In-training assessment - Its potential in enhancing clinical teaching

Context In-training assessment (ITA) has established its place alongside formative and summative assessment at both the undergraduate and postgraduate level. In this paper the authors aimed to identify those characteristics of ITA that could enhance clinical teaching. Methods A literature review and discussions by an expert working group at the Ninth Cambridge Conference identified the aspects of ITA that could enhance clinical teaching. Results The features of ITA identified included defining the specific benefits to the learner, teacher and institution, and highlighting the patient as the context for ITA and clinical teaching. The ‘mapping’ of a learner’s progress towards the clinical teaching objectives by using multiple assessments over time, by multiple observers in both a systematic and opportunistic way correlates with the incremental nature of reaching clinical competence. Conclusions The importance of ITA based on both direct and indirect evidence of what the learner actually does in the real clinical setting is emphasized. Particular attention is given to addressing concerns in the more controversial areas of assessor training, ratings and documentation for ITA. Areas for future research are also identified.

Stability Training and Measurement System for Sportsperson (P84)

Balance and stability are very important for everybody and especially for sports-person who undergo extreme physical activities. Balance and stability exercises not only have a great impact on the performance of the sportsperson but also play a pivotal role in their rehabilitation. Therefore, it is very essential to have knowledge about a sportsperson’s balance and also to quantify the same. In this work, we propose a system consisting of a wobble board, with a gyro enhanced orientation sensor and a motion display for visual feedback to help the sportsperson improve their stability. The display unit gives in real time the orientation of the wobble board, which can help the sportsperson to apply necessary corrective forces to maintain neutral position. The system is compact and portable. We also quantify balance and stability using power spectral density. The sportsperson is made stand on the wobble board and the angular orientation of the wobble board is recorded for each 0.1 second interval. The signal is analized using discrete Fourier transforms. The power of this signal is related to the stability of the subject. This procedure is used to measure the balance and stability of an elite cricket team. Representative results are shown below: Table 1 represents power comparison of two subjects and Table 2 represents power comparison of left leg and right leg of one subject. This procedure can also be used in clinical practice to monitor improvement in stability dysfunction of sportsperson with injuries or other related problems undergoing rehabilitation.

12-weeks supervised exercise training is a feasible and efficacious treatment for reducing depression in youth with major depressive disorder

Introduction: Major Depressive Disorder (MDD) has high prevalence among adolescents and young adults. Evidence of any effective treatments is limited. Exercise as an effective treatment for adults has some support but studies in younger populations are lacking. Therefore the aim of this study was to investigate the feasibility and preliminary efficacy of brief motivational interviewing (MI) plus 12-weeks exercise training as a treatment for MDD in youth...

Coping style and ecstasy use motives as predictors of current mood symptoms in ecstasy users

Background Elevated depressive and anxiety symptoms during childhood and adolescence have been associated with greater risk of later ecstasy use. Ecstasy users have reported using ecstasy to reduce depression or worry, or to escape. While these findings suggest that some people use ecstasy as a form of self-medication, limited research has been conducted examining the relationship between affective symptoms, coping styles and drug use motives in ecstasy users. This cross-sectional study aimed to determine if coping style and/or ecstasy use motives are associated with current mood symptoms in ecstasy users. Methods A community sample (n = 184) of 18–35 year olds who had taken ecstasy at least once in the past 12 months completed self-report measures of depression, anxiety, ecstasy use motives and coping styles. Timeline followback methods were used to collect information on lifetime ecstasy, recent drug use and life stress. Trauma exposure was measured using the Composite International Diagnostic Interview—Trauma List. Results Coping motives for ecstasy use and an emotion-focused coping style were significantly associated with current depressive and anxiety symptoms. Emotion-focused coping mediated the relationship between a history of trauma and current anxiety symptoms and moderated the relationship between recent stressful life events and current depressive symptoms. Conclusions These findings highlight the importance of interventions targeting motives for ecstasy use, and providing coping skills training for managing stressful life events among people with co-occurring depressive/anxiety symptoms and ecstasy use.

Vibrational phase relaxation of O–H stretch in bulk water: Role of large amplitude angular jumps and negative cross-correlations among the forces on the O–H bond

The ultrafast vibrational phase relaxation of O–H stretch in bulk water is investigated in molecular dynamics simulations. The dephasing time (T2) of the O–H stretch in bulk water calculated from the frequency fluctuation time correlation function (Cω(t)) is in the range of 70–80 femtosecond (fs), which is comparable to the characteristic timescale obtained from the vibrational echo peak shift measurements using infrared photon echo [W.P. de Boeij, M.S. Pshenichnikov, D.A. Wiersma, Ann. Rev. Phys. Chem. 49 (1998) 99]. The ultrafast decay of Cω(t) is found to be responsible for the ultrashort T2 in bulk water. Careful analysis reveals the following two interesting reasons for the ultrafast decay of Cω(t). (A) The large amplitude angular jumps of water molecules (within 30–40 fs time duration) provide a large scale contribution to the mean square vibrational frequency fluctuation and gives rise to the rapid spectral diffusion on 100 fs time scale. (B) The projected force, due to all the atoms of the solvent molecules on the oxygen (FO(t)) and hydrogen (FH(t)) atom of the O–H bond exhibit a large negative cross-correlation (NCC). We further find that this NCC is partly responsible for a weak, non-Arrhenius temperature dependence of the dephasing rate.

Total cross-section at LHC from minijets and soft gluon resummation in the infrared region

A model for total cross-sections incorporating QCD jet cross-sections and soft gluon resummation is described and compared with present data on pp and pp cross-sections. Predictions for LHC are presented for different parameter sets. It is shown that they differ according to the small x-behaviour of available parton density functions.

Infrared gluons, intrinsic transverse momentum and rising total cross-sections

We discuss the infrared limit for soft gluon k(t)-resummation and relate it to physical observables such as the intrinsic transverse momentum and the high energy limit of total cross-sections.

Novel application of a discrete choice experiment to identify preferences for a national healthcare-associated infection surveillance programme: A cross-sectional study

Objective: To identify key stakeholder preferences and priorities when considering a national healthcare-associated infection (HAI) surveillance programme through the use of a discrete choice experiment (DCE). Setting: Australia does not have a national HAI surveillance programme. An online web-based DCE was developed and made available to participants in Australia. Participants: A sample of 184 purposively selected healthcare workers based on their senior leadership role in infection prevention in Australia. Primary and secondary outcomes: A DCE requiring respondents to select 1 HAI surveillance programme over another based on 5 different characteristics (or attributes) in repeated hypothetical scenarios. Data were analysed using a mixed logit model to evaluate preferences and identify the relative importance of each attribute. Results: A total of 122 participants completed the survey (response rate 66%) over a 5-week period. Excluding 22 who mismatched a duplicate choice scenario, analysis was conducted on 100 responses. The key findings included: 72% of stakeholders exhibited a preference for a surveillance programme with continuous mandatory core components (mean coefficient 0.640 (p<0.01)), 65% for a standard surveillance protocol where patient-level data are collected on infected and non-infected patients (mean coefficient 0.641 (p<0.01)), and 92% for hospital-level data that are publicly reported on a website and not associated with financial penalties (mean coefficient 1.663 (p<0.01)). Conclusions: The use of the DCE has provided a unique insight to key stakeholder priorities when considering a national HAI surveillance programme. The application of a DCE offers a meaningful method to explore and quantify preferences in this setting.

Guided respiration mindfulness therapy: Development and evaluation of a brief therapist training program

The present paper describes the development and evaluation of a standardized multi-component therapist training program in guided respiration mindfulness therapy (GRMT). GMRT is a manual-based, experimental clinical intervention involving concentrated focus on sustained self-regulation of breathing, application of mindfulness to emergent somatic experience and relaxation. Therapists (n = 61) new to the approach attended a 2-day experiential workshop and were evaluated pre-post workshop for change in intervention knowledge, as well as change in mindfulness. These trainees also participated in post-workshop focus group sessions to explore perception of the intervention. A subset of 40 therapists participated in a second training component, and 14 of these were rated for competent delivery of the intervention during participation in a clinical trial. During training, therapists personally received the treatment giving the opportunity to assess treatment session (n = 283) impact on sense of wellbeing. Results indicated a brief focused training program can equip therapists with basic knowledge and skills required to deliver the standardized manual-based treatment. Qualitative analysis of focus group sessions showed that therapists endorsed the intervention for clinical use and found it personally beneficial. This research provides a foundation for further evaluation of clinical effectiveness of the intervention.

Workplace training and generic and technical skill development in the Australian construction industry

- Purpose The purpose of this paper is to investigate the current skills gap in both generic and skill areas within the construction industry in Queensland, Australia. - Design/methodology/approach An internet-based survey was administered to collect the opinions of construction employees about the workplace-training environment and their perceptions towards training. The survey intended to address the following research questions, specifically in relation to the construction industry. - Findings The survey results reveal that whilst overall participation in workplace training is high, the current workplace training environments do not foster balanced skill development. The study reveals that in the current absence of a formal and well-balanced training mechanism, construction workers generally resort to their own informal self-development initiatives to develop the needed role-specific theoretical knowledge. - Research limitations/implications The findings of the research are based on the data primarily collected in the construction industry in Queensland, Australia. The data are limited to a single Tier 2 construction company. - Practical implications The findings of this study can be utilised to suggest improvements in the current (or develop new) workplace training initiatives. - Social implications The research suggests that workplace training has positive relationship with career growth. The results suggest that in the construction industry, employees are generally well aware of the importance of workplace training in their career development and they largely appreciate training as being a critical factor for developing their capacity to perform their roles successfully, and to maintain their employability. - Originality/value This paper is unique as it investigates the current skills gap in both generic and skill areas within the construction industry in Queensland, Australia. So far no work has been undertaken to identify and discusses the main method of workplace learning within the Tier 2 industry in the context of Queensland Australia.

Training for reduction of design waste

Construction and demolition (C&D) waste have negative impacts on the environment. As a significant proportion of C&D waste is related to the design stage of a project, there is an opportunity for architects to reduce the waste. However, research suggests that many architects often do not understand the impact of their design on waste generation. Training and education are proposed by current researchers to improve architects’ knowledge; however, this has not been adequately validated as a viable approach to solving waste issues. This research investigates architects’ perceptions towards waste management in the design phase, and determines whether they feel they are adequately skilled in reducing C&D waste. Questionnaire surveys were distributed to architects from 98 architectural firms and 25 completed surveys were returned. The results show that while architects are aware of the relationship between design and waste, ‘extra time’ and ‘lack of knowledge’ are the key barriers to implementing waste reduction strategies. In addition, the majority of respondents acknowledge their lack of skill to reduce waste through design evaluation. Therefore, training programmes can be a viable strategy to enable them to address the pressing issue of C&D waste reduction.

Asymmetric cross-coupled differential pair configuration to realize neuron activation function and its derivative

In this brief, we present a new circuit technique to generate the sigmoid neuron activation function (NAF) and its derivative (DNAF). The circuit makes use of transistor asymmetry in cross-coupled differential pair to obtain the derivative. The asymmetry is introduced through external control signal, as and when required. This results in the efficient utilization of the hard-ware by realizing NAF and DNAF using the same building blocks. The operation of the circuit is presented in the subthreshold region for ultra low-power applications. The proposed circuit has been experimentally prototyped and characterized as a proof of concept on the 1.5-mum AMI technology.

Unfolding of Plasmodium falciparum Triosephosphate Isomerase in Urea and Guanidinium Chloride: Evidence for a Novel Disulfide Exchange Reaction in a Covalently Cross-Linked Mutant†

The conformational stability of Plasmodium falciparum triosephosphate isomerase (TIMWT) enzyme has been investigated in urea and guanidinium chloride (GdmCl) solutions using circular dichroism, fluorescence, and size-exclusion chromatography. The dimeric enzyme is remarkably stable in urea solutions. It retains considerable secondary, tertiary, and quaternary structure even in 8 M urea. In contrast, the unfolding transition is complete by 2.4 M GdmCl. Although the secondary as well as the tertiary interactions melt before the perturbation of the quaternary structure, these studies imply that the dissociation of the dimer into monomers ultimately leads to the collapse of the structure, suggesting that the interfacial interactions play a major role in determining multimeric protein stability. The C-m(urea)/C-m(GdmCl) ratio (where C-m is the concentration of the denaturant required at the transition midpoint) is unusually high for triosephosphate isomerase as compared to other monomeric and dimeric proteins. A disulfide crosslinked mutant protein (Y74C) engineered to form two disulfide cross-links across the interface (13-74') and (13'-74) is dramatically destablized in urea. The unfolding transition is complete by 6 M urea and involves a novel mechanism of dimer dissociation through intramolecular thiol-disulfide exchange.