The performance of doctors embraces attitudes to practice, knowledge, and skills. It is the outward and visible expression of our professionalism. In general, people think highly of the medical profession in Britain; rising expectations are a mark of our success. Nevertheless, self regulation, on which our professional independence and self respect depend, cannot be taken for granted. Sympathetic critics such as lay people, sociologists, and doctors reflect a wider public perception that we seem reluctant to assure doctors' competence and protect patients from poor practice. There are also criticisms that we are not addressing the widespread dissatisfaction with the attitude of some doctors, including their paternalism and poor communication with both patients and colleagues, and are failing to make self regulation demonstrably effective and responsive.

No abstract

No abstract

No abstract

Extreme temperature stress (ETS) is recognized as an important threat to the food supply in China. However, how much yield loss caused by ETS (YL ETS ) to the irrigated rice production still remains unclear. In this study, we provided a prototype for YL ETS assessments by using a process-based crop model (MCWLA-Rice) with the ETS impacts explicitly parameterized, to help understand the spatio-temporal patterns of YL ETS and the mechanism underlying the ETS impacts at a 0.5°×0.5°grid scale in the major irrigated rice planting areas across China during 1981-2010. On the basis of the optimal 30 sets of parameters, the ensemble simulations indicated the following: Regions I (northeastern China) and III 2 (the mid-lower reaches of the Yangtze River) were considered to be the most vulnerable areas to ETS, with the medium YL ETS of 18.4 and 12.9 %, respectively. Furthermore, large YL ETS values (>10 %) were found in some portions of Region II (the Yunnan-Guizhou Plateau), western Region III 1 (the Sichuan Basin), the middle of Region IV_ER (southern China cultivated by early rice), and the west and southeast of Region IV_LR (southern China cultivated by late rice). Over the past several decades, a significant decrease in YL ETS was detected in most of Region I and in northern Region IV_LR (with the medians of −0.53 and −0.28 % year −1 , respectively). However, a significant increase was found in most of Region III (including III 1 and III 2 ) and in Region IV_ER, particularly in the last decade (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010). Overall, reduced cold stress has improved the conditions for irrigated rice production across Climatic Change (2016) 134:635-650

For understanding magnetic effects on dynamical tides, we study the rotating magneto-hydrodynamic (MHD) flow driven by harmonic forcing. The linear responses are analytically derived in a periodic box under the local WKB approximation. Both the kinetic and Ohmic dissipations at the resonant frequencies are calculated and the various parameters are investigated. Although magnetic pressure may be negligible compared to thermal pressure, magnetic field can be important for the first-order perturbation, e.g. dynamical tides. It is found that magnetic field splits the resonant frequency, namely the rotating hydrodynamic flow has only one resonant frequency but the rotating MHD flow has two, one positive and the other negative. In the weak field regime the dissipations are asymmetric around the two resonant frequencies and this asymmetry is more striking with a weaker magnetic field. It is also found that both the kinetic and Ohmic dissipations at the resonant frequencies are inversely proportional to the Ekman number and the square of wavenumber. The dissipation at the resonant frequency on small scales is almost equal to the dissipation at the non-resonant frequencies, namely the resonance takes its effect on the dissipation at intermediate length scales. Moreover, the waves with phase propagation perpendicular to magnetic field are much more damped. It is also interesting to find that the frequency-averaged dissipation is constant. This result suggests that in compact objects magnetic effects on tidal dissipation should be considered.

By numerically solving the equations of rotating magnetohydrodynamics (MHD), the magnetic effect on dynamical tide is studied. It is found that magnetic field has a significant impact not only on the flow structure, i.e. the internal shear layers in rotating flow can be destroyed in the presence of a moderate or stronger magnetic field (in the sense that the Alfvén velocity is at least of the order of 0.1 of the surface rotational velocity), but also on the dispersion relation of waves excited by tidal force such that the range of tidal resonance is broadened by magnetic field. A major result is that the total tidal dissipation scales as square of the field strength, which can be used to estimate the strength of internal magnetic field in the astronomical object of a binary system. Moreover, with a moderate or stronger field the ratio of the magnetic dissipation to the viscous dissipation is almost inversely proportional to magnetic Prandtl number (i.e. the ratio of viscosity to magnetic diffusivity), and therefore in the astrophysical situation at small magnetic Prandtl number magnetic dissipation dominates over viscous dissipation with a moderate or stronger field.

We investigate numerically the Princeton magneto-rotational instability (MRI) experiment and the effect of conducting axial boundaries or endcaps. MRI is identified and found to reach a much higher saturation than for insulating endcaps. This is probably due to stronger driving of the base flow by the magnetically rather than viscously coupled boundaries. Although the computations are necessarily limited to lower Reynolds numbers (Re) than their experimental counterparts, it appears that the saturation level becomes independent of Re when Re is sufficiently large, whereas it has been found previously to decrease roughly as Re −1/4 with insulating endcaps. The much higher saturation levels will allow for the first positive detection of MRI beyond its theoretical and numerical predictions.