We report the carbon‐13 and oxygen‐18 isotope ratios in cellulose from the early and late wood of pedunculate oak (Quercus robur L.). The δ13 C value of the early wood correlates best with that of the late wood of the previous year. The δ18O value of the early wood correlates best with that of the late wood of the same year. We suggest that a biochemical explanation of these data is that there is a rapid cycle between hexose monophosphates and triose phosphates in oak stem tissue during cellulose synthesis. Evidence in support of this explanation is provided by the intramolecular distribution of 14C in labelled fructose extracted from cores of wood that had been supplied with [1−14C]‐ and [6‐14C]glucose.

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High-resolution stable isotope analyses were carried out on a sample of oak (Quercus petraea) from Cultra, Co Down, UK. A sampling strategy of unparallelled resolution was adopted in an attempt to reconstruct short-term climatic changes during the growing season. The results display a surprising clarity of signal and suggest a significant relationship between δ 13 C and relative humidity and, to a lesser extent, temperature. This preliminary study proposes possible reasons for the isotopic profile observed and highlights the perceived future value of intra-ring isotope studies ('microdendroclimatology').

Context Educators must prepare learners to navigate the complexities of clinical care. Training programmes have, however, traditionally prioritised teaching around the biomedical and the technical, not the socio‐relational or systems issues that create complexity. If we are to transform medical education to meet the demands of 21st century practice, we need to understand how clinicians perceive and respond to complex situations. Methods Constructivist grounded theory informed data collection and analysis; during semi‐structured interviews, we used rich pictures to elicit team members’ perspectives about clinical complexity in neurology and in the intensive care unit. We identified themes through constant comparative analysis. Results Routine care became complex when the prognosis was unknown, when treatment was either non‐existent or had been exhausted or when being patient and family centred challenged a system's capabilities, or participants’ training or professional scope of practice. When faced with complexity, participants reported that care shifted from relying on medical expertise to engaging in advocacy. Some physician participants, however, either did not recognise their care as advocacy or perceived it as outside their scope of practice. In turn, advocacy was often delegated to others. Conclusions Our research illuminates how expert clinicians manoeuvre moments of complexity; specifically, navigating complexity may rely on mastering health advocacy. Our results suggest that advocacy is often negotiated or collectively enacted in team settings, often with input from patients and families. In order to prepare learners to navigate complexity, we suggest that programmes situate advocacy training in complex clinical encounters, encourage reflection and engage non‐physician team members in advocacy training.

Context ‘Complexity’ is fast becoming a ‘god term’ in medical education, but little is known about how scholars in the field apply complexity science to the exploration of education phenomena. Complexity science presents both opportunities and challenges to those wishing to adopt its approaches in their research, and debates about its application in the field have emerged. However, these debates have tended towards a reductive characterisation of complexity versus simplicity. We argue that a more productive discussion centres on the multiplicity of complexity orientations, with their diverse disciplinary roots, concepts and terminologies. We discuss this multiplicity and use it to explore how medical education researchers have taken up complexity science in prominent journals in the field. Methods We synthesised the health sciences and medical education literature based on 46 papers published in the last 18 years (2000–2017) to describe the patterns of use of complexity science in medical education and to consider the consequences of those patterns for our ability to advance scholarly conversations about ‘complex’ phenomena in our field. Results We identified four patterns in the use of complexity science in medical education research. Firstly, complexity science is described in a variety of ways. Secondly, multiple approaches to complexity are used in combination in single papers. Thirdly, the type of complexity science used tends to be left implicit. Fourthly, the complexity orientation used is much more commonly located using secondary source citation rather than primary source citation. Conclusions The presence of these four patterns begs the question: Do medical education scholars understand that there are multiple legitimate orientations to complexity science, deriving from distinct disciplinary origins, drawing on different metaphors and serving distinct purposes? If we do not understand this, a cascade of potential consequences awaits. We may assume that complexity science is singular in that there is only one way to do it. This assumption may cause us to perceive our way as the ‘right’ way and to disregard other approaches as illegitimate. However, this perception of illegitimacy may limit our ability to enter into productive dialogue about our complexity science‐inspired research.