Cost of Training Crisis: Anaesthetics.

The anaesthetic training programme in the United Kingdom (UK) spans over seven years and is overseen by the Royal College of Anaesthetists (RCOA). Junior doctors in England are currently striking amid ongoing pay negotiations with the government, and almost all junior doctors are worried about the cost of living. This article provides an overview of the average financial cost of training for doctors in the anaesthetic training programme.

Longitudinal stream synoptic monitoring tracks chemicals along watershed continuums: a typology of trends.

There are challenges in monitoring and managing water quality due to spatial and temporal heterogeneity in contaminant sources, transport, and transformations. We demonstrate the importance of longitudinal stream synoptic (LSS) monitoring, which can track combinations of water quality parameters along flowpaths across space and time. Specifically, we analyze longitudinal patterns of chemical mixtures of carbon, nutrients, greenhouse gasses, salts, and metals concentrations along 10 flowpaths draining 1,765 km of the Chesapeake Bay region.

Measuring What Matters: A Qualitative Study of the Relevance and Clinical Utility of PROMIS Surveys in Systemic Lupus Erythematosus.

Objective: To evaluate the relevance and clinical utility of the Patient-Reported Outcomes Measurement Information System (PROMIS) surveys in patients with systemic lupus erythematosus (SLE).

Methods: Adults with SLE receiving routine outpatient care at a tertiary care academic medical center participated in a qualitative study. Patients completed PROMIS computerized adaptive tests (CATs) in 12 selected domains and rated the relevance of each domain to their experience with SLE.

A new two square agility test for workplace health-reliability, validity and minimal detectable change.

[Purpose] One promising strategy for workplace wellness programs is to emphasize functional mobility screening and coaching to promote suitable physical activity and reduce musculoskeletal risks. This study examined intra-rater reliability, test-retest reliability, concurrent validity, known-groups validity and minimal detectable change for a new Two Square Agility Test (TSAT) designed as a functional mobility measure to promote workplace health. [Participants and Methods] Two hundred forty eight non-disabled participants (ages 18-69) were measured for body size, physical activity and 3 trials of the Two Square Agility Test.

Human-accelerated weathering increases salinization, major ions, and alkalinization in fresh water across land use.

Human-dominated land uses can increase transport of major ions in streams due to the combination of human-accelerated weathering and anthropogenic salts. Calcium, magnesium, sodium, alkalinity, and hardness significantly increased in the drinking water supply for Baltimore, Maryland over almost 50 years (p<0.05) coinciding with regional urbanization.

Soil carbon and nitrogen accumulation in residential lawns of the Salt Lake Valley, Utah.

Urban lawn ecosystems are widespread across the United States, with fertilization rates commonly exceeding plant nitrogen (N) uptake rates. While urban soils have been shown to accumulate C and N over time, the long-term balance of N inputs and losses from lawn soils remains largely uncertain. We sampled residential lawn soils aged 7-100 years in the Salt Lake City metropolitan area as a means of inferring changes in total nitrogen (TN) content, organic carbon (OC) content, C:N ratio, and δN of bulk soil over time.

Influence of infrastructure on water quality and greenhouse gas dynamics in urban streams.

Streams and rivers are significant sources of nitrous oxide (NO), carbon dioxide (CO), and methane (CH) globally, and watershed management can alter greenhouse gas (GHG) emissions from streams. We hypothesized that urban infrastructure significantly alters downstream water quality and contributes to variability in GHG saturation and emissions. We measured gas saturation and estimated emission rates in headwaters of two urban stream networks (Red Run and Dead Run) of the Baltimore Ecosystem Study Long-Term Ecological Research project.

Differentiating Behavior Initiation and Maintenance: Theoretical Framework and Proof of Concept.

Although many interventions are effective for health behavior initiation, maintenance has proven elusive. Interventions targeting maintenance often extend the duration with which initiation content is delivered or the duration of follow-up without intervention. We posit that health behavior initiation and maintenance require separate psychological processes and skills.

Initial evaluation of an integrated treatment for comorbid PTSD and smoking using a nonconcurrent, multiple-baseline design.

The present study examined an integrated treatment for comorbid posttraumatic stress disorder (PTSD) and smoking entitled "Smoke-Free to Overcome PTSD: An Integrated Treatment" (STOP IT program). A nonconcurrent multiple-baseline design was used with six community-recruited adult smokers with PTSD to investigate both patient acceptance of the treatment and its initial efficacy on both PTSD and smoking. Potential order effects of exposure-based and affect management components were also examined.

A randomized controlled trial to evaluate the effectiveness of CouPLES: a spouse-assisted lifestyle change intervention to improve low-density lipoprotein cholesterol.

Objective: This randomized controlled trial evaluated the effectiveness of a telephone-delivered, spouse-assisted lifestyle intervention to reduce patient LDL-C.

Method: From 2007 to 2010, 255 outpatients with LDL-C>76 mg/dL and their spouses from the Durham Veterans Affairs Medical Center were randomized to intervention or usual care. The intervention comprised nine monthly goal-setting telephone calls to patients and support planning calls to spouses.

Soil warming, carbon-nitrogen interactions, and forest carbon budgets.

Soil warming has the potential to alter both soil and plant processes that affect carbon storage in forest ecosystems. We have quantified these effects in a large, long-term (7-y) soil-warming study in a deciduous forest in New England. Soil warming has resulted in carbon losses from the soil and stimulated carbon gains in the woody tissue of trees.

Effects of nutrient addition on leaf chemistry, morphology, and photosynthetic capacity of three bog shrubs.

Plants in nutrient-poor environments typically have low foliar nitrogen (N) concentrations, long-lived tissues with leaf traits designed to use nutrients efficiently, and low rates of photosynthesis. We postulated that increasing N availability due to atmospheric deposition would increase photosynthetic capacity, foliar N, and specific leaf area (SLA) of bog shrubs. We measured photosynthesis, foliar chemistry and leaf morphology in three ericaceous shrubs (Vaccinium myrtilloides, Ledum groenlandicum and Chamaedaphne calyculata) in a long-term fertilization experiment at Mer Bleue bog, Ontario, Canada, with a background deposition of 0.

An investigation of relations between crystal methamphetamine use and posttraumatic stress disorder.

Evidence documents elevated rates of various types of drug use among people with posttraumatic stress disorder (PTSD). However, relatively little research has specifically examined crystal methamphetamine (CM) use among individuals with PTSD. The present study examined the relation between PTSD diagnostic status, PTSD symptom severity within symptom type clusters, and CM use histories among traumatic event-exposed individuals with versus without PTSD.

Gender as a moderator of the relation between PTSD and disgust: a laboratory test employing individualized script-driven imagery.

The present study examines anxiety and disgust responding during exposure to trauma cues as a function of gender and posttraumatic stress disorder (PTSD). Trauma exposed adults without PTSD were compared to adults with PTSD during a script-driven imagery procedure that exposed each participant to individualized traumatic event cues. Anxiety responding during exposure to an individualized traumatic event script was not associated with gender, PTSD, or interaction of gender and PTSD in the present study.

An experimental investigation of the effects of acute sleep deprivation on panic-relevant biological challenge responding.

Prospective research indicates sleep deprivation potentiates anxiety development, yet relatively little research has examined the effects of sleep deprivation in terms of specific types of anxiety. The current study tested the association between acute sleep deprivation and panic-relevant biological challenge responding among nonclinical participants. One hundred and two participants were randomly assigned to either an experimental (acute sleep deprivation) or control (no sleep deprivation) group.

Test of the role of nicotine dependence in the relation between posttraumatic stress disorder and panic spectrum problems.

Posttraumatic stress disorder (PTSD) frequently co-occurs with panic spectrum problems. Relatively little empirical work has tested possible mechanisms accounting for this association. Nicotine dependence often ensues subsequent to PTSD onset and research suggests smoking high numbers of cigarettes daily may lead to panic problems.

Biomechanical and performance differences between female soccer athletes in National Collegiate Athletic Association Divisions I and III.

Context: The recent increase in women's varsity soccer participation has been accompanied by a lower extremity injury rate that is 2 to 6 times that of their male counterparts.

Objective: To define the differences between lower extremity biomechanics (knee abduction and knee flexion measures) and performance (maximal vertical jump height) between National Collegiate Athletic Association Division I and III female soccer athletes during a drop vertical jump.

Design: Mixed 2 x 2 design.

Association between pharmacy medication refill-based adherence rates and cd4 count and viral-load responses: A retrospective analysis in treatment-experienced adults with HIV.

Background: Current guidelines and most contemporary statements in the literature indicate that, like other medical conditions, HIV infection requires exceptionally high adherence to highly active antiretroviral therapy (HAART) for successful treatment.

Objective: This study was conducted to determine the association between pharmacy medication refill rates-a surrogate marker for adherence to HAART- and CD4-count/viral-load responses in patients with HIV METHODS: This retrospective study was conducted at the HIV Clinic, Veterans Affairs Medical Center, Durham, North Carolina. Male and female patients aged >/=18 years with a history of HIV who attended clinic appointments on 3 consecutive clinic days were enrolled.

A prospective test of anxiety sensitivity as a moderator of the relation between gender and posttraumatic symptom maintenance among high anxiety sensitive young adults.

The primary aim of this study was to evaluate the individual and combined influence of anxiety sensitivity (AS) and gender on the longitudinal prediction of posttraumatic symptoms. A large nonclinical sample of young adults (n=404) was prospectively followed over approximately 18 months. The primary findings indicated that gender and AS were uniquely associated with posttraumatic symptom levels during the follow-up period.

A comparison of dynamic coronal plane excursion between matched male and female athletes when performing single leg landings.

Background: Despite recent evidence supporting the use of neuromuscular training to reduce anterior cruciate ligament injury risk, female athletes continue to show an increased anterior cruciate ligament injury rate in collegiate basketball and soccer when compared to males. The purpose of the current study was to identify gender and task differences in measures that may increase the risk of anterior cruciate ligament injury in female basketball and soccer athletes.

Methods: Eleven female and 11 male collegiate basketball and soccer athletes were height (female mean 176 (SD 8 cm), male mean 176 (SD 8 cm)) and weight (female mean 73 (SD 7 kg), male mean 74 (SD 6 kg)) matched.

Use of an overhead goal alters vertical jump performance and biomechanics.

This study examined whether an extrinsic motivator, such as an overhead goal, during a plyometric jump may alter movement biomechanics. Our purpose was to examine the effects of an overhead goal on vertical jump height and lower-extremity biomechanics during a drop vertical jump and to compare the effects on female (N = 18) versus male (N = 17) athletes. Drop vertical jump was performed both with and without the use of an overhead goal.