Career choice in medicine

Background: Career Choice in Medicine is an important and problematic topic. Medical education has been framed as professional identity development, yet career choice has not been viewed as a matter of identity. My primary aim was to offer new insights by exploring career choice using Figured Worlds theory, a socio-cultural theory of identity. Graduate retention is a challenge for many countries, including Ireland. My secondary aim was to address a gap in the data on postgraduate trainees in Ireland and to use the Irish case to illustrate points transferable to other contexts. Methodology & Methods: This was a predominantly qualitative Mixed Methods programme of research. My qualitative studies were oriented towards social constructionism. I collated existing data from the Royal College of Physicians of Ireland (RCPI) and HSE-MET to describe trainees and their career paths. I surveyed Basic Specialist Training trainees (n=333) about their career plans. I surveyed new trainees (n=527) about their expectations of training and all RCPI trainees about their experiences of training (n=1246). I conducted semi-structured interviews with 18 medical students and doctors. A subgroup (n=6) provided longitudinal data. Figured Worlds theory and Gee’s discourse tools were used for analysis. Results: I have used the case of medical training and career choice in Ireland to explain how social, political and cultural context, and day to day experiences in the cultural world of medicine, shaped doctors’ career choices. My qualitative findings described a unifying model of career choice, consisting of priming, exposure, positioning and open-endedness, which can guide the design of interventions to shape and support career choice. Conclusion: My original contribution has been to demonstrate the fruitfulness of framing career choice in terms of identity development. This represents a turn in the conversation about career choice, which brings new starting points and moves the dialogue forward.

Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9

Background: Parental obesity is a predominant risk factor for childhood obesity. Family factors including socio-economic status (SES) play a role in determining parent weight. It is essential to unpick how shared family factors impact on child weight. This study aims to investigate the association between measured parent weight status, familial socio-economic factors and the risk of childhood obesity at age 9. Methodology/Principal Findings: Cross sectional analysis of the first wave (2008) of the Growing Up in Ireland (GUI) study. GUI is a nationally representative study of 9-year-old children (N = 8,568). Schools were selected from the national total (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Children and their parents had height and weight measurements taken using standard methods. Data were reweighted to account for the sampling design. Childhood overweight and obesity prevalence were calculated using International Obesity Taskforce definitions. Multinomial logistic regression examined the association between parent weight status, indicators of SES and child weight. Overall, 25% of children were either overweight (19.3%) or obese (6.6%). Parental obesity was a significant predictor of child obesity. Of children with normal weight parents, 14.4% were overweight or obese whereas 46.2% of children with obese parents were overweight or obese. Maternal education and household class were more consistently associated with a child being in a higher body mass index category than household income. Adjusted regression indicated that female gender, one parent family type, lower maternal education, lower household class and a heavier parent weight status significantly increased the odds of childhood obesity. Conclusions/Significance: Parental weight appears to be the most influential factor driving the childhood obesity epidemic in Ireland and is an independent predictor of child obesity across SES groups. Due to the high prevalence of obesity in parents and children, population based interventions are required.

'Lines of flight': digital musical instruments, inclusive music bands, meaningful engagement in music-making and learning

In this study I examine the development of three inclusive music bands in Cork city. Derived from Jellison’s research on inclusive music education, inclusive music bands involve students with disabilities coming together with typically developing peers to make and learn music that is meaningful (Jellison, 2012). As part of this study, I established three inclusive music bands to address the lack of inclusive music making and learning experiences in Cork city. Each of these bands evolved and adapted in order to be socio-culturally relevant within formal and informal settings: Circles (community education band), Till 4 (secondary school band) and Mish Mash (third level and community band). I integrated Digital Musical Instruments into the three bands, in order to ensure access to music making and learning for band members with profound physical disabilities. Digital Musical Instruments are electronic music devices that facilitate active music making with minimal movement. This is the first study in Ireland to examine the experiences of inclusive music making and learning using Digital Musical Instruments. I propose that the integration of Digital Musical Instruments into inclusive music bands has the potential to further the equality and social justice agenda in music education in Ireland. In this study, I employed qualitative research methodology, incorporating participatory action research methodology and case study design. In this thesis I reveal the experiences of being involved in an inclusive music band in Cork city. I particularly focus on examining whether the use of this technology enhances meaningful music making and learning experiences for members with disabilities within inclusive environments. To both inform and understand the person centered and adaptable nature of these inclusive bands, I draw theoretical insights from Sen’s Capabilities Approach and Deleuze and Guatarri’s Rhizome Theory. Supported by descriptive narrative from research participants and an indepth examination of literature, I discover the optimum conditions and associated challenges of inclusive music practice in Cork city.