of care varies across diagnosis, initiation of treatment, and short- and long-term needs. Several on-line educational and supportive resources for families and caregivers of patients with IS were identified. Conclusions Given the possibility of poor developmental outcomes in IS, including the emergence of other seizure disorders and cognitive and developmental problems, early recognition, referral, and treatment of IS are important for optimal patient outcomes. Dissemination of and access to educational and supportive resources for families and caregivers across the lifespan of the child with IS is an urgent need. Pediatric health care providers are well positioned to address these needs

Why geriatric medicine? A survey of UK specialist trainees in geriatric medicine

Background: There is global concern that there are insufficient numbers of geriatricians to meet the needs of the ageing population. A 2005 survey described factors that influenced why UK geriatricians had chosen to specialise in the field - in the decade since, UK postgraduate training has undergone a fundamental restructure. Objective: To explore whether the reasons for choosing a career in geriatric medicine in the UK had changed over time, with the goal of using this knowledge to inform recruitment and training initiatives. Design: An online survey was sent to all UK higher medical trainees in geriatric medicine. Methods: Survey questions that produced categorical data were analysed with simple descriptive statistics. For the survey questions that produced free-text responses, an inductive, iterative approach to analysis, in keeping with the principles of framework analysis, was employed. Results: 269 responses were received out of 641 eligible respondents. Compared with the previous survey, a substantially larger number of respondents regarded geriatric medicine to be their first-choice specialty and a smaller number regretted their career decision. A greater number chose geriatric medicine early in their medical careers. Commitments to the general medical rota and the burden of service provision were considered important downsides to the specialty. Conclusions: There are reasons to be optimistic about recruitment to geriatric medicine. Future attempts to drive up recruitment might legitimately focus on the role of the medical registrar and perceptions that geriatricians shoulder a disproportionate burden of service commitments and obligations to the acute medical take

Clinical Outcome Metrics for Optimization of Robust Training

The objective of this research is to develop and use clinical outcome metrics and training tools to quantify the differences in performance of a physician vs nonphysician crew medical officer (CMO) analogues during simulations

Clinical Outcome Metrics for Optimization of Robust Training

Develop and use clinical outcome metrics and training tools to quantify performance differences of physician vs. non-physician crew medical officer (CMO) analogs during simulations

Securing technology-critical metals for Britain

In the next 5-10 years the UK is going to see dramatic changes to many of its large industrial sectors, such as automotive, aerospace, and energy generation, as we move from a fossil-fuel-driven society to an electrically driven one. Many of these industries will be dependent on technology-critical metals (TCMs), for example, cobalt and lithium for the batteries in electric vehicles and rare-earths used in the magnets for electric motors and wind turbines. Many regions of the world, including the EU, have been developing strategies to access these technology-critical metals for their key industries, while the UK has lagged behind. The challenges already faced around access to key technology metals are potentially complicated for the UK by the nation’s exit from the EU, and the uncertainty that this has created with regard to trading relationships around the globe. It is in this challenging context that the UK must now fashion its own independent policy for access to technology critical metals

The genomic basis of parasitism in the Strongyloides clade of nematodes.

Soil-transmitted nematodes, including the Strongyloides genus, cause one of the most prevalent neglected tropical diseases. Here we compare the genomes of four Strongyloides species, including the human pathogen Strongyloides stercoralis, and their close relatives that are facultatively parasitic (Parastrongyloides trichosuri) and free-living (Rhabditophanes sp. KR3021). A significant paralogous expansion of key gene families--families encoding astacin-like and SCP/TAPS proteins--is associated with the evolution of parasitism in this clade. Exploiting the unique Strongyloides life cycle, we compare the transcriptomes of the parasitic and free-living stages and find that these same gene families are upregulated in the parasitic stages, underscoring their role in nematode parasitism

Solitary symbolic play, object substitution and peer role play skills at age 3 predict different aspects of age 7 structural language abilities in a matched sample of autistic and non-autistic children.

BACKGROUNDS AND AIMS: Early symbolic play abilities are closely related to long-term language development for both autistic and non-autistic children, but few studies have explored these relations for different dimensions of pretence and of language. The current study explores carer-reported measures of solitary symbolic play, object substitution and peer role play abilities at age 3, and their respective relations with parent-reported semantics, syntax and narrative abilities at age 7 for both autistic and non-autistic children. METHODS: We conducted secondary data analyses exploring links between different aspects of pretence and of language on the Longitudinal Study of Australian Children population cohort. We identified 92 autistic children and used propensity score matching to match them with 92 non-autistic children based on demographic and developmental information such as non-verbal IQ and socioeconomic status. We explored concurrent and longitudinal relations using correlation and regression models. Results: Both correlational and hierarchical regression analyses confirmed the significant effects of age 3 symbolic play abilities in facilitating age 7 semantics, syntax and narrative abilities for autistic children. We found that object substitution held most prominent influence, followed by peer role play and solitary symbolic play. In contrast, for non-autistic children, none of the age 3 symbolic play abilities were significant predictors, whereas socioeconomic status at birth and age 3 language abilities held significant influences on their age 7 semantics, syntax and narrative abilities. Conclusion: We discuss the implications of our findings for play interventions targeting language outcomes

Evidence for Protective Effects of Peer Play in the Early Years: Better Peer Play Ability at Age 3 Years Predicts Lower Risks of Externalising and Internalising Problems at Age 7 Years in a Longitudinal Cohort Analysis.

Acknowledgements: We would like to thank the Longitudinal Study of Australian Children for this amazing dataset. Yiran Vicky Zhao’s PhD is funded by the LEGO Foundation Cambridge Trust Scholarship. Jenny Louise Gibson is funded by LEGO Foundation. Thanks to Paul Ramchandani for helpful feedback.Funder: lego foundation cambridge trust studentshipFunder: lego foundationPeer play ability may be a protective factor against childhood mental health difficulties but there is lack of empirical evidence to support this hypothesis. We conducted longitudinal structural equation modelling study over a population cohort (N = 1676) to examine the effect of age 3 peer play ability on children's age 7 mental health outcomes (measured by the Strengths and Difficulties Questionnaire subscales). We modelled effects for the entire population and two sub-groups at high-risk for mental health problems based on age 3 temperament. Controlling for demographic variables, temperament, maternal distress, play with parents and number of siblings, better peer play ability at age 3 years predicted lower risk of problems on all 4 SDQ subscales at age 7 years for the general population. For the low-persistence subgroup, better peer play ability at age 3 predicted lower risk of age 7 hyperactivity, emotional and peer problems, whereas better peer play ability at age 3 predicted only lower risk of age 7 hyperactivity for the high-reactivity group. Taken together our results provide evidence that supports the hypothesis that early peer play ability may be a protective factor against later mental health difficulties. We conclude that further research aimed at establishing causation is worth pursuing