Search

The Supervisor Support Consensus Statement has been developed after consultation with supervisors of surgical training for the Royal Australasian College of Surgeons (RACS) programmes in Australia and Aotearoa New Zealand and other key stakeholders. Six key areas have been recognized with specific recommendations crafted to improve the support and recognition of Supervisors: 1. Clarity of role, 2. Education and Training, 3. Local support, 4. RACS support, 5. Recognition and valuing of the Supervisor role, 6. Risk Management. The purpose of this consensus statement is to clearly articulate supervisor opinions on the support they require to undertake this important role. It has been produced by an independent writing group of experienced surgical supervisors and educators, with support from RACS education department. The consensus statement is a response to a needs assessment of supervisors of surgical training. The statements in this consensus document have been generated from comments and feedback from supervisors that have been refined through process of extensive consultation using a Delphi methodology. We advise specialty training Committees consider these statements and mandate them as part of their accreditation of terms. The role of the supervisor of training requires greater recognition, and incorporation in the Enterprise Bargaining Agreement (EBA) in Australia and the ASMS Te Whatu Ora SECA in Aotearoa New Zealand would ensure the provisions in this document are enacted. The six areas identified have transferability to other specialities and countries and are valuable when considering how to support supervisors involved in training our next generation of specialist doctors. The purpose of this consensus statement is to clearly articulate supervisors' opinions on the support they require to undertake this important role. Six key areas have been recognized with specific recommendations crafted to improve the support and recognition of Supervisors: 1. Clarity of role, 2. Education and Training, 3. Local support, 4. RACS support, 5. Recognition and valuing of the Supervisor role, 6. Risk Management. The role of the supervisor of training requires greater recognition, and incorporation in the all facets of training in hospitals and by training boards would ensure the provisions in this document are enacted. [ABSTRACT FROM AUTHOR]

During the 1990s, coastal habitat off southeastern Massachusetts (SEMA) supported commercially viable fisheries for American lobster (Homarus americanus). Over the past two decades, landings and post‐larval settlement of lobsters in this region, which is near the southern edge of the species' range, have declined substantially, concurrent with a period of significant warming of the coastal waters off southern New England. Previous work has suggested that rising ocean temperatures may adversely impact the survival of larval and early benthic phase (EBP) lobsters and may cause adult lobsters to seek cooler offshore waters during the critical time of larval release. To investigate the manner in which the observed decline in lobster abundance may be linked to warming coastal waters, a high‐resolution hydrodynamic model was used to quantify the increase in water temperature experienced by EBP lobster off SEMA and to supply input to an individual‐based model of lobster larval transport from release areas delineated using fishery‐dependent data of late‐stage egg‐bearing lobsters. The results indicate that rising coastal water temperatures may have adversely impacted EBP lobster recruitment off SEMA by (1) causing an offshore shift in the area of larval release that resulted in a reduction in the delivery of larvae to suitable nearshore EBP habitat and (2) dramatically increasing thermal stress experienced by recently settled EBP lobsters. These findings highlight the implications of warming coastal waters on southern New England lobster population connectivity and provide insight to an understudied mechanism by which climate change affects marine species recruitment. [ABSTRACT FROM AUTHOR]

Background: Superior patient outcomes rely on surgical training being optimized. Accordingly, we conducted an international, prospective, cross‐sectional study determining relative impacts of COVID‐19, gender, race, specialty and seniority on mental health of surgical trainees. Method: Trainees across Australia, New Zealand and UK enrolled in surgical training accredited by the Royal Australasian College of Surgeons or Royal College of Surgeons were included. Outcomes included the short version of the Perceived Stress Scale, Oxford Happiness Questionnaire short scale, Patient Health Questionnaire‐2 and the effect on individual stress levels of training experiences affected by COVID‐19. Predictors included trainee characteristics and local COVID‐19 prevalence. Multivariable linear regression analyses were conducted to assess association between outcomes and predictors. Results: Two hundred and five surgical trainees were included. Increased stress was associated with number of COVID‐19 patients treated (P = 0.0127), female gender (P = 0.0293), minority race (P = 0.0012), less seniority (P = 0.001), and greater COVID‐19 prevalence (P = 0.0122). Lower happiness was associated with training country (P = 0.0026), minority race (P = 0.0258) and more seniority (P < 0.0001). Greater depression was associated with more seniority (P < 0.0001). Greater COVID‐19 prevalence was associated with greater reported loss of training opportunities (P = 0.0038), poor working conditions (P = 0.0079), personal protective equipment availability (P = 0.0008), relocation to areas of little experience (P < 0.0001), difficulties with career progression (P = 0.0172), loss of supervision (P = 0.0211), difficulties with pay (P = 0.0034), and difficulties with leave (P = 0.0002). Conclusion: This is the first study to specifically describe the relative impacts of COVID‐19 community prevalence, gender, race, surgical specialty and level of seniority on stress, happiness and depression of surgical trainees on an international scale. [ABSTRACT FROM AUTHOR]

Urgent and emergent operations should occur irrespective of COVID-19 vaccination status, as delays would likely significantly worsen patient outcomes (level III-2 to IV evidence). Achieving safe surgery after COVID-19 vaccination However, for urgent or emergency operations where patient outcome would be compromised by delay, surgery should proceed regardless of vaccination status (level III-2 to IV evidence). COVID-19 has changed surgery worldwide.1 As surgical outcomes for patients with COVID-19 are significantly poorer than those without,2 one of the most important preventative measures for surgical safety has been vaccination, which dramatically reduces transmission and disease severity. [Extracted from the article]

This study assessed the effects of typhoons on sea surface pCO2 and CO2 flux in the northern South China Sea (SCS). During the passage of three major typhoons from May to August 2013, sea surface pCO2, surface seawater temperature (SST), and other meteorological parameters were continuously measured on a moored buoy. Surface water in the region was a source of CO2 to the atmosphere with large variations ranging from hours to months. SST was the primary factor controlling the variation of surface pCO2 through most of the time period. Typhoons are seen to impact surface pCO2 in three steps: first by cooling, thus decreasing surface pCO2, and then by causing vertical mixing that brings up deep, high‐CO2 water, and lastly triggering net uptake of CO2 due to the nutrients brought up in this deep water. The typhoons of this study primarily impacted air‐sea CO2 flux via increasing wind speeds. The mean CO2 flux during a typhoon ranged from 3.6 to 5.4 times the pretyphoon mean flux. The magnitude of the CO2 flux during typhoons was strongly inversely correlated with the typhoon center distance. The effect of typhoons accounted for 22% of the total CO2 flux in the study period, during which typhoons occurred only 9% of the time. It was estimated that typhoons enhanced annual CO2 efflux by 23–56% in the northern SCS during the last decade. As such, tropical cyclones may play a large and increasingly important role in controlling CO2 fluxes in a warmer and stormier ocean of the future. Plain Language Summary: The global ocean absorbs about 25% of anthropogenic carbon dioxide emissions from the atmosphere and plays an important role in regulating global climate. One important question regarding estimates of carbon dioxide flux at the ocean surface is how episodic events such as typhoons affect surface seawater carbon dioxide and air‐sea carbon dioxide exchange. In this study, seawater temperature generally played a primary role in controlling surface seawater carbon dioxide under nontyphoon conditions in the northern South China Sea. We found that typhoons seem to have a three‐step effect on surface carbon dioxide: first cooling, which decreases carbon dioxide content, followed by vertical mixing that can bring up deep water with high concentrations of carbon dioxide and nutrients, and lastly the triggering of net uptake of carbon dioxide due to phytoplankton growth fueled by those nutrients. Increased air‐sea carbon dioxide flux during a typhoon is caused primarily by high wind speed. Typhoons enhanced carbon dioxide flux to the atmosphere by 23–56% annually in the study region. As such, typhoons may play a more important role in the control of carbon dioxide fluxes in a warmer and stormier ocean of the future. Key Points: Typhoons tend to have a three‐step effect on surface pCO2: first cooling, followed by mixing, and then potentially biological uptakeIncreased air‐sea CO2 flux during typhoon effect periods is caused primarily by high wind speedTyphoons enhance CO2 efflux by 23–56% in the northern South China Sea during the last decade [ABSTRACT FROM AUTHOR]

A Lagrangian model is constructed for a surface column of initial height h(0) that propagates at an average speed u and is subject to excess (i.e., net) evaporation of q m/year. It is shown that these parameters combine to form an evaporation length, L = uh(0)/q, which provides an estimate for the distance the column must travel before evaporating completely. While these changes in the surface water level due to evaporation are compensated by entrainment of water into the overall column, the changes in either near‐surface salinity or isotopic compositions are retained and can be measured. Observations of surface salinity and isotopic compositions of δ18O and δD along 1,000‐ to 3,500‐km long transects are used to estimate values of L in the Red Sea, Mediterranean Sea, Indian Ocean, and Gulf Stream. The variations of salinity, δ18O and δD in all four basins are linear. As anticipated, the estimated value of L is smallest in the slowly moving and arid Red Sea and is greatest in the fast‐moving Gulf Stream. Plain Language Summary: a conceptual Lagrangian model is developed for constraining rates of evaporation in the ocean. The model is applied to routinely measured variables in the ocean's surface such as salinity and isotopic compositions. Our results show that all variables yield very similar estimates of the model's parameter, which bolsters the use of surface transects of salinity to constrain calculated values of parameters relevant to rates of evaporation. Key Points: A Lagrangian model is developed for changes in salinity and isotopic composition of a moving water column that undergoes net evaporationThe model is successfully applied to four oceanic transectsThe observations provide reliable estimates of the model's new single‐parameter – evaporation length [ABSTRACT FROM AUTHOR]

The article reports that clinical academics are clinician leaders who, through training and experience, have chosen to make research and education a significant part of their professional career. It mentions that medical schools and Specialist Colleges play vital roles in providing the leadership necessary to establish a defined and flexible pathway that integrates clinical and research training.

Mesoscale eddies and boundary currents play a key role in the upper layer circulation of the Red Sea. This study assesses the physical and biochemical characteristics of an eastern boundary current (EBC) and recurrent eddies in the central Red Sea (CRS) using a combination of in situ and satellite observations. Hydrographic surveys in November 2013 (autumn) and in April 2014 (spring) in the CRS (22.15°N-24.1°N) included a total of 39 and 27 CTD stations, respectively. In addition, high-resolution hydrographic data were acquired in spring 2014 with a towed undulating vehicle (ScanFish). In situ measurements of salinity, temperature, chlorophyll fluorescence, colored dissolved organic matter (CDOM), and dissolved nitrate: phosphorous ratios reveal distinct water mass characteristics for the two periods. An EBC, observed in the upper 150 m of the water column during autumn, transported low-salinity and warm water from the south toward the CRS. Patches of the low-salinity water of southern origin tended to contain relatively high concentrations of chlorophyll and CDOM. The prominent dynamic feature observed in spring was a cyclonic/anticyclonic eddy pair. The cyclonic eddy was responsible for an upward nutrient flux into the euphotic zone. Higher chlorophyll and CDOM concentrations, and concomitant lower nitrate:phosphorous ratios indicate the influence of the EBC in the CRS at the end of the stratified summer period. [ABSTRACT FROM AUTHOR]

The authors discuss the role of doctors-in-training (DIT) in Australia in biomedical innovation and entrepreneurship. They emphasize the benefits that can be generated from engaging with biotechnology and pharmaceutical industries and cites international experience with training in biomedical innovation and entrepreneurship. Also discussed are the key drivers and benefits of training in biomedical innovation and entrepreneurship, along with recommendations to improve training for DITs.

The harvest of bay scallops ( Argopecten irradians) from Buzzards Bay, Massachusetts, U.S.A. undergoes large interannual fluctuations, varying by more than an order of magnitude in successive years. To investigate the extent to which these fluctuations may be due to yearly variations in the transport of scallop larvae from spawning areas to suitable juvenile habitat (settlement zones), a high-resolution hydrodynamic model was used to drive an individual-based model of scallop larval transport. Model results revealed that scallop spawning in Buzzards Bay occurs during a time when nearshore bay currents were principally directed up-bay in response to a persistent southwesterly sea breeze. This nearshore flow results in the substantial transport of larvae from lower-bay spawning areas to settlement zones further up-bay. Averaged over the entire bay, the spawning-to-settlement zone connectivity exhibits little interannual variation. However, connectivities between individual spawning and settlement zones vary by up to an order of magnitude. The model results identified spawning areas that have the greatest probability of transporting larvae to juvenile habitat. Because managers may aim to increase scallop populations either locally or broadly, the high-connectivity spawning areas were divided into: (i) high larval retention and relatively little larval transport to adjoining settlement areas, (ii) both significant larval retention and transport to more distant settlement areas, and (iii) little larval retention but significant transport to distant settlement areas. [ABSTRACT FROM AUTHOR]

A previous study documented a correlation between Atlantic Cod ( Gadus morhua) recruitment in the Gulf of Maine and an annual index of the north component of May winds. This correlation was supported by modeling studies that indicated strong recruitment of Gulf of Maine Atlantic Cod results from high retention of spring-spawned larvae in years when winds were predominately out of the north, which favor downwelling. We re-evaluated this relationship using updated recruitment estimates and found that the correlation decreased between recruitment and wind. The original relationship was largely driven by two recruitment estimates, one of which (2005 year-class) was highly uncertain because it was near the terminal year of the assessment. With additional data, the updated assessment estimated lower recruitment for the 2005 year-class, which consequently lowered the correlation between recruitment and wind. We then investigated whether an environmentally-explicit stock recruit function that incorporated an annual wind index was supported by either the original or updated assessment output. Although incorporation of the annual wind index produced a better fitting model, the uncertainty in the estimated parameters and the implied unexploited conditions were not appropriate for providing management advice. These results suggest the need for caution in the development of environmentally-explicit stock recruitment relationships, in particular when basing relationships and hypotheses on recruitment estimates from the terminal years of stock assessment models. More broadly, this study highlights a number of sources of uncertainty that should be considered when analyzes are performed on the output of stock assessment models. [ABSTRACT FROM AUTHOR]

Atlantic cod, Gadus morhua, harvested in US waters are currently managed as a Gulf of Maine stock and as a stock comprising Georges Bank and southern New England populations. Over the past two and a half decades, success of age-1 recruitment to the Gulf of Maine stock has varied by more than an order of magnitude. To investigate the hypothesis that this variation is related to variation in the transport of larval cod to nursery areas, we carried out model simulations of the movement of planktonic eggs and larvae spawned within the western Gulf of Maine during spring spawning events of 1995-2005. Results indicate that the retention of spring-spawned cod, and their transport to areas suitable for early stage juvenile development, is strongly dependent on local wind conditions. Larval cod retention is favored during times of downwelling-favorable winds and is least likely during times of upwelling-favorable winds, during which buoyant eggs and early stage larvae tend to be advected offshore to the Western Maine Coastal Current and subsequently carried out of the Gulf of Maine. Model results also indicate that diel vertical migration of later stage larvae enhances the likelihood of retention within the western Gulf of Maine. Consistent with model results is a strong correlation between age-1 recruitment success to the Gulf of Maine cod stock and the mean northward wind velocity measured in Massachusetts Bay during May. Based on these findings, we propose a wind index for strong recruitment success of age-1 cod to the Gulf of Maine stock. [ABSTRACT FROM AUTHOR]

Presents observations of a warm, negatively bouyant river plume entering a Laurentian Great Lake. Site description; River discharge and wind condition; Near-field plume conditions.

Researchers and clinicians are increasingly recognizing that psychological and psychiatric disorders are often developmentally progressive, and that diagnosis often represents a point along that progression that is defined largely by our abilities to detect symptoms. As a result, strategies that guide our searches for the root causes and etiologies of these disorders are beginning to change. This review describes interactions between genetics and experience that influence the development of psychopathologies. Following a discussion of normal brain development that highlights how specific cellular processes may be targeted by genetic or environmental factors, we focus on four disorders whose origins range from genetic (fragile X syndrome) to environmental (fetal alcohol syndrome) or a mixture of both factors (depression and schizophrenia). C.H. Waddington's canalization model (slightly modified) is used as a tool to conceptualize the interactive influences of genetics and experience in the development of these psychopathologies. Although this model was originally proposed to describe the 'canalizing' role of genetics in promoting normative development, it serves here to help visualize, for example, the effects of adverse (stressful) experience in the kindling model of depression, and the multiple etiologies that may underlie the development of schizophrenia. Waddington's model is also useful in understanding the canalizing influence of experience-based therapeutic approaches, which also likely bring about 'organic' changes in the brain. Finally, in light of increased evidence for the role of experience in the development and treatment of psychopathologies, we suggest that future strategies for identifying the underlying causes of these disorders be based less on the mechanisms of action of effective pharmacological treatments, and more on increased knowledge of the brain's cellular mechanisms of plastic change. [ABSTRACT FROM AUTHOR]

Converging approaches across domains of brain anatomy, cell biology, and behavior indicate that Fragile X syndrome, arising from impaired expression of a single gene and protein, appears to involve an aberration of normal developmental processes. Synapse overproduction and selective elimination, or pruning, characterize normal brain development. In autopsy tissue from Fragile X patients and in a knockout mouse model of the disease, synapse overproduction appears to occur unaccompanied by synapse pruning and maturation, leaving an excess of immature spine synapses in place. The absence of the Fragile X protein seems to impair the synthesis of important proteins at synapses. The developmental outcome in Fragile X is a nervous system that is relatively disorganized, resulting in disrupted perceptual, and cognitive social, behavior. © 2002 Wiley Periodicals, Inc. Dev Psychobiol 40: 323–338, 2002. DOI 10.1002/dev.10036 [ABSTRACT FROM AUTHOR]

The benthic environment of the Gulf of Maine is characterized by a thick and basin-wide nepheloid layer, classically defined as a near-bottom region of permanent sediment resuspension. The high frequency of commercial bottom trawling in particular regions of the Gulf of Maine, documented by records compiled by the National Marine Fisheries Service, may strongly affect measured resuspension fluxes and contribute to the maintenance of the nepheloid layer. Indirect evidence of the effects of bottom trawling on sediment resuspension is observed in the seasonal collection of large, benthic infaunal worms, along with substantial amounts of resuspended bottom sediment, in a sediment trap deployed 25 m off the bottom in the western gulf region of Wilkinson Basin. These collections appear to be coincident with seasonal periods of intensive bottom trawling in this area. By comparison, the western gulf region of Jordan Basin is typified by significantly reduced annual bottom-trawling activity, and very few infaunal worms are found in the seasonal collections of a sediment trap located 25–30 m off the bottom. The extent to which trawling-induced bottom sediment excavation and resuspension occurs has important implications for regional nutrient budgets in terms of the input of sedimentary nitrogen and silica into the water column via this anthropogenic activity. Sediment mixing and frequent bottom disturbance from trawling activity may also produce changes in the successional organization of soft-sediment infaunal communities. The potential effects of trawling require serious examination and quantification to accurately determine the impact of such anthropogenic activity on the benthic ecosystems of continental margin environments. [ABSTRACT FROM AUTHOR]

Investigates the larval fish transport within the estuarine region in North Carolina. Observation of estuarine ecology; Measurement of the larvae velocity distribution; Structure of semidiurnal tidal cycles.

Examines tidal and larval transport characteristics in the vicinity of a barrier island inlet. Observation of the continental shelf waters; Distribution of the larval catches; Identification of spatial inhomogeneity.

Investigates the fluctuation of temperature, salinity and pressure on larval ingress experiment in North Carolina. Volume of low-salinity; Observation of the water properties; Indication of larval transport and retention process.

The article focuses on the one-minute preceptor (OMP) model designed to improve clinical teaching methods. Topics discussed include the steps of the teaching tool, the types of questions that preceptors can ask under the OMP model and the limitations of traditional clinical teaching methods. Also discussed are the reasons for clinical teachers' difficulties in finding time-efficient teaching strategies.

The article explores the challenges in teaching professionalism in surgical education. Surgical education covers the competencies of professionalism and ethics which include awareness, insight, ethical practice, and confidentiality. Among the challenges of teaching professionalism are limited time and difficulty in defining borderline unprofessional behaviour traits.

The article focuses on the result of the Australian Medical Association's (AMA) Specialist Trainee Survey (STS) in 2014 in Australia. It provides overview of the advantage of the survey, which offers medical colleges with feedbacks from trainees about the effectiveness of their training and other aspects of their operations. It outlines the result of the survey, which motivates intuitions to review their education and training policies to address unfavorable issues.

There has been a decline in the proportion of clinical academics compared with full-time clinicians, since 2004. A Working Party was established to help develop and implement a model for the training of clinical academics. After a highly successful first summit in 2014 that summarised the challenges faced by clinical academics in Australia and New Zealand, a second summit was convened late in 2015 to report on progress and to identify key areas for further action. The second summit provided survey results that identified the varied training pathways currently offered to clinical academics and the institutions willing to be involved in developing improved pathways. A literature review also described the contributions that clinical academics make to the health sector and the challenges faced by this workforce sector. Current training pathways created for clinical academics by Australasian institutions were presented as examples of what can be done. The perspectives of government and research organisations presented at the summit helped define how key stakeholders can contribute. Following the summit, there was a strong commitment to continue to work towards developing a sustainable and defined training pathway for clinical academics. The need for a coordinated and integrated approach was highlighted. Some key objectives were agreed upon for the next phase, including identifying and engaging key advocates within government and leading institutions; publishing and profiling the contributions of successful clinical academics to healthcare outcomes; defining the stages of a clinical academic training pathway; and establishing a mentoring programme for training clinical academics. [ABSTRACT FROM AUTHOR]