title: A typology of longitudinal integrated clerkships.

authors: Worley, Paul

subjects: Australia

abstract: CONTEXT: Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. 
OBJECTIVES: This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. 
METHODS: Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. 
RESULTS: Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. 
CONCLUSIONS: Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context.

text: A typology of longitudinal integrated clerkships. CONTEXT: Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. 
OBJECTIVES: This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. 
METHODS: Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. 
RESULTS: Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. 
CONCLUSIONS: Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context.

year: 2016

title: Rates of accumulation of cadmium and uranium in a New Zealand hill farm soil as a result of long-term use of phosphate fertilizer

authors: Schipper, Louis A.

subjects: pasture

abstract: In New Zealand, phosphate (P) fertilisers used in agriculture are the main sources of the potentially toxic elements cadmium (Cd) and uranium (U), which occur as unwanted contaminants. New Zealand is developing draft soil guideline values (SGV) for maximum concentrations of Cd. To assess when soils under pasture for sheep production might reach a particular SGV, we analysed archived soil samples from a 23 yr P fertiliser trial. The pasture sites were at Whatawhata, North Island, New Zealand, and had received P fertiliser at the rates of 0, 30, 50 and 100 kg P ha⁻¹ yr⁻¹. From 1983 to 1989, P was applied as single superphosphate, from 1989 to 2006, P was applied as triple superphosphate. Soils from replicate paddocks were sampled annually to a depth of 75 mm on easy (10–20°) and steep (30–40°) slope classes. Total P, Cd and U were analysed by ICP-MS after acid digestion. Data were analysed by fitting trend lines using linear mixed models for two slope classes and for two sampling periods 1983–1989 and 1989–2006 when the soil sampling method and fertiliser type had been changed.

The changes in total P, Cd and U were directly related to the type and amount of P fertiliser applied, the control treatment showed no significant change in P, Cd or U. At 50 and 100 kg P ha⁻¹ yr⁻¹ there were generally linear increases in total P and total U, and the same trend line applied to both time periods, but the rate of increase in P was greater on the easy slope class. For Cd, a “broken stick” model was needed to explain the data. Pre-1989, Cd increased in the 50 and 100 kg P ha⁻¹ yr⁻¹ treatment (0.036–0.045 mg kg⁻¹ yr⁻¹, respectively): post 1988 the rate of increase declined markedly on those two treatments (0.005–0.015 mg kg⁻¹ yr⁻¹, respectively), and declined absolutely in the 30 kg P ha⁻¹ yr⁻¹ treatments. The maximum content of Cd was in the 100 kg P ha⁻¹ yr⁻¹ treatment which reached 0.931 mg Cd kg⁻¹ on the easy slope. For U there were steady linear increases for the 30, 50 and 100 kg P ha⁻¹ treatments, and no significant difference between the steep and easy slopes, nor the two sampling periods, the maximum concentration obtained was 2.80 mg U kg⁻¹ on the 100 kg P ha⁻¹ treatment. The results suggest that at rates of P fertiliser likely to be applied to hill farms (<50 kg P ha⁻¹ yr⁻¹ ), and using P fertiliser with low Cd content, then the Cd concentration in this soil will never reach a SGV of 1 mg kg⁻¹.

text: Rates of accumulation of cadmium and uranium in a New Zealand hill farm soil as a result of long-term use of phosphate fertilizer In New Zealand, phosphate (P) fertilisers used in agriculture are the main sources of the potentially toxic elements cadmium (Cd) and uranium (U), which occur as unwanted contaminants. New Zealand is developing draft soil guideline values (SGV) for maximum concentrations of Cd. To assess when soils under pasture for sheep production might reach a particular SGV, we analysed archived soil samples from a 23 yr P fertiliser trial. The pasture sites were at Whatawhata, North Island, New Zealand, and had received P fertiliser at the rates of 0, 30, 50 and 100 kg P ha⁻¹ yr⁻¹. From 1983 to 1989, P was applied as single superphosphate, from 1989 to 2006, P was applied as triple superphosphate. Soils from replicate paddocks were sampled annually to a depth of 75 mm on easy (10–20°) and steep (30–40°) slope classes. Total P, Cd and U were analysed by ICP-MS after acid digestion. Data were analysed by fitting trend lines using linear mixed models for two slope classes and for two sampling periods 1983–1989 and 1989–2006 when the soil sampling method and fertiliser type had been changed.

The changes in total P, Cd and U were directly related to the type and amount of P fertiliser applied, the control treatment showed no significant change in P, Cd or U. At 50 and 100 kg P ha⁻¹ yr⁻¹ there were generally linear increases in total P and total U, and the same trend line applied to both time periods, but the rate of increase in P was greater on the easy slope class. For Cd, a “broken stick” model was needed to explain the data. Pre-1989, Cd increased in the 50 and 100 kg P ha⁻¹ yr⁻¹ treatment (0.036–0.045 mg kg⁻¹ yr⁻¹, respectively): post 1988 the rate of increase declined markedly on those two treatments (0.005–0.015 mg kg⁻¹ yr⁻¹, respectively), and declined absolutely in the 30 kg P ha⁻¹ yr⁻¹ treatments. The maximum content of Cd was in the 100 kg P ha⁻¹ yr⁻¹ treatment which reached 0.931 mg Cd kg⁻¹ on the easy slope. For U there were steady linear increases for the 30, 50 and 100 kg P ha⁻¹ treatments, and no significant difference between the steep and easy slopes, nor the two sampling periods, the maximum concentration obtained was 2.80 mg U kg⁻¹ on the 100 kg P ha⁻¹ treatment. The results suggest that at rates of P fertiliser likely to be applied to hill farms (<50 kg P ha⁻¹ yr⁻¹ ), and using P fertiliser with low Cd content, then the Cd concentration in this soil will never reach a SGV of 1 mg kg⁻¹.

year: 2011

title: Bilingual/immersion education in Aotearoa/New Zealand: Setting the context.

authors: May, Stephen

subjects: bilingual education

abstract: Introduction to a special issue of IJBEB, focusing on recent developments in bilingual/
immersion education in Aotearoa/New Zealand, particularly, but not solely,
Maori-medium education.

text: Bilingual/immersion education in Aotearoa/New Zealand: Setting the context. Introduction to a special issue of IJBEB, focusing on recent developments in bilingual/
immersion education in Aotearoa/New Zealand, particularly, but not solely,
Maori-medium education.

year: 2005-01-01