Burnout and attrition in surgical trainees: what can be done to prevent it?

Burnout, mental health disorders and suicide are more common among doctors than the general population. Burnt-out doctors self-report increased rates of medical errors and the provision of suboptimal patient care. Surgeons in training are particularly at risk of burnout and are also less likely to seek professional support. Female surgical trainees have especially high rates of attrition, potentially because of issues surrounding childcare and motherhood. Several strategies to reduce burnout and promote resilience have been trialled among doctors. Schwartz rounds and mindfulness training have been shown to be effective, but only in those motivated to participate. A reduction in working hours has conflicting results, particularly among surgical trainees, which may be linked to the subsequent reduction in training opportunities, such as operative time and the ability to complete assessments. Early identification and targeted support of at-risk individuals is a potentially effective strategy that requires further research.

Genome evolution of ferns: evidence for relative stasis of genome size across the fern phylogeny.

The genome evolution of ferns has been considered to be relatively static compared with angiosperms. In this study, we analyse genome size data and chromosome numbers in a phylogenetic framework to explore three hypotheses: the correlation of genome size and chromosome number, the origin of modern ferns from ancestors with high chromosome numbers, and the occurrence of several whole-genome duplications during the evolution of ferns. To achieve this, we generated new genome size data, increasing the percentage of fern species with genome sizes estimated to 2.8% of extant diversity, and ensuring a comprehensive phylogenetic coverage including at least three species from each fern order. Genome size was correlated with chromosome number across all ferns despite some substantial variation in both traits. We observed a trend towards conservation of the amount of DNA per chromosome, although Osmundaceae and Psilotaceae have substantially larger chromosomes. Reconstruction of the ancestral genome traits suggested that the earliest ferns were already characterized by possessing high chromosome numbers and that the earliest divergences in ferns were correlated with substantial karyological changes. Evidence for repeated whole-genome duplications was found across the phylogeny. Fern genomes tend to evolve slowly, albeit genome rearrangements occur in some clades.

Phylogeny, rate variation, and genome size evolution of Pelargonium (Geraniaceae).

The phylogeny of 58 Pelargonium species was estimated using five plastid markers (rbcL, matK, ndhF, rpoC1, trnL-F) and one mitochondrial gene (nad5). The results confirmed the monophyly of three major clades and four subclades within Pelargonium but also indicate the need to revise some sectional classifications. This phylogeny was used to examine karyotype evolution in the genus: plotting chromosome sizes, numbers and 2C-values indicates that genome size is significantly correlated with chromosome size but not number. Accelerated rates of nucleotide substitution have been previously detected in both plastid and mitochondrial genes in Pelargonium, but sparse taxon sampling did not enable identification of the phylogenetic distribution of these elevated rates. Using the multigene phylogeny as a constraint, we investigated lineage- and locus-specific heterogeneity of substitution rates in Pelargonium for an expanded number of taxa and demonstrated that both plastid and mitochondrial genes have had accelerated substitution rates but with markedly disparate patterns. In the plastid, the exons of rpoC1 have significantly accelerated substitution rates compared to its intron and the acceleration was mainly due to nonsynonymous substitutions. In contrast, the mitochondrial gene, nad5, experienced substantial acceleration of synonymous substitution rates in three internal branches of Pelargonium, but this acceleration ceased in all terminal branches. Several lineages also have dN/dS ratios significantly greater than one for rpoC1, indicating that positive selection is acting on this gene, whereas the accelerated synonymous substitutions in the mitochondrial gene are the result of elevated mutation rates.

Strengthening the scientific contribution of botanic gardens to the second phase of the Global Strategy for Plant Conservation.

The need for action on the global environment is now well understood and governments, agencies, non-governmental organizations and botanic gardens have all been working in their various ways to promote environmental sustainability and reduce species and habitat loss for at least 10­20 years. The Global Strategy for Plant Conservation (GSPC) has been widely adopted, particularly by the botanic garden community, and has resulted in many successes despite failing to achieve its ultimate goal of halting the loss of plant biodiversity. The objectives and targets for Phase 2 of the GSPC, running from 2010 to 2020, mirror those of Phase 1 and had been largely agreed prior to their formal adoption at the Conference of the Parties to the Convention on Biological Diversity in Nagoya in October 2010. However, to be successful, the scientific contribution of botanic gardens needs to be strengthened, as does government policy and commitment. Botanic garden research to underpin conservation action, including the role of botanic garden horticulture, training and international capacity building, has a major part to play and needs to be better understood and better coordinated. We provide examples based on the experience of the Royal Botanic Garden Edinburgh in the UK and overseas. Government policy, at national and international levels, needs to reflect the fundamental importance of plant diversity in maintaining the biosphere and supporting humanity. The commitment of significant new resources is an essential prerequisite for success, but this needs to be well coordinated, inclusive of all stakeholders and carefully targeted. A further challenge is the need to integrate better the plant diversity-related activities of what are currently diverse and disconnected sectors, including agriculture, forestry, protected area management and botanic gardens.