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Neuropsychiatry training in the UK currently lacks a formal scheme or qualification, and its demand and availability have not been systematically explored. We conducted the largest UK-wide survey of psychiatry trainees to examine their experiences in neuropsychiatry training.
Results
In total, 185 trainees from all UK training regions completed the survey. Although 43.6% expressed interest in a neuropsychiatry career, only 10% felt they would gain sufficient experience by the end of training. Insufficient access to clinical rotations was the most common barrier, with significantly better access in London compared with other regions. Most respondents were in favour of additional neurology training (83%) and a formal accreditation in neuropsychiatry (90%).
Clinical implications
Strong trainee interest in neuropsychiatry contrasts with the limited training opportunities currently available nationally. Our survey highlights the need for increased neuropsychiatry training opportunities, development of a formalised training programme and a clinical accreditation pathway for neuropsychiatry in the UK.
Let $G$ be a split semisimple group over a global function field $K$. Given a cuspidal automorphic representation $\Pi$ of $G$ satisfying a technical hypothesis, we prove that for almost all primes $\ell$, there is a cyclic base change lifting of $\Pi$ along any $\mathbb {Z}/\ell \mathbb {Z}$-extension of $K$. Our proof does not rely on any trace formulas; instead it is based on using modularity lifting theorems, together with a Smith theory argument, to obtain base change for residual representations. As an application, we also prove that for any split semisimple group $G$ over a local function field $F$, and almost all primes $\ell$, any irreducible admissible representation of $G(F)$ admits a base change along any $\mathbb {Z}/\ell \mathbb {Z}$-extension of $F$. Finally, we characterize local base change more explicitly for a class of toral representations considered in work of Chan and Oi.
OBJECTIVES/GOALS: Community-based residency programs often lack formal training in research scholarship required by ACGME. To address this need, UCSF’s CTSI collaborated with residency leaders to implement a self-paced online curriculum for residents called Training in Practice Based Research (TIPR). We describe characteristics of the initial trainee cohort. METHODS/STUDY POPULATION: In the 2022-23 academic year, TIPR was offered to 10 UCSF-affiliated family medicine residency programs across Northern California and the Central Valley, and 8 chose to participate. An additional community-based psychiatry residency independently contacted our team and was also granted permission to participate. We conducted baseline surveys with participants to understand their prior research experience and motivation to join TIPR. Descriptive data for demographics of trainees and their prior research experience were collected using Qualtrics. Thematic analyses were conducted on qualitative responses. RESULTS/ANTICIPATED RESULTS: Of 32 participants, 29 completed the survey (91%). Learners identified as 40% non-Hispanic White, 28% Asian, 16% Hispanic, 9% non-Hispanic Black, and 15% non-Hispanic other. 28% were motivated to participate in the program because it was a residency requirement, 31% wanted to improve their scholarly skills and confidence, 16% were interested in career development, and 6% were interested in networking. 19% reported no research experience. Participants are currently working on scholarly projects designed during the first year of TIPR. In 2023-2024, with the addition of two new family medicine residency programs, an additional 40 residents have enrolled in TIPR. In April 2024, we will present data on projects completed, and demographics of the full cohort. DISCUSSION/SIGNIFICANCE: With CTSI support, TIPR has reached a large cohort of ethnically diverse physician trainees in community-based settings. Future evaluation will focus on whether TIPR increases the quantity and quality of practice-based research within residency training programs served by this program.
Simple extended constant capacitance surface complexation models have been developed to represent the adsorption of polyaromatic dyes (9-aminoacridine, 3,6-diaminoacridine, azure A and safranin O) to kaolinite, and the competitive adsorption of the dyes with Cd. The formulation of the models was based on data from recent publications, including quantitative adsorption measurements over a range of conditions (varying pH and concentration), acid-base titrations and attenuated total reflectance-Fourier transform infrared spectroscopic data. In the models the dye molecules adsorb as aggregates of three or four, forming outer-sphere complexes with sites on the silica face of kaolinite. Both electrostatic and hydrophobic interactions are implicated in the adsorption processes. Despite their simplicity, the models fit a wide range of experimental data, thereby supporting the underlying hypothesis that the flat, hydrophobic, but slightly charged silica faces of kaolinite facilitate the aggregation and adsorption of the flat, aromatic, cationic dye molecules.
Research among non-industrial societies suggests that body kinematics adopted during running vary between groups according to the cultural importance of running. Among groups in which running is common and an important part of cultural identity, runners tend to adopt what exercise scientists and coaches consider to be good technique for avoiding injury and maximising performance. In contrast, among groups in which running is not particularly culturally important, people tend to adopt suboptimal technique. This paper begins by describing key elements of good running technique, including landing with a forefoot or midfoot strike pattern and leg oriented roughly vertically. Next, we review evidence from non-industrial societies that cultural attitudes about running associate with variation in running techniques. Then, we present new data from Tsimane forager–horticulturalists in Bolivia. Our findings suggest that running is neither a common activity among the Tsimane nor is it considered an important part of cultural identity. We also demonstrate that when Tsimane do run, they tend to use suboptimal technique, specifically landing with a rearfoot strike pattern and leg protracted ahead of the knee (called overstriding). Finally, we discuss processes by which culture might influence variation in running techniques among non-industrial societies, including self-optimisation and social learning.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
Edited by
Jesper Gulddal, University of Newcastle, New South Wales,Alistair Rolls, University of Newcastle, New South Wales,Stewart King, Monash University, Victoria
The adventures of Sherlock Holmes and John Watson begin at the end of Watson's personal mobility. He has ‘gravitated to London, that great cesspool into which all the loungers and idlers of the Empire are irresistibly drained’, with his health, and his career as a colonial medic, ‘irretrievably ruined’ (Doyle 2006: 14). Watson, curious about his new flatmate's profession, makes a list of his new friend's unique specializations and areas of ignorance – Holmes possesses a precise knowledge of London and the surrounding suburbs and an encyclopaedic catalogue of crime and chemistry, but knows little else (34). Holmes's unconventional occupation is revealed not in some dramatic conversation about a crime, but through his particular beliefs about the brain's ability to store a finite amount of information, like an ‘attic’ belonging to a ‘workman’ (32). Sherlock Holmes, with his carefully stocked ‘brain attic’, is a domestic detective and so his skills are described in domestic terms. The ‘attic’ is immobile; his skills are limited and specialized; and his knowledge of London's geography is not transferrable to another locale. He is so narrowly specialized that we (and even Watson) might say he is provincial.
The irony in calling Sherlock Holmes provincial is that his province, his region or specialty, is London as the Victorian imperial centre. Holmes is an ideal late-Victorian scientist taken to a distinctly un-Victorian extreme of specificity. And yet, this strange, provincial character is central both in imperial space, as London's superdetective, and in the international genre of detective fiction writ large, as a prototype of ‘the great consulting detective’. Holmes's empire over the genre is wide but the character’s abilities as a detective are decidedly narrow.
There is a parallel relationship between how a great detective's skills are described and how the space they inhabit relates to imperial-cultural centres. A Holmes-like detective whose investigative space includes a different type of space or place might choose a different metaphor than ‘brain attic’ to describe their investigative toolkit, as their relationship to their space is different. Adapting a genre's conventions or tropes to local conditions and conventions is a well-studied phenomenon. What is not often discussed, and what is revealed by these subtle changes to Holmes-like detectives, is the politics inherent in this practice.
To identify potential participants for clinical trials, electronic health records (EHRs) are searched at potential sites. As an alternative, we investigated using medical devices used for real-time diagnostic decisions for trial enrollment.
Methods:
To project cohorts for a trial in acute coronary syndromes (ACS), we used electrocardiograph-based algorithms that identify ACS or ST elevation myocardial infarction (STEMI) that prompt clinicians to offer patients trial enrollment. We searched six hospitals’ electrocardiograph systems for electrocardiograms (ECGs) meeting the planned trial’s enrollment criterion: ECGs with STEMI or > 75% probability of ACS by the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI). We revised the ACI-TIPI regression to require only data directly from the electrocardiograph, the e-ACI-TIPI using the same data used for the original ACI-TIPI (development set n = 3,453; test set n = 2,315). We also tested both on data from emergency department electrocardiographs from across the US (n = 8,556). We then used ACI-TIPI and e-ACI-TIPI to identify potential cohorts for the ACS trial and compared performance to cohorts from EHR data at the hospitals.
Results:
Receiver-operating characteristic (ROC) curve areas on the test set were excellent, 0.89 for ACI-TIPI and 0.84 for the e-ACI-TIPI, as was calibration. On the national electrocardiographic database, ROC areas were 0.78 and 0.69, respectively, and with very good calibration. When tested for detection of patients with > 75% ACS probability, both electrocardiograph-based methods identified eligible patients well, and better than did EHRs.
Conclusion:
Using data from medical devices such as electrocardiographs may provide accurate projections of available cohorts for clinical trials.
This report uses 6-year outcomes of the Oregon Divorce Study to examine the processes by which parenting practices affect deviant peer association during two developmental stages: early to middle childhood and late childhood to early adolescence. The participants were 238 newly divorced mothers and their 5- to 8-year-old sons who were randomly assigned to Parent Management Training—Oregon Model (PMTO®) or to a no-treatment control group. Parenting practices, child delinquent behavior, and deviant peer association were repeatedly assessed from baseline to 6 years after baseline using multiple methods and informants. PMTO had a beneficial effect on parenting practices relative to the control group. Two stage models linking changes in parenting generated by PMTO to children's growth in deviant peer association were supported. During the early to middle childhood stage, the relationship of improved parenting practices on deviant peer association was moderated by family socioeconomic status (SES); effective parenting was particularly important in mitigating deviant peer association for lower SES families whose children experience higher densities of deviant peers in schools and neighborhoods. During late childhood and early adolescence, the relationship of improved parenting to youths' growth in deviant peer association was mediated by reductions in the growth of delinquency during childhood; higher levels of early delinquency are likely to promote deviant peer association through processes of selective affiliation and reciprocal deviancy training. The results are discussed in terms of multilevel developmental progressions of diminished parenting, child involvement in deviancy producing processes in peer groups, and increased variety and severity of antisocial behavior, all exacerbated by ecological risks associated with low family SES.
Contemporary research on prehispanic Maya landscapes has focused on caves as core features of the cultural geography. Investigations within a number of large caves have suggested that they served as the loci for important rituals, legitimized inhabitants’ claims to their territory, and helped establish the authority of a site’s ruling elite. The ubiquity and centrality of caves in the Maya worldview raises questions about what happened in regions where large caves did not naturally form. Recent investigations at the site of Maax Na in northern Belize suggest that small caves, despite their diminutive size, still functioned to establish legitimacy and uphold power. The results serve to demonstrate the pervasive power of key ideological concepts in shaping the cultural landscape and indicate the need to take these into account in documenting landmarks at Maya sites, as even the less imposing ones may have been important to their inhabitants.