Exodus? The training paths and plans of postgraduate medical trainees, under the Royal College of Physicians of Ireland

Background: In 2006, the Buttimer report highlighted the paucity of demographic data on those applying for and entering postgraduate medical education and training (PGMET) in Ireland. Today, concerns that there is an "exodus" of graduates of Irish medical schools are at the forefront of national discussion, however, published data on PGMET remains inadequate.

Aims: The objectives of this study were to collate existing data relating to trainees and training programmes at three stages of training and to examine the career plans of junior trainees.

Methods: Data from application forms for training programmes, commencing July 2012, under the Royal College of Physicians of Ireland (n = 870), were integrated with data from other existing sources. Candidates entering basic specialist training were surveyed with regard to career plans. Descriptive and comparative analysis was performed in SPSS version 18.

Results: Graduates of Irish medical schools made up over 70 % of appointees. Over 80 % of BST trainees aspired to work as consultants in Ireland, but 92.5 % planned to spend time working abroad (response rate 77 %). Decisions to leave the Irish system were linked to lifestyle, but also to failure to be appointed to higher specialist training. Significant numbers of trainees return to Ireland after a period abroad.

Conclusions: The trainee "exodus" is more complex than is often portrayed. The desire to spend time working outside Ireland must be accounted for in workforce planning and configuration of training programmes. Expansion of HST is a potential solution to reduce the numbers of graduates leaving Ireland post-BST.

Pupil constriction can alter the accuracy of dark room provocative test.

BACKGROUND: Primary angle-closure glaucoma (PACG) is a major cause of visual morbidity in East Asia. Dark-room provocative test (DRPT) has been used to determine which narrow angles have the risk to develop angle closure. However, the accuracy of DRPT might be altered because that after emerging from the dark room, the configuration of the angle is affected by the light of the slit-lamp and the appositionally closed angle reopens. The aim of this study was to examine the pupillary diameter in different light conditions and use it as a parameter to assess the accuracy of dark-room provocative test. METHODS: Patients with suspected primary angle-closure glaucoma undergoing DRPT were recruited. The anterior chamber angle was examined by anterior segment optical coherence tomography under the following conditions: (1) in standard room illumination; (2) after short-term dark-adaptation and (3) after DRPT. Mean values of pupil size and numbers of appositionally closed angle under different conditions were compared. RESULTS: A total of 47 eyes of 47 patients were analyzed. The pupil size after DRPT was smaller than that after short-term dark-adaptation (P < 0.001) and smaller than that in standard room illumination (P = 0.026). The numbers of appositionally closed angles after short-term dark-adaptation were significantly larger than those after DRPT (P < 0.001). There was no significant difference between the numbers of appositionally closed angles in standard room illumination and after DRPT (P = 0.157). CONCLUSIONS: Constriction of pupil size immediately after prolonged dark room provocative test may lead to change in the angle configuration, which may lead to false negative results. We suggest a modified protocol of recording intraocular pressure immediately after DRPT and performing gonioscopy following short-term dark adaptation to improve the accuracy of angle closure assessment.

Assessment of the impact speed and angle conditions for the EN1317 barrier tests

Roadside safety barriers designs are tested with passenger cars in Europe using standard EN1317 in which the impact angle for normal, high and very high containment level tests is 20°. In comparison to EN1317, the US standard MASH has higher impact angles for cars and pickups (25°) and different vehicle masses. Studies in Europe (RISER) and the US have shown values for the 90th percentile impact angle of 30°–34°. Thus, the limited evidence available suggests that the 20° angle applied in EN 1317 may be too low.
The first goal of this paper is to use the US NCHRP database (Project NCHRP 17–22) to assess the distribution of impact angle and collision speed in recent ROR accidents. Second, based on the findings of the statistical analysis and on analysis of impact angles and speeds in the literature, an LS-DYNA finite element analysis was carried out to evaluate the normal containment level of concrete barriers in non-standard collisions. The FE model was validated against a crash test of a portable concrete barrier carried out at the UK Transport Research Laboratory (TRL).
The accident data analysis for run-off road accidents indicates that a substantial proportion of accidents have an impact angle in excess of 20°. The baseline LS-DYNA model showed good comparison with experimental acceleration severity index (ASI) data and the parametric analysis indicates a very significant influence of impact angle on ASI. Accordingly, a review of European run-off road accidents and the configuration of EN 1317 should be performed.

Effective collision strengths for forbidden transitions among the 3s23p3 fine-structure levels of Cl III

Effective collision strengths for the 10 astrophysically important fine-structure forbidden transitions among the ⁴S^o, ²D^o and ²P^o levels in the 3s²3p³ configuration of Cl III are presented. The calculation employs the multichannel R-matrix method to compute the electron-impact excitation collision strengths in a close-coupling expansion, which incorporates the lowest 23 LS target eigenstates of Cl III. These states are formed from the 3s²3p³, 3s3p⁴, 3s²3p²3d and 3s²3p²4s configurations. The Maxwellian-averaged effective collision strengths are presented graphically for all 10 fine-structure transitions over a wide range of electron temperatures appropriate for astrophysical applications [log T(K) = 3.3 - log T(K) = 5.9]. Comparisons are made with the earlier seven-state close-coupling calculation of Butler & Zeippen, and in general excellent agreement is found in the low-temperature region where a comparison is possible [log T(K) = 3.3 - log T(K) = 4.7]. However, discrepancies of up to 30 per cent are found to occur for the forbidden transitions which involve the ⁴S^o ground state level, particularly for the lowest temperatures considered. At the higher temperatures, the present data are the only reliable results currently available.

The Un-Politics of New Public Management in Ireland

Many of the principles and indeed the rhetoric of New Public Management proved attractive to both politicians and senior bureaucrats across the developed world as a remedy for problems in policy processes. Ireland shares many features of its constitutional structures and political practices with Britain, Canada, Australia, New Zealand, all of them early and enthusiastic adopters of NPM. Some of the organizational and procedural changes in Irish public administration do indeed bear similarities to those we would expect to see as a result of adopting principles of NPM. However, we contend that surface impressions are misleading. Drawing on a time-series database of Irish state institutions, we show that organizational changes were not necessarily driven by NPM. The absence of strong political drivers meant that reform initiatives did not fundamentally alter the configuration of the Irish public administration. Many of the problems that NPM was intended to address are only now coming under scrutiny.

Transcallosal connectivity of the human cortical motor network

The organizational and architectural configuration of white matter pathways connecting brain regions has ramifications for all facets of the human condition, including manifestations of incipient neurodegeneration. Although diffusion tensor imaging (DTI) has been used extensively to visualize white matter connectivity, due to the widespread presence of crossing fibres, the lateral projections of the corpus callosum are not normally detected using this methodology. Detailed knowledge of the transcallosal connectivity of the human cortical motor network has therefore remained elusive. We employed constrained spherical deconvolution (CSD) tractography - an approach that is much less susceptible to the influence of crossing fibres, in order to derive complete in-vivo characterizations of white matter pathways connecting specific motor cortical regions to their counterparts and other loci in the opposite hemisphere. The revealed patterns of connectivity closely resemble those derived from anatomical tracing in primates. It was established that dorsal premotor cortex (PMd) and supplementary motor area (SMA) have extensive interhemispheric connectivity - exhibiting both dense homologous projections, and widespread structural relations with every other region in the contralateral motor network. Through this in-vivo portrayal, the importance of non-primary motor regions for interhemispheric communication is emphasized. Additionally, distinct connectivity profiles were detected for the anterior and posterior subdivisions of primary motor cortex. The present findings provide a comprehensive representation of transcallosal white matter projections in humans, and have the potential to inform the development of models and hypotheses relating structural and functional brain connectivity.

Narratively framing emergent identities in post-agreement societies: patterns of the Northern Irish identity within the provincial media

The research analyses ‘Northern Irish’ identity narratives post-agreement, and examines the configuration of frame agendas in terms of individual narrative components. A content analysis utilised news published through 1997–2014 within Northern Ireland daily newspapers – the Belfast Telegraph, the Irish News and the News Letter. A process of manifest coding produced an emergent coding scheme displaying the relative stability of media frames surrounding the Northern Irish identity as broadly partisan; however, there is also a subtle narrative shift of Northern Irish identity across the time periods; and findings of a dominant framing paradigm of political and social conceptions of identification post-agreement.

Performing Space

This article discusses how the notion of performance provides impetus for the design of interactive digital environments. These environments can ultimately be regarded as user-spaces; a condition which replaces the "fixed" art-object with a configuration of interactions. Our understanding of space, as suggested by Lefevbre (2001), defines the "inhabitant" as a full participant, a user, a performer of space. What is at play when the installation artist designs environments that invite performative exploration? The issue of improvised performance in the inhabiting of installation spaces is exposed. Two interactive installations by the author and works by others in the field provide a context for discussion for discussion and analysis.

Self-assembled triple helicates with preferential helicity

The enantiomerically pure ligands LRR and LSS (N,N'-bis(-2,2'-bipyridyl-5-yl)carbonyl-(1S/R,2S/R)-(+/-)-1,2-diaminocyclohexane) have been synthesised by linking two 2,2'-bipyridine units by (R,R)- and (S,S)-1,2-diaminocyclohexane respectively. The crystal structure confirmed that the ligand had a twisted orientation between the two chelating units. The reaction of LRR and LSS with Fe(II), Co(III), Cd(II) and Zn(II) afforded dinuclear complexes confirmed by ES mass spectroscopy. CD spectroscopy indicated that the chiral diaminocyclohexane conferred helicity to the metal centre giving a dominant triple helicate diastereoisomer, with the LRR ligand giving a delta-configuration of each metal centre (P helicate) and the LSS ligand a lambda configuration (M helicate). 1H NMR spectroscopy confirmed a dominant major diastereoisomer with cadmium. The Zn(II) and Cd(II) complexes however were observed to undergo rapid ligand dissociation in solution.

Compact ridge waveguide filter with parallel and series-coupled resonators

A novel 3rd-order compact E-plane ridge waveguide filter is presented. Miniaturization is achieved upon introducing a configuration of parallel-coupled E-plane ridge waveguide resonators. Furthermore, the proposed filter allows for transmission zeros at finite frequencies. Fabrication simplicity and mass producibility of standard E-plane filters is maintained. The numerical and experimental results are presented to validate the proposed configuration. A miniaturisation factor of 2 and very sharp upper cutoff are achieved. 2005 Wiley Periodicals, Inc.

Translating evidence into practice: A shared priority in public health?

Translational and transdisciplinary research is needed to tackle complex public health problems. This article has three aims. Firstly, to determine how academics and non-academics (practitioners, policy makers and community workers) identified with the goals of the UKCRC Centre of Excellence for Public Health in Northern Ireland and how their attitudes varied in terms of knowledge brokerage and translation. Secondly, to map and analyse the network structure of the public health sector and the placement of the Centre within this. Thirdly, to aggregate responses from members of the network by work setting to construct the trans-sectoral network and devise the Root Mean Sum of Squares to determine the quality and potential value of connections across this network.The analysis was based on data collected from 98 individuals who attended the launch of the Centre in June 2008. Analysis of participant expectations and personal goals suggests that the academic members of the network were more likely to expect the work of the Centre to produce new knowledge than non-academics, but less likely to expect the Centre to generate health interventions and influence health policy. Academics were also less strongly oriented than non-academics to knowledge transfer as a personal goal, though more confident that research findings would be diffused beyond the immediate network. A central core of five nodes is crucial to the overall configuration of the regional public health network in Northern Ireland, with the Centre being well placed to exert influence within this. Though the overall network structure is fairly robust, the connections between some component parts of the network - such as academics and the third sector - are unidirectional.Identifying these differences and core network structure is key to translational and transdisciplinary research. Though exemplified in a regional study, these techniques are generalisable and applicable to many networks of interest: public health, interdisciplinary research or organisational involvement and stakeholder linkage.

Optomechanical cooling with generalized interferometers

The fields in multiple-pass interferometers, such as the Fabry-Pérot cavity, exhibit great sensitivity not only to the presence but also to the motion of any scattering object within the optical path. We consider the general case of an interferometer comprising an arbitrary configuration of generic beam splitters and calculate the velocity-dependent radiation field and the light force exerted on a moving scatterer. We find that a simple configuration, in which the scatterer interacts with an optical resonator from which it is spatially separated, can enhance the optomechanical friction by several orders of magnitude.

Dynamical scattering models in optomechanics: Going beyond the 'coupled cavities' model

Recently [A. Xuereb, et al., Phys. Rev. Lett. 105, 013602 (2010)], we calculated the radiation field and the optical forces acting on a moving object inside a general one-dimensional configuration of immobile optical elements. In this article we analyse the forces acting on a semi-transparent mirror in the 'membrane-in-the-middle' configuration and compare the results obtained from solving scattering model to those from the coupled cavities model that is often used in cavity optomechanical system. We highlight the departure of this model from the more exact scattering theory when the reflectivity of the moving element drops below about 50%.

Developing Approaches for Solving a Telecommunications Feature Subscription Problem

Call control features (e.g., call-divert, voice-mail) are primitive options to which users can subscribe off-line to personalise their service. The configuration of a feature subscription involves choosing and sequencing features from a catalogue and is subject to constraints that prevent undesirable feature interactions at run-time. When the subscription requested by a user is inconsistent, one problem is to find an optimal relaxation, which is a generalisation of the feedback vertex set problem on directed graphs, and thus it is an NP-hard task. We present several constraint programming formulations of the problem. We also present formulations using partial weighted maximum Boolean satisfiability and mixed integer linear programming. We study all these formulations by experimentally comparing them on a variety of randomly generated instances of the feature subscription problem.

The two-way relationship between the Balanced Scorecard and Management Control Systems in organizations:Lessons from a Case Study

This paper reports a case study conducted in Quinta da Aveleda, one of
the three largest Portuguese wine companies. Our aim was to explore the
relationship established between a newly implemented Balanced Scorecard
(BSC) and the elements of the Management Control System (MCS) in the
organization. Thus, two specific objectives were pursued. Firstly, to identify
the influences (barriers, opportunities) of the existing MCS on the implementation
of the BSC. Secondly, to identify the impacts the BSC implementation
was able to exert on the configuration of the organization’s MCS.
We found that the budgeting process, the planning system, the information
infrastructure, and the organizational structure and culture were the elements
of the previous MCS that influenced the BSC implementation process.
Eventually, the BSC implementation led to important changes in the budgeting,
planning, reporting systems and processes. In order to explain these
findings, we briefly explored the main issues and factors accounting for the
scope and nature of the BSC’s impacts on Quinta da Aveleda. These issues
and factors were the mobilized organizational resources, the implementation
approach, the communication, and the organizational support.