Evaluation of a postgraduate examination for primary care: perceptions and performance of general practitioner trainers in the multiple choice paper of the Membership Examination of the Royal College of General Practitioners

This study aimed to investigate the performance of a sample of general practitioner (GP) trainers in the multiple choice paper (MCP) of the Membership Examination of the Royal College of General Practitioners (MRCGP) and to obtain their views of the content of the paper and its relevance to general practice using a written knowledge test and self-administered questionnaire. The participants were volunteer GP trainers in the Northern, Wessex, Kent, Education for Primary Care (2007) 18: 165–72 # 2007 Radcliffe Publishing Limited WHAT IS ALREADY KNOWN IN THIS AREA . Feedback from GP registrar candidates sitting the multiple choice paper (MCP) suggests that the paper has good face and content validity, although pressure of time is a problem. . Candidates find the questions in the paper challenging but most believe they assess common or important problems in general practice. WHAT THIS WORK ADDS . Most trainers in this study believed that the paper assessed knowledge of common or important topics relevant to general practice, that the majority of questions were appropriate, clear and unambiguous and that time pressure was not a problem. . Trainers in this study performed significantly better overall compared to registrars and did so without making prior preparation. SUGGESTIONS FOR FURTHER RESEARCH . Repeating the study with non-trainer GPs could provide further information on the validity of the MCP as an applied knowledge test appropriate for established GPs taking the MRCGP as well as those nearing completion of training Keywords: attitudes, examination, general practice trainers, MRCGP, Surrey and Sussex (KSS) and Northwest deaneries of the UK. The trainers completed a shortened version of an MRCGP MCP paper under examination conditions and provided feedback immediately afterwards. Of 191 trainers invited to participate, 86 (45%) sat the paper and of these, 81 completed the questionnaire. Most trainers believed that the paper assessed knowledge of common or important topics relevant to general practice, that the majority of questions were appropriate, clear and unambiguous and that time pressure was not a problem. Trainers performed significantly better compared to registrars overall, and in questions on medicine related to general practice and practice administration but not research methodology or critical appraisal. They did so without making prior preparation. The findings from this group of trainers lend support to the face validity and content validity of the MRCGP MCP examination as an assessment of applied knowledge of general practice

Operator/equipment Performance Measures: Results Of Literature Search

Literature review focuses on topics concerning perception, acceptable transmission delay, fidelity, and visual systems, including resolution, field of view, and target-background contrast

Assuring the quality of an applied knowledge assessment for licensing purposes (Membership of the Royal College of General Practitioners, MRCGP) in UK general practice

Background The Applied Knowledge Test (AKT) forms part of the tripos of the MRCGP exam. It is a computer-delivered licensing assessment of applied knowledge. This presentation demonstrates how the test quality is reviewed. Summary of work From the RCGP curriculum blueprint, the construction of test items is referenced to high quality evidence, peer reviewed and critically appraised before addition to the question bank. A standard process for question selection, proof reading and feedback to candidates supports its validity. New question formats include free text answers which enhance discrimination. Standard setting follows the modified Angoff process. Summary of results The test shows a high Cronbach’s alpha (0.88-0.92). Pre-trialling of questions, common to many postgraduate medical examinations, is deemed unnecessary with an alpha-coefficient for new questions in the most recent test > 0.8 (0.91 when adjusted for the test length). Computer delivered testing enables detailed analysis of patterns of timing and omission of items by candidates. Conclusions Systematic processes in test construction and computer delivery has enhanced continuous quality assurance of the AKT. Take-home messages Test performance relies on meticulous attention to detail in item writing and test construction. Use of un-trialled new questions enables reliable testing of emerging and changing knowledge

Spacecraft materials studies on the Aerospace Corporation tray on EOIM-3

A passive tray was flown on the Effects of Oxygen Interaction with Materials experiment on STS-46 (EOIM-3) with 82 samples from The Aerospace Corporation. A variety of advanced materials related to potential uses on future spacecraft were included for evaluation representing optical coatings, lubricants, polymers, composites, carbon-carbon composite protective coatings, graphite protective coatings, thermal-control materials, and some samples of current materials. An overview of the available results from the investigations of these materials is presented

Development of a cross-cultural HPV community engagement model within Scotland

Objective To examine cultural barriers and participant solutions regarding acceptance and uptake of the Human Papillomavirus (HPV) vaccine from the perspective of Black African, White-Caribbean, Arab, Indian, Bangladeshi and Pakistani young people.Methods Forty young people from minority ethnic communities in Scotland took part in a qualitative study, involving seven focus groups and four paired interviews, to explore their views and experiences of the HPV vaccine. Using critical discursive psychology, the analysis focussed on young people’s accounts of the barriers and enablers to information, access and uptake of the HPV vaccination programme.Results Participants suggested innovative strategies to tackle intergenerational concerns, information design and accessibility, and public health communications across diverse contexts. A cross-cultural community engagement model was developed, embracing diversity and contradiction across different ethnic groups. This included four inter-related strategies: providing targeted and flexible information for young people; vaccine provision across the life-course; intergenerational information and; specific cross-cultural communications.Conclusion This is the first HPV cross-cultural model inductively derived from accounts of young people from different ethnic communities. We recommend public health practitioners and policymakers consider utilising the processes and strategies illustrated within this model in order to increase dialogue around public engagement, awareness and receptivity towards the HPV vaccination

Perceptual and conceptual processing of visual objects across the adult lifespan

Abstract: Making sense of the external world is vital for multiple domains of cognition, and so it is crucial that object recognition is maintained across the lifespan. We investigated age differences in perceptual and conceptual processing of visual objects in a population-derived sample of 85 healthy adults (24–87 years old) by relating measures of object processing to cognition across the lifespan. Magnetoencephalography (MEG) was recorded during a picture naming task to provide a direct measure of neural activity, that is not confounded by age-related vascular changes. Multiple linear regression was used to estimate neural responsivity for each individual, namely the capacity to represent visual or semantic information relating to the pictures. We find that the capacity to represent semantic information is linked to higher naming accuracy, a measure of task-specific performance. In mature adults, the capacity to represent semantic information also correlated with higher levels of fluid intelligence, reflecting domain-general performance. In contrast, the latency of visual processing did not relate to measures of cognition. These results indicate that neural responsivity measures relate to naming accuracy and fluid intelligence. We propose that maintaining neural responsivity in older age confers benefits in task-related and domain-general cognitive processes, supporting the brain maintenance view of healthy cognitive ageing

Ageing increases reliance on sensorimotor prediction through structural and functional differences in frontostriatal circuits

This is the author accepted manuscript. It is currently under an indefinite embargo pending publication by Nature Publishing Group.The control of voluntary movement changes markedly with age. A critical component of motor control is the integration of sensory information with predictions of the consequences of action, arising from internal models of movement. This leads to sensorimotor attenuation – a reduction in the perceived intensity of sensations from self-generated compared to external actions. Here we show that sensorimotor attenuation occurs in 98% of adults in a population-based cohort (n=325; 18-88 years; the Cambridge Centre for Ageing and Neuroscience). Importantly, attenuation increases with age, in proportion to reduced sensory sensitivity. This effect is associated with differences in the structure and functional connectivity of the pre-supplementary motor area (pre-SMA), assessed with magnetic resonance imaging. The results suggest that ageing alters the balance between the sensorium and predictive models, mediated by the pre-SMA and its connectivity in frontostriatal circuits. This shift may contribute to the motor and cognitive changes observed with age.Cam-CAN research was supported by the Biotechnology and Biological Sciences Research Council (BB/H008217/1). JBR and NW were supported by the James S. McDonnell Foundation 21st Century Science Initiative, Scholar Award in Understanding Human Cognition. JBR was also supported by Wellcome Trust [103838] and the Medical Research Council [MC-A060-5PQ30]. DMW was supported by the Wellcome Trust [097803], Human Frontier Science Program and the Royal Society Noreen Murray Professorship in Neurobiology. RNH was supported by the Medical Research Council [MC-A060-5PR10]. RAK was supported by a Sir Henry Wellcome Trust Postdoctoral Fellowship [107392]. LG was funded by a Rubicon grant from the Netherlands Organisation for Scientific Research (NWO)

A Meta-Analysis of Probiotic Efficacy for Gastrointestinal Diseases

Background: Meta-analyses on the effects of probiotics on specific gastrointestinal diseases have generally shown positive effects on disease prevention and treatment; however, the relative efficacy of probiotic use for treatment and prevention across different gastrointestinal diseases, with differing etiology and mechanisms of action, has not been addressed. Methods/Principal Findings: We included randomized controlled trials in humans that used a specified probiotic in the treatment or prevention of Pouchitis, Infectious diarrhea, Irritable Bowel Syndrome, Helicobacter pylori, Clostridium difficile Disease, Antibiotic Associated Diarrhea, Traveler’s Diarrhea, or Necrotizing Enterocolitis. Random effects models were used to evaluate efficacy as pooled relative risks across the eight diseases as well as across probiotic species, single vs. multiple species, patient ages, dosages, and length of treatment. Probiotics had a positive significant effect across all eight gastrointestinal diseases with a relative risk of 0.58 (95 % (CI) 0.51–0.65). Six of the eight diseases: Pouchitis, Infectious diarrhea, Irritable Bowel Syndrome, Helicobacter pylori, Clostridium difficile Disease, and Antibiotic Associated Diarrhea, showed positive significant effects. Traveler’s Diarrhea and Necrotizing Enterocolitis did not show significant effects of probiotcs. Of the 11 species and species mixtures, all showed positive significant effects except for Lactobacillus acidophilus, Lactobacillus plantarum, and Bifidobacterium infantis. Across all diseases and probiotic species, positive significant effects of probiotics were observed for all age groups, single vs. multiple species, and treatment lengths

Oxidative discolouration in whole-head and cut lettuce: biochemical and environmental influences on a complex phenotype and potential breeding strategies to improve shelf-life

Lettuce discolouration is a key post-harvest trait. The major enzyme controlling oxidative discolouration has long been considered to be polyphenol oxidase (PPO) however, levels of PPO and subsequent development of discolouration symptoms have not always correlated. The predominance of a latent state of the enzyme in plant tissues combined with substrate activation and contemporaneous suicide inactivation mechanisms are considered as potential explanations for this phenomenon. Leaf tissue physical properties have been associated with subsequent discolouration and these may be influenced by variation in nutrient availability, especially excess nitrogen and head maturity at harvest. Mild calcium and irrigation stress has also been associated with a reduction in subsequent discolouration, although excess irrigation has been linked to increased discolouration potentially through leaf physical properties. These environmental factors, including high temperature and UV light intensities, often have impacts on levels of phenolic compounds linking the environmental responses to the biochemistry of the PPO pathway. Breeding strategies targeting the PALand PPOpathway biochemistry and environmental response genes are discussed as a more cost-effective method of mitigating oxidative discolouration then either modified atmosphere packaging or post-harvest treatments, although current understanding of the biochemistry means that such programs are likely to be limited in nature and it is likely that they will need to be deployed alongside other methods for the foreseeable future