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Mentorship is perceived to be an important component of residency education. However, evidence of the impact of mentorship on professional development in Emergency Medicine (EM) is lacking.
Online survey distributed to attending physician members of the Canadian Association of Emergency Physicians (CAEP), using a modified Dillman method. Survey contained questions about mentorship during residency training, and perceptions of the impact of mentorship on career development.
The response rate was 23.5% (309/1314). 63.6% reported having at least one mentor during residency. The proportion of participants with a formal mentorship component during residency was higher among those with mentors (44.5%) compared to those without any formal mentorship component during residency (8.0%, p<0.001). The most common topics discussed with mentors were career planning and work-life balance. The least common topics included research and finances. While many participants consulted their mentor regarding their first job (56.5%), fewer consulted their mentor regarding subspecialty training (45.1%) and research (41.1%). 71.8% chose to work in a similar centre as their mentor, but few completed the same subspecialty (24.8%), or performed similar research (30.4%). 94.1% stated that mentorship was important to success during residency. Participants in a formal mentorship program did not rate their experience of mentorship higher than those without a formal program.
Among academic EM physicians with an interest in mentorship, mentorship during EM residency may have a greater association with location of practice than academic scholarship or subspecialty choice. Formal mentorship programs increase the likelihood of obtaining a mentor, but do not appear to improve reported mentorship experiences.
The discovery of the first electromagnetic counterpart to a gravitational wave signal has generated follow-up observations by over 50 facilities world-wide, ushering in the new era of multi-messenger astronomy. In this paper, we present follow-up observations of the gravitational wave event GW170817 and its electromagnetic counterpart SSS17a/DLT17ck (IAU label AT2017gfo) by 14 Australian telescopes and partner observatories as part of Australian-based and Australian-led research programs. We report early- to late-time multi-wavelength observations, including optical imaging and spectroscopy, mid-infrared imaging, radio imaging, and searches for fast radio bursts. Our optical spectra reveal that the transient source emission cooled from approximately 6 400 K to 2 100 K over a 7-d period and produced no significant optical emission lines. The spectral profiles, cooling rate, and photometric light curves are consistent with the expected outburst and subsequent processes of a binary neutron star merger. Star formation in the host galaxy probably ceased at least a Gyr ago, although there is evidence for a galaxy merger. Binary pulsars with short (100 Myr) decay times are therefore unlikely progenitors, but pulsars like PSR B1534+12 with its 2.7 Gyr coalescence time could produce such a merger. The displacement (~2.2 kpc) of the binary star system from the centre of the main galaxy is not unusual for stars in the host galaxy or stars originating in the merging galaxy, and therefore any constraints on the kick velocity imparted to the progenitor are poor.
The Carolina Sandhills is a physiographic region of the Atlantic Coastal Plain province in the southeastern United States. In Chesterfield County (South Carolina), the surficial sand of this region is the Pinehurst Formation, which is interpreted as eolian sand derived from the underlying Cretaceous Middendorf Formation. This sand has yielded three clusters of optically stimulated luminescence ages: (1) 75 to 37 thousand years ago (ka), coincident with growth of the Laurentide Ice Sheet; (2) 28 to 18 ka, coincident with the last glacial maximum (LGM); and (3) 12 to 6 ka, mostly coincident with the Younger Dryas through final collapse of the Laurentide Ice Sheet. Relict dune morphologies are consistent with winds from the west or northwest, coincident with modern and inferred LGM January wind directions. Sand sheets are more common than dunes because of effects of coarse grain size (mean range: 0.35-0.59 mm) and vegetation. The coarse grain size would have required LGM wind velocities of at least 4-6 m/sec, accounting for effects of colder air temperatures on eolian sand transport. The eolian interpretation of the Carolina Sandhills is consistent with other evidence for eolian activity in the southeastern United States during the last glaciation.
What does friendship have to do with racial difference, settler colonialism and post-apartheid South Africa? While histories of apartheid and colonialism in South Africa have often focused on the ideologies of segregation and white supremacy, Ties that Bind explores how the intimacies of friendship create vital spaces for practices of power and resistance. Combining interviews, history, poetry, visual arts, memoir and academic essay, the collection keeps alive the promise of friendship and its possibilities while investigating how affective relations are essential to the social reproduction of power. From the intimacy of personal relationships to the organising ideology of liberal colonial governance, the contributors explore the intersection of race and friendship from a kaleidoscope of viewpoints and scales. Insisting on a timeline that originates in settler colonialism, Ties that Bind uncovers the implication of anti-blackness within nonracialism, and powerfully challenges a simple reading of the Mandela moment and the rainbow nation. In the wake of countrywide student protests calling for decolonisation of the university, and reignited debates around racial inequality, this timely volume insists that the history of South African politics has always already been about friendship. Written in an accessible and engaging style, Ties that Bind will interest a wide audience of scholars, students and activists, as well as general readers curious about contemporary South African debates around race and intimacy.
We report a case of Uhl’s anomaly imaged at 19 weeks of gestation by fetal echocardiography with pathological confirmation by anatomical gross heart specimen and tissue histology. Uhl’s anomaly of the right ventricle is a rare cardiac disorder with isolated right ventricular enlargement with almost complete absence of the right ventricular myocardium.
Pompe disease is a lysosomal storage disorder caused by a deficiency of the enzyme acid alpha-glucosidase. Patients have skeletal muscle and respiratory weakness with or without cardiomyopathy. The objective of our review was to systematically evaluate the quality of evidence from the literature to formulate evidence-based guidelines for the diagnosis and management of patients with Pompe disease. The literature review was conducted using published literature, clinical trials, cohort studies and systematic reviews. Cardinal treatment decisions produced seven management guidelines and were assigned a GRADE classification based on the quality of evidence in the published literature. In addition, six recommendations were made based on best clinical practices but with insufficient data to form a guideline. Studying outcomes in rare diseases is challenging due to the small number of patients, but this is in particular the reason why we believe that informed treatment decisions need to consider the quality of the evidence.
Infections cause morbidity and mortality in neonatal intensive care units (NICUs). The association between nursery design and nosocomial infections is unclear.
To determine whether rates of colonization by methicillin-resistant Staphylococcus aureus (MRSA), late-onset sepsis, and mortality are reduced in single-patient rooms.
Retrospective cohort study.
NICU in a tertiary referral center.
Our NICU is organized into single-patient and open-unit rooms. Clinical data sets including bed location and microbiology results were examined over 29 months. Differences in outcomes between bed configurations were determined by χ2 and Cox regression.
All NICU patients.
Among 1,823 patients representing 55,166 patient-days, single-patient and open-unit models had similar incidences of MRSA colonization and MRSA colonization-free survival times. Average daily census was associated with MRSA colonization rates only in single-patient rooms (hazard ratio, 1.31; P=.039), whereas hand hygiene compliance on room entry and exit was associated with lower colonization rates independent of bed configuration (hazard ratios, 0.834 and 0.719 per 1% higher compliance, respectively). Late-onset sepsis rates were similar in single-patient and open-unit models as were sepsis-free survival and the combined outcome of sepsis or death. After controlling for demographic, clinical, and unit-based variables, multivariate Cox regression demonstrated that bed configuration had no effect on MRSA colonization, late-onset sepsis, or mortality.
MRSA colonization rate was impacted by hand hygiene compliance, regardless of room configuration, whereas average daily census affected only infants in single-patient rooms. Single-patient rooms did not reduce the rates of MRSA colonization, late-onset sepsis, or death.
Infect Control Hosp Epidemiol 2015;36(10):1173–1182
The Ziegler Reservoir fossil site near Snowmass Village, Colorado (USA), provides a unique opportunity to reconstruct high-altitude paleoenvironmental conditions in the Rocky Mountains during the Last Interglacial Period. We used four different techniques to establish a chronological framework for the site. Radiocarbon dating of lake organics, bone collagen, and shell carbonate, and in situ cosmogenic 10Be and 26Al ages on a boulder on the crest of a moraine that impounded the lake suggest that the ages of the sediments that hosted the fossils are between ~140 ka and >45 ka. Uranium-series ages of vertebrate remains generally fall within these bounds, but extremely low uranium concentrations and evidence of open-system behavior limit their utility. Optically stimulated luminescence (OSL) ages (n = 18) obtained from fine-grained quartz maintain stratigraphic order, were replicable, and provide reliable ages for the lake sediments. Analysis of the equivalent dose (DE) dispersion of the OSL samples showed that the sediments were fully bleached prior to deposition and low scatter suggests that eolian processes were likely the dominant transport mechanism for fine-grained sediments into the lake. The resulting ages show that the fossil-bearing sediments span the latest part of Marine Oxygen Isotope Stage (MIS) 6, all of MIS 5 and MIS 4, and the earliest part of MIS 3.
In North America, terrestrial records of biodiversity and climate change that span Marine Oxygen Isotope Stage (MIS) 5 are rare. Where found, they provide insight into how the coupling of the ocean–atmosphere system is manifested in biotic and environmental records and how the biosphere responds to climate change. In 2010–2011, construction at Ziegler Reservoir near Snowmass Village, Colorado (USA) revealed a nearly continuous, lacustrine/wetland sedimentary sequence that preserved evidence of past plant communities between ~140 and 55 ka, including all of MIS 5. At an elevation of 2705 m, the Ziegler Reservoir fossil site also contained thousands of well-preserved bones of late Pleistocene megafauna, including mastodons, mammoths, ground sloths, horses, camels, deer, bison, black bear, coyotes, and bighorn sheep. In addition, the site contained more than 26,000 bones from at least 30 species of small animals including salamanders, otters, muskrats, minks, rabbits, beavers, frogs, lizards, snakes, fish, and birds. The combination of macro- and micro-vertebrates, invertebrates, terrestrial and aquatic plant macrofossils, a detailed pollen record, and a robust, directly dated stratigraphic framework shows that high-elevation ecosystems in the Rocky Mountains of Colorado are climatically sensitive and varied dramatically throughout MIS 5.