Anesthesiology leadership rounding: identifying opportunities for improvement.

Science.gov (United States)

Gravenstein, Dietrich; Ford, Susan; Enneking, F Kayser

2012-01-01

Rounding that includes participation of individuals with authority to implement changes has been advocated as important to the transformation of an institution into a high-quality and safe organization. We describe a Department of Anesthesiology's experience with leadership rounding. The Department Chair or other senior faculty designate, a quality coordinator, up to four residents, the ward charge nurse, and patient nurses participated in rounds at bedsides. During a 23-month period, 14 significant opportunities to improve care were identified. Nurses identified 5 of these opportunities, primary team physicians 2, the rounding team 4, and patients or their family members another 3. The anesthesiology service had sole or shared responsibility for 10 improvements. A variety of organizations track specific measures across all phases of the patient experience to gauge quality of care. Chart auditing tools for detecting threats to safety are often used. These measures and tools missed opportunities for improvement that were discovered only through rounding. We conclude that the introduction of leadership rounding by an anesthesiology service can identify opportunities for improving quality that are not captured by conventional efforts.

Accreditation Council for Graduate Medical Education (ACGME) Surgery Resident Operative Logs: The Last Quarter Century.

Science.gov (United States)

Drake, Frederick Thurston; Aarabi, Shahram; Garland, Brandon T; Huntington, Ciara R; McAteer, Jarod P; Richards, Morgan K; Zern, Nicole Kansier; Gow, Kenneth W

2017-05-01

To describe secular trends in operative experience for surgical trainees across an extended period using the most comprehensive data available, the Accreditation Council for Graduate Medical Education (ACGME) case logs. Some experts have expressed concern that current trainees are inadequately prepared for independent practice. One frequently mentioned factor is whether duty hours' restrictions (DHR) implemented in 2003 and 2004 contributed by reducing time spent in the operating room. A dataset was generated from annual ACGME reports. Operative volume for total major cases (TMC), defined categories, and four index laparoscopic procedures was evaluated. TMC dropped after implementation of DHR but rebounded after a transition period (949 vs 946 cases, P = nonsignificance). Abdominal cases increased from 22% of overall cases to 31%. Alimentary cases increased from 21% to 26%. Trauma and vascular surgery substantially decreased. For trauma, this drop took place well before DHR. The decrease in vascular surgery also began before DHR but continued afterward as well: 148 cases/resident in the late 1990s to 107 currently. Although total operative volume rebounded after implementation of DHR, diversity of operative experienced narrowed. The combined increase in alimentary and abdominal cases is nearly 13%, over a half-year's worth of operating in 5-year training programs. Bedrock general surgery cases-trauma, vascular, pediatrics, and breast-decreased. Laparoscopic operations have steadily increased. If the competence of current graduates has, in fact, diminished. Our analysis suggests that operative volume is not the problem. Rather, changing disease processes, subspecialization, reductions in resident autonomy, and technical innovation challenge how today's general surgeons are trained.

Enhancement of anesthesiology in-training exam performance with institution of an academic improvement policy.

Science.gov (United States)

Joseph, Julie A; Terry, Chris M; Waller, Eva J; Bortsov, Andrey V; Zvara, David A; Mayer, David C; Martinelli, Susan M

2014-01-01

Anesthesiology resident physicians across the United States complete an annual in-training examination (ITE). The ITE evaluates resident knowledge and provides personalized feedback to guide future study in low scoring sections(1). Performance on the ITE correlates with outcomes on the American Board of Anesthesiology (ABA) written board examination(2). Over the last several years, declining ITE scores were observed at the University of North Carolina (UNC). In response to this decline, our department reprioritized the ITE by instituting an academic improvement policy (AIP). The AIP employed both reward for satisfactory achievement and consequence for under-performance to elevate the ITE as a "high stakes" examination. Our hypothesis was that implementation of this AIP would improve ITE scores. ITE scores were compiled from 150 residents in the Department of Anesthesiology at UNC for graduating classes from 2004-2015. Data is presented as the number of residents scoring below the 20th percentile when compared to the national distribution before and after the AIP. In addition, average USMLE Step 1 three-digit scores for each graduating class were compared to average ITE percentile scores of the corresponding graduating class (USMLE does not provide percentile scores). Between 2009 and 2013, the number of residents who scored below the 20th percentile on the ITE increased steadily to a peak of 10 in 2011. After implementation of the AIP in July 2011, there was an 80% decrease in those scoring below the 20th percentile, from 10 to 2 residents (pITE scores improved after implementation of an academic improvement policy.

Leadership and management of academic anesthesiology departments in the United States.

Science.gov (United States)

Mets, Berend; Galford, Jennifer A

2009-03-01

To characterize the approach of academic chairs of anesthesiology in leading and managing their departments, and to gain insights into what they considered the most difficult challenges as chairs. Internet-based survey instrument conducted during July and August of 2006. Academic medical center. Department chairs of 132 academic anesthesiology programs who were listed on the Society of Academic Anesthesiology Chairs Listserv, were surveyed. The overall number of respondents were reported. However, as all questions were voluntary, not all were answered by each respondent. Observations are therefore reported as absolute numbers and percentages on a question-by-question basis. Respondents were asked to rank responses to some questions in order of importance (eg, 1 = most important). These data are presented as rank ordered median values, determined by the Kruskal-Wallis Test. Significant differences between groups were determined by Dunn's post test. A P-value Visionary and Coaching styles of leadership as most important. Seventy-nine percent had developed "Vision" statements for the department and 64% of respondents had set goals for divisions. To communicate within departments, 74% of Chairs had at least monthly faculty meetings and 50% held at least yearly faculty retreats. Chairs preferred communicating contentious issues face to face. Ninety-five percent of Chairs held at least yearly performance appraisals and 85% had an established incentive system in the department. Academic productivity (73%) and clinical time (68%) were the most common components of the incentive system. In 65% of departments, Chairs delegated the program directorship and in 73%, the running of the National Residency Matching Program. The financial state of the department was shared at least annually in 93% of departments. In most departments (77%), faculty salary ranges were known but individual faculty salaries were not shared. Chairs considered the most important leadership challenge to

Variation in National ACGME Case Log Data for Pediatric Orthopaedic Fellowships: Are Fellow Coding Practices Responsible?

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McClure, Philip K; Woiczik, Marcella; Karol, Lori; Sankar, Wudbhav N

The introduction of the 80-hour work week for Accreditation Council for Graduate Medical Education (ACGME) accredited fellowship programs initiated many efforts to optimize surgical training. One particular area of interest is on recording and tracking surgical experiences. The current standard is logging cases based on Current Procedural Terminology codes, which are primarily designed for billing. Proposed guidelines from the ACGME regarding logging exist, but their implementation is unknown, as is the variation in case volume across fellowship programs. The purpose of this study was to investigate variability in the national case log data, and explore potential sources of variation using fellow surveys. National ACGME case log data for pediatric orthopaedic fellowships from 2012 to 2015 were reviewed, with particular attention to the domains of spine, pelvis/hip, arthroscopy, trauma, and other (which includes clubfoot casting). To explore potential sources of case log variability, a survey on case logging behavior was distributed to all pediatric orthopaedic fellows for the academic year 2015 to 2016. Reported experiences based on ACGME case logs varied widely between fellows with percentage difference of up to 100% in all areas. Similarly, wide variability is present in coding practices of pediatric orthopaedic fellows, who often lack formal education on the topic of appropriate coding/logging. In the survey, hypothetical case scenarios had an absolute difference in recorded codes of up to 13 and a percentage difference of up to 100%. ACGME case log data for pediatric orthopaedic fellowships demonstrates wide variability in reported surgical experiences. This variability may be due, in part, to differences in logging practices by individual fellows. This observation makes meaningful interpretation of national data on surgical volume challenging. Proposed surgical experience minimums should be interpreted in light of these data, and may not be advisable unless

[Sex differences and anesthesiology: preface and comments].

Science.gov (United States)

Nishno, Takashi

2009-01-01

In this special issue, the topic of sex difference in the field of anesthesiology is featured. Eight subtopics are discussed including 1) sex differences in cardiovascular medicine, 2) perioperative cardiovascular management, 3) sex differences in the respiratory functions of the upper airway, 4) sex differences in the anesthetic management, 5) sex differences in pain, 6) sex differences in laboratory medicine, 7) sex differences in pharmacokinetics of anesthetics, and 8) postoperative nausea and vomiting. Although recent clinical and experimental studies have shown the existence of sex and/or gender differences in many fields of medicine, our knowledge of sex differences in anesthesiology is apparently insufficient. I believe that anesthesiologists should pay more attention to this topic to improve our daily practice of anesthesia.

Systematic reviews of anesthesiologic interventions reported as statistically significant

DEFF Research Database (Denmark)

Imberger, Georgina; Gluud, Christian; Boylan, John

2015-01-01

statistically significant meta-analyses of anesthesiologic interventions, we used TSA to estimate power and imprecision in the context of sparse data and repeated updates. METHODS: We conducted a search to identify all systematic reviews with meta-analyses that investigated an intervention that may......: From 11,870 titles, we found 682 systematic reviews that investigated anesthesiologic interventions. In the 50 sampled meta-analyses, the median number of trials included was 8 (interquartile range [IQR], 5-14), the median number of participants was 964 (IQR, 523-1736), and the median number...

Special article: Francis Hoeffer McMechan, MD: creator of modern anesthesiology?

Science.gov (United States)

Bacon, Douglas R

2012-12-01

If one person can be credited with the creation of the infrastructure of modern anesthesiology, that individual would be Francis Hoeffer McMechan. He has been largely forgotten since his death in 1939 despite his remarkable and enduring accomplishments. McMechan edited the first national journal devoted to anesthesiology, created and managed almost all of the national and regional societies devoted to the specialty between 1912 and his death, and created the first international physician certification as a specialist in anesthesiology. His accomplishments are even more amazing given the severe arthritis that left him wheelchair-bound for almost his entire professional life and denied him the ability to practice anesthesia. Our specialty owes an incredible debt to this largely unknown and unsung hero.

Pediatric Anesthesiology Fellows' Perception of Quality of Attending Supervision and Medical Errors.

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Benzon, Hubert A; Hajduk, John; De Oliveira, Gildasio; Suresh, Santhanam; Nizamuddin, Sarah L; McCarthy, Robert; Jagannathan, Narasimhan

2018-02-01

Appropriate supervision has been shown to reduce medical errors in anesthesiology residents and other trainees across various specialties. Nonetheless, supervision of pediatric anesthesiology fellows has yet to be evaluated. The main objective of this survey investigation was to evaluate supervision of pediatric anesthesiology fellows in the United States. We hypothesized that there was an indirect association between perceived quality of faculty supervision of pediatric anesthesiology fellow trainees and the frequency of medical errors reported. A survey of pediatric fellows from 53 pediatric anesthesiology fellowship programs in the United States was performed. The primary outcome was the frequency of self-reported errors by fellows, and the primary independent variable was supervision scores. Questions also assessed barriers for effective faculty supervision. One hundred seventy-six pediatric anesthesiology fellows were invited to participate, and 104 (59%) responded to the survey. Nine of 103 (9%, 95% confidence interval [CI], 4%-16%) respondents reported performing procedures, on >1 occasion, for which they were not properly trained for. Thirteen of 101 (13%, 95% CI, 7%-21%) reported making >1 mistake with negative consequence to patients, and 23 of 104 (22%, 95% CI, 15%-31%) reported >1 medication error in the last year. There were no differences in median (interquartile range) supervision scores between fellows who reported >1 medication error compared to those reporting ≤1 errors (3.4 [3.0-3.7] vs 3.4 [3.1-3.7]; median difference, 0; 99% CI, -0.3 to 0.3; P = .96). Similarly, there were no differences in those who reported >1 mistake with negative patient consequences, 3.3 (3.0-3.7), compared with those who did not report mistakes with negative patient consequences (3.4 [3.3-3.7]; median difference, 0.1; 99% CI, -0.2 to 0.6; P = .35). We detected a high rate of self-reported medication errors in pediatric anesthesiology fellows in the United States

Incidence and Factors Associated with Burnout in Anesthesiology: A Systematic Review.

Science.gov (United States)

Sanfilippo, Filippo; Noto, Alberto; Foresta, Grazia; Santonocito, Cristina; Palumbo, Gaetano J; Arcadipane, Antonio; Maybauer, Dirk M; Maybauer, Marc O

2017-01-01

Burnout syndrome has reached epidemic levels among physicians (reported around 50%). Anesthesiology is among the most stressful medical disciplines but there is paucity of literature as compared with others. Analysis of burnout is essential because it is associated with safety and quality of care. We summarize evidence on burnout in anesthesiology. We conducted a systematic review (MEDLINE up to 30.06.2017). We included studies reporting burnout in anesthesiology with no restriction on role or screening test used. Fifteen surveys/studies described burnout in anesthesiology, including different workers profiles (nurses, residents, consultants, and directors). All studies used the Maslach Burnout Inventory test but with significant differences for risk stratification. Burnout prevalence greatly varied across studies (10%-41% high risk, up to 59% at least moderate risk). Factors most consistently associated with burnout were strained working pattern, working as younger consultant, and having children. There was no consistent relationship between burnout and hospital characteristics, gender, or marital status. Burnout prevalence among anesthesiologists is relatively high across career stages, and some risk factors are reported frequently. However, the small number of studies as well as the large differences in their methodology and in reporting approach warrants further research in this field.

Medical education and the ACGME duty hour requirements: assessing the effect of a day float system on educational activities.

Science.gov (United States)

Roey, Steve

2006-01-01

In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted new resident work hour mandates, which are being shown to improve resident well-being and patient safety. However, there are limited data on the impact these new mandates may have on educational activities. To assess the impact on educational activities of a day float system created to meet ACGME work hour mandates. The inpatient ward coverage was changed by adding a day float team responsible for new patient admissions in the morning, with the on-call teams starting later and being responsible for new patient admissions thereafter. I surveyed the residents to assess the impact of this new system on educational activities-resident autonomy, attending teaching, conference attendance, resident teaching, self-directed learning, and ability to complete patient care responsibilities. There was no adverse effect of the day float system on educational activities. House staff reported increased autonomy, enhanced teaching from attending physicians, and improved ability to complete patient care responsibilities. Additionally, house staff demonstrated improved compliance with the ACGME mandates. The implementation of a novel day float system for the inpatient medicine ward service improved compliance with ACGME work duty requirements and did not adversely impact educational activities of the residency training program.

The use of TEE simulation in teaching basic echocardiography skills to senior anesthesiology residents.

Science.gov (United States)

Jelacic, Srdjan; Bowdle, Andrew; Togashi, Kei; VonHomeyer, Peter

2013-08-01

The authors evaluated the educational benefits of using a first-generation HeartWorks simulator to teach senior anesthesiology residents basic echocardiography skills. Prospective observational study. A single academic medical center (teaching hospital). Thirty-seven senior (fourth-year) anesthesiology residents participated in this study. Groups of 3 senior anesthesiology residents participated in a single 3-hour tutorial in the simulation laboratory in the authors' institution during their cardiothoracic anesthesiology rotation. A cardiothoracic anesthesiology faculty member demonstrated the use of the transesophageal echocardiography (TEE) simulator and instructed the residents on obtaining standard TEE views of normal anatomy. Prior to the laboratory session, the residents took an online multiple-choice pretest with 25 questions related to safety, probe manipulation, clinical application, and pathology, which was accompanied by echo images of normal cardiac anatomy and video clips of pathology. Three to four weeks after the TEE tutorial, the residents completed an online post-test and evaluation of the teaching session. There was a statistically significant increase in knowledge of normal echocardiographic anatomy (p = 0.04), with an average improvement in normal echocardiographic anatomy scores of 15%. Virtual reality TEE simulation technology was endorsed strongly by residents, produced a statistically significant improvement in knowledge of normal echocardiographic anatomy, and could be effective for teaching basic echocardiography to anesthesiology residents. Copyright © 2013 Elsevier Inc. All rights reserved.

Anesthesiology training using 3D imaging and virtual reality

Science.gov (United States)

Blezek, Daniel J.; Robb, Richard A.; Camp, Jon J.; Nauss, Lee A.

1996-04-01

Current training for regional nerve block procedures by anesthesiology residents requires expert supervision and the use of cadavers; both of which are relatively expensive commodities in today's cost-conscious medical environment. We are developing methods to augment and eventually replace these training procedures with real-time and realistic computer visualizations and manipulations of the anatomical structures involved in anesthesiology procedures, such as nerve plexus injections (e.g., celiac blocks). The initial work is focused on visualizations: both static images and rotational renderings. From the initial results, a coherent paradigm for virtual patient and scene representation will be developed.

[Publication performances of university clinics for anesthesiology: Germany, Austria and Switzerland from 2001 to 2010].

Science.gov (United States)

Putzer, G; Ausserer, J; Wenzel, V; Pehböck, D; Widmann, T; Lindner, K; Hamm, P; Paal, P

2014-04-01

This study assessed the publication performance of university departments of anesthesiology in Austria, Germany and Switzerland. The number of publications, original articles, impact factors and citations were evaluated. A search was performed in PubMed to identify publications related to anesthesiology from 2001 to 2010. All articles from anesthesiology journals listed in the fields of anesthesia/pain therapy, critical care and emergency medicine by the "journal citation report 2013" in Thomson Reuters ISI web of knowledge were included. Articles from non-anaesthesiology journals, where the stem of the word anesthesia (anes*, anaes*, anäst*, anast*) appears in the affiliation field of PubMed, were included as well. The time periods 2001-2005 and 2006-2010 were compared. Articles were allocated to university departments in Austria, Germany and Switzerland via the affiliation field. A total of 45 university departments in Austria, Germany and Switzerland and 125,979 publications from 2,863 journals (65 anesthesiology journals, 2,798 non-anesthesiology journals) were analyzed. Of the publications 23 % could not be allocated to a given university department of anesthesiology. In the observation period the university department of anesthesiology in Berlin achieved most publications (n = 479) and impact points (1,384), whereas Vienna accumulated most original articles (n = 156). Austria had the most publications per million inhabitants in 2006-2010 (n=50) followed by Switzerland (n=49) and Germany (n=35). The number of publications during the observation period decreased in Germany (0.5 %), Austria (7 %) and Switzerland (8 %). Tables 2 and 4-8 of this article are available at Springer Link under Supplemental. The research performance varied among the university departments of anesthesiology in Germany, Austria and Switzerland whereby larger university departments, such as Berlin or Vienna published most. Publication output in Germany, Austria and

Incidence and Factors Associated with Burnout in Anesthesiology: A Systematic Review

Directory of Open Access Journals (Sweden)

Filippo Sanfilippo

2017-01-01

Full Text Available Background. Burnout syndrome has reached epidemic levels among physicians (reported around 50%. Anesthesiology is among the most stressful medical disciplines but there is paucity of literature as compared with others. Analysis of burnout is essential because it is associated with safety and quality of care. We summarize evidence on burnout in anesthesiology. Methods. We conducted a systematic review (MEDLINE up to 30.06.2017. We included studies reporting burnout in anesthesiology with no restriction on role or screening test used. Results. Fifteen surveys/studies described burnout in anesthesiology, including different workers profiles (nurses, residents, consultants, and directors. All studies used the Maslach Burnout Inventory test but with significant differences for risk stratification. Burnout prevalence greatly varied across studies (10%–41% high risk, up to 59% at least moderate risk. Factors most consistently associated with burnout were strained working pattern, working as younger consultant, and having children. There was no consistent relationship between burnout and hospital characteristics, gender, or marital status. Conclusions. Burnout prevalence among anesthesiologists is relatively high across career stages, and some risk factors are reported frequently. However, the small number of studies as well as the large differences in their methodology and in reporting approach warrants further research in this field.

Incidence and Factors Associated with Burnout in Anesthesiology: A Systematic Review

Science.gov (United States)

Sanfilippo, Filippo; Noto, Alberto; Foresta, Grazia; Santonocito, Cristina; Palumbo, Gaetano J.; Arcadipane, Antonio; Maybauer, Dirk M.

2017-01-01

Background Burnout syndrome has reached epidemic levels among physicians (reported around 50%). Anesthesiology is among the most stressful medical disciplines but there is paucity of literature as compared with others. Analysis of burnout is essential because it is associated with safety and quality of care. We summarize evidence on burnout in anesthesiology. Methods We conducted a systematic review (MEDLINE up to 30.06.2017). We included studies reporting burnout in anesthesiology with no restriction on role or screening test used. Results Fifteen surveys/studies described burnout in anesthesiology, including different workers profiles (nurses, residents, consultants, and directors). All studies used the Maslach Burnout Inventory test but with significant differences for risk stratification. Burnout prevalence greatly varied across studies (10%–41% high risk, up to 59% at least moderate risk). Factors most consistently associated with burnout were strained working pattern, working as younger consultant, and having children. There was no consistent relationship between burnout and hospital characteristics, gender, or marital status. Conclusions Burnout prevalence among anesthesiologists is relatively high across career stages, and some risk factors are reported frequently. However, the small number of studies as well as the large differences in their methodology and in reporting approach warrants further research in this field. PMID:29318155

Attitudes and Perceptions of Surgical Oncology Fellows on ACGME Accreditation and the Complex General Surgical Oncology Certification.

Science.gov (United States)

Lee, David Y; Flaherty, Devin C; Lau, Briana J; Deutsch, Gary B; Kirchoff, Daniel D; Huynh, Kelly T; Lee, Ji-Hey; Faries, Mark B; Bilchik, Anton J

2015-11-01

With the first qualifying examination administered September 15, 2014, complex general surgical oncology (CGSO) is now a board-certified specialty. We aimed to assess the attitudes and perceptions of current and future surgical oncology fellows regarding the recently instituted Accreditation Council for Graduate Medical Education (ACGME) accreditation. A 29-question anonymous survey was distributed to fellows in surgical oncology fellowship programs and applicants interviewing at our fellowship program. There were 110 responses (79 fellows and 31 candidates). The response rate for the first- and second-year fellows was 66 %. Ninety-percent of the respondents were aware that completing an ACGME-accredited fellowship leads to board eligibility in CGSO. However, the majority (80 %) of the respondents stated that their decision to specialize in surgical oncology was not influenced by the ACGME accreditation. The fellows in training were concerned about the cost of the exam (90 %) and expressed anxiety in preparing for another board exam (83 %). However, the majority of the respondents believed that CGSO board certification will be helpful (79 %) in obtaining their future career goals. Interestingly, candidate fellows appeared more focused on a career in general complex surgical oncology (p = 0.004), highlighting the impact that fellowship training may have on organ-specific subspecialization. The majority of the surveyed surgical oncology fellows and candidates believe that obtaining board certification in CGSO is important and will help them pursue their career goals. However, the decision to specialize in surgical oncology does not appear to be motivated by ACGME accreditation or the new board certification.

A Citation Tracking System to Facilitate Sponsoring Institution Oversight of ACGME-Accredited Programs.

Science.gov (United States)

Long, Timothy R; Poe, John D; Zimmerman, Richard S; Rose, Steven H

2012-12-01

The Accreditation Council for Graduate Medical Education (ACGME) requires the graduate medical education committee and the designated institutional official to ensure that citations for noncompliance with the accreditation standards and institutional trends in citations are reviewed and corrected. To describe a citation tracking system (CTS) that uses Microsoft Office Access to efficiently catalogue, monitor, and document resolution of citations. The CTS was implemented in a sponsoring institution with oversight of 133 ACGME-accredited programs. The designated institutional official and the graduate medical education committee review all program letters of notification and enter citations into the CTS. A program-correction plan is required for each citation and is entered into the database. Open citations and action plans are reviewed by the graduate medical education committee and the designated institutional official on a quarterly basis, with decisions ranging from "closing" the citation to approving the action plan in process to requiring a new or modified action plan. Citation categories and subcategories are accessed on the ACGME website and entered into the CTS to identify trends. All 236 citations received since the 2006 Mayo School of Graduate Medical Education institutional site visit were entered into the CTS. On November 22, 2011, 26 of 236 citations (11%) were in active status with ongoing action plans, and 210 (89%) citations had been resolved and were closed. The CTS uses commercially available software to ensure citations are monitored and addressed and to simplify analysis of citation trends. The approach requires minimal staff time for data input and updates and can be performed without institutional information technology assistance.

[Student evaluation of anesthesiological teaching: steering instrument of a continuous improvement process].

Science.gov (United States)

Wittmann, M; Boehm, O; Thiessen, N; Hoeft, A; Knuefermann, P; Baumgarten, G

2012-07-01

The amendment to the higher education act ("Hochschulrahmengesetz") of 1998 postulates an evaluation of teaching for quality assurance. Hence, in the winter semester of 2004 the University Medical Center of Bonn introduced a semester questionnaire for students to evaluate the quality of teaching (EVALON). This evaluation is designed to be an objective benchmarking tool which is used for the distribution of university funds. It is also a steering instrument for direct improvement of teaching in clinical subjects. The aim of this study was to investigate, whether EVALON improved the quality of teaching between 2006 and 2010 and whether the department of anesthesiology improved its ranking in comparison with the other participating institutes. Data from the EVALON questionnaire from the years 2006-2010 were analyzed for improvements in the quality of teaching in anesthesiology. This study focused on three essential contents of the EVALON questionnaire (structural content and organizational procedure of lectures and seminars, course presentation), which were used for the generation of a ranking list of all participating medical institutes and departments. On the basis of these results, 12.5% of the funding was assigned for educational purposes. There was an average return rate of the questionnaires of 74.5%. A significant increase in the overall assessment score of 43.4% could be observed from 5.3 in the summer semester of 2006 to 7.6 in the winter semester of 2009/10. The evaluation score for the department of anesthesiology concerning structural content of seminars and lectures increased by 79% from 4.8 in 2006 to 8.6 in 2010. The quality of organizational procedure was evaluated with a score of 4.9 in 2006 and improved by 74% to 8.5 in 2010. The course presentation skills of the teachers as evaluated by EVALON improved by 61% from a score of 5.2 in 2006 to 8.4 in 2010. In comparison with all other participating medical institutes the department of anesthesiology

Plagiarism in Personal Statements of Anesthesiology Residency Applicants.

Science.gov (United States)

Parks, Lance J; Sizemore, Daniel C; Johnstone, Robert E

2016-02-15

Plagiarism by residency applicants in their personal statements, as well as sites that sell personal statements, have been described, and led in 2011 to advice to avoid plagiarism and the caution that plagiarism detection software was available. We screened personal statements of 467 anesthesiology residency applicants from 2013-2014 using Viper Plagiarism Scanner software, and studied them for plagiarism. After quotes and commonly used phrases were removed, 82 statements contained unoriginal content of 8 or more consecutive words. After the study, 13.6% of personal statements from non-United States medical school graduates, and 4.0% from United States medical school graduates, contained plagiarized material, a significant difference. Plagiarized content ranged up to 58%. Plagiarism continues to occur in anesthesiology residency personal statements, with a higher incidence among graduates of non-United States medical schools.

Attitudes of anesthesiology residents toward critical care medicine training.

Science.gov (United States)

Durbin, C G; McLafferty, C L

1993-09-01

The number of anesthesiology residents pursuing critical care medicine (CCM) fellowship training has been decreasing in recent years. A significant number of training positions remain unfilled each year. Possible causes of this decline were evaluated by surveying residents regarding their attitudes toward practice and training in CCM. All 38 anesthesiology programs having accredited CCM fellowships were surveyed. Four of these and one program without CCM fellowships were used to develop the survey instrument. Four programs without CCM fellowships and 34 programs with CCM fellowships make up the survey group. Returned were 640 surveys from 37 (97%) programs accounting for over 30% of the possible residents. Resident interest in pursuing CCM training decreased as year of residency increased (P questions suggested resident concerns with the following: stress of chronic care, financial consequences of additional year of training, ICU call frequency and load, ICU role ambiguity, and shared decision-making in the ICU. A recurring question was, "Are there jobs (outside of academics) for anesthesiologist intensivists?" Most residents knew a CCM anesthesiologist they admired and knew that there were unfilled fellowship positions available. Defining the job market, improving curriculum and teaching, supporting deferment of student loans, and introducing residents and medical students to the ICU earlier may increase the interest in CCM practice among anesthesiology residents.

Using cognitive modeling for requirements engineering in anesthesiology

NARCIS (Netherlands)

Pott, C; le Feber, J

2005-01-01

Cognitive modeling is a complexity reducing method to describe significant cognitive processes under a specified research focus. Here, a cognitive process model for decision making in anesthesiology is presented and applied in requirements engineering. Three decision making situations of

The Anesthesiologist-Informatician: A Survey of Physicians Board-Certified in Both Anesthesiology and Clinical Informatics.

Science.gov (United States)

Poterack, Karl A; Epstein, Richard H; Dexter, Franklin

2018-03-12

All 36 physicians board-certified in both anesthesiology and clinical informatics as of January 1, 2016, were surveyed via e-mail, with 26 responding. Although most (25/26) generally expressed satisfaction with the clinical informatics boards, and view informatics expertise as important to anesthesiology, most (24/26) thought it unlikely or highly unlikely that substantial numbers of anesthesiology residents would pursue clinical informatics fellowships. Anesthesiologists wishing to qualify for the clinical informatics board examination under the practice pathway need to devote a substantive amount of worktime to informatics. There currently are options outside of formal fellowship training to acquire the knowledge to pass.

Shortening the Miles to the Milestones: Connecting EPA-Based Evaluations to ACGME Milestone Reports for Internal Medicine Residency Programs.

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Choe, John H; Knight, Christopher L; Stiling, Rebekah; Corning, Kelli; Lock, Keli; Steinberg, Kenneth P

2016-07-01

The Next Accreditation System requires internal medicine training programs to provide the Accreditation Council for Graduate Medical Education (ACGME) with semiannual information about each resident's progress in 22 subcompetency domains. Evaluation of resident "trustworthiness" in performing entrustable professional activities (EPAs) may offer a more tangible assessment construct than evaluations based on expectations of usual progression toward competence. However, translating results from EPA-based evaluations into ACGME milestone progress reports has proven to be challenging because the constructs that underlay these two systems differ.The authors describe a process to bridge the gap between rotation-specific EPA-based evaluations and ACGME milestone reporting. Developed at the University of Washington in 2012 and 2013, this method involves mapping EPA-based evaluation responses to "milestone elements," the narrative descriptions within the columns of each of the 22 internal medicine subcompetencies. As faculty members complete EPA-based evaluations, the mapped milestone elements are automatically marked as "confirmed." Programs can maintain a database that tallies the number of times each milestone element is confirmed for a resident; these data can be used to produce graphical displays of resident progress along the internal medicine milestones.Using this count of milestone elements allows programs to bridge the gap between faculty assessments of residents based on rotation-specific observed activities and semiannual ACGME reports based on the internal medicine milestones. Although potentially useful for all programs, this method is especially beneficial to large programs where clinical competency committee members may not have the opportunity for direct observation of all residents.

Anesthesiology teaching during undergraduation through an academic league: what is the impact in students' learning?

Science.gov (United States)

Ramalho, Alan Saito; Silva, Felipe Duarte; Kronemberger, Tatiana Barboza; Pose, Regina Albanese; Torres, Marcelo Luis Abramides; Carmona, Maria José Carvalho; Auler, José Otávio Costa

2012-01-01

Academic leagues have been consolidated as instruments of medical teaching and for the introducing of medical students to practice of specialties, including anesthesiology. As the role of leagues in the development process of competencies and learning of their students is not well known, the learning of members of an anesthesiology academic league was evaluated after participating in its activities for one year. Students of an anesthesiology academic league were followed up from March to December 2010 and evaluated through objective cognitive tests of multiple choice applied before the beginning of activities and after their conclusion. Attendance in activities and epidemiologic profile of students were correlated with the tests results. Twenty medical students from 3rd to 6th year were analyzed, with an average age of 22.8 (21-26) years. The average participation in the proposed activities was 10.4/13 (80%). The average of right answers on the first test was 8.1/17 (47.6%), and 3rd year students had lower grades (pperformance (pevaluation tests, suggesting that the league is a useful teaching instrument that can provide improved learning of anesthesiology. Participation in activities was connected with improved performance. Activities developed in leagues may have a positive role in students' academic education, more specifically in this article, in anesthesiology. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

Anesthesiological ethics: can informed consent be implied?

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Spike, Jeffrey R

2012-01-01

Surgical ethics is a well-recognized field in clinical ethics, distinct from medical ethics. It includes at least a dozen important issues common to surgery that do not exist in internal medicine simply because of the differences in their practices. But until now there has been a tendency to include ethical issues of anesthesiology as a part of surgical ethics. This may mask the importance of ethical issues in anesthesiology, and even help perpetuate an unfortunate view that surgeons are "captain of the ship" in the operating theater (leaving anesthesiologists in a subservient role). We will have a better ethical understanding if we see surgery and anesthesia as two equal partners, ethically as well as in terms of patient care. Informed consent is one such issue, but it is not limited to that. Even on the topic of what type of anesthesia to use, anesthesiologists have often felt subsumed to the surgeon's preferences. This commentary takes the case study and uses it as a exemplar for this very claim: it is time to give due recognition for a new field in clinical ethics, ethics in anesthesia.

Understanding Conflict Management Styles in Anesthesiology Residents.

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Vasilopoulos, Terrie; Giordano, Christopher R; Hagan, Jack D; Fahy, Brenda G

2018-05-17

Successful conflict resolution is vital for effective teamwork and is critical for safe patient care in the operating room. Being able to appreciate the differences in training backgrounds, individual knowledge and opinions, and task interdependency necessitates skilled conflict management styles when addressing various clinical and professional scenarios. The goal of this study was to assess conflict styles in anesthesiology residents via self- and counterpart assessment during participation in simulated conflict scenarios. Twenty-two first-year anesthesiology residents (first postgraduate year) participated in this study, which aimed to assess and summarize conflict management styles by 3 separate metrics. One metric was self-assessment with the Thomas-Kilmann Conflict Mode Instrument (TKI), summarized as percentile scores (0%-99%) for 5 conflict styles: collaborating, competing, accommodating, avoiding, and compromising. Participants also completed self- and counterpart ratings after interactions in a simulated conflict scenario using the Dutch Test for Conflict Handling (DUTCH), with scores ranging from 5 to 25 points for each of 5 conflict styles: yielding, compromising, forcing, problem solving, and avoiding. Higher TKI and DUTCH scores would indicate a higher preference for a given conflict style. Sign tests were used to compare self- and counterpart ratings on the DUTCH scores, and Spearman correlations were used to assess associations between TKI and DUTCH scores. On the TKI, the anesthesiology residents had the highest median percentile scores (with first quartile [Q1] and third quartile [Q3]) in compromising (67th, Q1-Q3 = 27-87) and accommodating (69th, Q1-Q3 = 30-94) styles, and the lowest scores for competing (32nd, Q1-Q3 = 10-57). After each conflict scenario, residents and their counterparts on the DUTCH reported higher median scores for compromising (self: 16, Q1-Q3 = 14-16; counterpart: 16, Q1-Q3 = 15-16) and problem solving (self: 17, Q1-Q3 = 16

The Impact of 2011 ACGME Duty Hour Restrictions on Internal Medicine Resident Workload and Education

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Vucicevic, Darko; Mookadam, Farouk; Webb, Brandon J.; Labonte, Helene R.; Cha, Stephen S.; Blair, Janis E.

2015-01-01

The Accreditation Council for Graduate Medical Education (ACGME) implemented work hour restrictions for physicians in training in 2003 that were revised July 1, 2011. Current published data are insufficient to assess whether such work hour restrictions will have long-term impact on residents' education. We searched computer-generated reports…

Teaching hospital financial status and patient outcomes following ACGME duty hour reform.

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Navathe, Amol S; Silber, Jeffrey H; Small, Dylan S; Rosen, Amy K; Romano, Patrick S; Even-Shoshan, Orit; Wang, Yanli; Zhu, Jingsan; Halenar, Michael J; Volpp, Kevin G

2013-04-01

To examine whether hospital financial health was associated with differential changes in outcomes after implementation of 2003 ACGME duty hour regulations. Observational study of 3,614,174 Medicare patients admitted to 869 teaching hospitals from July 1, 2000 to June 30, 2005. Interrupted time series analysis using logistic regression to adjust for patient comorbidities, secular trends, and hospital site. Outcomes included 30-day mortality, AHRQ Patient Safety Indicators (PSIs), failure-to-rescue (FTR) rates, and prolonged length of stay (PLOS). All eight analyses measuring the impact of duty hour reform on mortality by hospital financial health quartile, in postreform year 1 ("Post 1") or year 2 ("Post 2") versus the prereform period, were insignificant: Post 1 OR range 1.00-1.02 and Post 2 OR range 0.99-1.02. For PSIs, all six tests showed clinically insignificant effect sizes. The FTR rate analysis demonstrated nonsignificance in both postreform years (OR 1.00 for both). The PLOS outcomes varied significantly only for the combined surgical sample in Post 2, but this effect was very small, OR 1.03 (95% CI 1.02, 1.04). The impact of 2003 ACGME duty hour reform on patient outcomes did not differ by hospital financial health. This finding is somewhat reassuring, given additional financial pressure on teaching hospitals from 2011 duty hour regulations. © Health Research and Educational Trust.

Views of surgery program directors on the current ACGME and proposed IOM duty-hour standards.

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Willis, Ross E; Coverdill, James E; Mellinger, John D; Collins, J Craig; Potts, John R; Dent, Daniel L

2009-01-01

The purpose of this study was to survey the experiences of surgery program directors with the current Accreditation Council for Graduate Medical Education (ACGME) duty-hour standards and views of the Institute of Medicine (IOM) proposed duty-hour recommendations. A total of 118 program directors (47.6% of all surgery programs in the US) responded to the survey. Results showed that the current duty-hour standards have hindered clinical education opportunities by reducing or eliminating rotations on many services, didactic teaching conferences, and clinical bedside teaching opportunities. Additionally, patient safety has been compromised by frequent hand offs of care. Most IOM recommendations were perceived as extremely difficult or impossible to implement, with the exception of the moonlighting recommendation. The results indicated that adopting the IOM recommendations is not feasible given current workforce limitations, and most program directors supported maintaining the current duty-hour standards until such time as there is evidence-based outcomes research to direct change. The conclusion was that the current ACGME duty-hour standards have reduced teaching opportunities and narrowed the scope of training.

Annual State of Connecticut Obstetrics and Gynecology Resident Research Day.

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Seagle, Brandon-Luke L; Ballard, Jennifer; Kakar, Freshta; Panarelli, Erin; Samuelson, Robert; Shahabi, Shohreh

2015-01-01

To increase opportunities for Obstetrics and Gynecology(Ob/Gyn) residents to present their research, an Annual State of Connecticut Ob/Gyn Resident Research Day (RRD) was created. At the first annual RRD, 33 residents, representing five of six Connecticut Ob/Gyn residency programs, presented 39 poster and eight oral presentations. RRD evaluators rated the overall symposium and the quality of resident oral and poster presentations as either "excellent" or "above average." Residency program directors reported that the symposium was "very helpful" for evidencing resident scholarship as required by the Accreditation Council for Graduate Medical Education (ACGME). Surveyed residents reported that the symposium promoted their research and was a valuable investment of their time. An annual specialty-specific, statewide RRD was created, experienced good participation, and was well evaluated. The annual, statewide Ob/Gyn RRD may serve as a model for development of other specialty-specific, statewide RRD events.

Have personal statements become impersonal? An evaluation of personal statements in anesthesiology residency applications.

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Max, Bryan A; Gelfand, Brian; Brooks, Meredith R; Beckerly, Rena; Segal, Scott

2010-08-01

To evaluate personal statements submitted to a major academic anesthesiology program to determine the prevalence of common features and overall subjective quality, and to survey anesthesiology program directors as to how they utilized these statements during the resident selection process. Structured analysis of de-identified personal statements and Internet-based survey of program directors. Large academic anesthesiology training program. 670 applicant personal statements and academic anesthesiology program directors. Prevalence of 13 specific essay features and 8 quality ratings were calculated for the essays and correlated with other aspects of the residency application, as abstracted from the Electronic Residency Application Service (ERAS) files. A 6-question survey regarding use of personal statements was collected from program directors. 70 of 131 program directors queried responded to our survey. Interest in physiology and pharmacology, enjoyment of a hands-on specialty, and desire to comfort anxious patients were each mentioned in more than half of the essays. Candidates invited for an interview had essays that received higher quality ratings than essays of those not invited (P = 0.02 to P essay. Only 41% found the personal statement to be very or somewhat important in selecting candidates for interview invitations. However, over 90% stated that they used the statements during actual interviews with invited applicants. The data showed a high prevalence of common features found within personal statements and a general ambivalence amongst those program directors for whom the statements were intended. Copyright 2010 Elsevier Inc. All rights reserved.

Patient Simulation: A Literary Synthesis of Assessment Tools in Anesthesiology

Directory of Open Access Journals (Sweden)

Alice A. Edler

2009-12-01

Full Text Available High-fidelity patient simulation (HFPS has been hypothesized as a modality for assessing competency of knowledge and skill in patient simulation, but uniform methods for HFPS performance assessment (PA have not yet been completely achieved. Anesthesiology as a field founded the HFPS discipline and also leads in its PA. This project reviews the types, quality, and designated purpose of HFPS PA tools in anesthesiology. We used the systematic review method and systematically reviewed anesthesiology literature referenced in PubMed to assess the quality and reliability of available PA tools in HFPS. Of 412 articles identified, 50 met our inclusion criteria. Seventy seven percent of studies have been published since 2000; more recent studies demonstrated higher quality. Investigators reported a variety of test construction and validation methods. The most commonly reported test construction methods included “modified Delphi Techniques” for item selection, reliability measurement using inter-rater agreement, and intra-class correlations between test items or subtests. Modern test theory, in particular generalizability theory, was used in nine (18% of studies. Test score validity has been addressed in multiple investigations and shown a significant improvement in reporting accuracy. However the assessment of predicative has been low across the majority of studies. Usability and practicality of testing occasions and tools was only anecdotally reported. To more completely comply with the gold standards for PA design, both shared experience of experts and recognition of test construction standards, including reliability and validity measurements, instrument piloting, rater training, and explicit identification of the purpose and proposed use of the assessment tool, are required.

The impact of new-generation physicians on the function of academic anesthesiology departments.

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Kapur, Patricia A

2007-12-01

Academic departments of anesthesiology have had to adapt a wide variety of clinical and educational work functions to the viewpoints, values and normative expectations of the newer generations of physicians who now present themselves for training as well as for faculty employment. This commentary will elaborate on key points that academic departments must recognize and incorporate into their functional and organizational imperatives in order to remain successful with regard to physician recruitment and retention. Recognition of differences between newer-generation vs. established physician issues and concerns include differences in: learning style, teaching style, approach to clinical schedules and the concept of life-work balance, academic and personal motivation, desire for control of their work experience, effective productivity incentives, as well as communication style issues and implications thereof. The spectrum of physicians who contribute to the impact of these factors on contemporary academic anesthesiology departments include faculty, nonfaculty staff physicians, residents and medical students. Academic departments of anesthesiology which can successfully incorporate the changes and most importantly the functional and organizational flexibility needed to respond to the newer generations' worldview and so-called balanced goals will be able to best attract high-caliber housestaff and future faculty.

The ACGME case log: General surgery resident experience in pediatric surgery

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Gow, Kenneth W.; Drake, F. Thurston; Aarabi, Shahram; Waldhausen, John H.

2014-01-01

Background General surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time. Methods The ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989–1990 to 2010–2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989–90 to AY1993–94), Period II (AY1994–95 to AY1998–99), Period III (AY1999–00 to AY2002–03), Period IV (AY2003–04 to AY2006–07), and Period V (AY2007–08 to AY2010–11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P < .05. Results Overall GS case load remained relatively stable. Of total cases, PS cases accounted for 5.4% in Period I and 3.7% in Period V. Designated pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time. Conclusions GS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended. PMID:23932601

Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies.

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Waterbrook, Anna L; Spear Ellinwood, Karen C; Pritchard, T Gail; Bertels, Karen; Johnson, Ariel C; Min, Alice; Stoneking, Lisa R

2018-01-01

Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones. Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2). Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received milestone scores and narrative feedback on the non-medical knowledge-based ACGME sub-competencies and indicated the shadow experience and subsequent feedback were valuable. Medical education specialists who observe residents over the course of an entire shift and evaluate non-medical knowledge-based skills are perceived by EM residents to provide meaningful feedback and add valuable information for the biannual review process.

ACGME core competency training, mentorship, and research in surgical subspecialty fellowship programs.

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Francesca Monn, M; Wang, Ming-Hsien; Gilson, Marta M; Chen, Belinda; Kern, David; Gearhart, Susan L

2013-01-01

To determine the perceived effectiveness of surgical subspecialty training programs in teaching and assessing the 6 ACGME core competencies including research. Cross-sectional survey. ACGME approved training programs in pediatric urology and colorectal surgery. Program Directors and recent trainees (2007-2009). A total of 39 program directors (60%) and 57 trainees (64%) responded. Both program directors and recent trainees reported a higher degree of training and mentorship (75%) in patient care and medical knowledge than the other core competencies (pinterpersonal and communication, and professionalism training were perceived effective to a lesser degree. Specifically, in the areas of teaching residents and medical students and team building, program directors, compared with recent trainees, perceived training to be more effective, (p = 0.004, p = 0.04). Responses to questions assessing training in systems based practice ubiquitously identified a lack of training, particularly in financial matters of running a practice. Although effective training in research was perceived as lacking by recent trainees, 81% reported mentorship in this area. According to program directors and recent trainees, the most effective method of teaching was faculty supervision and feedback. Only 50% or less of the recent trainees reported mentorship in career planning, work-life balance, and job satisfaction. Not all 6 core competencies and research are effectively being taught in surgery subspecialty training programs and mentorship in areas outside of patient care and research is lacking. Emphasis should be placed on faculty supervision and feedback when designing methods to better incorporate all 6 core competencies, research, and mentorship. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Scientific publications in anesthesiology journals from East Asia: a 10-year survey of the literature.

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Li, Zhi; Qiu, Li-Xin; Wu, Fei-Xiang; Yang, Li-Qun; Sun, Yu-Ming; Yu, Wei-Feng

2011-04-01

The scientific publications in anesthesiology research from East Asian authors have not been reported yet. The present study was designed to analyze the contribution of articles from East Asia to anesthesiology research. Articles published in 17 journals in anesthesiology originating from Japan, China, and South Korea from 2000 to 2009 were retrieved from the PubMed database and Web of Science. From 2000 to 2009, there were 3,076 articles published from East Asia. During this period, there were a notable decrease in publications from Japan and modest increases in publications from both China and South Korea. The average 5-year impact factor of the published articles was similar among the three regions, and China had the highest average number of citations to each article. Anesthesia & Analgesia published more articles than any other journal from all three regions. Our analysis showed that Japan was the most productive region in East Asia, but there was a notable decrease in publications from Japan in 2000-2009. The impact factor of the articles suggests similar levels of scholarship. Anesthesia & Analgesia was the most popular journal in East Asia.

Milestones on a Shoestring: A Cost-Effective, Semi-automated Implementation of the New ACGME Requirements for Radiology.

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Schmitt, J Eric; Scanlon, Mary H; Servaes, Sabah; Levin, Dayna; Cook, Tessa S

2015-10-01

The advent of the ACGME's Next Accreditation System represents a significant new challenge for residencies and fellowships, owing to its requirements for more complex and detailed information. We developed a system of online assessment tools to provide comprehensive coverage of the twelve ACGME Milestones and digitized them using freely available cloud-based productivity tools. These tools include a combination of point-of-care procedural assessments, electronic quizzes, online modules, and other data entry forms. Using free statistical analytic tools, we also developed an automated system for management, processing, and data reporting. After one year of use, our Milestones project has resulted in the submission of over 20,000 individual data points. The use of automated statistical methods to generate resident-specific profiles has allowed for dynamic reports of individual residents' progress. These profiles both summarize data and also allow program directors access to more granular information as needed. Informatics-driven strategies for data assessment and processing represent feasible solutions to Milestones assessment and analysis, reducing the potential administrative burden for program directors, residents, and staff. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

The Media Response to the ACGME's 2017 Relaxed Resident Duty-Hour Restrictions.

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Zhang, Zi; Krauthamer, Alan V; Rosenkrantz, Andrew B

2018-03-01

In March 2017, the ACGME relaxed resident duty-hour restrictions to allow first-year residents to work 24-hour shifts, affecting the internship experience of incoming radiology residents. The aim of this study was to assess the media response to this duty-hour change, comparing news articles with favorable and unfavorable views. Google News was used to identify 36 relevant unique news articles published over a 4-week period after the announcement. Articles' stance was categorized as favorable, unfavorable, or neutral. Additional article characteristics were explored. Article sources were 58% national, 22% local, and 20% medical news. Article stance was most commonly unfavorable for national news sources (48%), compared with neutral for local (62%) and medical (72%) news sources. Most common reasons for unfavorable stance were sleep deprivation (n = 11), medical errors (n = 11), residents' health (n = 9), risk for car accidents (n = 9), a patriarchal hazing system (n = 6), and work-life balance (n = 5). Most common reasons for favorable stance were impact on resident education (n = 7) and continuity of care (n = 7). Supporting data were cited by 38% of unfavorable and 100% of favorable articles. Unfavorable articles most commonly quoted physicians affiliated with resident advocacy groups; favorable articles most commonly quoted physicians affiliated with the ACGME. The relaxed duty-hour restrictions received an overall unfavorable media response, particularly in nonmedical news sources, driven by concerns regarding sleep-deprived doctors. Favorable articles ubiquitously cited data supporting the safety of relaxed duty hour restrictions. Further research is warranted to better understand the impact of relaxed resident duty-hour limits on sleep deprivation, residents' health and education, and the quality of patient care. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Anesthesiology resident personality type correlates with faculty assessment of resident performance.

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Schell, Randall M; Dilorenzo, Amy N; Li, Hsin-Fang; Fragneto, Regina Y; Bowe, Edwin A; Hessel, Eugene A

2012-11-01

To study the association between anesthesiology residents' personality preference types, faculty evaluations of residents' performance, and knowledge. Convenience sample and prospective study. Academic department of anesthesiology. Consenting anesthesiology residents (n = 36). All participants completed the Myers Briggs Type Indicator® (MBTI®). All residents' 6-month summation of daily focal evaluations completed by faculty [daily performance score (DPS); 1 = unsatisfactory, 2 = needs improvement, 3 = meets expectations, 4 = exceeds expectations], as well as a global assessment of performance (GAP) score based on placement of each resident into perceived quartile compared with their peers (ie,1 = first, or top, quartile) by senior faculty (n = 7) who also completed the MBTI, were obtained. The resident MBTI personality preferences were compared with the DPS and GAP scores, the United States Medical Licensing Examination (USMLE) I and II scores, and faculty MBTI personality type. There was no association between personality preference type and performance on standardized examinations (USMLE I, II). The mean GAP score was better (higher quartile score) for Extraverts than Introverts (median 2.0 vs 2.6, P = 0.0047) and for Sensing versus Intuition (median 2.0 vs 2.6, P = 0.0206) preference. Faculty evaluator MBTI preference type did not influence the GAP scores they assigned residents. Like GAP, the DPS was better for residents with Sensing versus Intuition preference (median 3.5 vs 3.3, P = 0.0111). No difference in DPS was noted between Extraverts and Introverts. Personality preference type was not associated with resident performance on standardized examinations, but it was associated with faculty evaluations of resident performance. Residents with Sensing personality preference were evaluated more favorably on global and focal faculty evaluations than those residents who chose the Intuition preference. Extraverted residents were evaluated more favorably on

Readability evaluation of Internet-based patient education materials related to the anesthesiology field.

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De Oliveira, Gildasio S; Jung, Michael; Mccaffery, Kirsten J; McCarthy, Robert J; Wolf, Michael S

2015-08-01

The main objective of the current investigation was to assess the readability of Internet-based patient education materials related to the field of anesthesiology. We hypothesized that the majority of patient education materials would not be written according to current recommended readability grade level. Online patient education materials describing procedures, risks, and management of anesthesia-related topics were identified using the search engine Google (available at www.google.com) using the terms anesthesia, anesthesiology, anesthesia risks, and anesthesia care. Cross-sectional evaluation. None. Assessments of content readability were performed using validated instruments (Flesch-Kincaid Grade Formulae, the Gunning Frequency of Gobbledygook, the New Dale-Chall Test, the Fry graph, and the Flesch Reading Ease score). Ninety-six Web sites containing Internet patient education materials (IPEMs) were evaluated. The median (interquartile range) readability grade level for all evaluated IPEMs was 13.5 (12.0-14.6). All the evaluated documents were classified at a greater readability level than the current recommended readability grade, P Internet-based patient education materials related to the field of anesthesiology are currently written far above the recommended readability grade level. High complexity of written education materials likely limits access of information to millions of American patients. Redesign of online content of Web sites that provide patient education material regarding anesthesia could be an important step in improving access to information for patients with poor health literacy. Copyright © 2015 Elsevier Inc. All rights reserved.

Research Productivity and Rankings of Anesthesiology Departments in Canada and the United States: The Relationship Between the h-Index and Other Common Metrics [RETRACTED].

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Bunting, Alexandra C; Alavifard, Sepand; Walker, Benjamin; Miller, Donald R; Ramsay, Tim; Boet, Sylvain

2018-03-05

To evaluate the relative research productivity and ranking of anesthesiology departments in Canada and the United States, using the Hirsch index (h-index) and 4 other previously validated metrics. We identified 150 anesthesiology departments in Canada and the United States with an accredited residency program. Publications for each of the 150 departments were identified using Thomson's Institute for Scientific Information Web of Science, and the citation report for each department was exported. The bibliometric data were used to calculate publication metrics for 3 time periods: cumulative (1945-2014), 10 years (2005-2014), and 5 years (2010-2014). The following group metrics were then used to determine the publication impact and relative ranking of all 150 departments: h-index, m-index, total number of publications, sum of citations, and average number of citations per article. Ranking for each metric were also stratified by using a proxy for departmental size. The most common journals in which US and Canadian anesthesiology departments publish their work were identified. The majority (23 of the top 25) of top-ranked anesthesiology departments are in the United States, and 2 of the top 25 departments (University of Toronto; McGill University) are in Canada. There was a strong positive relationship between each of h-index, total number of publications, and the sum of citations (0.91-0.97; P productivity on most metrics. The most frequent journals in which US and Canadian anesthesiology departments publish are Anesthesiology, Anesthesia and Analgesia, and the Canadian Journal of Anesthesia. Our study ranked the Canadian and US anesthesiology departmental research productivity using the h-index applied to each department, total number of publications, total number of citations, and average number of citations. The strong relationship between the h-index and both the number of publications and number of citations of anesthesiology departments shows that the departments

Factors Affecting the Choice of Anesthesiology by Medical Students for Specialty Training.

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Chandra, Phool; Hughes, Mark

1984-01-01

A study of medical students' choice of anesthesiology as a specialty and the quality of clerkships available established several factors in students' choice, including the negative effect of certified registered nurse anesthetists on the operating room floor. A study of relationships with nurse practitioners, physician's assistants, and…

Leadership in anesthesiology: not just a one man show

Directory of Open Access Journals (Sweden)

Tjokorda GA Senapathi

2017-05-01

Full Text Available Anesthesiology had been one of highly skilled professional specialty with diversity of training but with a structured model of leadership culture. The culture which could be drawn back since medical training to become a medical doctor. School of medicine had already established a standard model of teaching and training. The tutoring method is implemented mostly based on classroom meetings in traditional basic lesson, bedside teaching for clerkship and internship and lately adopted method of case-based discussion

High-fidelity simulation of lung isolation with double-lumen endotracheal tubes and bronchial blockers in anesthesiology resident training.

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Failor, Erin; Bowdle, Andrew; Jelacic, Srdjan; Togashi, Kei

2014-08-01

Demonstrate the feasibility of using the AirSim Bronchi airway simulator to teach residents how to manage lung isolation with double-lumen endotracheal tubes and bronchial blockers and evaluate their performance with a detailed checklist. Prospective observational study. University anesthesiology residency training program. Anesthesiology residents taking a cardiothoracic anesthesiology rotation. Residents were instructed in 7 tasks using the AirSim Bronchi: The use of the fiberoptic bronchoscope, methods for placing left and right double-lumen endotracheal tubes and 3 bronchial blockers (Univent, Arndt, and Cohen), and application of continuous positive airway pressure (CPAP) to the unventilated lung. Two to 3 weeks later, checklists and a detailed scoring system were used to assess performance. Residents rated the curriculum and their own confidence in performing the tasks using a 5-point Likert scale. Thirteen residents completed the curriculum. Their median Likert scale ratings of the curriculum based on a questionnaire with 6 items ranged from 4 to 5 of 5. Resident confidence scores for each lung isolation technique improved after the simulation training, with the median gain ranging from 0.5 to 1.5 Likert levels depending on the task. The largest improvement occurred with the bronchial blockers (psimulator in a novel simulation curriculum to teach lung-isolation techniques to anesthesiology residents and evaluated performance using a detailed checklist scoring system. This curriculum is a promising educational tool. Copyright © 2014 Elsevier Inc. All rights reserved.

Summer anesthesiology externship: Demonstrating the ability of early clinical involvement to educate and increase specialty interest.

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Baker, Kevin S; Cormican, Daniel; Seidman, Peggy A

2012-01-01

We describe the influence of a 6-week "Summer Anesthesiology Externship" featuring didactic, procedure, and simulation education on formation of medical students' specialty choice. Eighteen months after externship completion, externs were sent a questionnaire with Likert scale agreement ratings of subspecialties/simulations and yes/no questions about student career interests before/after the program, stipend importance, and procedural skill performance during/after the program. General anesthesiology had the highest subspecialty approval rating (9.0). Externs strongly agreed that simulations successfully progressed at first year student understanding levels (9.2 mean agreement rating), increased confidence in being part of a care team (9.4 mean agreement rating), and provided personal/interpersonal development. Externs unanimously agreed that the program introduced them to the breadth of anesthesiology, and that practicing clinical/procedural skills improved confidence when performing the procedures later in medical school. Four of 14 students applied for the externship with some focus on anesthesiology as a career choice. After the externship, a significantly higher number of students (12 of 14) were strongly considering applying to the field (prate than our general medical student classes (p<0.0001). Both CA1 and CA3 resident post-test scores improved at the end of the ultrasound guided regional workshop. Our study showed a 68% improvement in test scores, which is larger than the 50% improvement previously reported. These results show that fast learning can occur in this type of setting. Furthermore, knowledge acquired during the workshop was retained when CA1 residents were re-tested one year after the workshop. The ultrasound-guided regional anesthesia workshop will become part of the didactic series for our CA1 residents and will be a required learning activity. Additional work still needs to be done to find out the best way to test knowledge and skill

American Society of Anesthesiologists

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... SEN Summit Calendar of Events Relive ANESTHESIOLOGY 2017 Experience 400 hours of presentations with ANESTHESIOLOGY Annual Meeting OnDemand. Purchase now Research Anesthesiology Journal Anesthesia Patient Safety Foundation ...

Results of a Flipped Classroom Teaching Approach in Anesthesiology Residents.

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Martinelli, Susan M; Chen, Fei; DiLorenzo, Amy N; Mayer, David C; Fairbanks, Stacy; Moran, Kenneth; Ku, Cindy; Mitchell, John D; Bowe, Edwin A; Royal, Kenneth D; Hendrickse, Adrian; VanDyke, Kenneth; Trawicki, Michael C; Rankin, Demicha; Guldan, George J; Hand, Will; Gallagher, Christopher; Jacob, Zvi; Zvara, David A; McEvoy, Matthew D; Schell, Randall M

2017-08-01

In a flipped classroom approach, learners view educational content prior to class and engage in active learning during didactic sessions. We hypothesized that a flipped classroom improves knowledge acquisition and retention for residents compared to traditional lecture, and that residents prefer this approach. We completed 2 iterations of a study in 2014 and 2015. Institutions were assigned to either flipped classroom or traditional lecture for 4 weekly sessions. The flipped classroom consisted of reviewing a 15-minute video, followed by 45-minute in-class interactive sessions with audience response questions, think-pair-share questions, and case discussions. The traditional lecture approach consisted of a 55-minute lecture given by faculty with 5 minutes for questions. Residents completed 3 knowledge tests (pretest, posttest, and 4-month retention) and surveys of their perceptions of the didactic sessions. A linear mixed model was used to compare the effect of both formats on knowledge acquisition and retention. Of 182 eligible postgraduate year 2 anesthesiology residents, 155 (85%) participated in the entire intervention, and 142 (78%) completed all tests. The flipped classroom approach improved knowledge retention after 4 months (adjusted mean = 6%; P  = .014; d  = 0.56), and residents preferred the flipped classroom (pre = 46%; post = 82%; P  flipped classroom approach to didactic education resulted in a small improvement in knowledge retention and was preferred by anesthesiology residents.

The Impact of a Dedicated Research Education Month for Anesthesiology Residents

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Robert E. Freundlich

2015-01-01

Full Text Available An educational intervention was implemented at the University of Michigan starting in 2008, in which anesthesiology interns complete a dedicated month-long didactic rotation in evidence-based medicine (EBM and research methodology. We sought to assess its utility. Scores on a validated EBM test before and after the rotation were compared and assessed for significance of improvement. A survey was also given to gauge satisfaction with the quality of the rotation and self-reported improvement in understanding of EBM topics. Fourteen consecutive interns completed the research rotation during the study period. One hundred percent completed both the pre- and postrotation test. The mean pretest score was 7.78 ± 2.46 (median = 7.5, 0–15 scale, and interquartile range 7.0–10.0 and the mean posttest score was 10.00 ± 2.35 (median = 9.5, interquartile range 8.0–12.3, which represented a statistically significant increase (P=0.011, Wilcoxon signed-rank test. All fourteen of the residents “agreed” or “strongly agreed” that they would recommend the course to future interns and that the course increased their ability to critically review the literature. Our findings demonstrate that this can be an effective means of improving understanding of EBM topics and anesthesiology research.

Comparison of Registered and Reported Outcomes in Randomized Clinical Trials Published in Anesthesiology Journals.

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Jones, Philip M; Chow, Jeffrey T Y; Arango, Miguel F; Fridfinnson, Jason A; Gai, Nan; Lam, Kevin; Turkstra, Timothy P

2017-10-01

Randomized clinical trials (RCTs) provide high-quality evidence for clinical decision-making. Trial registration is one of the many tools used to improve the reporting of RCTs by reducing publication bias and selective outcome reporting bias. The purpose of our study is to examine whether RCTs published in the top 6 general anesthesiology journals were adequately registered and whether the reported primary and secondary outcomes corresponded to the originally registered outcomes. Following a prespecified protocol, an electronic database was used to systematically screen and extract data from RCTs published in the top 6 general anesthesiology journals by impact factor (Anaesthesia, Anesthesia & Analgesia, Anesthesiology, British Journal of Anaesthesia, Canadian Journal of Anesthesia, and European Journal of Anaesthesiology) during the years 2007, 2010, 2013, and 2015. A manual search of each journal's Table of Contents was performed (in duplicate) to identify eligible RCTs. An adequately registered trial was defined as being registered in a publicly available trials registry before the first patient being enrolled with an unambiguously defined primary outcome. For adequately registered trials, the outcomes registered in the trial registry were compared with the outcomes reported in the article, with outcome discrepancies documented and analyzed by the type of discrepancy. During the 4 years studied, there were 860 RCTs identified, with 102 RCTs determined to be adequately registered (12%). The proportion of adequately registered trials increased over time, with 38% of RCTs being adequately registered in 2015. The most common reason in 2015 for inadequate registration was registering the RCT after the first patient had already been enrolled. Among adequately registered trials, 92% had at least 1 primary or secondary outcome discrepancy. In 2015, 42% of RCTs had at least 1 primary outcome discrepancy, while 90% of RCTs had at least 1 secondary outcome discrepancy

QUALIS EVALUATION OF MEDICINE III: ANALYSIS OF ANESTHESIOLOGY AND GYNECOLOGY AND OBSTETRICS JOURNALS.

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Calderon, Iracema de Mattos Paranhos

2015-01-01

To know the current publication of Anesthesiology and Obstetrics and Gynecology subareas, to support the updating of Qualis Journals criteria in these specific subareas. Cross-sectional, descriptive study in which was evaluated in quantitatively and qualitatively way the bibliographic production of Anesthesiology and Obstetrics and Gynecology subareas, from January 2010 to December 2012. Were investigated the values ​​of the impact factor; calculated (i) the number (n) and the percentage of journals in each stratum Qualis A1, A2, B1, B2, B3, B4 and B5, and (ii) the median values ​​and their extreme limits (minimum values ​​and maximum) and quartiles (p25; p50; p75; p90) of the impact factors in the different strata. The bibliographic production of the three-year period 2010-2012 was published in 69 journals in Anesthesiology subarea and in 345 in Gynecology and Obstetrics. In Anesthesiology, 44% were within the limits of impact factor of superior A1, A2 and B1; in Obstetrics and Gynecology, 42.4% were in those limits and strata. Despite lagging behind by international standards, publications of Anesthesiology and Obstetrics and Gynecology showed tendency to improve the quality. In these sub-areas, the median of journals impact factor is beyond the limits defined by the area in the last assessment. Therefore, it must be reconsidered new indicators to assess this aspect. Conhecer a publicação atual das subáreas Anestesiologia e Ginecologia e Obstetrícia, para subsidiar a atualização dos critérios Qualis-periódicos, específicos dessas subáreas. Estudo de corte transversal, descritivo, onde avaliou-se, de modo quantitativo e qualitativo, a produção bibliográfica das subáreas Anestesiologia e Ginecologia e Obstetrícia, no período de janeiro de 2010 a dezembro de 2012. Foram definidos os valores do fator de impacto das revistas; foram calculados (i) o número (n) e percentual de periódicos em cada um dos estratos Qualis - A1, A2, B1, B2, B3

Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies

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Waterbrook AL

2018-05-01

Full Text Available Anna L Waterbrook,1 Karen C Spear Ellinwood,2 T Gail Pritchard,3 Karen Bertels,1 Ariel C Johnson,4 Alice Min,1 Lisa R Stoneking1 1Department of Emergency Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA; 2Department of Obstetrics and Gynecology, The University of Arizona College of Medicine, Tucson, AZ, USA; 3Department of Pediatrics, The University of Arizona College of Medicine, Tucson, AZ, USA; 4College of Medicine, The University of Arizona College of Medicine, Tucson, AZ, USA Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management are challenging for a supervising emergency medicine (EM physician to evaluate in real-time on shift while also managing a busy emergency department (ED. This study examines residents’ perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills.Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones.Results: Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2. Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received

[Premedication visits in departments of anesthesiology in Hessen. Compilation of organizational and performance portfolios].

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Aust, H; Veltum, B; Wächtershäuser, T; Wulf, H; Eberhart, L

2014-02-01

Many anesthesia departments operate a pre-anesthesia assessment clinic (PAAC). Data regarding organization, equipment and structure of such clinics are not yet available. Information about modern anesthesiology techniques and procedures contributes to a reduction in emotional stress of the patients but such modern techniques often require additional technical hardware and costs and are not equally available. This survey examined the current structures of PAAC in the state of Hessen, demonstrated current concepts and associated these with the performance and the portfolio of procedures in these departments. An online survey was carried out. Data on structure, equipment, organization and available methods were compiled. In addition, anesthesia department personnel were asked to give individual subjective attitudes toward the premedication work. Of the anesthesia departments in Hessen 84 % participated in the survey of which 91 % operated a PAAC. A preoperative contact with the anesthesiologist who would perform anesthesia existed in only 19 % of the departments. Multimedia processing concepts for informed consent in a PAAC setting were in general rare. Many modern procedures and anesthesia techniques were broadly established independent of the hospital size. Regarding the individual and subjective attitudes of anesthetists towards the work, the psychological and medical importance of the pre-medication visit was considered to be very high. The PAACs are now well established. This may make economic sense but is accompanied by an anonymization of care in anesthesiology. The high quality, safety and availability of modern anesthesiology procedures and monitoring concepts should be communicated to patients all the more as an expression of trust and high patient safety. These factors can be facilitated in particular by multimedia tools which have as yet only been sparsely implemented in PAACs.

[Use of personal computers by diplomats of anesthesiology in Japan].

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Yamamoto, K; Ohmura, S; Tsubokawa, T; Kita, M; Kushida, Y; Kobayashi, T

1999-04-01

Use of personal computers by diplomats of the Japanese Board of Anesthesiology working in Japanese university hospitals was investigated. Unsigned questionnaires were returned from 232 diplomats of 18 anesthesia departments. The age of responders ranged from twenties to sixties. Personal computer systems are used by 223 diplomats (96.1%), while nine (3.9%) do not use them. The computer systems used are: Apple Macintosh 77%, IBM compatible PC 21% and UNIX 2%. Although 197 diplomats have e-mail addresses, only 162 of them actually send and receive e-mails. Diplomats in fifties use e-mail most actively and those in sixties come second.

[Books on anesthesiology and resuscitation published in Spain. An approach to their study].

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Guardiola, E; Baños, J E

1998-03-01

Few authors have examined the publication of medical books. Our aim was to analyze the nature of books published in Spain on anesthesiology and recovery. Books listed by the Spanish ISBN agency were selected if they included anestesi* or reanima* in any field. Duplicates were removed. Multiple editions or references were considered single books, with data for the oldest edition entered into analysis. Multiple volume collections were grouped as complete works. Data analyzed for each book were year of publication, language (of publication and the original), subject (according to ISBN classification) and place of publication. Nine subject classifications were applied: general, recovery, anesthetic techniques, pharmacology, obstetrics/gynecology, pediatrics, veterinary anesthesia, dental anesthesia and miscellaneous. We analyzed 216 books. Years that saw publication of the greatest number of books were 1988 (17), 1993 (16) and 1979 (15), and the five-year period in which the most books were published was 1985 to 1989 (48 books, 22.2%). Most books (114, 52.8%) were originally written in English, Spanish being the second most common original language (58, 26.8%). All books were published in Spanish. The Spanish ISBN classification system identified 11 categories: general diseases/clinical medicine/therapy (161, 74.5%); drugs/pharmacology/physical therapy/toxicology (20, 9.3%); gynecology/obstetrics (9, 4.2%), veterinary medicine (9, 4.2%) and medicine (8, 3.7%). Classification by specific subjects showed a predominance of monographs or treatises on general aspects (42, 19.4%) followed by books on recovery (37, 17.1%), anesthetic techniques (25, 11.6%) and pharmacology (17, 7.9%). Most books were published in Barcelona (142, 65.7%), Madrid (36, 16.7%) or Saragossa (10, 4.6%). Spanish publication of books on anesthesiology and recovery has increased in recent years. Most books are translations usually from English. Spanish ISBN agency data, although it has limitations, can

Job burnout in 159 anesthesiology trainees

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Yesim Cokay Abut

2012-01-01

Full Text Available Background: Anesthesiology may be stressful and most anesthesiologists develop mechanisms for coping. However, inexperienced trainee anesthesiologists seem to be vulnerable. We studied stress perception and job burnout in trainee anesthesiologists. Methods: Responses to perceived stress scale (PSS and Maslach Burnout Inventory (MBI were evaluated in 159 trainee anesthesiologists. Results: In our results, when perceived stress was increased, emotional exhaustion and depersonalization increased but personal accomplishment decreased, as expected. Perceived stress was very high in the early years of training. There was a negative correlation between age and emotional exhaustion and depersonalization, but positive correlation with personal accomplishment. Female anesthesiologists had higher personal accomplishment, but lower depersonalization points than male anesthesiologists in our study. There was no statistical association between marital status, PSS, and MBI; ≥2 children group had a significant high personal accomplishment but low depersonalization and emotional exhaustion scores. Line regression analysis showed a statistically significant relationship between PSS and emotional exhaustion and between age and depersonalization. Conclusions: Social factors such as gender and number of children affect the work life of our trainees.

Age and individual sleep characteristics affect cognitive performance in anesthesiology residents after a 24-hour shift.

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Tadinac, Meri; Sekulić, Ante; Hromatko, Ivana; Mazul-Sunko, Branka; Ivancić, Romina

2014-03-01

Previous research has shown that both shift work and sleep deprivation have an adverse influence on various aspects of human cognitive performance. The aim of this study was to explore changes in cognitive functioning and subjective sleepiness of anesthesiology residents after a 24-hour shift. Twenty-six anesthesiology residents completed a set of psychological instruments at the beginning and at the end of the shift, as well as a questionnaire regarding information about the shift, Stanford Sleepiness Scale, and Circadian Type Questionnaire. There was a significant decline in cognitive performance measured by the Auditory Verbal Learning Test after the shift. The effect was stronger in older participants and in those with high scores on rigidity of sleep scale and low scores on the ability to overcome sleepiness scale. There were no differences in the digits forward test (a measure of concentration), while digits backward test (a measure of working memory) even showed an improved performance after the shift. Although participants reported being significantly sleepier after the shift, the subjective sleepiness did not correlate with any of the objective measures of cognitive performance. In conclusion, the performance in short tasks involving concentration and working memory was not impaired, while performance in long-term and monotone tasks declined after sleep deprivation, and the magnitude of this decline depended on the specific individual characteristics of sleep and on age Surprisingly, age seemed to have an important impact on cognitive functions after shift work even in the relatively age-homogeneous population of young anesthesiology residents.

[Role of an educational-and-methodological complex in the optimization of teaching at the stage of additional professional education of physicians in the specialty "anesthesiology and reanimatology"].

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Buniatian, A A; Sizova, Zh M; Vyzhigina, M A; Shikh, E V

2010-01-01

An educational-and-methodological complex (EMC) in the specialty 'Anesthesiology and Reanimatology", which promotes manageability, flexibility, and dynamism of an educational process, is of great importance in solving the problem in the systematization of knowledge and its best learning by physicians at a stage of additional professional education (APE). EMC is a set of educational-and-methodological materials required to organize and hold an educational process for the advanced training of anesthesiologists and resuscitation specialists at the stage of APE. EMC includes a syllabus for training in the area "Anesthesiology and Reanimatology" by the appropriate training pattern (certification cycles, topical advanced training cycles); a work program for training in the specialty "Anesthesiology and Reanimatology"; a work curriculums for training in allied specialties (surgery, traumatology and orthopedics, obstetrics and gynecology, and pediatrics); work programs on basic disciplines (pharmacology, normal and pathological physiology, normal anatomy, chemistry and biology); working programs on the area "Public health care and health care service", guidelines for the teacher; educational-and-methodological materials for the student; and quiz programs. The main point of EMC in the specialty "Anesthesiology and Reanimatology" is a work program. Thus, educational-and-methodological and teaching materials included into the EMC in the specialty 'Anesthesiology and Reanimatology" should envisage the logically successive exposition of a teaching material, the use of currently available methods and educational facilities, which facilitates the optimization of training of anesthesiologists and resuscitation specialists at the stage of APE.

Simulation in pediatric anesthesiology.

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Fehr, James J; Honkanen, Anita; Murray, David J

2012-10-01

Simulation-based training, research and quality initiatives are expanding in pediatric anesthesiology just as in other medical specialties. Various modalities are available, from task trainers to standardized patients, and from computer-based simulations to mannequins. Computer-controlled mannequins can simulate pediatric vital signs with reasonable reliability; however the fidelity of skin temperature and color change, airway reflexes and breath and heart sounds remains rudimentary. Current pediatric mannequins are utilized in simulation centers, throughout hospitals in-situ, at national meetings for continuing medical education and in research into individual and team performance. Ongoing efforts by pediatric anesthesiologists dedicated to using simulation to improve patient care and educational delivery will result in further dissemination of this technology. Health care professionals who provide complex, subspecialty care to children require a curriculum supported by an active learning environment where skills directly relevant to pediatric care can be developed. The approach is not only the most effective method to educate adult learners, but meets calls for education reform and offers the potential to guide efforts toward evaluating competence. Simulation addresses patient safety imperatives by providing a method for trainees to develop skills and experience in various management strategies, without risk to the health and life of a child. A curriculum that provides pediatric anesthesiologists with the range of skills required in clinical practice settings must include a relatively broad range of task-training devises and electromechanical mannequins. Challenges remain in defining the best integration of this modality into training and clinical practice to meet the needs of pediatric patients. © 2012 Blackwell Publishing Ltd.

Sensorimotor and executive function slowing in anesthesiology residents after overnight shifts.

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Williams, George W; Shankar, Bairavi; Klier, Eliana M; Chuang, Alice Z; El Marjiya-Villarreal, Salma; Nwokolo, Omonele O; Sharma, Aanchal; Sereno, Anne B

2017-08-01

Medical residents working overnight call shifts experience sleep deprivation and circadian clock disruption. This leads to deficits in sensorimotor function and increases in workplace accidents. Using quick tablet-based tasks, we investigate whether measureable executive function differences exist following a single overnight call versus routine shift, and whether factors like stress, rest and caffeine affect these measures. A prospective, observational, longitudinal, comparison study was conducted. An academic tertiary hospital's main operating room suite staffed by attending anesthesiologists, anesthesiology residents, anesthesiologist assistants and nurse anesthetists. Subjects were 30 anesthesiology residents working daytime shifts and 30 peers working overnight call shifts from the University of Texas Health Science Center at Houston. Before and after their respective work shifts, residents completed the Stanford Sleepiness Scale (SSS) and the ProPoint and AntiPoint tablet-based tasks. These latter tasks are designed to measure sensorimotor and executive functions, respectively. The SSS is a self-reported measure of sleepiness. Response times (RTs) are measured in the pointing tasks. Call residents exhibited increased RTs across their shifts (post-pre) on both ProPoint (p=0.002) and AntiPoint (pRoutine residents. Increased stress was associated with decreases in AntiPoint RT for Routine (p=0.007), but with greater increases in sleepiness for Call residents (proutine daytime shift residents, (2) sensorimotor slowing is greater in overnight Call residents who drink caffeine habitually, and (3) increased stress during a shift reduces (improves) cognitive RTs during routine daytime but not overnight call shifts. Copyright © 2017 Elsevier Inc. All rights reserved.

Managing intergenerational differences in academic anesthesiology.

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Shangraw, Robert E; Whitten, Charles W

2007-12-01

Common definitions for workplace generations are the silent generation (born 1925-1945), the baby boomer generation (1946-1962), generation X (1963-1981), and generation Y (1982-2000). Distinct motivational and value perceptions stereotype generations. This review defines the characteristics of workplace generations today and provides insight into how differences influence the workplace environment. Senior faculty members are mostly boomers, whereas residents and junior faculty members tend to belong to generation X. Medical students and incoming interns are from generation Y. When compared with boomers, generation X is more savvy with technology, more independent, less loyal to the institution, and seeks balance between work and lifestyle. The 80-h resident working week restriction has reinforced differences between older and younger physicians. Generation Y exhibits traits that are similar to those of generation X. Their increased interest in anesthesiology may reflect, in part, their assumption that it affords better control of lifestyle. Understanding, improved communication strategies, mentorship, and flexibility in methods employed to achieve common goals are most likely to capture the interest and cooperation of members of generation X and possibly Y. Future studies should test effects of particular interventions on outcome in terms of recruitment and performance milestones.

Anesthesiological Management of a Patient with Williams Syndrome Undergoing Spine Surgery

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Federico Boncagni

2016-01-01

Full Text Available Williams Syndrome (WS is a complex neurodevelopmental disorder associated with a mutation on chromosome 7. Patients with WS usually display dysmorphic facial and musculoskeletal features, congenital heart diseases, metabolic disturbances and cognitive impairment. Structural cardiovascular abnormalities are present in the majority of the children and may provide a substrate for perioperative Sudden Cardiac Death, as presented by several reports, something that creates a great challenge to the anesthetic conduct. We present the case of a 12-year old girl who required anesthetic care for surgical correction of an acquired kyphoscoliosis. Potential anesthesiological implications of WS are subsequently reviewed.

Anesthesiology Point of Care project.

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McDonald, John S; Noback, Carl R; Cheng, Drew; Lee, T K; Nenov, Val

2002-01-01

We are developing a dynamic prototype visual communication system for the operating room environs. This has classically been viewed as an isolated and impenetrable workplace. All medical experiences and all teaching remain in a one to one closed loop with no recall or subsequent sharing for the training and education of other colleagues. The "Anesthesia Point of Care" (APOC) concept embraces the sharing of, recording of, and presentation of various physiological and pharmacological events so that real time memory can be shared at a later time for the edification of other colleagues who were not present at the time of the primary learning event. In addition it also provides a remarkably rapid tool for fellow faculty to respond to obvious stress and crisis events that can be broadcast instantly at the time of happening. Finally, it also serves as an efficient and effective means of paging and general communication throughout the daily routines among various healthcare providers in anesthesiology who work as a team unit; these include the staff, residents, CRNAs, physician assistants, and technicians. This system offers a unique opportunity to eventually develop future advanced ideas that can include training exercises, presurgical evaluations, surgical scheduling and improvements in efficiency based upon earlier than expected case completion or conversely later than expected case completion and even as a unique window to development of improved billing itemization and coordination.

HIPAA Compliance with Mobile Devices Among ACGME Programs.

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McKnight, Randall; Franko, Orrin

2016-05-01

To analyze self-reported HIPAA compliance with mobile technologies among residents, fellows, and attendings at ACGME training programs. A digital survey was sent to 678 academic institutions over a 1-month period. 2427 responses were analyzed using Chi-squared tests for independence. Post-hoc Bonferroni correction was applied for all comparisons between training levels, clinical setting, and specialty. 58 % of all residents self-report violating HIPAA by sharing protected health information (PHI) via text messaging with 27 % reporting they do it "often" or "routinely" compared to 15-19 % of attendings. For all specialties, 35 % of residents use text messaging photo or video sharing with PHI. Overall, 5 % of respondents "often" or "routinely" used HIPAA compliant (HCApps) with no significant differences related to training level. 20 % of residents admitted to using non-encrypted email at some point. 53 % of attendings and 41 % of residents utilized encrypted email routinely. Physicians from surgical specialties compared to non-surgical specialties demonstrated higher rates of HIPAA violations with SMS use (35 % vs. 17.7 %), standard photo/video messages (16.3 % vs. 4.7 %), HCApps (10.9 % vs. 4.9 %), and non-HCApps (5.6 % vs 1.5 %). The most significant barriers to complying with HIPAA were inconvenience (58 %), lack of knowledge (37 %), unfamiliarity (34 %), inaccessible (29 %) and habit (24 %). Medical professionals must acknowledge that despite laws to protect patient confidentiality in the era of mobile technology, over 50 % of current medical trainees knowingly violate these rules regularly despite the threat of severe consequences. The medical community must further examine the reason for these inconsistencies and work towards possible solutions.

Quality Improvement in Anesthesiology - Leveraging Data and Analytics to Optimize Outcomes.

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Valentine, Elizabeth A; Falk, Scott A

2018-03-01

Quality improvement is at the heart of practice of anesthesiology. Objective data are critical for any quality improvement initiative; when possible, a combination of process, outcome, and balancing metrics should be evaluated to gauge the value of an intervention. Quality improvement is an ongoing process; iterative reevaluation of data is required to maintain interventions, ensure continued effectiveness, and continually improve. Dashboards can facilitate rapid analysis of data and drive decision making. Large data sets can be useful to establish benchmarks and compare performance against other providers, practices, or institutions. Audit and feedback strategies are effective in facilitating positive change. Copyright © 2017 Elsevier Inc. All rights reserved.

Competency-based education in anesthesiology: history and challenges.

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Ebert, Thomas J; Fox, Chris A

2014-01-01

The Accreditation Council for Graduate Medical Education is transitioning to a competency-based system with milestones to measure progress and define success of residents. The confines of the time-based residency will be relaxed. Curriculum must be redesigned and assessments will need to be precise and in-depth. Core anesthesiology faculty will be identified and will be the "trained observers" of the residents' progress. There will be logistic challenges requiring creative management by program directors. There may be residents who achieve "expert" status earlier than the required 36 months of clinical anesthesia education, whereas others may struggle to achieve acceptable status and will require additional education time. Faculty must accept both extremes without judgment. Innovative new educational opportunities will need to be created for fast learners. Finally, it will be important that residents embrace this change. This will require programs to clearly define the specific aims and measurement endpoints for advancement and success.

Assessment of Clinical Education in the Alborz University of Medical Sciences from Surgical Technology and Anesthesiology Students’ Point of View

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T. Bahrami Babaheidary

2012-07-01

Conclusion: Because of surgical technology and anesthesiology students needs to acquire clinical skills along with theoretical training, providing suitable clinical environment seems to be critical to achieve essential in-depth experience in professional aspects.

[The anesthesiological procedure for correcting preloading in the surgery of acquired mitral valve defects].

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Kiselev, V O; Shipulin, V M; Evtushenko, A V; Podoksenov, Iu K; Shishneva, E V

2000-01-01

Intraoperative correction of preload in patients with acquired valvular disease (AVD) complicated by right-ventricular failure and severe pulmonary hypertension necessitates search for pathogenetically based algorithms of anesthesiological strategy. The objective of this study was to develop a strategy of assessing and treating the preload at the stage of induction anesthesia in patients with right-ventricular failure. During surgery central hemodynamic parameters and their response to a short head-down-tilt (15-20 degrees) were evaluated in patients (n = 42) with cardiac index (CI) less than 2 l/min/m2 after induction anesthesia. The patients were divided into 2 groups with different severity of preoperative status. Group 1 (main) included 24 patients with stages II-III cardiac failure (according to N. Strazhesko and B. Vasilenko) and group 2 (control) consisted of 18 patients with stage IIA cardiac failure. Progressing preoperative cardiac failure resulted in decrease of cardiac index and failure of compensatory hemodynamic mechanisms in AVD patients. The level of right-ventricular preload, pulmonary resistance, and stroke index were lower in group 1 than in the controls; however, 8% of group 1 patients responded positively to increased preload. In the control group 50% responded favorably to head-down-tilt. Hence, comprehensive assessment of cardiac index, central hemodynamic parameters and their response to head-down tilt help individually choose the anesthesiological strategy.

Reporting and Methodology of Multivariable Analyses in Prognostic Observational Studies Published in 4 Anesthesiology Journals: A Methodological Descriptive Review.

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Guglielminotti, Jean; Dechartres, Agnès; Mentré, France; Montravers, Philippe; Longrois, Dan; Laouénan, Cedric

2015-10-01

Prognostic research studies in anesthesiology aim to identify risk factors for an outcome (explanatory studies) or calculate the risk of this outcome on the basis of patients' risk factors (predictive studies). Multivariable models express the relationship between predictors and an outcome and are used in both explanatory and predictive studies. Model development demands a strict methodology and a clear reporting to assess its reliability. In this methodological descriptive review, we critically assessed the reporting and methodology of multivariable analysis used in observational prognostic studies published in anesthesiology journals. A systematic search was conducted on Medline through Web of Knowledge, PubMed, and journal websites to identify observational prognostic studies with multivariable analysis published in Anesthesiology, Anesthesia & Analgesia, British Journal of Anaesthesia, and Anaesthesia in 2010 and 2011. Data were extracted by 2 independent readers. First, studies were analyzed with respect to reporting of outcomes, design, size, methods of analysis, model performance (discrimination and calibration), model validation, clinical usefulness, and STROBE (i.e., Strengthening the Reporting of Observational Studies in Epidemiology) checklist. A reporting rate was calculated on the basis of 21 items of the aforementioned points. Second, they were analyzed with respect to some predefined methodological points. Eighty-six studies were included: 87.2% were explanatory and 80.2% investigated a postoperative event. The reporting was fairly good, with a median reporting rate of 79% (75% in explanatory studies and 100% in predictive studies). Six items had a reporting rate website. Limiting the number of candidate variables, including cases with missing data, and not arbitrarily categorizing continuous variables should be encouraged.

[Implementation of a residency program in anesthesiology in the Northeast of Brazil: impact on work processes and professional motivation].

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Fernandes, Cláudia Regina; Sousa, Rafael Queiroz de; Arcanjo, Francisco Sávio Alves; Neto, Gerardo Cristino de Menezes; Gomes, Josenília Maria Alves; Giaxa, Renata Rocha Barreto

2015-01-01

Understand, through the theory of social representations, the influence exerted by the establishment a residency program in anesthesiology on anesthetic care and professional motivation in a tertiary teaching hospital in the Northeast of Brazil. Qualitative methodology. The theoretical framework comprised the phenomenology and the Social Representation Theory. Five multidisciplinary focus groups were formed with 17 health professionals (five surgeons, five anesthesiologists, two nurses, and five nursing technicians), who work in operating rooms and post-anesthesia care units, all with prior and posterior experience to the establishment of residency. From the response content analysis, the following empirical categories emerged: motivation to upgrade, recycling of anesthesiologists and improving anesthetic practice, resident as an interdisciplinary link in perioperative care, improvements in the quality of perioperative care, recognition of weaknesses in the perioperative process. It was evident upper gastrointestinal bleeding secondary to prolonged intubation that the creation of a residency in anesthesiology brings advancements that are reflected in the motivation of anesthesiologists; the resident worked as an interdisciplinary link between the multidisciplinary team; there was recognition of weaknesses in the system, which were identified and actions to overcome it were proposed. The implementation of a residency program in anesthesiology at a tertiary education hospital in the Northeast of Brazil promoted scientific updates, improved the quality of care and processes of interdisciplinary care, recognized the weaknesses of the service, developed action plans and suggested that this type of initiative may be useful in remote areas of developing countries. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Implementation of a residency program in anesthesiology in the Northeast of Brazil: impact on work processes and professional motivation

Directory of Open Access Journals (Sweden)

Cláudia Regina Fernandes

2015-04-01

Full Text Available BACKGROUND AND OBJECTIVES: To understand, through the theory of social representations, the influence exerted by the establishment of a residency program in anesthesiology on anesthetic care and professional motivation in a tertiary teaching hospital in the Northeast of Brazil. METHOD: Qualitative methodology. The theoretical framework comprised the phenomenology and the social representation theory. Five multidisciplinary focus groups were formed with 17 health professionals (five surgeons, five anesthesiologists, two nurses, and five nursing technicians, who work in operating rooms and post-anesthesia care units, all with a prior and a posteriori experience to the establishment of residency. RESULTS: From the response content analysis, the following empirical categories emerged: motivation to upgrade, recycling of anesthesiologists and improving anesthetic practice, resident as an interdisciplinary link in perioperative care, improvements in the quality of perioperative care, and recognition of weaknesses in the perioperative process. It was evident from upper gastrointestinal bleeding secondary to prolonged intubation that the creation of a residency in anesthesiology brings advancements that are reflected in the motivation of anesthesiologists; the resident worked as an interdisciplinary link between the multidisciplinary team; there was recognition of weaknesses in the system, which were identified and actions to overcome it were proposed. CONCLUSION: The implementation of a residency program in anesthesiology at a tertiary education hospital in the Northeast of Brazil promoted scientific updates, improved the quality of care and processes of interdisciplinary care, recognized the weaknesses of the service, developed action plans and suggested that this type of initiative may be useful in remote areas of developing countries.

Outbreak of parvovirus B19 infection among anesthesiology and surgical fellows.

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Lara-Medrano, Reynaldo; Martínez-Reséndez, Michel Fernando; Garza-González, Elvira; Medina-Torres, Ana Gabriela; Camacho-Ortiz, Adrián

2016-09-01

A human parvovirus B19 outbreak was detected in personnel assigned to a surgical area (anesthesiology fellows and an otorhinolaryngology fellow) in a university hospital. The attack rate between susceptible members was higher than previous reports. Diagnosis was determined by polymerase chain reaction for human parvovirus B19 in serum of 1 subject and immunoglobulin M/immunoglobulin G antibody titer in the remaining subjects. Medical personnel were put on leave of absence until resolution of symptoms and laboratory confirmation of health. No cases of infection were detected in hospitalized patients or other health care workers on follow-up. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Current applications of big data in obstetric anesthesiology.

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Klumpner, Thomas T; Bauer, Melissa E; Kheterpal, Sachin

2017-06-01

The narrative review aims to highlight several recently published 'big data' studies pertinent to the field of obstetric anesthesiology. Big data has been used to study rare outcomes, to identify trends within the healthcare system, to identify variations in practice patterns, and to highlight potential inequalities in obstetric anesthesia care. Big data studies have helped define the risk of rare complications of obstetric anesthesia, such as the risk of neuraxial hematoma in thrombocytopenic parturients. Also, large national databases have been used to better understand trends in anesthesia-related adverse events during cesarean delivery as well as outline potential racial/ethnic disparities in obstetric anesthesia care. Finally, real-time analysis of patient data across a number of disparate health information systems through the use of sophisticated clinical decision support and surveillance systems is one promising application of big data technology on the labor and delivery unit. 'Big data' research has important implications for obstetric anesthesia care and warrants continued study. Real-time electronic surveillance is a potentially useful application of big data technology on the labor and delivery unit.

Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.

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Rajaram, Ravi; Saadat, Lily; Chung, Jeanette; Dahlke, Allison; Yang, Anthony D; Odell, David D; Bilimoria, Karl Y

2016-12-01

In 2011, the Accreditation Council for Graduate Medical Education (ACGME) expanded restrictions on resident duty hours. While studies have shown no association between these restrictions and improved outcomes, process-of-care and patient experience measures may be more sensitive to resident performance, and thus may be impacted by duty hour policies. The objective of this study was to evaluate the association between the 2011 resident duty hour reform and measures of processes-of-care and patient experience. Hospital Consumer Assessment of Healthcare Providers and Systems survey data and process-of-care scores were obtained from the Centers for Medicare and Medicaid Services Hospital Compare website for 1 year prior to (1 July 2010 to 30 June 2011) and 1 year after (1 July 2011 to 30 June 2012) duty hour reform implementation. Using a difference-in-differences model, non-teaching and teaching hospitals were compared before and after the 2011 reform to test the association of this policy with changes in process-of-care and patient experience measure scores. Duty hour reform was not associated with a change in the five patient experience measures evaluated, including patients rating a hospital 9 or 10 (coefficient -0.003, 95% CI -0.79 to 0.79) or stating they would 'definitely recommend' a hospital (coefficient -0.28, 95% CI -1.01 to 0.44). For all 10 process-of-care measures examined, such as antibiotic timing (coefficient -0.462, 95% CI -1.502 to 0.579) and discontinuation (0.188, 95% CI -0.529 to 0.904), duty hour reform was not associated with a change in scores. The 2011 ACGME duty hour reform was not associated with improvements in process-of-care and patient experience measures. These data should be considered when considering reform of resident duty hour policies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The perspective of the vascular surgery trainee on new ACGME regulations, fatigue, resident training, and patient safety.

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De Martino, Randall R; Brewster, L P; Kokkosis, A A; Glass, C; Boros, M; Kreishman, P; Kauvar, D A; Farber, A

2011-11-01

To assess the opinions of vascular surgery trainees on the new Accreditation Council for Graduate Medical Education (ACGME) guidelines. A questionnaire was developed and electronically distributed to trainee members of the Society for Vascular Surgery. Of 238 eligible vascular trainees, 38 (16%) participated. Respondents were predominantly 30 to 35 years of age (47%), male (69%), in 2-year fellowship (73%), and at large academic centers (61%). Trainees report occasionally working while fatigued (63%). Fellows were more likely to report for duty while fatigued (P = .012) than integrated vascular residents. Respondents thought further work-hour restrictions would not improve patient care or training (P life. Respondents reported that duty hours should vary by specialty (81%) and allow flexibility in the last years of training (P balanced against the need to adequately train vascular surgeons.

Use of tablet (iPad®) as a tool for teaching anesthesiology in an orthopedic rotation.

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Tanaka, Pedro Paulo; Hawrylyshyn, Kathryn Ashley; Macario, Alex

2012-01-01

The goal of this study was to compare scores on house staff evaluations of "overall teaching quality" during a rotation in anesthesia for orthopedics in the first six months (n=11 residents were provided with curriculum in a printed binder) and in the final six months (n=9 residents were provided with the same curriculum in a tablet computer (iPad, Apple®, Inc, Cupertino, Ca)). At the beginning of the two-week rotation, the resident was given an iPad containing: a syllabus with daily reading assignments, rotation objectives according to the ACGME core competencies, and journal articles. Prior to the study, these curriculum materials had been distributed in a printed binder. The iPad also provided peer reviewed internet sites and direct access to online textbooks, but was not linked to the electronic medical record. At the end of the rotation, residents anonymously answered questions to evaluate the rotation on an ordinal scale from 1 (unsatisfactory) to 5 (outstanding). All residents were unaware that the data would be analyzed retrospectively for this study. The mean global rating of the rotation as assessed by "overall teaching quality of this rotation" increased from 4.09 (N=11 evaluations before intervention, SD 0.83, median 4, range 3-5) to 4.89 (N=9 evaluations after intervention, SD 0.33, median 5, range 4-5) p=0.04. Residents responded favorably to the introduction of an innovative iPad based curriculum for the orthopedic anesthesia rotation. More studies are needed to show how such mobile computing technologies can enhance learning, especially since residents work at multiple locations, have duty hour limits, and the need to document resident learning in six ACGME core competencies. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

Pediatric anesthesiology fellow education: is a simulation-based boot camp feasible and valuable?

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Ambardekar, Aditee P; Singh, Devika; Lockman, Justin L; Rodgers, David L; Hales, Roberta L; Gurnaney, Harshad G; Nathan, Aruna; Deutsch, Ellen S

2016-05-01

Pediatric anesthesiologists must manage crises in neonates and children with timely responses and limited margin for error. Teaching the range of relevant skills during a 12-month fellowship is challenging. An experiential simulation-based curriculum can augment acquisition of knowledge and skills. To develop a simulation-based boot camp (BC) for novice pediatric anesthesiology fellows and assess learner perceptions of BC activities. We hypothesize that BC is feasible, not too basic, and well received by fellows. Skills stations, team-based in situ simulations, and group discussions of complex cases were designed. Stations were evaluated by anonymous survey; fellows rated usefulness in improving knowledge, self-confidence, technical skill, and clinical performance using a Likert scale (1 strongly disagree to 5 strongly agree). They were also asked if stations were too basic or too short. Median and interquartile range (IQR) data were calculated and noted as median (IQR). Fellows reported the difficult airway station and simulated scenarios improved knowledge, self-confidence, technical skill, and clinical performance. They disagreed that stations were too basic or too short with exception of the difficult airway session, which was too short [4 (4-3)]. Fellows believed the central line station improved knowledge [4 (4-3)], technical skills [4 (4-4)], self-confidence [4 (4-3)], and clinical performance [4 (4-3)]; scores trended toward neutral likely because the station was perceived as too basic [3.5 (4-3)]. An interactive session on epinephrine and intraosseous lines was valued. Complicated case discussion was of educational value [4 (5-4)], the varied opinions of faculty were helpful [4 (5-4)], and the session was neither too basic [2 (2-2)] nor too short [2 (2-2)]. A simulation-based BC for pediatric anesthesiology fellows was feasible, perceived to improve confidence, knowledge, technical skills, and clinical performance, and was not too basic. © 2016 John Wiley

[Stress and job satisfaction in the discipline of inpatient anesthesiology : results of a web-based survey].

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Bauer, J; Groneberg, D A

2014-01-01

How do physicians in the specialty of anesthesiology perceive the working conditions regarding stress and job satisfaction? The health system in Germany has been confronted with a rapidly changing framework over the last 20 years: For example, an increased influence of economic patterns on the workflow and the medical decision of physicians has been established forcing them to always take the economic aspects into account. Moreover, a new generation (generation Y) of physicians with other requirements of the work place, meaning mainly a demand for a better work-life balance, has gained a foothold in hospitals. These changes make it very important to investigate the status quo of current working conditions. Working conditions in hospitals in the specialty of anesthesiology is the main issue investigated in this study. For this study 1,321 completed online-questionnaires from physicians in hospitals with the specialty of anesthesiology were analyzed. The questionnaire was based on the stress theory, the effort-reward-imbalance model (ERI) and the job-demand-control model (JDC).The items used in the questionnaire were taken from the ERI questionnaire and the short questionnaire on work analysis (KFZA). By calculating a certain ratio of several items (according to the stress theory), the prevalence of distress could be measured. In addition the overall job satisfaction in the field of anesthesiology was measured and analyzed. In this study 47.0 % (95 %-CI: 44.3-49.7 %) of all respondents showed signs of distress. Simultaneously, 61.8 % (95 %-CI: 59.2-64.5 %) were very satisfied with the job situation. Regarding gender, female physicians perceived a lower control of the work situation whereas male physicians perceived a much higher decision level. This led to a higher prevalence of distress in the group of female physicians regarding the JDC model (odds ratio, OR: 1.54, 95 %-CI: 1.19-2.01). Regarding age, the prevalence of distress increased from 36.5�

Status of anesthesiology resident research education in the United States: structured education programs increase resident research productivity.

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Ahmad, Shireen; De Oliveira, Gildasio S; McCarthy, Robert J

2013-01-01

The enhancement of resident research education has been proposed to increase the number of academic anesthesiologists with the skills and knowledge to conduct meaningful research. Program directors (PDs) of the U.S. anesthesiology residency programs were surveyed to evaluate the status of research education during residency training and to test the hypothesis that structured programs result in greater resident research productivity based on resident publications. Survey responses were solicited from 131 anesthesiology residency PDs. Seventy-four percent of PDs responded to the survey. Questions evaluated department demographic information, the extent of faculty research activity, research resources and research funding in the department, the characteristics of resident research education and resident research productivity, departmental support for resident research, and perceived barriers to resident research education. Thirty-two percent of programs had a structured resident research education program. Structured programs were more likely to be curriculum based, require resident participation in a research project, and provide specific training in presentation and writing skills. Productivity expectations were similar between structured and nonstructured programs. Forty percent of structured programs had > 20% of trainees with a publication in the last 2 years compared with 14% of departments with unstructured programs (difference, 26%; 99% confidence interval [CI], 8%-51%; P = 0.01). The percentage of programs that had research rotations for ≥2 months was not different between the structured and the nonstructured programs. A research rotation of >2 months did not increase the percentage of residents who had published an article within the last 2 months compared with a research rotation of 20% of residents with a publication in the last 2 years compared with 36% in programs with >20% of faculty involvement (difference, 21%; 99% CI, -4% to 46%; P = 0.03). Our

A tribute to Dr. Paul A. J. Janssen: entrepreneur extraordinaire, innovative scientist, and significant contributor to anesthesiology.

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Stanley, Theodore H; Egan, Talmage D; Van Aken, Hugo

2008-02-01

Dr. Paul Janssen was the founder of Janssen Pharmaceutica and the developer of over 80 pharmaceutical compounds that proved useful in human, botanical, and veterinary medicine. He and his coworkers synthesized the fentanyl family of drugs, many other potent analgesics, droperidol, etomidate, and numerous other important medicines that were extremely useful in psychiatry, parasitology, gastroenterology, cardiology, virology, and immunology. Anesthesiology and medicine as a whole have benefited a great deal from his resourcefulness, creativity, and entrepreneurial spirit.

A retrospective review of required projects in systems-based practice in a single anesthesiology residency: a 10-year experience.

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Sakai, Tetsuro; Emerick, Trent D; Patel, Rita M

2015-09-01

The Accreditation Council for Graduate Medical Education has emphasized in its core competencies and more recently, in its Milestones Project, that residents understand the importance of systems-based practice (SBP). The objectives of the study are to evaluate the quality of residents' SBP projects and to determine the degrees that were subsequently implemented. A retrospective educational observational study. A university-based anesthesiology training institution. One hundred forty-nine anesthesiology residents in their final (postgraduate year 4) year of training who completed SBP projects for the last 10 years (2004-2013). A structured SBP course was provided for postgraduate year 4 anesthesiology residents with deadlines set such as project identification, data collection, and proposal draft. Each resident's written SBP proposal received inputs by 2 members of the department executive steering committee. The SBP projects concluded with oral presentations by each resident to the department executive steering committee, who provided overall scores. All SBP projects were categorized into 7 categories: safety initiatives, economic analysis, process analysis, policy change recommendations, education initiatives, teamwork/communication, and operating room efficiency. Evaluation scores using a Likert scale (1-9, where 9 is the best) were analyzed. The rate of implementation of project ideas within the department based on the presentations to the executive committee was examined. Of 149 projects, policy change recommendations was the most frequently chosen category (46 projects; 30.9%), followed by process analysis (36 projects; 24.2%). The overall evaluation score was 7.6 ± 0.6 (mean ± SD). A total of 53 projects (35.6%) were implemented in the department. There was no statistical difference between SBPs with implementation vs SBPs without implementation in terms of evaluation scores, year of the presentation, or categories. This SBP project has given residents the

A case study of translating ACGME practice-based learning and improvement requirements into reality: systems quality improvement projects as the key component to a comprehensive curriculum.

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Tomolo, A M; Lawrence, R H; Aron, D C

2009-10-01

In 2002, the Accreditation Council for Graduate Medical Education (ACGME) introduced a new requirement: residents must demonstrate competency in Practice-Based Learning and Improvement (PBLI). Training in this domain is still not consistently integrated into programmes, with few, if any, adequately going beyond knowledge of basic content and addressing all components of the requirement. To summarise the implementation of a PBLI curriculum designed to address all components of the requirement and to evaluate the impact on the practice system. A case-study approach was used for identifying and evaluating the steps for delivering the curriculum, along with the Model for Improvement's successive Plan-Do-Study-Act (PDSA) cycles (July 2004-May 2006). Notes from curriculum development meetings, notes and presentation slides made by teams about their projects, resident curriculum exit evaluations curriculum and interviews. Residents reported high levels of comfort by applying PBLI-related knowledge and skills and that the curriculum improved their ability to do various PBLI tasks. The involvement of multiple stakeholders increased. Twelve of the 15 teams' suggestions with practical systems-relevant outcomes were implemented and sustained beyond residents' project periods. While using the traditional PDSA cycles was helpful, there were limitations. A PBLI curriculum that is centred around practice-based quality improvement projects can fulfil the objectives of this ACGME competency while accomplishing sustained outcomes in quality improvement. A comprehensive curriculum is an investment but offers organisational rewards. We propose a more realistic and informative representation of rapid PDSA cycle changes.

Training anesthesiology residents in providing anesthesia for awake craniotomy: learning curves and estimate of needed case load.

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Bilotta, Federico; Titi, Luca; Lanni, Fabiana; Stazi, Elisabetta; Rosa, Giovanni

2013-08-01

To measure the learning curves of residents in anesthesiology in providing anesthesia for awake craniotomy, and to estimate the case load needed to achieve a "good-excellent" level of competence. Prospective study. Operating room of a university hospital. 7 volunteer residents in anesthesiology. Residents underwent a dedicated training program of clinical characteristics of anesthesia for awake craniotomy. The program was divided into three tasks: local anesthesia, sedation-analgesia, and intraoperative hemodynamic management. The learning curve for each resident for each task was recorded over 10 procedures. Quantitative assessment of the individual's ability was based on the resident's self-assessment score and the attending anesthesiologist's judgment, and rated by modified 12 mm Likert scale, reported ability score visual analog scale (VAS). This ability VAS score ranged from 1 to 12 (ie, very poor, mild, moderate, sufficient, good, excellent). The number of requests for advice also was recorded (ie, resident requests for practical help and theoretical notions to accomplish the procedures). Each task had a specific learning rate; the number of procedures necessary to achieve "good-excellent" ability with confidence, as determined by the recorded results, were 10 procedures for local anesthesia, 15 to 25 procedures for sedation-analgesia, and 20 to 30 procedures for intraoperative hemodynamic management. Awake craniotomy is an approach used increasingly in neuroanesthesia. A dedicated training program based on learning specific tasks and building confidence with essential features provides "good-excellent" ability. © 2013 Elsevier Inc. All rights reserved.

Guidelines for Percutaneous Dilatational Tracheostomy (PDT) from the Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM)

DEFF Research Database (Denmark)

Madsen, Kristian Rørbæk; Guldager, Henrik; Rewers, Mikael

2011-01-01

Percutaneous dilatational tracheostomy is a common procedure in intensive care. This guideline from the Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM) describes indications and contraindications, timing, complications...

Wellness program for anesthesiology residents: a randomized, controlled trial.

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Saadat, H; Snow, D L; Ottenheimer, S; Dai, F; Kain, Z N

2012-10-01

Multiple reports illustrate the deleterious effects of stress on physicians' mental and physical health, as well as on patient care. This study evaluates the effects of a wellness program on anesthesiology residents' well-being. Sixty residents were randomly assigned to one of three groups: (1) wellness intervention group, (2) no-treatment control with release time, and (3) no-treatment control with routine duties. Coping, stressors, social support, psychological symptoms, and alcohol and tobacco use were measured using a pre-test-post-test design. Residents in the wellness program reported significantly fewer stressors in their role as parent, increased social support at work, greater problem-solving coping, and less anxiety as compared with one or both of the control groups. Findings related to reducing avoidance coping and alcohol consumption also were suggestive of positive intervention effects. An intervention to increase the use of active coping and social support, to reduce reliance on avoidance coping, and to decrease work and family stressors had an overall pattern of beneficial effects on residents' well-being. The importance of offering such programs during residency training, ways to strengthen intervention effectiveness, and areas for future research are discussed. © 2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.

Fatigue Risk Management: The Impact of Anesthesiology Residents' Work Schedules on Job Performance and a Review of Potential Countermeasures.

Science.gov (United States)

Wong, Lily R; Flynn-Evans, Erin; Ruskin, Keith J

2018-04-01

Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being. We then propose countermeasures that have been implemented to mitigate the effects of fatigue and describe how training programs or practice groups who must work overnight can adapt these strategies for use in a hospital setting. Countermeasures include the use of scheduling interventions, strategic naps, microbreaks, caffeine use during overnight and extended shifts, and the use of bright lights in the clinical setting when possible or personal blue light devices when the room lights must be turned off. Although this review focuses primarily on anesthesiology residents in training, many of the mitigation strategies described here can be used effectively by physicians in practice.

Body temperature change during anesthesia for electroconvulsive therapy: implications for quality incentives in anesthesiology.

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Modell, Jerome H; Gravenstein, Nikolaus; Morey, Timothy E

2008-11-01

The American Society of Anesthesiologists has announced that perioperative normothermia is a "Quality Incentive in Anesthesiology." We examined whether we could meet this quality incentive in a simple population: patients undergoing anesthesia for electroconvulsive therapy (ECT). We compared infrared-measured ear temperature before anesthesia to temperature upon delivery of patients to the postanesthesia care unit (PACU) after 101 consecutive brief anesthetics to facilitate ECT. For 35 procedures, the patients had an infrared ear thermometer temperature of measures were substandard. Also, current methods of measuring temperature may be inadequate to ascertain if patients are hypothermic after surgery. As the avoidance of hypothermia is a meritorious goal, anesthesia departments need to ensure that their temperature monitoring equipment is adequate to ensure accurate measurement of postanesthetic temperature if this variable is to be used as a quality incentive.

Marketing or strategy? Defining the best approach to expand the anesthesiology workforce in Israel.

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Lewis, Michael C; Grant, Gilbert J

2015-01-01

There is a chronic shortage of anesthesiologists in Israel. The study by Cohen et al. suggests that a marketing campaign may be one method of addressing this shortage. This commentary argues for a more comprehensive strategy based on the US experience. This would not only involve marketing as suggested by Cohen et al. but would also involve a fundamental change in the Israel anesthesia care model, as well as providing substantial financial incentives to young physicians. We believe that a combination of these approaches will help to alleviate the shortage of anesthesia providers in Israel. Creating a new class of physician extenders, namely, anesthesiologist assistants, would also provide an employment pathway for the skilled medical technicians trained by the Israel Defense Forces, and other non-physicians with an interest in anesthesiology.

Anesthesiologic Effects of Transperitoneal Versus Extraperitoneal Approach During Robot-Assisted Radical Prostatectomy: Results of a Prospective Randomized Study

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Fabrizio Dal Moro

2015-06-01

Full Text Available ABSTRACTObjectives:To compare the effects of CO2 insufflation on hemodynamics and oxygen levels and on acid-base level during Robot-Assisted Radical Prostatectomy (RARP with transperitoneal (TP versus extra-peritoneal (EP accesses.Materials and Methods:Sixty-two patients were randomly assigned to TP (32 and EP (30 to RARP. Pre-operation data were collected for all patients. Hemodynamic, respiratory and blood acid-base parameters were measured at the moment of induction of anesthesia (T0, after starting CO2 insuffation (T1, and at 60 (T2 and 120 minutes (T3 after insufflation. In all cases, the abdominal pressure was set at 15 mmHg. Complications were reported according to the Clavien-Dindo classification. Student's two–t-test, with a significance level set at pResults:The demographic characteristics of the patients in both groups were statistically comparable. Analysis of intra-operative anesthesiologic parameters showed that partial CO2 pressure during EP was significantly higher than during TP, with a consequent decrease in arterial pH. Other parameters analysed were similar in the two groups. Postoperative complications were comparable between groups. The most important limitations of this study were the small size of the patient groups and the impossibility of maintaining standard abdominal pressure throughout the operational phases, despite attempts to regulate it.Conclusions:This prospective randomized study demonstrates that, from the anesthesiologic viewpoint, during RARP the TP approach is preferable to EP, because of lower CO2 reabsorption and risk of acidosis.

Migration and Workforce Planning in Medicine with Special Focus on Anesthesiology

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Jannicke Mellin-Olsen

2017-07-01

Full Text Available Counting health personnel and defining migration is more complicated than one should think at first glance. Migrating health workers are not a homogenous group, and many factors cause people to migrate—not only low wages but also lack of professional development possibilities, poor job satisfaction, outdated equipment, unsafe environment, and more. The opposite factors encourage people to stay. Many countries, including high-income countries benefit from remittances from migrating individuals. The World Health Organization has installed a code of Practice on the international recruitment of health workers. Although member countries have committed to follow this Code, it is not widely adhered to. Planning for the future is difficult, also because there are so many unknown factors related to the development of health-care levels, policies, inflow and outflow and more. Action must be taken in both donor and receiving countries. In anesthesiology, there is a huge workforce deficit globally. The world would need 136,000 additional physician anesthesia providers today to achieve an absolute minimum of five per 100,000 population. This will not happen unless all countries follow those that already have taken proactive steps in leading the direction forward. Anaesthesiology Society involvement is crucial.

Anesthesiology Journal club assessment by means of semantic changes.

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Vieira, Joaquim Edson; Torres, Marcelo Luís Abramides; Pose, Regina Albanese; Auler, José Otávio Costa Junior

2014-01-01

the interactive approach of a journal club has been described in the medical education literature. The aim of this investigation is to present an assessment of journal club as a tool to address the question whether residents read more and critically. this study reports the performance of medical residents in anesthesiology from the Clinics Hospital - University of São Paulo Medical School. All medical residents were invited to answer five questions derived from discussed papers. The answer sheet consisted of an affirmative statement with a Likert type scale (totally disagree-disagree-not sure-agree-totally agree), each related to one of the chosen articles. The results were evaluated by means of item analysis - difficulty index and discrimination power. residents filled one hundred and seventy three evaluations in the months of December 2011 (n=51), July 2012 (n=66) and December 2012 (n=56). The first exam presented all items with straight statement, second and third exams presented mixed items. Separating "totally agree" from "agree" increased the difficulty indices, but did not improve the discrimination power. the use of a journal club assessment with straight and inverted statements and by means of five points scale for agreement has been shown to increase its item difficulty and discrimination power. This may reflect involvement either with the reading or the discussion during the journal meeting. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

The Evaluation of the Distribution and Antimcrobial Susceptibility Profile of the Strains Isolated at Anesthesiology Intensive Care Unit

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Gulfem Ece

2013-10-01

Full Text Available Aim: Hospital infections are important uptodate health problems because of high mortality and increased cost. The increment in antimicrobial resistance is progressing though new antimicrobial agents are arising. This leads to an increase in hospital infections and difficulty in treatment. In our study we aimed to evaluate the antimicrobial susceptibility of the strains isolated at Anesthesiology Intensive Care Unit. Material and Method: The antimicrobial susceptibility of the strains isolated at Anesthesiology Intensive Care Unit between April 1st 2012- October 25th 2012 were included. The identification and the antimicrobial susceptibility were studied by automatized Vitek version 2.0 (Biomerieux, France. Results: A total of 155 strains isolated from wound, blood, tracheal secretion, sputum and urine samples were included. They are consisted of 40 A. baumannii, 24 E.coli, 25 P. aeruginosa, 20 K.pneumoniae, 12 Methicilin Resistant Coagulase Negative Staphylococci (MRCoNS, nine Methiciline Susceptible S.aureus (MSSA, eight C.albicans, four Methicilin Resistant S.aureus (MRSA, one C.famata, one C.tropicalis, three E.faecalis, two E.faecium, three S.marsecens, two P. mirabilis and one H.influenzae. Clinical samples were 81 tracheal secretions, 25 wound specimen, 23 blood culture, 18 urine, seven sputum, and one BAL. All the Gram positive strains were susceptible to glycopeptides. Enterobacteriaceae members were susceptible to imipenem and meropenem. Discussion: Antimicrobial resistance is an important issue worldwide. Multidiciplinary approach is needed as in ICUs where the complicated patients are followed. Monitoring antibiotic resistance profile contributes to treatment and decreasing resistance rates. The resistance profile will guide the antibiotic use policy. Increment in number of isolates in future will help to obtain the antimicrobial resistance profile.

Anesthesiology residents' perspective about good teaching--a qualitative needs assessment.

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Ortwein, Heiderose; Blaum, Wolf E; Spies, Claudia D

2014-01-01

Germany, like many other countries, will soon have a shortage of qualified doctors. One reason for the dissatisfaction amongst medical residents are the relatively unstructured residency training programs despite increasing importance of outcome-based education. The aim of our study was to identify characteristics and requirements for good teaching during anesthesiology residency training from the resident's point of view. A consensus workshop with residents from all medical universities in Germany was held. Participants were allocated to one of the three topics, chosen based on a 2009 nationwide evaluation of residency. The three topics were (A) characteristics of helpful/good teachers, (B) characteristics of helpful/good conditions and (C) characteristics of helpful/good curricular structure. Each group followed a nominal group technique consensus process to define and rank characteristics for a good residency. 31 (79.5%) resident representatives were present. The consented results put emphasis on the importance of structured curricula including transparent goals and objectives, in training formative assessments and quality assurance measures for the program. Residents further long for trained trainers with formal teaching qualifications and protected teaching time. Good residency training requires careful consideration of all stakeholders' needs. Results reflect and extend previous findings and are at least to some degree easily implemented. These findings are an important step to establish a broader consensus within the discipline.

Benchmarks for Support and Outcomes for Internal Medicine-Pediatrics Residency Programs: A 5-Year Review

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Aronica, Michael; Williams, Ronald; Dennar, Princess E.; Hopkins, Robert H.

2015-01-01

Background Combined internal medicine and pediatrics (medicine-pediatrics) residencies were Accreditation Council for Graduate Medical Education (ACGME) accredited separately from their corresponding categorical residencies in June 2006. Objective We investigated how ACGME accreditation of medicine-pediatrics programs has affected the levels of support (both financial and personnel), the National Resident Matching Program (NRMP) match rate, performance on the board examination, and other graduate outcomes. Methods From 2009 through 2013 we sent an annual SurveyMonkey online survey to members of the Medicine-Pediatrics Program Directors Association. Questions pertained to program characteristics, program director support, recruitment, ambulatory training, and graduate data. More than 79% of responders completed the entire survey for each year (sample size was 60 program directors). Results Compared to the time prior to accreditation of the specialty, there was an increase in program directors who are dually trained (89% versus 93%), an increase in program director salary ($134,000 before accreditation versus $185,000 in 2013, P medicine. Conclusions Our data show widespread improved support for medicine-pediatrics programs since the 2006 start of ACGME accreditation. PMID:26692969

Anesthesiology residents’ perspective about good teaching – a qualitative needs assessment

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Ortwein, Heiderose

2014-02-01

Full Text Available [english] Background: Germany, like many other countries, will soon have a shortage of qualified doctors. One reason for the dissatisfaction amongst medical residents are the relatively unstructured residency training programs despite increasing importance of outcome-based education. The aim of our study was to identify characteristics and requirements for good teaching during anesthesiology residency training from the resident’s point of view. Methods: A consensus workshop with residents from all medical universities in Germany was held. Participants were allocated to one of the three topics, chosen based on a 2009 nationwide evaluation of residency. The three topics were (A characteristics of helpful/good teachers, haracteristics of helpful/good conditions and (C characteristics of helpful/good curricular structure. Each group followed a nominal group technique consensus process to define and rank characteristics for a good residency.Results: 31 (79.5% resident representatives were present. The consented results put emphasis on the importance of structured curricula including transparent goals and objectives, in training formative assessments and quality assurance measures for the program. Residents further long for trained trainers with formal teaching qualifications and protected teaching time.Conclusions: Good residency training requires careful consideration of all stakeholders’ needs. Results reflect and extend previous findings and are at least to some degree easily implemented. These findings are an important step to establish a broader consensus within the discipline.

Benchmarks for Support and Outcomes for Internal Medicine-Pediatrics Residency Programs: A 5-Year Review.

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Aronica, Michael; Williams, Ronald; Dennar, Princess E; Hopkins, Robert H

2015-12-01

Combined internal medicine and pediatrics (medicine-pediatrics) residencies were Accreditation Council for Graduate Medical Education (ACGME) accredited separately from their corresponding categorical residencies in June 2006. We investigated how ACGME accreditation of medicine-pediatrics programs has affected the levels of support (both financial and personnel), the National Resident Matching Program (NRMP) match rate, performance on the board examination, and other graduate outcomes. From 2009 through 2013 we sent an annual SurveyMonkey online survey to members of the Medicine-Pediatrics Program Directors Association. Questions pertained to program characteristics, program director support, recruitment, ambulatory training, and graduate data. More than 79% of responders completed the entire survey for each year (sample size was 60 program directors). Compared to the time prior to accreditation of the specialty, there was an increase in program directors who are dually trained (89% versus 93%), an increase in program director salary ($134,000 before accreditation versus $185,000 in 2013, P Pediatrics examination was comparable to that for pediatrics residents. Since accreditation, a larger number of residents are choosing careers in hospital medicine. Our data show widespread improved support for medicine-pediatrics programs since the 2006 start of ACGME accreditation.

Correlation Between Protein Intake and Nitrogen Balance of Surgical Patients in Anesthesiology and Intensive Care Installation, Sanglah General Hospital, Denpasar, Bali, Indonesia

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Made Wiryana

2016-06-01

Full Text Available Background: A cell injury from surgical stress in a trauma or a non-trauma case will induce a hyper metabolic response in which the protein degradation increases, the somatic protein synthesis decreases and the amino acid catabolism increases. Thus, the pyper metabolic response contributes to nitrogen loss in urine. This response, without an adequate nutrition, will lead an iatrogenic malnutrition and deterioration. A balance nitrogen formula through urinary urea nitrogen is one of many nutrition evaluation methods. This method aids in evaluating the daily nutrition status and it can be the baseline data for daily intake. Objective: To find a correlation between the protein intake and the nitrogen balance of the surgical patients in anesthesiology and intensive care installation, Sanglah General Hospital, Denpasar, Bali. Methods: Fifty-one surgical patients with trauma and non-trauma cases were observed for their protein intake for 2-3 days continuously. Moreover, they were evaluated for their nitrogen balance based on the urinary urea nitrogen per 24 hours for 2-3 days. For statistical analysis, we utilized Shapiro-Francia, Shapiro-Wilk, Spearman Frank correlation, two-sample t test, and multivariate regression analysis in Strata SE 12.1. Results: The correlation between the protein intake and the nitrogen balance on the first day was ra=0.50 (p<0.05, on the second day ra=0.70 (p<0,05, and on the third day ra=0.740 (p<0,05. Conclusions: There is a correlation between the protein intake and the nitrogen balance of surgical patients in Anesthesiology and Intensive Care Installation Sanglah General Hospital Denpasar. 

Creating physicians of the 21st century: assessment of the clinical years

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Vanderbilt AA

2017-06-01

Full Text Available Allison A Vanderbilt,1 Sara Q Perkins,2 Moriah K Muscaro,2 Thomas J Papadimos,3 Reginald F Baugh4 1Department of Family Medicine, 2College of Medicine and Life Sciences, University of Toledo, 3Department of Anesthesiology, 4Department of Surgery, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA Abstract: Medical education has been under a constant state of revision for the past several years. The overarching theme of the curriculum revisions for medical schools across the USA has been creating better physicians for the 21st century, with the same end result: graduating medical students at the optimal performance level when entering residency. We propose a robust, thorough assessment process that will address the needs of clerkships, residents, students, and, most importantly, medical schools to best measure and improve clinical reasoning skills that are required for the learning outcomes of our future physicians. The Accreditation Council for Graduate Medical Education (ACGME evaluates and accredits medical school graduates based on competency-based outcomes and the assessment of specialty-specific milestones; however, there is some evidence that medical school graduates do not consistently meet the Level 1 milestones prior to entering/beginning residency, thus starting their internship year underprepared and overwhelmed. Medical schools should take on the responsibility to provide competency-based assessments for their students during the clinical years. These assessments should be geared toward preparing them with the cognitive competencies and skills needed to successfully transition to residency. Then, medical schools can produce students who will ultimately be prepared for transition to their residency programs to provide quality care. Keywords: ACGME Core Competencies, milestones, clerkships, medical education, evaluation 

Comparison of the didactic lecture with the simulation/model approach for the teaching of a novel perioperative ultrasound curriculum to anesthesiology residents.

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Ramsingh, Davinder; Alexander, Brenton; Le, Khanhvan; Williams, Wendell; Canales, Cecilia; Cannesson, Maxime

2014-09-01

To expose residents to two methods of education for point-of-care ultrasound, a traditional didactic lecture and a model/simulation-based lecture, which focus on concepts of cardiopulmonary function, volume status, and evaluation of severe thoracic/abdominal injuries; and to assess which method is more effective. Single-center, prospective, blinded trial. University hospital. Anesthesiology residents who were assigned to an educational day during the two-month research study period. Residents were allocated to two groups to receive either a 90-minute, one-on-one didactic lecture or a 90-minute lecture in a simulation center, during which they practiced on a human model and simulation mannequin (normal pathology). Data points included a pre-lecture multiple-choice test, post-lecture multiple-choice test, and post-lecture, human model-based examination. Post-lecture tests were performed within three weeks of the lecture. An experienced sonographer who was blinded to the education modality graded the model-based skill assessment examinations. Participants completed a follow-up survey to assess the perceptions of the quality of their instruction between the two groups. 20 residents completed the study. No differences were noted between the two groups in pre-lecture test scores (P = 0.97), but significantly higher scores for the model/simulation group occurred on both the post-lecture multiple choice (P = 0.038) and post-lecture model (P = 0.041) examinations. Follow-up resident surveys showed significantly higher scores in the model/simulation group regarding overall interest in perioperative ultrasound (P = 0.047) as well understanding of the physiologic concepts (P = 0.021). A model/simulation-based based lecture series may be more effective in teaching the skills needed to perform a point-of-care ultrasound examination to anesthesiology residents. Copyright © 2014 Elsevier Inc. All rights reserved.

Relationships between high-stakes clinical skills exam scores and program director global competency ratings of first-year pediatric residents

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Langenau, Erik E.; Pugliano, Gina; Roberts, William L.

2011-01-01

Background Responding to mandates from the Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA), residency programs have developed competency-based assessment tools. One such tool is the American College of Osteopathic Pediatricians (ACOP) program directors’ annual report. High-stakes clinical skills licensing examinations, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE), also assess competency in several clinical domains. Objective The purpose of this study is to investigate the relationships between program director competency ratings of first-year osteopathic residents in pediatrics and COMLEX-USA Level 2-PE scores from 2005 to 2009. Methods The sample included all 94 pediatric first-year residents who took COMLEX-USA Level 2-PE and whose training was reviewed by the ACOP for approval of training between 2005 and 2009. Program director competency ratings and COMLEX-USA Level 2-PE scores (domain and component) were merged and analyzed for relationships. Results Biomedical/biomechanical domain scores were positively correlated with overall program director competency ratings. Humanistic domain scores were not significantly correlated with overall program director competency ratings, but did show moderate correlation with ratings for interpersonal and communication skills. The six ACGME or seven AOA competencies assessed empirically by the ACOP program directors’ annual report could not be recovered by principal component analysis; instead, three factors were identified, accounting for 86% of the variance between competency ratings. Discussion A few significant correlations were noted between COMLEX-USA Level 2-PE scores and program director competency ratings. Exploring relationships between different clinical skills assessments is inherently difficult because of the heterogeneity of tools used and overlap of constructs within the AOA

Relationships between high-stakes clinical skills exam scores and program director global competency ratings of first-year pediatric residents

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Erik E. Langenau

2011-09-01

Full Text Available Responding to mandates from the Accreditation Council for Graduate Medical Education (ACGME and American Osteopathic Association (AOA, residency programs have developed competency-based assessment tools. One such tool is the American College of Osteopathic Pediatricians (ACOP program directors’ annual report. High-stakes clinical skills licensing examinations, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE, also assess competency in several clinical domains.The purpose of this study is to investigate the relationships between program director competency ratings of first-year osteopathic residents in pediatrics and COMLEX-USA Level 2-PE scores from 2005 to 2009.The sample included all 94 pediatric first-year residents who took COMLEX-USA Level 2-PE and whose training was reviewed by the ACOP for approval of training between 2005 and 2009. Program director competency ratings and COMLEX-USA Level 2-PE scores (domain and component were merged and analyzed for relationships.Biomedical/biomechanical domain scores were positively correlated with overall program director competency ratings. Humanistic domain scores were not significantly correlated with overall program director competency ratings, but did show moderate correlation with ratings for interpersonal and communication skills. The six ACGME or seven AOA competencies assessed empirically by the ACOP program directors’ annual report could not be recovered by principal component analysis; instead, three factors were identified, accounting for 86% of the variance between competency ratings.A few significant correlations were noted between COMLEX-USA Level 2-PE scores and program director competency ratings. Exploring relationships between different clinical skills assessments is inherently difficult because of the heterogeneity of tools used and overlap of constructs within the AOA and ACGME core competencies.

50th Year Anniversary of Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

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Lertakyamanee, Jariya

2016-05-01

Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, has started to be a formal anesthesia division, divided from division of Surgery in 1965; hence our 50th year anniversary in 2015. Research is now a priority and mandatory mission, according to the vision of Mahidol University. Second mission is to teach and train, and we produce the highest number of states-of-the-art anesthesiologists and anesthetic nurses each year Curriculum and training are being continuously improved. From a small unit, now it is one of the largest departments and extends the service, our third mission, to more than only in the operating theaters. We look after pre-anesthesia assessment, inside and outside operating room anesthesia, post-operative pain relief Intensive Care Unit, and chronic pain management. The number of patients and their diseases increase; so do the complexities of surgeries. There are tremendous changes in drugs and equipment. There is the fourth mission on administration, IT and resource management. And the fifth mission which is corporate social responsibility. However, we still believe that compassion, responsibility and integrity are most important. We have taught and tried to live by the teaching of HRH the King's Father. And these will contribute to our progress and shine in the next 50 years.

Milestones: a rapid assessment method for the Clinical Competency Committee

OpenAIRE

Nabors, Christopher; Forman, Leanne; Peterson, Stephen J.; Gennarelli, Melissa; Aronow, Wilbert S.; DeLorenzo, Lawrence; Chandy, Dipak; Ahn, Chul; Sule, Sachin; Stallings, Gary W.; Khera, Sahil; Palaniswamy, Chandrasekar; Frishman, William H.

2016-01-01

Introduction Educational milestones are now used to assess the developmental progress of all U.S. graduate medical residents during training. Twice annually, each program?s Clinical Competency Committee (CCC) makes these determinations and reports its findings to the Accreditation Council for Graduate Medical Education (ACGME). The ideal way to conduct the CCC is not known. After finding that deliberations reliant upon the new milestones were time intensive, our internal medicine residency pr...

Peer chart audits: A tool to meet Accreditation Council on Graduate Medical Education (ACGME competency in practice-based learning and improvement

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Patel Sangnya

2007-07-01

Full Text Available Abstract Background The Accreditation Council on Graduate Medical Education (ACGME supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. Methods A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin from the charts of patients followed by their physician peers. No formal feedback or education was provided. Results Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33% (p = 0.001, 26% (from 45% to 71% (p Conclusion Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial.

[Anesthesiological management of awake craniotomy : Asleep-awake-asleep technique or without sedation].

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Seemann, M; Zech, N; Graf, B; Hansen, E

2015-02-01

Awake craniotomy is indicated in deep brain stimulation (DBS) for treatment of certain movement disorders, such as in Parkinson disease patients or in the surgery of brain tumors in close vicinity to the language area. The standard procedure is the asleep-awake-asleep technique where general anesthesia or analgosedation is intermittently interrupted for neurological testing. In DBS the intraoperative improvement of symptoms, stereotactic navigation and microelectrode reading guide to the optimal position. In brain tumor resection, reversible functional impairments during electrical stimulation on the brain surface (brain mapping) show the exact individual position of eloquent or motoric areas that should be protected.The anesthesiology procedures used are very variable. It is a balancing act between overdosing of anesthetics with impairment of respiration and alertness and underdosing with pain, strain and stress for the patient. For the asleep-awake-asleep technique high acceptance but also frequent and partly severe complications have been reported. The psychological stress for the patient can be immense. Obviously, a feeling of being left alone and being at someone's mercy is not adequately treated by drugs and performance of the neurological tests is undoubtedly better and more reliable with less pharmacological impairment. Cranial nerve blocks can reduce the amount of anesthetics as they provide analgesia of the scalp more efficiently than local infiltration. With these nerve blocks, a strong therapeutic relationship and a specific communication, sedatives can be avoided and the need for opioids markedly reduced or abolished. The suggestive communication promotes for instance dissociation to an inner safe refuge, as well as reframing of disturbing noises and sensations. Each of the methods applied for awake craniotomy can profit from the principles of this awake-awake-awake technique.

Predicting success on the certification examinations of the American Board of Anesthesiology.

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McClintock, Joseph C; Gravlee, Glenn P

2010-01-01

Currently, residency programs lack objective predictors for passing the sequenced American Board of Anesthesiology (ABA) certification examinations on the first attempt. Our hypothesis was that performance on the ABA/American Society of Anesthesiologists In-Training Examination (ITE) and other variables can predict combined success on the ABA Part 1 and Part 2 examinations. The authors studied 2,458 subjects who took the ITE immediately after completing the first year of clinical anesthesia training and took the ABA Part 1 examination for primary certification immediately after completing residency training 2 yr later. ITE scores and other variables were used to predict which residents would complete the certification process (passing the ABA Part 1 and Part 2 examinations) in the shortest possible time after graduation. ITE scores alone accounted for most of the explained variation in the desired outcome of certification in the shortest possible time. In addition, almost half of the observed variation and most of the explained variance in ABA Part 1 scores was accounted for by ITE scores. A combined model using ITE scores, residency program accreditation cycle length, country of medical school, and gender best predicted which residents would complete the certification examinations in the shortest possible time. The principal implication of this study is that higher ABA/ American Society of Anesthesiologists ITE scores taken at the end of the first clinical anesthesia year serve as a significant and moderately strong predictor of high performance on the ABA Part 1 (written) examination, and a significant predictor of success in completing both the Part 1 and Part 2 examinations within the calendar year after the year of graduation from residency. Future studies may identify other predictors, and it would be helpful to identify factors that predict clinical performance as well.

[Model to predict staffing for anesthesiology and post-anesthesia intensive care units and pain clinics].

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Canet, J; Moral, V; Villalonga, A; Pelegrí, D; Gomar, C; Montero, A

2001-01-01

Human resources account for a large part of the budgets of anesthesia and post-anesthesia intensive care units and pain clinics (A-PICU-PC). Adequate staffing is a key factor in providing for both effective care and professional staff development. Changes in professional responsibilities have rendered obsolete the concept of one anesthesiologist per operating room. Duties must be analyzed objectively to facilitate understanding between hospital administrators and A-PICU-PC chiefs of service when assigning human resources. The Catalan Society of Anesthesiology, Post-anesthesia Intensive Care and Pain Therapy has developed a model for estimating requirements for A-PICU-PC staffing based on three factors: 1) Definition of staff positions that must be filled and criteria for assigning human resources; 2) Estimation of non-care-related time required by the department for training, teaching, research and internal management, and 3) Estimation of staff required to cover absences from work for vacations, personal leave or illness. The model revealed that the ratio of number of staff positions to number of persons employed by an A-PICU-PC is approximately 1.3. Differences in the nature of services managed by an A-PICU-PC or the type of hospital might change the ratio slightly. The model can be applied universally, independently of differences that might exist among departments. Widespread application would allow adoption of a common language to be used by health care managers and A-PICU-PC departments when discussing a basis for consensus about our specialty.

Jumpstarting Academic Careers: A Workshop and Tools for Career Development in Anesthesiology.

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Yanofsky, Samuel D; Voytko, Mary Lou; Tobin, Joseph R; Nyquist, Julie G

2011-01-01

Career development is essential and has the potential to assist in building a sustained faculty within academic departments of Anesthesiology. Career development is essential for growth in academic medicine. Close attention to the details involved in career management, goal setting as part of career planning, and professional networking are key elements. This article examines the specific educational strategies involved in a 120 minute workshop divided into four 25 minute segments with 20 minutes at the end for discussion for training junior faculty in career development. The teaching methods include 1) brief didactic presentations, 2) pre-workshop completion of two professional development tools, 3) facilitated small group discussion using trained facilitators and 4) use of a commitment to change format. Three major learning tools were utilized in conjunction with the above methods: a professional network survey, a career planning and development form and a commitment to change form. Forty one participants from 2009 reported 80 projected changes in their practice behaviors in relation to career management: Build or enhance professional network and professional mentoring (36.3%); Set career goals, make a plan, follow though, collaborate, publish (35.1%); Increase visibility locally or nationally (10.0%); Building core skills, such as clinical, teaching, leading (36.3%); Identify the criteria for promotion in own institution (5.0%); Improved methods of documentation (2.5%). Over the past two years, the workshop has been very well received by junior faculty, with over 95% marking each of the following items as excellent or good (presentation, content, audiovisuals and objectives met). The challenge for continuing development and promotion of academic anesthesiologists lies in the explicit training of faculty for career advancement. Designing workshops using educational tools to promote a reflective process of the faculty member is the one method to meet this

Pass rates on the American Board of Family Medicine Certification Exam by residency location and size.

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Falcone, John L; Middleton, Donald B

2013-01-01

The Accreditation Council for Graduate Medical Education (ACGME) sets residency performance standards for the American Board of Family Medicine Certification Examination. This study aims are to describe the compliance of residency programs with ACGME standards and to determine whether residency pass rates depend on program size and location. In this retrospective cohort study, residency performance from 2007 to 2011 was compared with the ACGME performance standards. Simple linear regression was performed to see whether program pass rates were dependent on program size. Regional differences in performance were compared with χ(2) tests, using an α level of 0.05. Of 429 total residency programs, there were 205 (47.8%) that violate ACGME performance standards. Linear regression showed that program pass rates were positively correlated and dependent on program size (P family medicine training programs do not meet the ACGME examination performance standards. Pass rates are associated with residency program size, and regional variation occurs. These findings have the potential to affect ACGME policy and residency program application patterns.

Strategies to optimize MEDLINE and EMBASE search strategies for anesthesiology systematic reviews. An experimental study.

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Volpato, Enilze de Souza Nogueira; Betini, Marluci; Puga, Maria Eduarda; Agarwal, Arnav; Cataneo, Antônio José Maria; Oliveira, Luciane Dias de; Bazan, Rodrigo; Braz, Leandro Gobbo; Pereira, José Eduardo Guimarães; El Dib, Regina

2018-01-15

A high-quality electronic search is essential for ensuring accuracy and comprehensiveness among the records retrieved when conducting systematic reviews. Therefore, we aimed to identify the most efficient method for searching in both MEDLINE (through PubMed) and EMBASE, covering search terms with variant spellings, direct and indirect orders, and associations with MeSH and EMTREE terms (or lack thereof). Experimental study. UNESP, Brazil. We selected and analyzed 37 search strategies that had specifically been developed for the field of anesthesiology. These search strategies were adapted in order to cover all potentially relevant search terms, with regard to variant spellings and direct and indirect orders, in the most efficient manner. When the strategies included variant spellings and direct and indirect orders, these adapted versions of the search strategies selected retrieved the same number of search results in MEDLINE (mean of 61.3%) and a higher number in EMBASE (mean of 63.9%) in the sample analyzed. The numbers of results retrieved through the searches analyzed here were not identical with and without associated use of MeSH and EMTREE terms. However, association of these terms from both controlled vocabularies retrieved a larger number of records than did the use of either one of them. In view of these results, we recommend that the search terms used should include both preferred and non-preferred terms (i.e. variant spellings and direct/indirect order of the same term) and associated MeSH and EMTREE terms, in order to develop highly-sensitive search strategies for systematic reviews.

Effect of Performance Deficiencies on Graduation and Board Certification Rates: A 10-yr Multicenter Study of Anesthesiology Residents.

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Turner, Judi A; Fitzsimons, Michael G; Pardo, Manuel C; Hawkins, Joy L; Huang, Yue Ming; Rudolph, Maria D D; Keyes, Mary A; Howard-Quijano, Kimberly J; Naim, Natale Z; Buckley, Jack C; Grogan, Tristan R; Steadman, Randolph H

2016-07-01

This multicenter, retrospective study was conducted to determine how resident performance deficiencies affect graduation and board certification. Primary documents pertaining to resident performance were examined over a 10-yr period at four academic anesthesiology residencies. Residents entering training between 2000 and 2009 were included, with follow-up through February 2016. Residents receiving actions by the programs' Clinical Competency Committee were categorized by the area of deficiency and compared to peers without deficiencies. A total of 865 residents were studied (range: 127 to 275 per program). Of these, 215 residents received a total of 405 actions from their respective Clinical Competency Committee. Among those who received an action compared to those who did not, the proportion graduating differed (93 vs. 99%, respectively, P graduating dropped to 55%. When more than three Accreditation Council for Graduate Medical Education Core Competencies were deficient, the proportion graduating also dropped significantly. Overall graduation and board certification rates were consistently high in residents with no, or isolated, deficiencies. Residents deficient in an Essential Attribute, or multiple competencies, are at high risk of not graduating or achieving board certification. More research is needed on the effectiveness and selective deployment of remediation efforts, particularly for high-risk groups.

Effect of Performance Deficiencies on Graduation and Board Certification Rates: A 10-Year Multicenter Study of Anesthesiology Residents

Science.gov (United States)

Turner, Judi A.; Fitzsimons, Michael G.; Pardo, Manuel C.; Hawkins, Joy L.; Huang, Yue Ming; Rudolph, Maria D. D.; Keyes, Mary A.; Howard-Quijano, Kimberly J.; Naim, Natale Z.; Buckley, Jack C.; Grogan, Tristan R.; Steadman, Randolph H.

2016-01-01

Background This multi-center, retrospective study was conducted to determine how resident performance deficiencies affect graduation and board certification. Methods Primary documents pertaining to resident performance were examined over a 10-year period at four academic anesthesiology residencies. Residents entering training between 2000 and 2009 were included, with follow-up through February 2016. Residents receiving actions by the programs’ Clinical Competency Committee were categorized by the area of deficiency and compared to peers without deficiencies. Results A total of 865 residents were studied (range: 127–275 per program). Of these, 215 residents received a total of 405 actions from their respective Clinical Competency Committee. Among those who received an action compared to those who did not, the proportion graduating differed (93% versus 99%, respectively, Pgraduating dropped to 55%. When more than three Accreditation Council for Graduate Medical Education core competencies were deficient, the proportion graduating also dropped significantly. Conclusions Overall graduation and board certification rates were consistently high in residents with no, or isolated, deficiencies. Residents deficient in an Essential Attribute, or multiple competencies, are at high risk of not graduating or achieving board certification. More research is needed on the effectiveness and selective deployment of remediation efforts, particularly for high-risk groups. PMID:27119434

Cost implications of reduced work hours and workloads for resident physicians.

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Nuckols, Teryl K; Bhattacharya, Jay; Wolman, Dianne Miller; Ulmer, Cheryl; Escarce, José J

2009-05-21

Although the Accreditation Council for Graduate Medical Education (ACGME) limits the work hours of residents, concerns about fatigue persist. A new Institute of Medicine (IOM) report recommends, among other changes, improved adherence to the 2003 ACGME limits, naps during extended shifts, a 16-hour limit for shifts without naps, and reduced workloads. We used published data to estimate labor costs associated with transferring excess work from residents to substitute providers, and we examined the effects of our assumptions in sensitivity analyses. Next, using a probability model to represent labor costs as well as mortality and costs associated with preventable adverse events, we determined the net costs to major teaching hospitals and cost-effectiveness across a range of hypothetical changes in the rate of preventable adverse events. Annual labor costs from implementing the IOM recommendations were estimated to be $1.6 billion (in 2006 U.S. dollars) across all ACGME-accredited programs ($1.1 billion to $2.5 billion in sensitivity analyses). From a 10% decrease to a 10% increase in preventable adverse events, net costs per admission ranged from $99 to $183 for major teaching hospitals and from $17 to $266 for society. With 2.5% to 11.3% decreases in preventable adverse events, costs to society per averted death ranged from $3.4 million to $0. Implementing the four IOM recommendations would be costly, and their effectiveness is unknown. If highly effective, they could prevent patient harm at reduced or no cost from the societal perspective. However, net costs to teaching hospitals would remain high. 2009 Massachusetts Medical Society

A Critical Analysis of Anesthesiology Podcasts: Identifying Determinants of Success.

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Singh, Devin; Alam, Fahad; Matava, Clyde

2016-08-17

demonstrated evidence of peer review with podcasts targeting anesthesiologists most strongly associated with peer-reviewed podcasts (Spearman R=0.886; P=.004) CONCLUSIONS: We present the first report on the scope of anesthesia podcasts in Canada. We have developed a novel tool for assessing the success of an anesthesiology podcast series and identified factors linked to this success measure as well as evidence of a peer-review process for a given podcast. To enable advancement in this area of anesthesia e-resources, podcast creators and users should consider factors associated with success when creating podcasts. The lack of these aspects may be associated with the early demise of a podcast series.

Quarterly, Bi-annual and Annual Reports

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National Oceanic and Atmospheric Administration, Department of Commerce — The Quarterly, Bi-annual and Annual Reports are periodic reports issued for public release. For the deep set fishery these reports are issued quarterly and anually....

Targeting Epigenetic Mechanisms in Pain due to Trauma and Traumatic Brain Injury(TBI)

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2016-10-01

after incision and TBI, and the relationship of those changes to CXCR2 expression ST4.1 Establish spinal cord sites and cell types displaying...we plan to use oral preparations of these drugs and establish dose-response relationships as these will be pharmacologically useful and make the...Anesthesiology Annual Awards Dinner . Palo Alto, CA, June, 2016. 4. Epigenetic Regulation of Chronic Pain after Traumatic Brain Injury. De-Yong

Science of health care delivery milestones for undergraduate medical education.

Science.gov (United States)

Havyer, Rachel D; Norby, Suzanne M; Leep Hunderfund, Andrea N; Starr, Stephanie R; Lang, Tara R; Wolanskyj, Alexandra P; Reed, Darcy A

2017-08-25

The changing healthcare landscape requires physicians to develop new knowledge and skills such as high-value care, systems improvement, population health, and team-based care, which together may be referred to as the Science of Health Care Delivery (SHCD). To engender public trust and confidence, educators must be able to meaningfully assess physicians' abilities in SHCD. We aimed to develop a novel set of SHCD milestones based on published Accreditation Council for Graduate Medical Education (ACGME) milestones that can be used by medical schools to assess medical students' competence in SHCD. We reviewed all ACGME milestones for 25 specialties available in September 2013. We used an iterative, qualitative process to group the ACGME milestones into SHCD content domains, from which SHCD milestones were derived. The SHCD milestones were categorized within the current ACGME core competencies and were also mapped to Association of American Medical Colleges' Entrustable Professional Activities (AAMC EPAs). Fifteen SHCD sub-competencies and corresponding milestones are provided, grouped within ACGME core competencies and mapped to multiple AAMC EPAs. This novel set of milestones, grounded within the existing ACGME competencies, defines fundamental expectations within SHCD that can be used and adapted by medical schools in the assessment of medical students in this emerging curricular area. These milestones provide a blueprint for SHCD content and assessment as ongoing revisions to milestones and curricula occur.

US residency training before and after the 1997 Balanced Budget Act.

Science.gov (United States)

Salsberg, Edward; Rockey, Paul H; Rivers, Kerri L; Brotherton, Sarah E; Jackson, Gregory R

2008-09-10

Graduate medical education (GME) determines the size and characteristics of the future workforce. The 1997 Balanced Budget Act (BBA) limited Medicare funding for additional trainees in GME. There has been concern that because Medicare is the primary source of GME funding, the BBA would discourage growth in GME. To examine the number of residents in training before and after the BBA, as well as more recent changes in GME by specialty, sex, and type and location of education. Descriptive study using the American Medical Association/Association of American Medical Colleges National GME Census on physicians in Accreditation Council for Graduate Medical Education (ACGME)-accredited programs to examine changes in the number and characteristics of residents before and after the BBA. Differences in the number of physicians in ACGME-accredited training programs overall, by specialty, and by location and type of education. The number of residents and fellows changed little between academic year (AY) 1997 (n = 98,143) and AY 2002 (n = 98,258) but increased to 106,012 in AY 2007, a net increase of 7869 (8.0%) over the decade. The annual number of new entrants into GME increased by 7.6%, primarily because of increasing international medical graduates (IMGs). United States medical school graduates (MDs) comprised 44.0% of the overall growth from 2002 to 2007, followed by IMGs (39.2%) and osteopathic school graduates (18.8%). United States MD growth largely resulted from selection of specialties with longer training periods. From 2002 to 2007, US MDs training in primary care specialties decreased by 2641, while IMGs increased by 3286. However, increasing subspecialization rates led to fewer physicians entering generalist careers. After the 1997 BBA, there appears to have been a temporary halt in the growth of physicians training in ACGME programs; however, the number increased from 2002 to 2007.

Local and national trends in general surgery residents' operative experience: do work hour limitations negatively affect case volume in small community-based programs?

Science.gov (United States)

Markelov, Alexey; Sakharpe, Aniket; Kohli, Harjeet; Livert, David

2011-12-01

The goals of this study were to analyze the impact of work hour restrictions on the operative case volume at a small community-based general surgery residency training program and compare changes with the national level. Annual national resident case log data from Accreditation Council for Graduate Medical Education (ACGME) website and case logs of graduating Easton Hospital residents (years 2002-2009) were used for analysis. Weighted average change in total number of cases in our institution was -1.20 (P = 0.52) vs 1.78 (P = 0.07) for the national program average with statistically significant difference on comparison (P = 0.027). We also found significant difference in case volume changes at the national level compared with our institution for the following ACGME defined subcategories: alimentary tract [8.19 (P < 0.01) vs -1.08 (P = 0.54)], abdomen [8.48 (P < 0.01) vs -6.29 (P < 0.01)], breast [1.91 (P = 0.89) vs -3.6 (P = 0.02)], and vascular [4.03 (P = 0.02) vs -3.98 (P = 0.01)]. Comparing the national trend to the community hospital we see that there is total increase in cases at the national level whereas there is a decrease in case volume at the community hospital. These trends can also be followed in ACGME defined subcategories which form the major case load for a general surgical training such as alimentary tract, abdominal, breast, and vascular procedures. We hypothesize that work hour restrictions have been favorable for the larger programs, as these programs were able to better integrate the night float system, restructure their call schedule, and implement institutional modifications which are too resource demanding for smaller training programs.

Medical students' perceptions of international accreditation.

Science.gov (United States)

Ibrahim, Halah; Abdel-Razig, Sawsan; Nair, Satish C

2015-10-11

This study aimed to explore the perceptions of medical students in a developing medical education system towards international accreditation. Applicants to an Internal Medicine residency program in an academic medical center in the United Arab Emirates (UAE) accredited by the Accreditation Council for Graduate Medical Education-International (ACGME-I) were surveyed between May and June 2014. The authors analysed responses using inductive qualitative thematic analysis to identify emergent themes. Seventy-eight of 96 applicants (81%) completed the survey. The vast majority of respondents 74 (95%) reported that ACGME-I accreditation was an important factor in selecting a residency program. Five major themes were identified, namely improving the quality of education, increasing opportunities, meeting high international standards, improving program structure, and improving patient care. Seven (10%) of respondents felt they would be in a position to pursue fellowship training or future employment in the United States upon graduation from an ACGME-I program. UAE trainees have an overwhelmingly positive perception of international accreditation, with an emphasis on improving the quality of training provided. Misperceptions, however, exist about potential opportunities available to graduates of ACGME-I programs. As more countries adopt the standards of the ACGME-I or other international accrediting bodies, it is important to recognize and foster trainee "buy-in" of educational reform initiatives.

[Simulation-based intervention to improve anesthesiology residents communication with families of critically ill patients--preliminary prospective evaluation].

Science.gov (United States)

Berkenstadt, Haim; Perlson, Daria; Shalomson, Orit; Tuval, Atalia; Haviv-Yadid, Yael; Ziv, Amitai

2013-08-01

Although effective communication with families of critically ill patients is a vital component of quality care, training in this field is neglected. The article aims to validate communication skills training program for anesthesiology residents in the intensive care set up. Ten anesthesia residents, following 3 months of Intensive Care Unit (ICU) rotation, had 4 hours of lectures and one day simulation-based communication skills training with families of critically ill patients. Participants completed an attitude questionnaire over 3 time periods--before training [t1], immediately following training (t2) and three months following training (t3). The participants' communication skills were assessed by two blinded independent observers using the SEGUE framework while performing a simulation-based scenario at t1 and t3. Seven participants finished the study protocol. Participants ndicated communication importance as 3.68 +/- 0.58 (t1), 4.05 +/- 0.59 (t2), 4.13 +/- 0.64 (t3); their communication ability as 3.09 +/- 0.90 (t1), 3.70 +/- 0.80 (t2), 3.57 +/- 0.64 (t3); the contribution of lecture to communication 3.04 +/- 0.43 (t1), 3.83 +/- 0.39 (t2), 3.87 +/- 0.51 (t3), and contribution of simulation training to communication 3.00 +/- 0.71 (t1), 4.04 +/- 0.52 (t2), 3.84 +/- 0.31 (t3). The differences did not reach statistical significance. Objective assessment of the communication skills using the SEGUE framework indicated that 6/7 participants improved their communication skills, with communication ability before training at 2.66 +/- 0.83 and 1 month following training it was 3.38 +/- 0.78 (p = 0.09). This preliminary study demonstrates the value of communication skills training in the intensive care environment.

[Personnel marketing in anesthesiology. Perception, use and evaluation by the target group].

Science.gov (United States)

Berlet, T

2015-09-01

The human resources situation in the healthcare system is characterized by a manpower shortage. Recruiting medical staff is of great importance for hospitals and particularly in anesthesiology. Approaching and recruiting staff usually happens through external personnel marketing (PM); however, up until now the efficacy of these PM measures has barely been empirically investigated. The goal of this empirical study was to examine how familiar hospital physicians at varying career levels are with the different tools employed by external PM and how frequently they used as well as rated these tools in terms of benefits. Based on this information, the preferences of medical staff with respect to detailing the workplace of "hospital physician" as well as factors of the hospital's attractiveness as an employer were evaluated. Another aim was to derive recommendations on how to optimize the marketing instruments used for external PM in the healthcare system. In an internet-based survey, 154 female and male physicians were questioned about their knowledge, use and benefit assessment of a total of 43 PM tools. Conventional methods of addressing applicants were commonly used but ranked behind the more personal and direct targeting tools in terms of benefit assessments. Internet-based tools with a conceptual affinity to conventional methods were also highly rated in terms of benefits. In contrast, unconventional methods of addressing applicants were hardly known and were not viewed as being useful. The PM tools from the field of "overall conditions for cooperation in the company" mainly received high to very high benefit assessments. These referred primarily to non-monetary factors, human resource development measures and also to aspects of remuneration. Image-promoting PM tools were rarely assessed as being useful, with the exception of measures aimed at creating personal contact between the hospital or unit/department and applicants or those allowing personal insight into the

Medical students’ perceptions of international accreditation

Science.gov (United States)

Abdel-Razig, Sawsan; Nair, Satish C

2015-01-01

Objectives This study aimed to explore the perceptions of medical students in a developing medical education system towards international accreditation. Methods Applicants to an Internal Medicine residency program in an academic medical center in the United Arab Emirates (UAE) accredited by the Accreditation Council for Graduate Medical Education-International (ACGME-I) were surveyed between May and June 2014. The authors analysed responses using inductive qualitative thematic analysis to identify emergent themes. Results Seventy-eight of 96 applicants (81%) completed the survey. The vast majority of respondents 74 (95%) reported that ACGME-I accreditation was an important factor in selecting a residency program. Five major themes were identified, namely improving the quality of education, increasing opportunities, meeting high international standards, improving program structure, and improving patient care. Seven (10%) of respondents felt they would be in a position to pursue fellowship training or future employment in the United States upon graduation from an ACGME-I program. Conclusions UAE trainees have an overwhelmingly positive perception of international accreditation, with an emphasis on improving the quality of training provided. Misperceptions, however, exist about potential opportunities available to graduates of ACGME-I programs. As more countries adopt the standards of the ACGME-I or other international accrediting bodies, it is important to recognize and foster trainee “buy-in” of educational reform initiatives. PMID:26454402

[Anesthesia for medical students : A brief guide to practical anesthesia in adults with a web-based video illustration].

Science.gov (United States)

Mathis, S; Schlafer, O; Abram, J; Kreutziger, J; Paal, P; Wenzel, V

2016-12-01

In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career.Traditional strategies to teach medical students in anesthesiology in medical school consist of airway management or cardiopulmonary resuscitation attempts in manikins. Anesthesiology is a complex interaction consisting of anatomy, physiology, pharmacology, clinical evaluation, experience, knowledge, and manual skills. While some medical schools offer teaching in high fidelity simulators, clinical teaching in the operating room is often limited. When medical students opt for a clinical rotation in anesthesiology, there is a chance to demonstrate the fascinating world of anesthesiology, but this chance has to be utilized carefully by anesthesiologists, as young talents have to be discovered, supported, and challenged.We have put together a short guide for medical students for a clinical rotation in anesthesiology in adults in order to generate basic knowledge and interest in anesthesiology as well as a sense of achievement. Basic knowledge about premedication, induction, maintenance and strategies for anesthesia is discussed. Further, the most important anesthesia drugs are discussed and manual skills, such as intravenous cannulation, mask ventilation, intubation, and regional anesthesia are featured with QR-code based video illustrations on a smartphone or personal computer. We did not discuss possible local mannerism and special patient groups (e. g., children, special medical history), local guidelines

Annual report 1973

International Nuclear Information System (INIS)

1973-01-01

The GKSS scientific annual report summarizes the problems and results of the research and development projects of 1973. In contrast to earlier annual reports, a comprehensive description of the research facilities is not included. The annual report was extended by the paragraph 'Financial Report 1973' in the chapter 'Development of Geesthacht Research Centre'. The financial report gives a survey of the financial transactions and the major operations of the year under review. (orig./AK) [de

The design and implementation of an automated system for logging clinical experiences using an anesthesia information management system.

Science.gov (United States)

Simpao, Allan; Heitz, James W; McNulty, Stephen E; Chekemian, Beth; Brenn, B Randall; Epstein, Richard H

2011-02-01

Residents in anesthesia training programs throughout the world are required to document their clinical cases to help ensure that they receive adequate training. Current systems involve self-reporting, are subject to delayed updates and misreported data, and do not provide a practicable method of validation. Anesthesia information management systems (AIMS) are being used increasingly in training programs and are a logical source for verifiable documentation. We hypothesized that case logs generated automatically from an AIMS would be sufficiently accurate to replace the current manual process. We based our analysis on the data reporting requirements of the American College of Graduate Medical Education (ACGME). We conducted a systematic review of ACGME requirements and our AIMS record, and made modifications after identifying data element and attribution issues. We studied 2 methods (parsing of free text procedure descriptions and CPT4 procedure code mapping) to automatically determine ACGME case categories and generated AIMS-based case logs and compared these to assignments made by manual inspection of the anesthesia records. We also assessed under- and overreporting of cases entered manually by our residents into the ACGME website. The parsing and mapping methods assigned cases to a majority of the ACGME categories with accuracies of 95% and 97%, respectively, as compared with determinations made by 2 residents and 1 attending who manually reviewed all procedure descriptions. Comparison of AIMS-based case logs with reports from the ACGME Resident Case Log System website showed that >50% of residents either underreported or overreported their total case counts by at least 5%. The AIMS database is a source of contemporaneous documentation of resident experience that can be queried to generate valid, verifiable case logs. The extent of AIMS adoption by academic anesthesia departments should encourage accreditation organizations to support uploading of AIMS-based case

Maintaining the Fire but Avoiding Burnout: Implementation and Evaluation of a Resident Well-Being Program.

Science.gov (United States)

Riall, Taylor S; Teiman, Joshua; Chang, Michelle; Cole, Denzel; Leighn, Tambre; McClafferty, Hilary; Nfonsam, Valentine N

2018-04-01

There have been few programs designed to improve surgical resident well-being, and such efforts often lack formal evaluation. General surgery residents participated in the Energy Leadership Well-Being and Resiliency Program. They were assessed at baseline and 1 year after implementation using the Energy Leadership Index (measures emotional intelligence), Maslach Burnout Inventory General Survey, Perceived Stress Scale, the Beck Depression Inventory, and the annual required ACGME resident survey. Scores before and after implementation were compared using paired t-tests for continuous variables and chi-square tests for categorical variables. Forty-nine general surgery residents participate in the program. One year after implementation, resident score on the Energy Leadership Index improved (from 3.16 ± 0.24 to 3.24 ± 0.32; p = 0.03). Resident perceived stress decreased from baseline (Perceived Stress Scale score, from 17.0 ± 7.2 to 15.7 ± 6.2; p = 0.05). Scores on the emotional exhaustion scale of the Maslach Burnout Inventory decreased (from 16.8 ± 8.4 to 14.4 ± 8.5; p = 0.04). Resident-reported satisfaction improved in many areas; satisfaction with leadership skills, work relationships, communication skills, productivity, time management, personal freedom, and work-life balance, increased during the 1-year intervention (p = NS). On the annual ACGME resident survey, residents' evaluation of the program as positive or very positive increased from 80% to 96%. This study demonstrates that formal implementation of a program to improve resident well-being positively impacted residents' perceived stress, emotional exhaustion, emotional intelligence, life satisfaction, and their perception of the residency program. Formal evaluation and reporting of such efforts allow for reproducibility and scalability, with the potential for widespread impact on resident well-being. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Risø annual report 2001

DEFF Research Database (Denmark)

2002-01-01

In this annual report, we present a small selection of Risø’s achievements in 2001. A more detailed review of Risø’s projects can be found in the Risø Annual Accounts for 2001 as well as in the annual progress reports prepared by the individual researchdepartments.......In this annual report, we present a small selection of Risø’s achievements in 2001. A more detailed review of Risø’s projects can be found in the Risø Annual Accounts for 2001 as well as in the annual progress reports prepared by the individual researchdepartments....

Annual Report 2010-2011

International Development Research Centre (IDRC) Digital Library (Canada)

... 2013-2014 Annual Report 2013-2014 Rapport annuel 2013-2014 Annual Report 2014-2015 Annual Report 2014-2015 Rapport annuel 2014-2015 Investing in Solutions Strategic Plan 2015-2020 Investing in Solutions Strategic Plan 2015-2020 Investir dans des solutions Plan stratégique 2015-2020 Financial statements ...

NUKEM annual report 1981

International Nuclear Information System (INIS)

The annual report of this important undertaking in the German nuclear industry informs about its structure, holdings and activities in 1981. The report of the management is followed by remarks on the annual statement of accounts (annual balance, profit-loss accounting) and the report of the Supervisory Board. In the annex the annual balance of NUKEM GmbH/HOBEG mbH as per December 31, 1981, and the profit-loss accounting of NUKEM GmbH/HOBEG mbH for the business year 1981 are presented. (UA) [de

The State of Evaluation in Internal Medicine Residency

Science.gov (United States)

Holmboe, Eric; Beasley, Brent W.

2008-01-01

Background There are no nationwide data on the methods residency programs are using to assess trainee competence. The Accreditation Council for Graduate Medical Education (ACGME) has recommended tools that programs can use to evaluate their trainees. It is unknown if programs are adhering to these recommendations. Objective To describe evaluation methods used by our nation’s internal medicine residency programs and assess adherence to ACGME methodological recommendations for evaluation. Design Nationwide survey. Participants All internal medicine programs registered with the Association of Program Directors of Internal Medicine (APDIM). Measurements Descriptive statistics of programs and tools used to evaluate competence; compliance with ACGME recommended evaluative methods. Results The response rate was 70%. Programs were using an average of 4.2–6.0 tools to evaluate their trainees with heavy reliance on rating forms. Direct observation and practice and data-based tools were used much less frequently. Most programs were using at least 1 of the Accreditation Council for Graduate Medical Education (ACGME)’s “most desirable” methods of evaluation for all 6 measures of trainee competence. These programs had higher support staff to resident ratios than programs using less desirable evaluative methods. Conclusions Residency programs are using a large number and variety of tools for evaluating the competence of their trainees. Most are complying with ACGME recommended methods of evaluation especially if the support staff to resident ratio is high. PMID:18612734

Annual, semi-annual and ter-annual variations of gravity wave momentum flux in 13 years of SABER data

Science.gov (United States)

Chen, Dan; Preusse, Peter; Ern, Manfred; Strube, Cornelia

2017-04-01

In this study, the variations at different time scales such as the annual cycle, the semiannual oscillation (SAO), the ter-annual cycle (about four monthly) and the quasi-biennial oscillation (QBO) in zonal mean GW amplitudes and GW momentum flux (GWMF) have been investigated using satellite observations from 2002-2014 and combining ECMWF high resolution data with the GORGRAT model. The global distribution (patterns) of spectral amplitudes of GW momentum flux in stratosphere and mesosphere (from 30 km to 90 km) show that the annual cycle is the most predominant variation, and then are SAO, ter-annual cycle and QBO. For annual components, two relatively isolated amplitude maxima appear in each hemisphere: a subtropical maximum is associated with convective sources in summer, a mid and high latitude maximum is associated with the polar vortex in winter. In the subtropics, GWs propagate upward obliquely to the higher latitudes. The winter maximum in the southern hemisphere has larger momentum flux than that one in the northern hemisphere. While on the SH the phase (i.e. time corresponding to the maximum GWMF) continuously descends with the maximum in July in the upper mesosphere and in September in the lower stratosphere, on the northern hemisphere, the phase has no visible altitude dependence with a maximum in December. For semiannual variations, in the MLT (70-80 km) region, there is an obvious enhancement of spectral amplitude at equatorial latitudes which relate to the dissipation of convectively forced GWs. The SAO in absolute momentum flux and the annual cycle in zonal momentum flux indicated that the variations at mid-latitudes (about from 30°-40°) are not a SAO signals but rather an annual cycle when the direction of GWMF is considered. The ter-annual cycle may be related to the duration of active convection in subtropical latitudes (from June to Sep. in north hemisphere) Indications for QBO are found latitude extension to mid-latitudes in stratosphere of

The SRTR/OPTN Annual Data Report

Science.gov (United States)

... Annual Data Report The SRTR/OPTN Annual Data Report Statistics on donation and transplantation in the United ... US in 2015. The SRTR/OPTN Annual Data Report SRTR/OPTN Annual Data Report Learn more from ...

Black sea annual and inter-annual water mass variations from space

DEFF Research Database (Denmark)

Yildiz, H.; Andersen, Ole Baltazar; Simav, M.

2011-01-01

influenced by the leakage of hydrological signals from the surrounding land. After applying the corresponding correction, we found a good agreement with water mass variations derived from steric-corrected satellite altimetry observations. Both GRACE and altimetry show significant annual water mass variations......This study evaluates the performance of two widely used GRACE solutions (CNES/GRGS RL02 and CSR RL04) in deriving annual and inter-annual water mass variations in the Black Sea for the period 2003–2007. It is demonstrated that the GRACE derived water mass variations in the Black Sea are heavily...

78 FR 64912 - Annual Retail Trade Survey

Science.gov (United States)

2013-10-30

... collect data covering annual sales, annual e-commerce sales, year-end inventories held inside and outside... provides, on a comparable classification basis, annual sales, annual e-commerce sales, year-end inventories... firms selected will provide, with measurable reliability, statistics on annual sales, annual e-commerce...

Morbidity, mortality, and health care costs for patients undergoing spine surgery following the ACGME resident duty-hour reform: Clinical article.

Science.gov (United States)

Babu, Ranjith; Thomas, Steven; Hazzard, Matthew A; Lokhnygina, Yuliya V; Friedman, Allan H; Gottfried, Oren N; Isaacs, Robert E; Boakye, Maxwell; Patil, Chirag G; Bagley, Carlos A; Haglund, Michael M; Lad, Shivanand P

2014-10-01

The Accreditation Council for Graduate Medical Education (ACGME) implemented resident duty-hour restrictions on July 1, 2003, in concern for patient and resident safety. Whereas studies have shown that duty-hour restrictions have increased resident quality of life, there have been mixed results with respect to patient outcomes. In this study, the authors have evaluated the effect of duty-hour restrictions on morbidity, mortality, length of stay (LOS), and charges in patients who underwent spine surgery. The Nationwide Inpatient Sample was used to evaluate the effect of duty-hour restrictions on complications, mortality, LOS, and charges by comparing the prereform (2000-2002) and postreform (2005-2008) periods. Outcomes were compared between nonteaching and teaching hospitals using a difference-in-differences (DID) method. Results A total of 693,058 patients were included in the study. The overall complication rate was 8.6%, with patients in the postreform era having a significantly higher rate than those in the pre-duty-hour restriction era (8.7% vs. 8.4%, p duty-hour reform era. The DID analysis to compare the magnitude in change between teaching and nonteaching institutions revealed that teaching institutions to had a significantly greater increase in complications during the postreform era (p = 0.0002). The overall mortality rate was 0.37%, with no significant difference between the pre- and post-duty-hour eras (0.39% vs. 0.36%, p = 0.12). However, the mortality rate significantly decreased in nonteaching hospitals in the postreform era (0.30% vs. 0.23%, p = 0.0008), while remaining the same in teaching institutions (0.46% vs. 0.46%, p = 0.75). The DID analysis to compare the changes in mortality between groups revealed that the difference between the effects approached significance (p = 0.069). The mean LOS for all patients was 4.2 days, with hospital stay decreasing in nonteaching hospitals (3.7 vs. 3.5 days, p duty-hour reform era, increasing from $40,000 in

Inverse analysis of a rectangular fin using the lattice Boltzmann method

International Nuclear Information System (INIS)

Bamdad, Keivan; Ashorynejad, Hamid Reza

2015-01-01

Highlights: • Lattice Boltzmann method is used to study a transient conductive-convective fin. • LBM and Conjugate Gradient Method (CGM) are used to solve an inverse problem in fins. • LBM–ACGM estimates the unknown boundary conditions of fins accurately. • The accuracy and CPU time of LBM–ACGM are compared to IFDM–ACGM. • LBM–ACGM could be a good alternative for the conventional inverse methods. - Abstract: Inverse methods have many applications in determining unknown variables in heat transfer problems when direct measurements are impossible. As most common inverse methods are iterative and time consuming especially for complex geometries, developing more efficient methods seems necessary. In this paper, a direct transient conduction–convection heat transfer problem (fin) under several boundary conditions was solved by using lattice Boltzmann method (LBM), and then the results were successfully validated against both the finite difference method and analytical solution. Then, in the inverse problem both unknown base temperatures and heat fluxes in the rectangular fin were estimated by combining the adjoint conjugate gradient method (ACGM) and LBM. A close agreement between the exact values and estimated results confirmed the validity and accuracy of the ACGM–LBM. To compare the calculation time of ACGM–LBM, the inverse problem was solved by implicit finite difference methods as well. This comparison proved that the ACGM–LBM was an accurate and fast method to determine unknown thermal boundary conditions in transient conduction–convection heat transfer problems. The findings can efficiently determine the unknown variables in fins when a desired temperature distribution is available

Accreditation Council for Graduate Medical Education Core Competencies at a Community Teaching Hospital: Is There a Gap in Awareness?

Science.gov (United States)

Al-Temimi, Mohammed; Kidon, Michael; Johna, Samir

2016-01-01

Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs. Knowledge of ACGME core competencies. Fifty percent of physicians responded to the survey, and 172 (71%) of respondents were involved in teaching residents. Of physicians who taught residents and had complete responses (N = 164), 65 (39.7%) were unsure of their knowledge of the core competencies. However, most stated that they provided direct teaching to residents related to the knowledge, skills, and attitudes stated in each of the 6 competencies as follows: medical knowledge (96.3%), patient care (95.7%), professionalism (90.7%), interpersonal and communication skills (86.3%), practice-based learning (85.9%), and system-based practice (79.6%). Physician specialty, years in practice (1-10 vs > 10), and number of rotations taught per year (1-6 vs 7-12) were not associated with knowledge of the competencies (p > 0.05); however, full-time faculty (teaching 10-12 rotations per year) were more likely to provide competency-based teaching. Objective assessment of faculty awareness of ACGME core competencies is essential when starting a residency program. Discrepancy between knowledge of the competencies and acclaimed provision of competency-based teaching emphasizes the need for standardized teaching methods that incorporate the values of these competencies.

Internal medicine rounding practices and the Accreditation Council for Graduate Medical Education core competencies.

Science.gov (United States)

Shoeb, Marwa; Khanna, Raman; Fang, Margaret; Sharpe, Brad; Finn, Kathleen; Ranji, Sumant; Monash, Brad

2014-04-01

The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees' competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies. We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model. We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills. HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies. © 2014 Society of Hospital Medicine.

Osteopathic Emergency Medicine Programs Infrequently Publish in High-Impact Emergency Medicine Journals

OpenAIRE

Baskin, Sean M; Lin, Christina; Carlson, Jestin N

2014-01-01

Introduction: Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. Methods: We performed a retrospective literature re...

Anesthesiology mentoring.

Science.gov (United States)

Wenzel, Volker; Gravenstein, Nikolaus

2016-12-01

Mentoring is fundamentally valuable and important to students considering a path into our specialty, as well as to colleagues already in it and with ambition to advance. General principles and personal experiences are collected and described to help inform future mentors and to reinforce the value of having a mentor and the satisfaction (and work) that is associated with such a role. Detecting a latent talent among medical students or residents may be challenging but is worth the effort to develop personal careers and the specialty itself. Upon agreeing to jointly move a certain project, a professional plan is needed to improve chances of success and decrease the likelihood of frustration. Various challenges always have to be detected and solved, with the ultimate goal to guide a medical student to residency, subsequently into faculty status and preferably to lifelong collaboration. Access to a mentor is an often-cited key to choosing a specialty and the success of junior colleagues and thus the entire department. Mentoring is fundamentally valuable in providing role modeling and also in protecting the mentee from the inefficiency of learning lessons the hard way.

16 CFR 305.5 - Determinations of estimated annual energy consumption, estimated annual operating cost, and...

Science.gov (United States)

2010-01-01

... consumption, estimated annual operating cost, and energy efficiency rating, and of water use rate. 305.5... RULE CONCERNING DISCLOSURES REGARDING ENERGY CONSUMPTION AND WATER USE OF CERTAIN HOME APPLIANCES AND... § 305.5 Determinations of estimated annual energy consumption, estimated annual operating cost, and...

Idaho National Laboratory PCB Annual Document Log and Annual Records Report for calendar year 2014

Energy Technology Data Exchange (ETDEWEB)

Layton, Deborah L. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-06-01

The requirements for the reporting of polychlorinated biphenyl (PCB)-related activities are found in 40 Code of Federal Regulations (CFR) 761 Subpart J, "General Records and Reports." The PCB Annual Document Log is a detailed record of the PCB waste handling activities at the facility. The facility must prepare it each year by July 1 and maintain it at the facility for at least 3 years after the facility ceases using or storing PCBs and PCB items. While submittal of the PCB Annual Document Log to the U.S. Environmental Protection Agency (EPA) is not required by regulation, EPA has verbally requested in telephone conversations that this report be submitted to them on an annual basis. The Annual Records are not required to be submitted to EPA and are not considered to be part of the Annual Document Log, but are included to provide the complete disposition history or status of all PCB activities during the year. The Annual Document Log section of this report (Section 2.0) meets the requirements of 40 CFR 761.180(a)(2), as applicable, while the Annual Records section (Section 3.0) meets the requirement of 40 CFR 761.180(a)(1).

Presentation of research in anesthesia: Culmination into publication?

Directory of Open Access Journals (Sweden)

Asha Tyagi

2013-01-01

Full Text Available Background: To assess the quality of research presentations made in conferences, its success or failure to be published in a peer-reviewed journal is a well-accepted marker. However, there is no data regarding the publication of research presentations made in Indian conferences of anesthesiology. Objective: The primary objective was to determine publication rate of research presented at the largest and best attended national conference in anesthesiology, the Indian Society of Anaesthesiologists′ Conference (ISACON, and also compare it with the rate from an international conference American Society of Anesthesiologists (ASA annual meeting held in the same year. Materials and Methods: All 363 abstracts presented as poster or podium presentations at the ISACON, and an equal number of randomly selected abstracts presented at ASA annual meeting were searched on Pubmed and Google Scholar for their full-text publications in peer-reviewed journals using a standardized search strategy. As secondary observations, abstracts were assessed for completeness by noting certain components central to research methodology. Also, changes between abstract of the presentation and published paper were noted with respect to certain components. Results: The publication rate of presentations at ISACON and ASA meetings was 5% and 22%, respectively. The abstracts from ISACON lacked central components of research such as methods and statistical tests. The commonest change in the full-text publications as compared with the original abstract from both conferences was a change in authorship. Conclusion: Steps are required to augment full-text publication of Indian research, including a more rigorous peer review of abstracts submitted to ISACON to ensure their completeness.

45 CFR 1176.5 - Annual plan.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Annual plan. 1176.5 Section 1176.5 Public Welfare... ENDOWMENT FOR THE HUMANITIES PART-TIME CAREER EMPLOYMENT § 1176.5 Annual plan. (a) An agencywide plan for promoting part-time employment opportunities will be developed annually. This plan will establish annual...

The Medicare Annual Wellness Visit.

Science.gov (United States)

Colburn, Jessica L; Nothelle, Stephanie

2018-02-01

The Medicare Annual Wellness Visit is an annual preventive health benefit, which was created in 2011 as part of the Patient Protection and Affordable Care Act. The visit provides an opportunity for clinicians to review preventive health recommendations and screen for geriatric syndromes. In this article, the authors review the requirements of the Annual Wellness Visit, discuss ways to use the Annual Wellness Visit to improve the care of geriatric patients, and provide suggestions for how to incorporate this benefit into a busy clinic. Copyright © 2017 Elsevier Inc. All rights reserved.

Reading Ease of Bilingual Annual Reports.

Science.gov (United States)

Courtis, John K.; Hassan, Salleh

2002-01-01

Examines reading ease between the English and Chinese versions of 65 corporate annual reports in Hong Kong and the English and Malay versions of 53 annual reports in Malaysia. Notes that the English passages in Malaysian annual reports are easier to read than the English passages in Hong Kong annual reports. Suggests that different language…

Annual Report 1997

Energy Technology Data Exchange (ETDEWEB)

Golnik, N.; Mika, J.R.; Wieteska, K. [eds.

1998-12-31

This Annual Report of the Institute of Atomic Energy describes the results of the research works carried out at the Institute at 1997. As in the preceding years the authors of the individual scientific reports published in this Annual Report are fully responsible for their content and layout. The Report contains the information on other activities of the Institute as well. (author)

Annual Report 2001

International Nuclear Information System (INIS)

Swiboda, G.

2002-01-01

This Annual Report of the Institute of Atomic Energy describes the results of the research works carried out at the Institute at 2001. As in the preceding years the authors of the individual scientific reports published in this Annual Report are fully responsible for their content and layout. The Report contains the information on other activities of the Institute as well. (author)

Annual Report 1997

International Nuclear Information System (INIS)

Golnik, N.; Mika, J.R.; Wieteska, K.

1998-01-01

This Annual Report of the Institute of Atomic Energy describes the results of the research works carried out at the Institute at 1997. As in the preceding years the authors of the individual scientific reports published in this Annual Report are fully responsible for their content and layout. The Report contains the information on other activities of the Institute as well. (author)

Annual Report 1997

Energy Technology Data Exchange (ETDEWEB)

Golnik, N; Mika, J R; Wieteska, K [eds.

1999-12-31

This Annual Report of the Institute of Atomic Energy describes the results of the research works carried out at the Institute at 1997. As in the preceding years the authors of the individual scientific reports published in this Annual Report are fully responsible for their content and layout. The Report contains the information on other activities of the Institute as well. (author)

Annual report 1976

International Nuclear Information System (INIS)

1977-01-01

This annual report is the fifth issued in English from the Tandem Accelerator Laboratory in Uppsala since research was started in November 1970. It covers work performed during the calendar year 1976 and updates information given in earlier annual reports with regard to laboratory facilities such as computer configuration and layout of the experimental area. The descriptions of the research projects are also in general more detailed than usual and may sometime contain results obtained before 1976 in order to avoid too many references to earlier annual reports. It has, for instance, been thought of interest to make the sections on the study of beam foil excitation of atoms and on the measurements of nuclear deformations by the REPREC method quite extensive. (Auth.)

Stockholder Reactions to Corporate Annual Reports.

Science.gov (United States)

Means, Thomas Lee

A study was conducted to assess the extent to which (1) stockholders consider corporate annual reports to be informative and useful, (2) they actually read annual reports, (3) they consider annual reports to be impressive, and (4) they are motivated by the annual report to invest further in corporations in which they already own stock. After the…

CSIR Annual report 1992

CSIR Research Space (South Africa)

CSIR

1992-01-01

Full Text Available stream_source_info Annual Report_ 1992.pdf.txt stream_content_type text/plain stream_size 39 Content-Encoding ISO-8859-1 stream_name Annual Report_ 1992.pdf.txt Content-Type text/plain; charset=ISO-8859-1 ...

CSIR Annual report 1976

CSIR Research Space (South Africa)

CSIR

1976-01-01

Full Text Available stream_source_info Annual Report_1976.pdf.txt stream_content_type text/plain stream_size 75 Content-Encoding ISO-8859-1 stream_name Annual Report_1976.pdf.txt Content-Type text/plain; charset=ISO-8859-1 ...

CSIR Annual report 1978

CSIR Research Space (South Africa)

CSIR

1978-01-01

Full Text Available stream_source_info Annual Report_1978.pdf.txt stream_content_type text/plain stream_size 78 Content-Encoding ISO-8859-1 stream_name Annual Report_1978.pdf.txt Content-Type text/plain; charset=ISO-8859-1 ...

CSIR Annual report 1965

CSIR Research Space (South Africa)

CSIR

1965-01-01

Full Text Available stream_source_info Annual Report_ 1965.pdf.txt stream_content_type text/plain stream_size 48 Content-Encoding ISO-8859-1 stream_name Annual Report_ 1965.pdf.txt Content-Type text/plain; charset=ISO-8859-1 ...

CSIR Annual report 1991

CSIR Research Space (South Africa)

CSIR

1991-01-01

Full Text Available stream_source_info Annual Report_ 1991.pdf.txt stream_content_type text/plain stream_size 40 Content-Encoding ISO-8859-1 stream_name Annual Report_ 1991.pdf.txt Content-Type text/plain; charset=ISO-8859-1 ...

CSIR Annual report 1979

CSIR Research Space (South Africa)

CSIR

1979-01-01

Full Text Available stream_source_info CSIR Annual report_1979.pdf.txt stream_content_type text/plain stream_size 86 Content-Encoding ISO-8859-1 stream_name CSIR Annual report_1979.pdf.txt Content-Type text/plain; charset=ISO-8859-1 ...

Annual report to Congress

International Nuclear Information System (INIS)

1987-01-01

This is the ninth Annual Report to Congress of the United States Department of Energy. It covers the activities of all elements of the Department except the independent Federal Regulatory Commission, which issues its own annual report. 88 refs., 43 tabs

Effect of Process Changes in Surgical Training on Quantitative Outcomes From Surgery Residency Programs.

Science.gov (United States)

Dietl, Charles A; Russell, John C

2016-01-01

The purpose of this article is to review the literature on process changes in surgical training programs and to evaluate their effect on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies, American Board of Surgery In-Training Examination (ABSITE) scores, and American Board of Surgery (ABS) certification. A literature search was obtained from MEDLINE via PubMed.gov, ScienceDirect.com, Google Scholar on all peer-reviewed studies published since 2003 using the following search queries: surgery residency training, surgical education, competency-based surgical education, ACGME core competencies, ABSITE scores, and ABS pass rate. Our initial search list included 990 articles on surgery residency training models, 539 on competency-based surgical education, 78 on ABSITE scores, and 33 on ABS pass rate. Overall, 31 articles met inclusion criteria based on their effect on ACGME Core Competencies, ABSITE scores, and ABS certification. Systematic review showed that 5/31, 19/31, and 6/31 articles on process changes in surgical training programs had a positive effect on patient care, medical knowledge, and ABSITE scores, respectively. ABS certification was not analyzed. The other ACGME core competencies were addressed in only 6 studies. Several publications on process changes in surgical training programs have shown a positive effect on patient care, medical knowledge, and ABSITE scores. However, the effect on ABS certification, and other quantitative outcomes from residency programs, have not been addressed. Studies on education strategies showing evidence that residency program objectives are being achieved are still needed. This article addresses the 6 ACGME Core Competencies. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Idaho National Laboratory PCB Annual Document Log and Annual Records Report for Calendar Year 2013

Energy Technology Data Exchange (ETDEWEB)

no name on report

2014-06-01

The requirements for the reporting of polychlorinated biphenyl (PCB)-related activities are found in 40 Code of Federal Regulations (CFR) 761 Subpart J, "General Records and Reports." The PCB Annual Document Log is a detailed record of the PCB waste handling activities at the facility. The facility must prepare it each year by July 1 and maintain it at the facility for at least 3 years after the facility ceases using or storing PCBs and PCB items. While submittal of the PCB Annual Document Log to the U.S. Environmental Protection Agency (EPA) is not required by regulation, EPA has verbally requested in telephone conversations that this report be submitted to them on an annual basis. The Annual Document Log section of this report meets the requirements of 40 CFR 761.180(a)(2), as applicable, while the Annual Records section meets the requirement of 40 CFR 761.180(a)(1).

Natural gas annual 1991

International Nuclear Information System (INIS)

1993-01-01

The Natural Gas Annual 1991 provides information on the supply and disposition of natural gas to a wide audience including industry, consumers Federal and State agencies, and education institutions. This report, the Natural Gas Annual 1991 Supplement: Company Profiles, presents a detailed profile of selected companies

Soil respiration at mean annual temperature predicts annual total across vegetation types and biomes

Directory of Open Access Journals (Sweden)

M. Bahn

2010-07-01

Full Text Available Soil respiration (SR constitutes the largest flux of CO₂ from terrestrial ecosystems to the atmosphere. However, there still exist considerable uncertainties as to its actual magnitude, as well as its spatial and interannual variability. Based on a reanalysis and synthesis of 80 site-years for 57 forests, plantations, savannas, shrublands and grasslands from boreal to tropical climates we present evidence that total annual SR is closely related to SR at mean annual soil temperature (SR_MAT, irrespective of the type of ecosystem and biome. This is theoretically expected for non water-limited ecosystems within most of the globally occurring range of annual temperature variability and sensitivity (Q₁₀. We further show that for seasonally dry sites where annual precipitation (P is lower than potential evapotranspiration (PET, annual SR can be predicted from wet season SR_MAT corrected for a factor related to P/PET. Our finding indicates that it can be sufficient to measure SR_MAT for obtaining a well constrained estimate of its annual total. This should substantially increase our capacity for assessing the spatial distribution of soil CO₂ emissions across ecosystems, landscapes and regions, and thereby contribute to improving the spatial resolution of a major component of the global carbon cycle.

77 FR 64463 - Annual Retail Trade Survey

Science.gov (United States)

2012-10-22

... covering annual sales, annual e- commerce sales, year-end inventories held inside and outside the United... industries, merchandise line sales, and percent of e-commerce sales to customers located outside the United... comparable classification basis, annual sales, annual e-commerce sales, purchases, total and detailed...

Annual Partnership Report, 2016

Science.gov (United States)

Wyoming Community College Commission, 2016

2016-01-01

The "Annual Partnership Report" catalogs partnerships that Wyoming community colleges established and maintained for each fiscal year. This partnership report fulfills statutory reporting requirement W.S. 21-18-202(e)(iv) which mandates the development of annual reports to the legislature on the outcomes of partnerships between colleges…

76 FR 69239 - Annual Retail Trade Survey

Science.gov (United States)

2011-11-08

... collect data covering annual sales, annual e-commerce sales, year-end inventories held inside and outside... industries, merchandise line sales, and percent of e-commerce sales to customers located outside the United... (NAICS). ARTS provides, on a comparable classification basis, annual sales, annual e-commerce sales...

Conference summaries. Canadian Nuclear Association 29. annual conference; Canadian Nuclear Society 10. annual conference

Energy Technology Data Exchange (ETDEWEB)

NONE

1990-12-31

Separate abstracts were prepared for 15 papers from the twenty-ninth Annual Conference of the Canadian Nuclear Association. Abstracts were also prepared for the 102 papers from the tenth Annual Conference of the Canadian Nuclear Society.

Conference summaries. Canadian Nuclear Association 29. annual conference; Canadian Nuclear Society 10. annual conference

International Nuclear Information System (INIS)

1989-01-01

Separate abstracts were prepared for 15 papers from the twenty-ninth Annual Conference of the Canadian Nuclear Association. Abstracts were also prepared for the 102 papers from the tenth Annual Conference of the Canadian Nuclear Society

Annual and inter-annual variations of 6.5-day-planetary-waves in MLT observed by TIMED/SABER

Science.gov (United States)

Huang, Yingying; Li, Huijun; Li, Chongyin; Zhang, Shaodong

2017-04-01

Annual and inter-annual variations of 6.5DWs in 20-110 km, 52°S-52°N, 2002-2016 are studied by using v2.0 TIMED/SABER kinetic temperature data. Firstly, global annual variations of 6.5DW's spectral power and amplitudes are obtained. Strong wave amplitudes emerge in 30°S/N-50°S/N, and peaks in altitude separate in stratosphere (40-50 km), mesosphere (80-90 km) and the lower thermosphere (100-110 km), respectively. Their annual variations are similar in both hemispheres, but different in altitude. In 40-50 km, the annual maximums emerge mostly in winters: Dec.-Jan. in the NH and Jul.-Aug. in the SH. In MLT, annual peaks arise twice in each half of year. In 80-90 km, they're mainly in equinoctial seasons and winters: May, Aug.-Sep. and Jan. in the NH and Feb., Nov. and May in the SH. In 100-110 km, they emerge mainly in equinoctial seasons: Apr.-May and Aug.-Sep. in the NH and Feb.-Mar. and Oct.-Nov. in the SH. Then, inter-annual variations of 6.5DW amplitudes during the 14-year period are studied. Frequency spectra of monthly-mean amplitudes show that, main dynamics in long-term variations of 6.5DWs are AO and SAO in both hemispheres. Besides, QBO are visible in both hemispheres and 4-month period signals are noticed in the NH in MLT. Amplitudes of SAO, AO and QBO are obtained by bandpass filter. Their amplitudes are comparable in stratosphere and mesosphere, and QBO signals are weaker than the others in the LT. Vertical variations both of SAO and AO amplitudes are very stable. AO structures have little inter-annual changes, while inter-annual variations of SAO are significant and are related with 6.5DW. It means that annual and inter-annual variations of 6.5DW are mainly controlled by AO and SAO, respectively. Although QBO signals are weaker and their variations are less regular than AO and SAO, their phases seems to relate with inter-annual variations of 6.5DW as well.

77 FR 16484 - Annual Stress Test

Science.gov (United States)

2012-03-21

...-2011-0029] RIN 1557-AD58 Annual Stress Test AGENCY: Office of the Comptroller of the Currency, Treasury... billion to conduct an annual stress test and comply with certain reporting and disclosure requirements. To... conduct annual stress tests pursuant to regulations prescribed by their respective Federal primary...

28 CFR 16.208 - Annual report.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Annual report. 16.208 Section 16.208 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Public Observation of Parole Commission Meetings § 16.208 Annual report. The Commission shall report annually to...

77 FR 61238 - Annual Stress Test

Science.gov (United States)

2012-10-09

...-2011-0029] RIN 1557-AD58 Annual Stress Test AGENCY: Office of the Comptroller of the Currency (``OCC... conduct annual stress tests pursuant to regulations prescribed by their respective primary financial... annual stress test as prescribed by this rule. Under the final rule covered institutions are divided into...

77 FR 3408 - Annual Stress Test

Science.gov (United States)

2012-01-24

...-2011-0029] RIN 1557-AD58 Annual Stress Test AGENCY: Office of the Comptroller of the Currency (``OCC... certain companies to conduct annual stress tests pursuant to regulations prescribed by their respective... stress test as prescribed by this proposed rule. In addition to the annual stress test requirement, such...

Annual radiation dose in thermoluminescence dating

International Nuclear Information System (INIS)

Li Huhou

1988-01-01

The annual radiation dose in thermoluminescence dating has been discussed. The autor gives an entirely new concept of the enviromental radiation in the thermoluminescence dating. Methods of annual dose detemination used by author are dating. Methods of annual dose determination used by author are summed up, and the results of different methods are compared. The emanium escapiug of three radioactive decay serieses in nature has been considered, and several determination methods are described. The contribution of cosmic rays for the annual radiation dose has been mentioned

Annual radiation dose in thermoluminescence dating

Energy Technology Data Exchange (ETDEWEB)

Huhou, Li [Chinese Academy of Social Sciences, Beijing, BJ (China). Inst. of Archaeology

1988-11-01

The annual radiation dose in thermoluminescence dating has been discussed. The autor gives an entirely new concept of the enviromental radiation in the thermoluminescence dating. Methods of annual dose detemination used by author are dating. Methods of annual dose determination used by author are summed up, and the results of different methods are compared. The emanium escapiug of three radioactive decay serieses in nature has been considered, and several determination methods are described. The contribution of cosmic rays for the annual radiation dose has been mentioned.

Annual report 2003

International Nuclear Information System (INIS)

2003-01-01

Delivering products and services to nuclear power plants operators, AREVA operates in every sector of the civilian nuclear power and fuel cycle industry. This annual report 2003 provides, in seven chapters, information on persons responsible for the annual report and for auditing the financial statements, general information on the company and share capital (statute, capital, share trading, dividends), information on company operations, changes and future prospects, assets, financial position and financial performance, corporate governance, recent developments and future prospects. (A.L.B.)

U.S. Annual Climatological Summaries

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Annual Climatological Summary contains historical monthly and annual summaries for over 8000 U.S. locations. Observing stations are located in the United States of...

Simulation in teaching regional anesthesia: current perspectives

Directory of Open Access Journals (Sweden)

Udani AD

2015-08-01

Full Text Available Ankeet D Udani,1 T Edward Kim,2,3 Steven K Howard,2,3 Edward R Mariano2,3On behalf of the ADAPT (Anesthesiology-Directed Advanced Procedural Training Research Group1Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA; 2Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; 3Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USAAbstract: The emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine. To date, there have been a wide variety of simulation applications in this field, and efficacy has largely been assumed. However, a thorough review of the literature reveals that effective teaching strategies, including simulation, in regional anesthesiology and acute pain medicine are not established completely yet. Future research should be directed toward comparative-effectiveness of simulation versus other accepted teaching methods, exploring the combination of procedural training with realistic clinical scenarios, and the application of simulation-based teaching curricula to a wider range of learner, from the student to the practicing physician.Keywords: regional anesthesia, simulation, medical education, ultrasound, nerve block, simulator

Annual Percentage Rate and Annual Effective Rate: Resolving Confusion in Intermediate Accounting Textbooks

Science.gov (United States)

Vicknair, David; Wright, Jeffrey

2015-01-01

Evidence of confusion in intermediate accounting textbooks regarding the annual percentage rate (APR) and annual effective rate (AER) is presented. The APR and AER are briefly discussed in the context of a note payable and correct formulas for computing each is provided. Representative examples of the types of confusion that we found is presented…

Ethnic and Gender Diversity in Radiology Fellowships.

Science.gov (United States)

West, Derek L; Nguyen, HaiThuy

2017-06-01

The purpose of the study is to assess ethnic and gender diversity in US radiology fellowship programs from 2006 to 2013. Data for this study was obtained from Journal of the American Medical Association supplements publications from 2005 to 2006 to 2012-2013 (Gonzalez-Moreno, Innov Manag Policy Pract. 15(2):149, 2013; Nivet, Acad Med. 86(12):1487-9, 2011; Reede, Health Aff. 22(4):91-3, 2003; Chapman et al., Radiology 270(1):232-40, 2014; Getto, 2005; Rivo and Satcher, JAMA 270(9):1074-8, 1993; Schwartz et al., Otolaryngol Head Neck Surg. 149(1):71-6, 2013; Simon, Clin Orthop Relat Res. 360:253-9, 1999) and the US census 2010. For each year, Fisher's exact test was used to compare the percentage of women and under-represented minorities in each Accreditation Council for Graduate Medical Education (ACGME)-certified radiology fellowship to the percentage of women and under-represented minorities in (1) all ACGME-certified radiology fellowships combined, (2) radiology residents, (3) ACGME-certified fellows in all of medicine combined, (4) ACGME-certified residents in all of medicine combined, and (5) graduating medical students. Chi-Squared test was used to compare the percentage of women and under-represented minorities and the 2010 US census. p gender and ethnic disparities. Outreach efforts, pipeline programs, and mentoring may be helpful in addressing this issue.

29 CFR 1904.32 - Annual summary.

Science.gov (United States)

2010-07-01

... 29 Labor 5 2010-07-01 2010-07-01 false Annual summary. 1904.32 Section 1904.32 Labor Regulations... Requirements § 1904.32 Annual summary. (a) Basic requirement. At the end of each calendar year, you must: (1... deficiencies identified; (2) Create an annual summary of injuries and illnesses recorded on the OSHA 300 Log...

Annual Energy Review, 2008

Energy Technology Data Exchange (ETDEWEB)

None

2009-06-01

The Annual Energy Review (AER) is the Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are statistics on total energy production, consumption, trade, and energy prices; overviews of petroleum, natural gas, coal, electricity, nuclear energy, renewable energy, and international energy; financial and environment indicators; and data unit conversions.

2017 Annual Disability Statistics Supplement

Science.gov (United States)

Lauer, E. A; Houtenville, A. J.

2018-01-01

The "Annual Disability Statistics Supplement" is a companion report to the "Annual Disability Statistics Compendium." The "Supplement" presents statistics on the same topics as the "Compendium," with additional categorizations by demographic characteristics including age, gender and race/ethnicity. In…

CSIR Annual report 1948-49

CSIR Research Space (South Africa)

CSIR

1949-01-01

Full Text Available stream_source_info Annual Report_1948-1949.pdf.txt stream_content_type text/plain stream_size 92 Content-Encoding ISO-8859-1 stream_name Annual Report_1948-1949.pdf.txt Content-Type text/plain; charset=ISO-8859-1 ...

CSIR Annual report 1954-55

CSIR Research Space (South Africa)

CSIR

1955-01-01

Full Text Available stream_source_info Annual Report_1954-55.pdf.txt stream_content_type text/plain stream_size 206 Content-Encoding ISO-8859-1 stream_name Annual Report_1954-55.pdf.txt Content-Type text/plain; charset=ISO-8859-1 ...

The impact of inter-annual variability of annual cycle on long-term persistence of surface air temperature in long historical records

Science.gov (United States)

Deng, Qimin; Nian, Da; Fu, Zuntao

2018-02-01

Previous studies in the literature show that the annual cycle of surface air temperature (SAT) is changing in both amplitude and phase, and the SAT departures from the annual cycle are long-term correlated. However, the classical definition of temperature anomalies is based on the assumption that the annual cycle is constant, which contradicts the fact of changing annual cycle. How to quantify the impact of the changing annual cycle on the long-term correlation of temperature anomaly variability still remains open. In this paper, a recently developed data adaptive analysis tool, the nonlinear mode decomposition (NMD), is used to extract and remove time-varying annual cycle to reach the new defined temperature anomalies in which time-dependent amplitude of annual cycle has been considered. By means of detrended fluctuation analysis, the impact induced by inter-annual variability from the time-dependent amplitude of annual cycle has been quantified on the estimation of long-term correlation of long historical temperature anomalies in Europe. The results show that the classical climatology annual cycle is supposed to lack inter-annual fluctuation which will lead to a maximum artificial deviation centering around 600 days. This maximum artificial deviation is crucial to defining the scaling range and estimating the long-term persistence exponent accurately. Selecting different scaling range could lead to an overestimation or underestimation of the long-term persistence exponent. By using NMD method to extract the inter-annual fluctuations of annual cycle, this artificial crossover can be weakened to extend a wider scaling range with fewer uncertainties.

Achieving Accreditation Council for Graduate Medical Education duty hours compliance within advanced surgical training: a simulation-based feasibility assessment.

Science.gov (United States)

Obi, Andrea; Chung, Jennifer; Chen, Ryan; Lin, Wandi; Sun, Siyuan; Pozehl, William; Cohn, Amy M; Daskin, Mark S; Seagull, F Jacob; Reddy, Rishindra M

2015-11-01

Certain operative cases occur unpredictably and/or have long operative times, creating a conflict between Accreditation Council for Graduate Medical Education (ACGME) rules and adequate training experience. A ProModel-based simulation was developed based on historical data. Probabilistic distributions of operative time calculated and combined with an ACGME compliant call schedule. For the advanced surgical cases modeled (cardiothoracic transplants), 80-hour violations were 6.07% and the minimum number of days off was violated 22.50%. There was a 36% chance of failure to fulfill any (either heart or lung) minimum case requirement despite adequate volume. The variable nature of emergency cases inevitably leads to work hour violations under ACGME regulations. Unpredictable cases mandate higher operative volume to ensure achievement of adequate caseloads. Publically available simulation technology provides a valuable avenue to identify adequacy of case volumes for trainees in both the elective and emergency setting. Copyright © 2015 Elsevier Inc. All rights reserved.

New common program requirements for the resident physician workforce and the omission of strategic napping: A missed opportunity.

Science.gov (United States)

Shnayder, Michelle M; St Onge, Joan E; Caban-Martinez, Alberto J

2017-09-01

Napping has known benefits for fatigue mitigation and improved alertness. However the Accreditation Council for Graduate Medical Education (ACGME) New Common Program Requirements recently removed the 16 h work limit for PGY1 residents and removed any suggestions of napping. We utilized a cross-sectional study design to administer a 44-item questionnaire in June 2016 to 858 residents and fellows at one large urban academic medical center. We assessed: 1) resident physician sentiment of work environment supportiveness for napping at work; and 2) agreement with 2011 ACGME guidelines on workweek hour limitations and strategic napping recommendations. While 89% of residents reported access to an on-call room at work, only 20% felt their work environment supported a culture of napping while at work. Over 76% expressed agreement with the 2011 ACGME work-hour restrictions. Strategies to support napping and well-being within the resident physician workforce and organizational setting are warranted. © 2017 Wiley Periodicals, Inc.

Advancing Simulation-Based Education in Pain Medicine.

Science.gov (United States)

Singh, Naileshni; Nielsen, Alison A; Copenhaver, David J; Sheth, Samir J; Li, Chin-Shang; Fishman, Scott M

2018-02-27

The Accreditation Council for Graduate Medical Education (ACGME) has recently implemented milestones and competencies as a framework for training fellows in Pain Medicine, but individual programs are left to create educational platforms and assessment tools that meet ACGME standards. In this article, we discuss the concept of milestone-based competencies and the inherent challenges for implementation in pain medicine. We consider simulation-based education (SBE) as a potential tool for the field to meet ACGME goals through advancing novel learning opportunities, engaging in clinically relevant scenarios, and mastering technical and nontechnical skills. The sparse literature on SBE in pain medicine is highlighted, and we describe our pilot experience, which exemplifies a nascent effort that encountered early difficulties in implementing and refining an SBE program. The many complexities in offering a sophisticated simulated pain curriculum that is valid, reliable, feasible, and acceptable to learners and teachers may only be overcome with coordinated and collaborative efforts among pain medicine training programs and governing institutions.

Annual Growth Bands in Hymenaea courbaril

Energy Technology Data Exchange (ETDEWEB)

Westbrook, J A; Guilderson, T P; Colinvaux, P A

2004-02-09

One significant source of annual temperature and precipitation data arises from the regular annual secondary growth rings of trees. Several tropical tree species are observed to form regular growth bands that may or may not form annually. Such growth was observed in one stem disk of the tropical legume Hymenaea courbaril near the area of David, Panama. In comparison to annual reference {Delta}{sup 14}C values from wood and air, the {Delta}{sup 14}C values from the secondary growth rings formed by H. courbaril were determined to be annual in nature in this one stem disk specimen. During this study, H. courbaril was also observed to translocate recently produced photosynthate into older growth rings as sapwood is converted to heartwood. This process alters the overall {Delta}{sup 14}C values of these transitional growth rings as cellulose with a higher {Delta}{sup 14}C content is translocated into growth rings with a relatively lower {Delta}{sup 14}C content. Once the annual nature of these growth rings is established, further stable isotope analyses on H. courbaril material in other studies may help to complete gaps in the understanding of short and of long term global climate patterns.

2017 Annual Disability Statistics Compendium

Science.gov (United States)

Lauer, E. A.; Houtenville, A. J.

2018-01-01

The "Annual Disability Statistics Compendium" and its compliment, the "Annual Disability Statistics Supplement," are publications of statistics about people with disabilities and about the government programs which serve them. The "Compendium" and "Supplement" are designed to serve as a summary of government…

Recommended integrative medicine competencies for family medicine residents.

Science.gov (United States)

Locke, Amy B; Gordon, Andrea; Guerrera, Mary P; Gardiner, Paula; Lebensohn, Patricia

2013-01-01

The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care. © 2013 Elsevier Inc. All rights reserved.

Preparing Future Leaders: An Integrated Quality Improvement Residency Curriculum.

Science.gov (United States)

Potts, Stacy; Shields, Sara; Upshur, Carole

2016-06-01

The Accreditation Council for Graduate Medical Education (ACGME) has recognized the importance of quality improvement (QI) training and requires that accredited residencies in all specialties demonstrate that residents are "integrated and actively participate in interdisciplinary clinical quality improvement and patient safety activities." However, competing demands in residency training may make this difficult to accomplish. The study's objective is to develop and evaluate a longitudinal curriculum that meets the ACGME requirement for QI and patient safety training and links to patient-centered medical home (PCMH) practices. Residents in the Worcester Family Medicine Residency (WFMR) participated in a faculty-developed quality improvement curriculum that included web-based tutorials, quality improvement projects, and small-group sessions across all 3 years of residency. They completed self-evaluations of knowledge and use of curricular activities annually and at graduation, and comparisons were made between two graduating classes, as well as comparison of end of PGY2 to end of PGY3 for one class. Graduating residents who completed the full 3 years of the curriculum rated themselves as significantly more skilled in nine of 15 areas assessed at end of residency compared to after PGY2 and reported confidence in providing future leadership in a focus group. Five areas were also rated significantly higher than prior-year residents. Involving family medicine residents in a longitudinal curriculum with hands-on practice in implementing QI, patient safety, and chronic illness management activities that are inclusive of PCMH goals increased their self-perceived skills and leadership ability to implement these new and emerging evidence-based practices in primary care.

Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey.

Science.gov (United States)

Goren, Eric N; Leizman, Debra S; La Rochelle, Jeffrey; Kogan, Jennifer R

2015-09-01

Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not been described. We aimed to determine the current status of medical students' overnight experiences in Internal Medicine clerkships and sub-internships, and to assess internal medicine educators' perceptions of the importance of overnight work during internal medicine rotations. In May 2014, the Clerkship Directors in Internal Medicine (CDIM) conducted its annual survey. Twenty-eight questions about student participation in overnight work and perceptions of the importance of overnight work (rated on 1-5 Likert scale, 1 = very unimportant and 5 =  ery important) were included. Descriptive statistics were used to summarize responses. Free text results were analyzed qualitatively. The response rate was 78 %. A minority of respondents reported students having any overnight experience during the clerkship (38.7 %) or the sub-internship (40.7 %). Only 5 % of respondents reported having students assigned to night-float rotations outside of clerkships or sub-internships. Respondents agreed that overnight experiences were more important during the sub-internship than the clerkship, 4.0 ± 1.1 vs. 3.2 ± 1.2, p intern in particular was an important chance to practice providing emergency cross coverage and other intern roles. In the era of ACGME duty hours, there is a need to further examine whether there is a role for increased overnight hospital experiences for medical students.

Evaluating Coding Accuracy in General Surgery Residents' Accreditation Council for Graduate Medical Education Procedural Case Logs.

Science.gov (United States)

Balla, Fadi; Garwe, Tabitha; Motghare, Prasenjeet; Stamile, Tessa; Kim, Jennifer; Mahnken, Heidi; Lees, Jason

The Accreditation Council for Graduate Medical Education (ACGME) case log captures resident operative experience based on Current Procedural Terminology (CPT) codes and is used to track operative experience during residency. With increasing emphasis on resident operative experiences, coding is more important than ever. It has been shown in other surgical specialties at similar institutions that the residents' ACGME case log may not accurately reflect their operative experience. What barriers may influence this remains unclear. As the only objective measure of resident operative experience, an accurate case log is paramount in representing one's operative experience. This study aims to determine the accuracy of procedural coding by general surgical residents at a single institution. Data were collected from 2 consecutive graduating classes of surgical residents' ACGME case logs from 2008 to 2014. A total of 5799 entries from 7 residents were collected. The CPT codes entered by residents were compared to departmental billing records submitted by the attending surgeon for each procedure. Assigned CPT codes by institutional American Academy of Professional Coders certified abstract coders were considered the "gold standard." A total of 4356 (75.12%) of 5799 entries were identified in billing records. Excel 2010 and SAS 9.3 were used for analysis. In the event of multiple codes for the same patient, any match between resident codes and billing record codes was considered a "correct" entry. A 4-question survey was distributed to all current general surgical residents at our institution for feedback on coding habits, limitations to accurate coding, and opinions on ACGME case log representation of their operative experience. All 7 residents had a low percentage of correctly entered CPT codes. The overall accuracy proportion for all residents was 52.82% (range: 43.32%-60.07%). Only 1 resident showed significant improvement in accuracy during his/her training (p = 0

Importância do treinamento de residentes em eventos adversos durante anestesia: experiência com o uso do simulador computadorizado Importancia del entrenamiento de los practicantes (médicos en ejercicio en eventos adversos durante la anestesia: experiencia con el uso del simulador computadorizado Importance of critical events training for anesthesiology residents: experience with computer simulator

Directory of Open Access Journals (Sweden)

Domingos Dias Cicarelli

2005-04-01

durante los procedimientos anestésicos. Sin embargo, continua importante el entrenamiento de los médicos practicantes para este tipo de ocurrencia. El objetivo de este estudio fue evaluar el desempeño práctico de los médicos practicantes de Anestesiología en eventos adversos durante una anestesia simulada. MÉTODO: Fueron evaluados 17 médicos en especialización de primero y segundo años de Anestesiología (ME1 y ME2 y 5 instructores del Centro de Enseñanza y Entrenamiento (CEE del HCFMUSP (Título Superior en Anestesiología - TSA. Fue utilizado el simulador computadorizado Anesthesia Simulator Consultant (ASC versión 2.0 - 1995/Anesoft para realización de las simulaciones de los eventos. Los incidentes críticos escogidos fueron fibrilación ventricular (FV y choque anafiláctico. Después de la realización de la simulación, fueron impresos los resultados de cada participante, evaluados y puntuados las conductas adoptadas para resolver los incidentes críticos pre-determinados. Los participantes evaluaron el simulador a través de un cuestionario para ser respondido. RESULTADOS: No hubo diferencia estadística entre las medias obtenidas por los grupos, sin embargo, se notó una tendencia de un desempeño mejor de los grupos TSA y ME2 en la simulación de FV. En relación al choque anafiláctico, hubo una tendencia de desempeño mejor del grupo TSA. CONCLUSIONES: El entrenamiento para el diagnóstico y conductas en eventos adversos debe ser un foco de atención durante el entrenamiento de médicos practicantes y en la actualización de anestesiologistas. El uso del simulador puede ser una de las formas de realizar el entrenamiento en estas situaciones.BACKGROUND AND OBJECTIVES: Because of monitoring and drugs evolution, there has been a decrease in the incidence of critical events during anesthetic procedures. Despite this low frequency, critical event training for Anesthesiology residents remains important. This study aimed at evaluating Anesthesiology

NERSC 2001 Annual Report; ANNUAL

International Nuclear Information System (INIS)

Hules, John

2001-01-01

The National Energy Research Scientific Computing Center (NERSC) is the primary computational resource for scientific research funded by the DOE Office of Science. The Annual Report for FY2001 includes a summary of recent computational science conducted on NERSC systems (with abstracts of significant and representative projects); information about NERSC's current systems and services; descriptions of Berkeley Lab's current research and development projects in applied mathematics, computer science, and computational science; and a brief summary of NERSC's Strategic Plan for 2002-2005

76 FR 64894 - Annual Wholesale Trade Survey

Science.gov (United States)

2011-10-19

... covering annual sales, e-commerce sales, year-end inventories held inside and outside the United States and... on annual sales, e-commerce sales, purchases, total operating expenses, year-end inventories held... DEPARTMENT OF COMMERCE Bureau of the Census [Docket Number 111007614-1611-01] Annual Wholesale...

Annual nitrate drawdown observed by SOCCOM profiling floats and the relationship to annual net community production

Science.gov (United States)

Johnson, Kenneth S.; Plant, Joshua N.; Dunne, John P.; Talley, Lynne D.; Sarmiento, Jorge L.

2017-08-01

Annual nitrate cycles have been measured throughout the pelagic waters of the Southern Ocean, including regions with seasonal ice cover and southern hemisphere subtropical zones. Vertically resolved nitrate measurements were made using in situ ultraviolet spectrophotometer (ISUS) and submersible ultraviolet nitrate analyzer (SUNA) optical nitrate sensors deployed on profiling floats. Thirty-one floats returned 40 complete annual cycles. The mean nitrate profile from the month with the highest winter nitrate minus the mean profile from the month with the lowest nitrate yields the annual nitrate drawdown. This quantity was integrated to 200 m depth and converted to carbon using the Redfield ratio to estimate annual net community production (ANCP) throughout the Southern Ocean south of 30°S. A well-defined, zonal mean distribution is found with highest values (3-4 mol C m-2 yr-1) from 40 to 50°S. Lowest values are found in the subtropics and in the seasonal ice zone. The area weighted mean was 2.9 mol C m-2 yr-1 for all regions south of 40°S. Cumulative ANCP south of 50°S is 1.3 Pg C yr-1. This represents about 13% of global ANCP in about 14% of the global ocean area.Plain Language SummaryThis manuscript reports on 40 annual cycles of nitrate observed by chemical sensors on SOCCOM profiling floats. The annual drawdown in nitrate concentration by phytoplankton is used to assess the spatial variability of annual net community production in the Southern Ocean. This ANCP is a key component of the global carbon cycle and it exerts an important control on atmospheric carbon dioxide. We show that the results are consistent with our prior understanding of Southern Ocean ANCP, which has required decades of observations to accumulate. The profiling floats now enable annual resolution of this key process. The results also highlight spatial variability in ANCP in the Southern Ocean.

Petroleum supply annual 1992

International Nuclear Information System (INIS)

1993-01-01

The Petroleum Supply Annual (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1992 through annual and monthly surveys. The PSA is divided into two volumes. The first volume contains four sections: Summary Statistics, Detailed Statistics, Refinery Capacity, and Oxygenate Capacity each with final annual data. This second volume contains final statistics for each month of 1992, and replaces data previously published in the Petroleum Supply Monthly (PSM). The tables in Volumes 1 and 2 are similarly numbered to facilitate comparison between them. Explanatory Notes, located at the end of this publication, present information describing data collection, sources, estimation methodology, data quality control procedures, modifications to reporting requirements and interpretation of tables. Industry terminology and product definitions are listed alphabetically in the Glossary

47 CFR 73.3612 - Annual employment report.

Science.gov (United States)

2010-10-01

... gender, race and ethnicity of a broadcast station's workforce collected in the annual employment report... 47 Telecommunication 4 2010-10-01 2010-10-01 false Annual employment report. 73.3612 Section 73... BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.3612 Annual employment report. Each...

75 FR 63804 - Annual Retail Trade Survey

Science.gov (United States)

2010-10-18

... collect data covering annual sales, annual e-commerce sales, year-end inventories held inside and outside... industries, merchandise line sales, percent of sales by class of customer, and percent of e-commerce sales to..., annual e-commerce sales, purchases, total operating expenses, accounts receivables, and year-end...

50 CFR 300.62 - Annual management measures.

Science.gov (United States)

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Annual management measures. 300.62 Section... REGULATIONS Pacific Halibut Fisheries § 300.62 Annual management measures. Annual management measures may be... of unloading and weighing, and sport fishing for halibut. The Assistant Administrator will publish...

47 CFR 76.1802 - Annual employment report.

Science.gov (United States)

2010-10-01

... gender, race and ethnicity of an employment unit's workforce collected in the annual employment report... 47 Telecommunication 4 2010-10-01 2010-10-01 false Annual employment report. 76.1802 Section 76... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Reports and Filings § 76.1802 Annual employment report. Each...

47 CFR 1.785 - Annual financial reports.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Annual financial reports. 1.785 Section 1.785..., and Reports Involving Common Carriers Financial and Accounting Reports and Requests § 1.785 Annual financial reports. (a) An annual financial report shall be filed by telephone carriers and affiliates as...

5 CFR 870.204 - Annual rates of pay.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Annual rates of pay. 870.204 Section 870... rates of pay. (a) (1) An insured employee's annual pay is his/her annual rate of basic pay as fixed by law or regulation. (2) Annual pay for this purpose includes the following: (i) Interim geographic...

The research rotation: competency-based structured and novel approach to research training of internal medicine residents

Directory of Open Access Journals (Sweden)

Dimitrov Vihren

2006-10-01

Full Text Available Abstract Background In the United States, the Accreditation Council of graduate medical education (ACGME requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

Annual report June 1988

International Nuclear Information System (INIS)

1988-01-01

This annual report reviews the activities of the National Accelerator Centre until June 1988. The 200 MeV cyclotron facility, the Pretoria cyclotron facility and the Van De Graaff facility are discussed in detail. Aspects of the 200 MeV cyclotron facility examined are, inter alia: the injector cyclotrons, the separated-sector cyclotron, the control system, the beam transport system and radioisotope production. Separate abstracts were prepared for the various subdivisions contained in this annual report

Natural gas annual 1991

International Nuclear Information System (INIS)

1992-01-01

The Natural Gas Annual provides information on the supply and disposition of natural gas to a wide audience including industry, consumers, Federal and State agencies, and educational institutions. The 1991 data are presented in a sequence that follows natural gas (including supplemental supplies) from its production to its end use. Tables summarizing natural gas supply and disposition form 1987 to 1991 are given for each Census Division and each State. Annual historical data are shown at the national level

Natural gas annual 1993

International Nuclear Information System (INIS)

1994-01-01

The Natural Gas Annual provides information on the supply and disposition of natural gas to a wide audience including industry, consumers, Federal and State agencies, and educational institutions. The 1993 data are presented in a sequence that follows natural gas (including supplemental supplies) from its production to its end use. Tables summarizing natural gas supply and disposition from 1989 to 1993 are given for each Census Division and each State. Annual historical data are shown at the national level

29 CFR 403.2 - Annual financial report.

Science.gov (United States)

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Annual financial report. 403.2 Section 403.2 Labor... STANDARDS LABOR ORGANIZATION ANNUAL FINANCIAL REPORTS § 403.2 Annual financial report. (a) Every labor... Standards within 90 days after the end of each of its fiscal years, a financial report signed by its...

29 CFR 408.5 - Annual financial report.

Science.gov (United States)

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Annual financial report. 408.5 Section 408.5 Labor... STANDARDS LABOR ORGANIZATION TRUSTEESHIP REPORTS § 408.5 Annual financial report. During the continuance of... organization the annual financial report and any Form T-1 reports required by part 403 of this chapter, signed...

A serendipidade na medicina e na anestesiologia A serendipidade en la medicina y en la anestesiologia Serendipity in medicine and anesthesiology

Directory of Open Access Journals (Sweden)

Nilton Bezerra do Vale

2005-04-01

biología, anatomía, física, química, fisiología, farmacología, astronomía, arqueología y... mucha suerte. CONCLUSIONES: Aunque accidentes en la pesquisa y en la sala de operación sean lamentables, hay aquéllos que acontecen y, a veces, pueden llevar a avances espectaculares, como tratamientos heroicos y hasta Premios Nobel. Mantener la mente abierta es un trazo común a aquellos que desean contar con la gran suerte, como afirmaba el físico americano Henry (1842: "Las semillas del hallazgo flotan constantemente alrededor nuestro, pero apenas lanzan raíces en las mentes bien preparadas para recibirlas".BACKGROUND AND OBJECTIVES: This study has evaluated more than a hundred of the most fortunate couplings of a brilliant mind with fortunate luck (serendipity, through the re-reading of most relevant histories on science-related (n = 46 and anesthesiology-related (n = 16 inventions and discoveries. CONTENTS: This educational article encourages anesthesiologists to appreciate events related to scientific inventions and discoveries, showing that serendipity is possible, provided it is expected. Each discovery or invention includes history, references and scientific or anecdotal explanation. In addition to traditional discoveries, such as wine, gravity, photograph, Velcro, airbag, etc., there are other Medicine-related (microscope, X-rays, vaccine, penicillin, insulin, laser, Paps smear, etc. and Anesthesiology-related (isometry, gloves, N2O, ether, barbiturates, benzodiazepines, blood patch, etc. discoveries. Creativity and serendipity may act as cornerstones for clinical and basic research of pioneer inventions for medical and anesthesiologic advances. In fact, topics related to biology, anatomy, physics, chemistry, physiology, pharmacology, astronomy and archeology should be master and … lots of luck. CONCLUSIONS: Although research and operating room accidents are regrettable, some of them happen and may sometimes lead to spectacular advances, such as heroic

Natural gas annual 1995

International Nuclear Information System (INIS)

1996-11-01

The Natural Gas Annual provides information on the supply and disposition of natural gas to a wide audience including industry, consumers, Federal and State agencies, and educational institutions. The 1995 data are presented in a sequence that follows natural gas (including supplemental supplies) from its production to its end use. This is followed by tables summarizing natural gas supply and disposition from 1991 to 1995 for each Census Division and each State. Annual historical data are shown at the national level

Annual report and accounts 1994

International Nuclear Information System (INIS)

1994-01-01

The Annual Report of the Southern Electric Group presents the Chairman's statement, and a review by the Chief Executive which covers productivity and efficiency, VAT, subsidiaries, associated activity, energy efficiency, safety and caring for the environment. This is followed by a financial review, the director's report, and the annual accounts for the year ended 31 March 1994. (UK)

Trends in U.S. Pediatric Otolaryngology Fellowship Training.

Science.gov (United States)

Espinel, Ali; Poley, Marian; Zalzal, George H; Chan, Kenny; Preciado, Diego

2015-10-01

Interest in pediatric otolaryngology fellowship training is growing. The workforce implications of this growing interest are unclear and understudied. To analyze trends in pediatric otolaryngology training, determine where fellows who graduated over the past 10 years are currently practicing, and test the hypothesis that graduates from Accreditation Council for Graduate Medical Education (ACGME)–accredited programs were more likely to have academic tertiary positions with faculty appointments. We conducted a web-based analysis of pediatric otolaryngology fellowship graduates. The names of all 274 applicants who were matched to pediatric otolaryngology fellowships from May 31, 2003, to May 31, 2014, were obtained from the SF Match website. Accreditation status of each program for each match year was obtained from the ACGME website. We then performed an Internet search for the current practice location of each matched applicant. Analysis was conducted from January 1, 2015, to May 1, 2015. Practice setting per year of fellowship match and accreditation status of program. For the 2003 to the 2014 match years, there was an increase from 5 to 22 accredited pediatric otolaryngology fellowship programs overall; simultaneously, the number of yearly matched applicants increased from 14 to 35. More graduates with ACGME accreditation practice at academic settings compared with graduates without ACGME accreditation although the difference was not statistically significant (67.1% vs. 50.7%; P = .15). Graduates from accredited programs, however, were significantly more likely to practice at a hospital-based setting compared with those from nonaccredited programs (81.7% vs. 65.5%; P = .003). Fellows trained in the last 10 years are relatively well distributed across the country. The number of pediatric otolaryngology fellowship applicants as well as total number of matched applicants and ACGME-accredited positions has risen in the last 10 years. It appears that a higher

Decision support using anesthesia information management system records and accreditation council for graduate medical education case logs for resident operating room assignments.

Science.gov (United States)

Wanderer, Jonathan P; Charnin, Jonathan; Driscoll, William D; Bailin, Michael T; Baker, Keith

2013-08-01

Our goal in this study was to develop decision support systems for resident operating room (OR) assignments using anesthesia information management system (AIMS) records and Accreditation Council for Graduate Medical Education (ACGME) case logs and evaluate the implementations. We developed 2 Web-based systems: an ACGME case-log visualization tool, and Residents Helping in Navigating OR Scheduling (Rhinos), an interactive system that solicits OR assignment requests from residents and creates resident profiles. Resident profiles are snapshots of the cases and procedures each resident has done and were derived from AIMS records and ACGME case logs. A Rhinos pilot was performed for 6 weeks on 2 clinical services. One hundred sixty-five requests were entered and used in OR assignment decisions by a single attending anesthesiologist. Each request consisted of a rank ordered list of up to 3 ORs. Residents had access to detailed information about these cases including surgeon and patient name, age, procedure type, and admission status. Success rates at matching resident requests were determined by comparing requests with AIMS records. Of the 165 requests, 87 first-choice matches (52.7%), 27 second-choice matches (16.4%), and 8 third-choice matches (4.8%) were made. Forty-three requests were unmatched (26.1%). Thirty-nine first-choice requests overlapped (23.6%). Full implementation followed on 8 clinical services for 8 weeks. Seven hundred fifty-four requests were reviewed by 15 attending anesthesiologists, with 339 first-choice matches (45.0%), 122 second-choice matches (16.2%), 55 third-choice matches (7.3%), and 238 unmatched (31.5%). There were 279 overlapping first-choice requests (37.0%). The overall combined match success rate was 69.4%. Separately, we developed an ACGME case-log visualization tool that allows individual resident experiences to be compared against case minimums as well as resident peer groups. We conclude that it is feasible to use ACGME case

Tools for the direct observation and assessment of psychomotor skills in medical trainees: a systematic review.

Science.gov (United States)

Jelovsek, J Eric; Kow, Nathan; Diwadkar, Gouri B

2013-07-01

The Accreditation Council for Graduate Medical Education (ACGME) Milestone Project mandates programmes to assess the attainment of training outcomes, including the psychomotor (surgical or procedural) skills of medical trainees. The objectives of this study were to determine which tools exist to directly assess psychomotor skills in medical trainees on live patients and to identify the data indicating their psychometric and edumetric properties. An electronic search was conducted for papers published from January 1948 to May 2011 using the PubMed, Education Resource Information Center (ERIC), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science electronic databases and the review of references in article bibliographies. A study was included if it described a tool or instrument designed for the direct observation of psychomotor skills in patient care settings by supervisors. Studies were excluded if they referred to tools that assessed only clinical or non-technical skills, involved non-medical health professionals, or assessed skills performed on a simulator. Overall, 4114 citations were screened, 168 (4.1%) articles were reviewed for eligibility and 51 (1.2%) manuscripts were identified as meeting the study inclusion criteria. Three authors abstracted and reviewed studies using a standardised form for the presence of key psychometric and edumetric elements as per ACGME and American Psychological Association (APA) recommendations, and also assigned an overall grade based on the ACGME Committee on Educational Outcome Assessment grading system. A total of 30 tools were identified. Construct validity based on associations between scores and training level was identified in 24 tools, internal consistency in 14, test-retest reliability in five and inter-rater reliability in 20. The modification of attitudes, knowledge or skills was reported using five tools. The seven-item Global Rating Scale and the Procedure-Based Assessment received an

Emotional intelligence and its correlation to performance as a resident: a preliminary study.

Science.gov (United States)

Talarico, Joseph F; Metro, David G; Patel, Rita M; Carney, Patricia; Wetmore, Amy L

2008-03-01

To test the hypothesis that emotional intelligence, as measured by the Bar-On Emotional Quotient Inventory (EQ-I) 125 (Multi Health Systems, Toronto, Ontario, Canada) personal inventory, would correlate with resident performance. Prospective survey. University-affiliated, multiinstitutional anesthesiology residency program. Current clinical anesthesiology years one to three (PGY 2-4) anesthesiology residents enrolled in the University of Pittsburgh Anesthesiology Residency Program. Participants confidentially completed the Bar-On EQ-I 125 survey. Results of the individual EQ-I 125 and daily evaluations by the faculty of the residency program were compiled and analyzed. There was no positive correlation between any facet of emotional intelligence and resident performance. There was statistically significant negative correlation (-0.40; P Emotional intelligence, as measured by the Bar-On EQ-I personal inventory, does not strongly correlate to resident performance as defined at the University of Pittsburgh.

Natural gas annual 1997

International Nuclear Information System (INIS)

1998-10-01

The Natural Gas Annual provides information on the supply and disposition of natural gas to a wide audience including industry, consumers, Federal and State agencies, and educational institutions. The 1997 data are presented in a sequence that follows natural gas (including supplemental supplies) from its production to its end use. This is followed by tables summarizing natural gas supply and disposition from 1993 to 1997 for each Census Division and each State. Annual historical data are shown at the national level. 27 figs., 109 tabs

Natural gas annual 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-10-01

The Natural Gas Annual provides information on the supply and disposition of natural gas to a wide audience including industry, consumers, Federal and State agencies, and educational institutions. The 1997 data are presented in a sequence that follows natural gas (including supplemental supplies) from its production to its end use. This is followed by tables summarizing natural gas supply and disposition from 1993 to 1997 for each Census Division and each State. Annual historical data are shown at the national level. 27 figs., 109 tabs.

Chemical and biological nonproliferation program. FY99 annual report; ANNUAL

International Nuclear Information System (INIS)

NONE

2000-01-01

This document is the first of what will become an annual report documenting the progress made by the Chemical and Biological Nonproliferation Program (CBNP). It is intended to be a summary of the program's activities that will be of interest to both policy and technical audiences. This report and the annual CBNP Summer Review Meeting are important vehicles for communication with the broader chemical and biological defense and nonproliferation communities. The Chemical and Biological Nonproliferation Program Strategic Plan is also available and provides additional detail on the program's context and goals. The body of the report consists of an overview of the program's philosophy, goals and recent progress in the major program areas. In addition, an appendix is provided with more detailed project summaries that will be of interest to the technical community

Uranium industry annual 1998

International Nuclear Information System (INIS)

1999-01-01

The Uranium Industry Annual 1998 (UIA 1998) provides current statistical data on the US uranium industry's activities relating to uranium raw materials and uranium marketing. It contains data for the period 1989 through 2008 as collected on the Form EIA-858, ''Uranium Industry Annual Survey.'' Data provides a comprehensive statistical characterization of the industry's activities for the survey year and also include some information about industry's plans and commitments for the near-term future. Data on uranium raw materials activities for 1989 through 1998, including exploration activities and expenditures, EIA-estimated reserves, mine production of uranium, production of uranium concentrate, and industry employment, are presented in Chapter 1. Data on uranium marketing activities for 1994 through 2008, including purchases of uranium and enrichment services, enrichment feed deliveries, uranium fuel assemblies, filled and unfilled market requirements, and uranium inventories, are shown in Chapter 2. The methodology used in the 1998 survey, including data edit and analysis, is described in Appendix A. The methodologies for estimation of resources and reserves are described in Appendix B. A list of respondents to the ''Uranium Industry Annual Survey'' is provided in Appendix C. The Form EIA-858 ''Uranium Industry Annual Survey'' is shown in Appendix D. For the readers convenience, metric versions of selected tables from Chapters 1 and 2 are presented in Appendix E along with the standard conversion factors used. A glossary of technical terms is at the end of the report. 24 figs., 56 tabs

Making residency work hour rules work.

Science.gov (United States)

Cohen, I Glenn; Czeisler, Charles A; Landrigan, Christopher P

2013-01-01

In July 2011, the ACGME implemented new rules that limit interns to 16 hours of work in a row, but continue to allow 2nd-year and higher resident physicians to work for up to 28 consecutive hours. Whether the ACGME's 2011 work hour limits went too far or did not go far enough has been hotly debated. In this article, we do not seek to re-open the debate about whether these standards get matters exactly right. Instead, we wish to address the issue of effective enforcement. That is, now that new work hour limits have been established, and given that the ACGME has been unable to enforce work hour limits effectively on its own, what is the best way to make sure the new limits are followed in order to reduce harm to residents, patients, and others due to sleep-deprived residents? We focus on three possible national approaches to the problem, one rooted in funding, one rooted in disclosure, and one rooted in tort law. © 2013 American Society of Law, Medicine & Ethics, Inc.

Annual Report 1978

International Nuclear Information System (INIS)

1979-01-01

The annual report gives the specific scientific results in the fields of nuclear and radiation physics, radiation chemistry, radiochemistry and data processing with a list of publications. (orig.) [de

Annual Report 1974

International Nuclear Information System (INIS)

1975-01-01

This annual report supersedes the work done in the nuclear physics institute at Lyon. The studied matters are the following: nuclear theory, nuclear reactions, nuclear spectroscopy and nuclear chemistry [fr

Annual Adjustment Factors

Data.gov (United States)

Department of Housing and Urban Development — The Department of Housing and Urban Development establishes the rent adjustment factors - called Annual Adjustment Factors (AAFs) - on the basis of Consumer Price...

Petroleum supply annual 1998: Volume 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-06-01

The ``Petroleum Supply Annual`` (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1998 through annual and monthly surveys. The PSA is divided into two volumes. This first volume contains three sections: Summary Statistics, Detailed Statistics, and Refinery Statistics; each with final annual data. The second volume contains final statistics for each month of 1998, and replaces data previously published in the PSA. The tables in Volumes 1 and 2 are similarly numbered to facilitate comparison between them. 16 figs., 59 tabs.

Petroleum supply annual, 1997. Volume 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-06-01

The Petroleum Supply Annual (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1997 through annual and monthly surveys. The PSA is divided into two volumes. This first volume contains three sections: Summary Statistics, Detailed Statistics, and Refinery Statistics; each with final annual data. The second volume contains final statistics for each month of 1997, and replaces data previously published in the Petroleum Supply Monthly (PSM). The tables in Volumes 1 and 2 are similarly numbered to facilitate comparison between them. 16 figs., 48 tabs.

Petroleum supply annual 1992: Volume 1

International Nuclear Information System (INIS)

1993-01-01

The Petroleum Supply Annual (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1992 through annual and monthly surveys. The PSA is divided into two volumes. This first volume contains four sections: Summary Statistics, Detailed Statistics, Refinery Capacity and Oxygenate Capacity each with final annual data. The second volume contains final statistics for each month of 1992, and replaces data previously published in the Petroleum Supply Monthly (PSM). The tables in Volumes 1 and 2 are similarly numbered to facilitate comparison between them

Petroleum supply annual 1998: Volume 1

International Nuclear Information System (INIS)

1999-06-01

The ''Petroleum Supply Annual'' (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1998 through annual and monthly surveys. The PSA is divided into two volumes. This first volume contains three sections: Summary Statistics, Detailed Statistics, and Refinery Statistics; each with final annual data. The second volume contains final statistics for each month of 1998, and replaces data previously published in the PSA. The tables in Volumes 1 and 2 are similarly numbered to facilitate comparison between them. 16 figs., 59 tabs

Petroleum supply annual, 1997. Volume 1

International Nuclear Information System (INIS)

1998-06-01

The Petroleum Supply Annual (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1997 through annual and monthly surveys. The PSA is divided into two volumes. This first volume contains three sections: Summary Statistics, Detailed Statistics, and Refinery Statistics; each with final annual data. The second volume contains final statistics for each month of 1997, and replaces data previously published in the Petroleum Supply Monthly (PSM). The tables in Volumes 1 and 2 are similarly numbered to facilitate comparison between them. 16 figs., 48 tabs

Annual report 1980

International Nuclear Information System (INIS)

1981-01-01

This annual report contains a description of the named institute, the research programm, reports from the scientific establishments, a description of different cooperations, and a list of scientific publications. (HSI) [de

Entry of US Medical School Graduates Into Family Medicine Residencies: 2015-2016.

Science.gov (United States)

Kozakowski, Stanley M; Travis, Alexandra; Bentley, Ashley; Fetter, Gerald

2016-10-01

This is the 35th national study conducted by the American Academy of Family Physicians (AAFP) that reports retrospectively the percentage of graduates from MD-granting and DO-granting medical schools who entered Accreditation Council for Graduate Medical Education (ACGME)-accredited family medicine residency programs as first-year residents. Approximately 8.7% of the 18,929 students graduating from US MD-granting medical schools and 15.5% of the 5,314 students graduating from DO-granting medical schools between July 2014 and June 2015 entered an ACGME family medicine residency in 2015. Together, 10.2% of graduates of MD- and DO-granting schools entered family medicine. Of the 1,640 graduates of the MD-granting medical schools who entered a family medicine residency in 2015, 80% graduated from 70 of the 134 schools (52%). In 2015, DO-granting medical schools graduated 823 into ACGME-accredited family medicine residencies, 80% graduating from 19 of the 32 schools (59%). In aggregate, medical schools west of the Mississippi River represent less than a third of all MD-granting schools but have a rate of students selecting family medicine that is 40% higher than schools located east of the Mississippi. Fifty-one percent (24/47) of states and territories containing medical schools produce 80% of the graduates entering ACGME-accredited family medicine residency programs. A rank order list of MD-granting medical schools was created based on the last 3 years' average percentage of graduates who became family medicine residents, using the 2015 and prior AAFP census data.

Selective pathology fellowships: diverse, innovative, and valuable subspecialty training.

Science.gov (United States)

Iezzoni, Julia C; Ewton, April; Chévez-Barrios, Patricia; Moore, Stephen; Thorsen, Linda M; Naritoku, Wesley Y

2014-04-01

Although selective pathology fellowships have a long-standing history of developing trainees with advanced expertise in specific areas of pathology other than those of the American Board of Pathology-certified subspecialties, the widespread interest in this training continues to grow. To describe the historical background and current status of selective pathology fellowships, and to provide examples of 3 programs. In addition, Accreditation Council for Graduate Medical Education (ACGME)-accredited programs and nonaccredited programs in Selective Pathology are compared. ACGME data banks and publicly available online materials were used. Program directors of the fellowships examples in this paper provided program-specific information. Additionally, an online survey of the program directors and program coordinators of ACGME-accredited programs and nonaccredited programs in selective pathology was performed. There are currently 76 ACGME-accredited selective pathology programs. The programs are distributed between 3 major categories: surgical pathology, focused anatomic pathology, and focused clinical pathology. Although the vast majority of programs are concerned that their funding source may be cut in the next 3 years, most programs will not change the number of fellowship positions in their programs. Program requirements devoted specifically and solely to selective pathology have been developed and are in effect. The value of this training is recognized not only by pathologists, but by clinicians as well, in both academia and private practice. Importantly, the diversity and innovation inherent in selective pathology allow these programs to adeptly address new subspecialty areas and technologic advances in the current and evolving practice of pathology.

Charting the Road to Competence: Developmental Milestones for Internal Medicine Residency Training

Science.gov (United States)

Green, Michael L.; Aagaard, Eva M.; Caverzagie, Kelly J.; Chick, Davoren A.; Holmboe, Eric; Kane, Gregory; Smith, Cynthia D.; Iobst, William

2009-01-01

Background The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project requires that residency program directors objectively document that their residents achieve competence in 6 general dimensions of practice. Intervention In November 2007, the American Board of Internal Medicine (ABIM) and the ACGME initiated the development of milestones for internal medicine residency training. ABIM and ACGME convened a 33-member milestones task force made up of program directors, experts in evaluation and quality, and representatives of internal medicine stakeholder organizations. This article reports on the development process and the resulting list of proposed milestones for each ACGME competency. Outcomes The task force adopted the Dreyfus model of skill acquisition as a framework the internal medicine milestones, and calibrated the milestones with the expectation that residents achieve, at a minimum, the “competency” level in the 5-step progression by the completion of residency. The task force also developed general recommendations for strategies to evaluate the milestones. Discussion The milestones resulting from this effort will promote competency-based resident education in internal medicine, and will allow program directors to track the progress of residents and inform decisions regarding promotion and readiness for independent practice. In addition, the milestones may guide curriculum development, suggest specific assessment strategies, provide benchmarks for resident self-directed assessment-seeking, and assist remediation by facilitating identification of specific deficits. Finally, by making explicit the profession's expectations for graduates and providing a degree of national standardization in evaluation, the milestones may improve public accountability for residency training. PMID:21975701

The effect of dual accreditation on family medicine residency programs.

Science.gov (United States)

Mims, Lisa D; Bressler, Lindsey C; Wannamaker, Louise R; Carek, Peter J

2015-04-01

In 1985, the American Osteopathic Association (AOA) Board of Trustees agreed to allow residency programs to become dually accredited by the AOA and Accreditation Council for Graduate Medical Education (ACGME). Despite the increase in such programs, there has been minimal research comparing these programs to exclusively ACGME-accredited residencies. This study examines the association between dual accreditation and suggested markers of quality. Standard characteristics such as regional location, program structure (community or university based), postgraduate year one (PGY-1) positions offered, and salary (PGY-1) were obtained for each residency program. In addition, the faculty to resident ratio in the family medicine clinic and the number of half days residents spent in the clinic each week were recorded. Initial Match rates and pass rates of new graduates on the ABFM examination from 2009 to 2013 were also obtained. Variables were analyzed using chi-square and Student's t test. Logistic regression models were then created to predict a program's 5-year aggregate initial Match rate and Board pass rate in the top tertile as compared to the lowest tertile. Dual accreditation was obtained by 117 (27.0%) of programs. Initial analyses revealed associations between dually accredited programs and mean year of initial ACGME program accreditation, regional location, program structure, tracks, and alternative medicine curriculum. When evaluated in logistic regression, dual accreditation status was not associated with Match rates or ABFM pass rates. By examining suggested markers of program quality for dually accredited programs in comparison to ACGME-only accredited programs, this study successfully established both differences and similarities among the two types.

2010 Annual Report

Energy Technology Data Exchange (ETDEWEB)

None

2010-01-01

This annual report includes: an overview of Western; approaches for future hydropower and transmission service; major achievements in FY 2010; FY 2010 customer Integrated Resource Planning, or IRP, survey; and financial data.

77 FR 3166 - Annual Stress Test

Science.gov (United States)

2012-01-23

... FEDERAL DEPOSIT INSURANCE CORPORATION 12 CFR Part 325, Subpart C RIN 3064-AD91 Annual Stress Test... Reform and Consumer Protection Act (the ``Dodd-Frank Act'') regarding stress tests (``proposed rule... to conduct annual stress tests in accordance with the proposed rule, report the results of such...

Cost-efficient staffing under annualized hours

NARCIS (Netherlands)

van der Veen, Egbert; Hans, Elias W.; Veltman, Bart; Berrevoets, Leo M.; Berden, Hubert J.J.M.

2012-01-01

We study how flexibility in workforce capacity can be used to efficiently match capacity and demand. Flexibility in workforce capacity is introduced by the annualized hours regime. Annualized hours allow organizations to measure working time per year, instead of per month or per week. An additional

Obtaining your annual internal taxation certificate

CERN Document Server

2006-01-01

(cf. Article R IV 2.04 of the Staff Regulations) Your annual internal taxation certificate will state the taxable amount of your CERN remuneration, payments and other financial benefits and the amount of tax levied by the Organization during the previous financial year. In France, your tax return must be accompanied by this certificate. Current Members of the Personnel (including Members of the Personnel participating in a pre-retirement programme): - You will receive an e-mail containing a link to your printable annual certificate, which will be stored together with your pay and leave statements (e-Payslips). - You can also access your annual certificate via https://hrt.cern.ch (open 'My Payslips' at the bottom of the main menu.) - If you experience any technical difficulties in accessing your annual certificate (e.g. invalid AIS login or password), please contact CERN's AIS support team at ais.support@cern.ch. Former Members of the Personnel:- If you remember your AIS login and password, you can acc...

25 CFR 41.12 - Annual budget.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Annual budget. 41.12 Section 41.12 Indians BUREAU OF... NAVAJO COMMUNITY COLLEGE Tribally Controlled Community Colleges § 41.12 Annual budget. Appropriations... identified in the Bureau of Indian Affairs Budget Justification. Funds appropriated for grants under this...

30 CFR 281.27 - Annual rental.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Annual rental. 281.27 Section 281.27 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF MINERALS OTHER THAN OIL, GAS, AND SULPHUR IN THE OUTER CONTINENTAL SHELF Financial Considerations § 281.27 Annual rental...

Annual report 1990

International Nuclear Information System (INIS)

Gaeggeler, H.W.; Lorenzen, R.

1991-04-01

This annual report of the chemistry laboratory gives an overview of research performed during 1990 in the field of geochemistry, trace analysis, aerosol chemistry, heavy elements, cement chemistry and analytical chemistry. figs., tabs., refs

1986 Annual Report

International Nuclear Information System (INIS)

1987-01-01

This annual report describes the reasearch activity carried out during 1986 by the Fusion Department of the Italian Commision for Nuclear and Alternative Energy Sources (ENEA). The report outlines the main results obtained by the three major projects of the Fusion Department (Fusion Physics, Frascati Tokamak Upgrade, and Fusion Reactor Engineering), plus the divisional project Inertial Confinement mentioned separately because of its particular scientific content. Most of the research work was performed by the Fusion Department at its location at the ENEA Frascati Energy Research Center, but some work was also done elsewhere, or with recourse to other ENEA departments. The research activity described in this annual report was carried out with the frame of the Association Euratom-ENEA on Fusion, with the exception of some minor activities

Optimization of serious bacterial infections intensive therapy in children in Anesthesiology and Intensive Care Department

Directory of Open Access Journals (Sweden)

M. Yu. Kurochkin

2014-08-01

Full Text Available Effective selection of antibiotics in children with severe bacterial infections is often difficult because of microflora resistance. Extracorporeal detoxication methods, particularly discrete plasmapheresis are usually used for septic shock and total organ failure prevention. The aim of research. To conduct microbiological monitoring and to study a dynamics of medium molecular peptides in discrete plasmapheresis for intensive care optimization in children with severe bacterial infections in Anesthesiology and Intensive Care Department (AICU. Materials and methods. We investigated respiratory tract microflora by bacteriological method in 120 newborns and 30 children from 1 month with severe bacterial infections at admission and during prolonged stay in AICU. Discrete plasmapheresis was held in four children. Dynamic of medium molecular peptides was studied at admission, before discrete plasmapheresis and after it. Statistical data processing was performed using the Microsoft Excel software package. Results. It was found that in AICU in older children in admission grampositive and gramnegative flora was defined in equal quantity. The best sensitivity of the respiratory tract microflora was for the glycopeptides, oxazolidinones , II generation cephalosporins and macrolides, more than 60% - for aminoglycosides and lincosamides. However, when children spent more than 7-14 days in the department, nosocomial microflora was represented primarily by gram-negative organisms (80%, especially Pseudomonas aeruginosa. It was found to be inappropriate to use cephalosporins and macrolides in AICU for older children after their long stay there; the sensitivity to aminoglycosides was less than 60%, to anti-pseudomonal carbapenems not more than 30%. In AICU of newborns grampositive flora was found in 95%, mostly Staphylococcus haemolyticus. It was entirely sensitive for glycopeptides, oxazolidinones, fluoroquinolones, carbapenems, and also for co-trimoxazole and

1999 Annual Cathodic Protection Survey Report for PFP

International Nuclear Information System (INIS)

BOWMAN, T.J.

2000-01-01

This cathodic protection (CP) report documents the results of the 1999 annual CP survey of the underground piping within PFP property. An annual survey of CP systems is required by Washington Administrative Code (WAC). A spreadsheet to document the 1999 annual survey polarization data is included in this report. Graphs are included to trend the cathodic voltages and the polarization voltages at each test station on PFP property. The trending spans from 1994 to 1999. Graphs are also included to trend voltage and amperage outputs of each rectifier during the annual surveys. During the annual survey, resistance testing between the underground piping was conducted at each test station. The testing showed that all piping (with test leads into the test stations) was continuous with every pipe represented in the test stations. The resistance data is not documented in this report but can be accessed in work package 22-99-01003. During the annual survey, the wiring configurations of anode junction boxes AJB(R45-1) and AJB(45-1) were documented. The sketches can be accessed from the JCS work record of work package 22-99-01003. Analysis, conclusions, and recommendations of the 1999 annual CP survey results are included in this report

28 CFR 43.4 - Annual reports.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Annual reports. 43.4 Section 43.4 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RECOVERY OF COST OF HOSPITAL AND MEDICAL CARE AND TREATMENT FURNISHED BY THE UNITED STATES § 43.4 Annual reports. The head of each Department or Agency...

42 CFR 419.50 - Annual review.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Annual review. 419.50 Section 419.50 Public Health... review. (a) General rule. Not less often than annually, CMS reviews and updates groups, relative payment... selection of representatives of providers to review (and advise CMS concerning) the clinical integrity of...

45 CFR 1620.5 - Annual review.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Annual review. 1620.5 Section 1620.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PRIORITIES IN USE OF RESOURCES § 1620.5 Annual review. (a) Priorities shall be set periodically and shall be reviewed by the...

Measuring Clinical Productivity.

Science.gov (United States)

Hudson, Mark E; Lebovitz, Evan E

2018-06-01

Productivity measurements have been used to evaluate and compare physicians and physician practices. Anesthesiology is unique in that factors outside anesthesiologist control impact opportunity for revenue generation and make comparisons between providers and facilities challenging. This article uses data from the multicenter University of Pittsburgh Physicians Department of Anesthesiology to demonstrate factors influencing productivity opportunity by surgical facility, between department divisions and subspecialties within multispecialty divisions, and by individuals within divisions. The complexities of benchmarking anesthesiology productivity are demonstrated, and the potential value of creating a productivity profile for facilities and groups is illustrated. Copyright © 2018 Elsevier Inc. All rights reserved.

Annual cropped area expansion and agricultural production ...

African Journals Online (AJOL)

Ethiopian Journal of Environmental Studies and Management ... considerable annual increase of varying extent over time and space for both annual output and area ... The study suggests improving productivity through sustainable agricultural ...

Annual report 2002

International Nuclear Information System (INIS)

Toncik, M.

2003-04-01

In this Annual report the operating of the Slovak Environmental Agency in 2002 is reported. Structure of the Agency, mission, personnel structure, financing, monitoring of the environment, international cooperation and coordination of research programmes are reviewed

Strategy disclosure in Dutch annual reports

NARCIS (Netherlands)

Santema, S.C.; Rijt, van de J.

2001-01-01

Much attention is being paid to the financial part of the annual reports of companies. Not much research has been done into the quality of the Report of the Executive Board in annual reports (the narrative part). During the past 2 years Dutch firms were reviewed on the way the Executive Board dealt

2016 Annual Technology Baseline (ATB) - Webinar Presentation

Energy Technology Data Exchange (ETDEWEB)

Cole, Wesley; Kurup, Parthiv; Hand, Maureen; Feldman, David; Sigrin, Benjamin; Lantz, Eric; Stehly, Tyler; Augustine, Chad; Turchi, Craig; Porro, Gian; O' Connor, Patrick; Waldoch, Connor

2016-09-13

This deck was presented for the 2016 Annual Technology Baseline Webinar. The presentation describes the Annual Technology Baseline, which is a compilation of current and future cost and performance data for electricity generation technologies.

Annual environmental monitoring report, January--December 1976

International Nuclear Information System (INIS)

1977-05-01

Environmental monitoring results continue to demonstrate that, except for penetrating radiation, environmental radiological impact due to SLAC operation is not distinguishable from natural environmental sources. During 1976 the maximum neutron dose near the site boundary was 3.4 mrem. This represents about 3.4% of the annual dose from natural sources at this elevation and 0.68% of the technical standard of 500 mrem per person annually. There have been no measurable increases in radioactivity in ground water attributable to SLAC operations. Airborne radioactivity released from SLAC also continues to make only a negligible environmental impact and result in a site boundary annual dose of less than 0.01 mrem, which represents less than 0.01% of the annual dose from the natural radiation environment and about 0.002% of the technical standard

Annual report 2005

International Nuclear Information System (INIS)

Toncik, M.

2006-04-01

In this Annual report the operating of the Slovak Environmental Agency in 2005 is reported. The structure of the Agency, mission, personnel structure, financing, monitoring of the environment, international cooperation and coordination of research programmes are reviewed

Annual report 2004

International Nuclear Information System (INIS)

Toncik, M.

2005-04-01

In this Annual report the operating of the Slovak Environmental Agency in 2004 is reported. The structure of the Agency, mission, personnel structure, financing, monitoring of the environment, international cooperation and coordination of research programmes are reviewed

Annual report 2003

International Nuclear Information System (INIS)

Toncik, M.

2004-04-01

In this Annual report the operating of the Slovak Environmental Agency in 2003 is reported. The structure of the Agency, mission, personnel structure, financing, monitoring of the environment, international cooperation and coordination of research programmes are reviewed

Annual report 2006

International Nuclear Information System (INIS)

Anon

2007-04-01

In this Annual report the operating of the Slovak Environmental Agency in 2006 is reported. The structure of the Agency, mission, personnel structure, financing, monitoring of the environment, international cooperation and coordination of research programmes are reviewed

49 CFR 219.800 - Annual reports.

Science.gov (United States)

2010-10-01

..., DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Annual Report § 219.800 Annual reports. (a) Each... also use the electronic version of the MIS form provided by the DOT. The Administrator may designate... submission to FRA. For information on where to submit MIS forms and for the electronic version of the form...

Petroleum supply annual 1994. Volume 1

International Nuclear Information System (INIS)

1995-01-01

The Petroleum Supply Annual (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1994 through annual and monthly surveys. The PSA is divided into two volumes. This first volume contains four sections: Summary Statistics, Detailed Statistics, Refinery Capacity, and Oxygenate Capacity each with final annual data. The second volume contains final statistics for each month of 1994, and replaces data previously published in the Petroleum Supply Monthly (PSM). The tables in Volumes 1 and 2 are similarly numbered to facilitate comparison between them. Below is a description of each section in Volume 1 of the PSA

International energy annual 1996

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-02-01

The International Energy Annual presents an overview of key international energy trends for production, consumption, imports, and exports of primary energy commodities in over 220 countries, dependencies, and areas of special sovereignty. Also included are population and gross domestic product data, as well as prices for crude oil and petroleum products in selected countries. Renewable energy reported in the International Energy Annual includes hydroelectric power, geothermal, solar, and wind electric power, biofuels energy for the US, and biofuels electric power for Brazil. New in the 1996 edition are estimates of carbon dioxide emissions from the consumption of petroleum and coal, and the consumption and flaring of natural gas. 72 tabs.

Emotional Intelligence and the ACGME Competencies.

Science.gov (United States)

Webb, Anita R; Young, Richard A; Baumer, Joane G

2010-12-01

Residency programs desire assessment tools for teaching and measuring resident attainment of the Accreditation Council for Graduate Medical Education competencies, including interpersonal and communication skills. We sought to evaluate the use of emotional intelligence (EI) assessment and training tools in assessing and enhancing interpersonal and communication skills. We used a quasi-experimental design, with an intervention and control group composed of 1 class each of family medicine residents. The intervention was EI coaching. The assessment used the Emotional and Social Competence Inventory, a 360-degree EI survey consisting of self and other (colleague) ratings for 12 EI competencies. There were 21 participants in each of the 3 assessments (test, posttest, and control). Our EI coaching intervention had very limited participation due to a lack of protected time for EI coaching and residents' competing obligations. Return rates for self surveys were 86% to 91% and 66% to 68% for others. On all 3 trials, ratings by others were significantly higher than self ratings for every competence (range, P competencies. None of the intervention group self ratings increased significantly on posttesting, whereas ratings by others increased significantly for coach/mentor (P coaching intervention was unsuccessful, the effects of coaching on interpersonal and communication skills could not be assessed.

Annual report 1981

International Nuclear Information System (INIS)

1982-01-01

In this annual report the work done at the named Institute is described. This concerns particle and fields in the solar system, infrared astronomy, X-ray astronomy, γ-astronomy, and molecule spectroscopy. A list of publications is added. (HSI)

Annual environmental monitoring report, January--December 1975

International Nuclear Information System (INIS)

1976-04-01

Environmental monitoring results continue to demonstrate that, except for penetrating radiation, environmental radiological impact due to SLAC operation is not distinguishable from natural environmental sources. During 1975 the maximum neutron dose near the site boundary was 15.8 mrem. This represents about 16 percent of the annual dose from natural sources at this elevation and 3.2 percent of the technical standard of 500 mrem per person annually. There have been no measurable increases in radioactivity in ground water attributable to SLAC operations. Airborne radioactivity released from SLAC also continues to make only a negligible environmental impact and results in a site boundary annual dose of less than 2.4 mrem, which represents less than 2.4 percent of the annual dose from the natural radiation environment and about 0.5 percent of the technical standard

Annual Conference Abstracts

Science.gov (United States)

Journal of Engineering Education, 1972

1972-01-01

Includes abstracts of papers presented at the 80th Annual Conference of the American Society for Engineering Education. The broad areas include aerospace, affiliate and associate member council, agricultural engineering, biomedical engineering, continuing engineering studies, chemical engineering, civil engineering, computers, cooperative…

Annual results 2004

International Nuclear Information System (INIS)

2005-01-01

This 2004 annual evaluation of the french RTE company (electric power transport network) provides information on the 2004 results on: institutional information, financial results, customers and market, industrial resources, environment and consultation, human resources and international aspects. (A.L.B.)

Annual report 1987

International Nuclear Information System (INIS)

1988-01-01

In this annual report of the Dutch Interfacultary Reactor Institute, summary and detailed reports are presented of current research during 1987 of the departments radiochemistry, radiation chemistry, radiation physics and reactor physics. (H.W.). 61 refs.; 13 figs.; 14 tabs

2018 NDIA Precision Strike Annual Review (PSAR-18)

Science.gov (United States)

2018-03-20

Planning Agenda as of 9 MAR 18 Ginny Sniegon: 703-575-6653 PRECISION STRIKE ANNUAL REVIEW (PSAR-18) 20 MARCH 2018...Ginny Sniegon PSA Programs Vice-Chair: Captain David “Jumbo” Baird, USN Annual Review Chair: Kurt Chankaya Congressional & William J. Perry...0745 PSA ANNUAL REVIEW WELCOME: Ken Masson—PSA Chairman 0755 PSAR-18 OPENING REMARKS: Kurt Chankaya—PSAR-18 Event Chair 0800 CONGRESSIONAL

Revisiting the rotating call schedule in less than 80 hours per week.

Science.gov (United States)

Roses, Robert E; Foley, Paul J; Paulson, Emily C; Pray, Lori; Kelz, Rachel R; Williams, Noel N; Morris, Jon B

2009-01-01

The Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions have prompted many surgical training programs to adopt a night-float resident coverage system (NF). Dissatisfaction with NF prompted us to transition to a rotating junior resident call model (Q4) with 24-hour call shifts at the outset of the 2007-2008 academic year. We performed a prospective study to determine the influence of this transition on resident education, morale, and quality of life, as well as on ACGME work rule compliance and American Board of Surgery In-Training Examination (ABSITE) scores. Residents were surveyed after 1 year of NF and again 1 year after the introduction of Q4. Responses to a series of statements about the influence of the call model (NF or Q4) on educational opportunities and morale were solicited. The survey used a 5-point Likert response scale (1 = complete disagreement to 5 = complete agreement). Median values of participant responses were calculated and compared using the Wilcoxon rank-sum test. Compliance with ACGME work rules, ABSITE scores, and operative case logs from the 2006-2007 and 2007-2008 academic years were also compared. Residents were significantly more enthusiastic about Q4 compared with NF, particularly when asked about the influence these systems had on morale (median response = 4.0 [Q4] compared with 2.0 [NF]; p = 0.001) and engagement of residents by the teaching faculty (median response = 4.0 [Q4] compared with 1.0 [NF]; p = 0.001). Case logs revealed a similar operative experience for first-year residents irrespective of the call schedule (p = 0.51). Excellent compliance with ACGME work rules was maintained as reflected by the percentage of monthly 80-hour violations per resident months worked (3% [Q4] compared with 0.7% [NF]). No difference was observed in the ABSITE scores of first-year residents (a mean percentile point increase of 1 was found after the introduction of Q4). Educational opportunities, compliance with

Creation of an emergency surgery service concentrates resident training in general surgical procedures.

Science.gov (United States)

Ahmed, Hesham M; Gale, Stephen C; Tinti, Meredith S; Shiroff, Adam M; Macias, Aitor C; Rhodes, Stancie C; Defreese, Marissa A; Gracias, Vicente H

2012-09-01

Emergency general surgery (EGS) is increasingly being provided by academic trauma surgeons in an acute care surgery model. Our tertiary care hospital recently changed from a model where all staff surgeons (private, subspecialty academic, and trauma academic) were assigned EGS call to one in which an emergency surgery service (ESS), staffed by academic trauma faculty, cares for all EGS patients. In the previous model, many surgeries were "not covered" by residents because of work-hour restrictions, conflicting needs, or private surgeon preference. The ESS was separate from the trauma service. We hypothesize that by creating a separate ESS, residents can accumulate needed and concentrated operative experience in a well-supervised academic environment. A prospectively accrued EGS database was retrospectively queried for the 18-month period: July 2010 to June 2011. The Accreditation Council for Graduate Medical Education (ACGME) databases were queried for operative numbers for our residency program and for national resident data for 2 years before and after creating the ESS. The ACGME operative requirements were tabulated from online sources. ACGME requirements were compared with surgical cases performed. During the 18-month period, 816 ESS operations were performed. Of these, 307 (38%) were laparoscopy. Laparoscopic cholecystectomy and appendectomy were most common (138 and 145, respectively) plus 24 additional laparoscopic surgeries. Each resident performed, on average, 34 basic laparoscopic cases during their 2-month rotation, which is 56% of their ACGME basic laparoscopic requirement. A diverse mixture of 70 other general surgical operations was recorded for the remaining 509 surgical cases, including reoperative surgery, complex laparoscopy, multispecialty procedures, and seldom-performed operations such as surgery for perforated ulcer disease. Before the ESS, the classes of 2008 and 2009 reported that only 48% and 50% of cases were performed at the main academic

Use of a structured template to facilitate practice-based learning and improvement projects.

Science.gov (United States)

McClain, Elizabeth K; Babbott, Stewart F; Tsue, Terance T; Girod, Douglas A; Clements, Debora; Gilmer, Lisa; Persons, Diane; Unruh, Greg

2012-06-01

The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to meet and demonstrate outcomes across 6 competencies. Measuring residents' competency in practice-based learning and improvement (PBLI) is particularly challenging. We developed an educational tool to meet ACGME requirements for PBLI. The PBLI template helped programs document quality improvement (QI) projects and supported increased scholarly activity surrounding PBLI learning. We reviewed program requirements for 43 residency and fellowship programs and identified specific PBLI requirements for QI activities. We also examined ACGME Program Information Form responses on PBLI core competency questions surrounding QI projects for program sites visited in 2008-2009. Data were integrated by a multidisciplinary committee to develop a peer-protected PBLI template guiding programs through process, documentation, and evaluation of QI projects. All steps were reviewed and approved through our GME Committee structure. An electronic template, companion checklist, and evaluation form were developed using identified project characteristics to guide programs through the PBLI process and facilitate documentation and evaluation of the process. During a 24 month period, 27 programs have completed PBLI projects, and 15 have reviewed the template with their education committees, but have not initiated projects using the template. The development of the tool generated program leaders' support because the tool enhanced the ability to meet program-specific objectives. The peer-protected status of this document for confidentiality and from discovery has been beneficial for program usage. The document aggregates data on PBLI and QI initiatives, offers opportunities to increase scholarship in QI, and meets the ACGME goal of linking measures to outcomes important to meeting accreditation requirements at the program and institutional level.

Annual report 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-07-01

This annual report presents an evaluation of activities of the Entomology Unit of the FAO/IAEA Agriculture and Biotechnology Laboratory, Seibersdorf. The major themes of the report include mass rearing and quality control in Tsetse fly and research on Medfly genetic sexing strains.

Annual report 1996

International Nuclear Information System (INIS)

1996-01-01

This annual report presents an evaluation of activities of the Entomology Unit of the FAO/IAEA Agriculture and Biotechnology Laboratory, Seibersdorf. The major themes of the report include mass rearing and quality control in Tsetse fly and research on Medfly genetic sexing strains

Annual report 1999

International Nuclear Information System (INIS)

1999-01-01

This annual report presents an evaluation of activities of the Entomology Unit of the FAO/IAEA Agriculture and Biotechnology Laboratory, Seibersdorf. The major themes of the report include mass rearing and quality control in Tsetse fly and research on Medfly genetic sexing strains

Annual report 1997

International Nuclear Information System (INIS)

1997-01-01

This annual report presents an evaluation of activities of the Entomology Unit of the FAO/IAEA Agriculture and Biotechnology Laboratory, Seibersdorf. The major themes of the report include mass rearing and quality control in Tsetse fly and research on Medfly genetic sexing strains

The impact of the implementation of work hour requirements on residents' career satisfaction, attitudes and emotions.

Science.gov (United States)

Choi, Dongseok; Dickey, Jamie; Wessel, Kristen; Girard, Donald E

2006-10-17

To assess the impact of work hours' limitations required by the Accreditation Council for Graduate Medical Education (ACGME) on residents' career satisfaction, emotions and attitudes. A validated survey instrument was used to assess residents' levels of career satisfaction, emotions and attitudes before and after the ACGME duty hour requirements were implemented. The "pre" implementation survey was distributed in December 2002 and the "post" implementation one in December 2004. Only the latter included work-hour related questions. The response rates were 56% for the 2002 and 72% for the 2004 surveys respectively. Although career satisfaction remained unchanged, numerous changes occurred in both emotions and attitudes. Compared to those residents who did not violate work-hour requirements, those who did were significantly more negative in attitudes and emotions. With the implementation of the ACGME work hour limitations, the training experience became more negative for those residents who violated the work hour limits and had a small positive impact on those who did not violate them. Graduate medical education leaders must innovate to make the experiences for selected residents improved and still maintain compliance with the work hour requirements.

Results of the Association of Directors of Radiation Oncology Programs (ADROP) Survey of Radiation Oncology Residency Program Directors

International Nuclear Information System (INIS)

Harris, Eleanor; Abdel-Wahab, May; Spangler, Ann E.; Lawton, Colleen A.; Amdur, Robert J.

2009-01-01

Purpose: To survey the radiation oncology residency program directors on the topics of departmental and institutional support systems, residency program structure, Accreditation Council for Graduate Medical Education (ACGME) requirements, and challenges as program director. Methods: A survey was developed and distributed by the leadership of the Association of Directors of Radiation Oncology Programs to all radiation oncology program directors. Summary statistics, medians, and ranges were collated from responses. Results: Radiation oncology program directors had implemented all current required aspects of the ACGME Outcome Project into their training curriculum. Didactic curricula were similar across programs nationally, but research requirements and resources varied widely. Program directors responded that implementation of the ACGME Outcome Project and the external review process were among their greatest challenges. Protected time was the top priority for program directors. Conclusions: The Association of Directors of Radiation Oncology Programs recommends that all radiation oncology program directors have protected time and an administrative stipend to support their important administrative and educational role. Departments and institutions should provide adequate and equitable resources to the program directors and residents to meet increasingly demanding training program requirements.

Annual Statistical Supplement, 2002

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2002 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2010

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2010 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2007

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2007 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2001

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2001 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2016

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2016 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2011

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2011 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2005

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2005 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2015

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2015 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2003

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2003 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2017

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2017 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2008

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2008 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2014

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2014 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2004

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2004 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2000

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2000 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2009

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2009 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Annual Statistical Supplement, 2006

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2006 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Coal industry annual 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-12-01

Coal Industry Annual 1997 provides comprehensive information about US coal production, number of mines, prices, productivity, employment, productive capacity, and recoverable reserves. US Coal production for 1997 and previous years is based on the annual survey EIA-7A, Coal Production Report. This report presents data on coal consumption, coal distribution, coal stocks, coal prices, and coal quality for Congress, Federal and State agencies, the coal industry, and the general public. Appendix A contains a compilation of coal statistics for the major coal-producing States. This report includes a national total coal consumption for nonutility power producers that are not in the manufacturing, agriculture, mining, construction, or commercial sectors. 14 figs., 145 tabs.

Coal industry annual 1997

International Nuclear Information System (INIS)

1998-12-01

Coal Industry Annual 1997 provides comprehensive information about US coal production, number of mines, prices, productivity, employment, productive capacity, and recoverable reserves. US Coal production for 1997 and previous years is based on the annual survey EIA-7A, Coal Production Report. This report presents data on coal consumption, coal distribution, coal stocks, coal prices, and coal quality for Congress, Federal and State agencies, the coal industry, and the general public. Appendix A contains a compilation of coal statistics for the major coal-producing States. This report includes a national total coal consumption for nonutility power producers that are not in the manufacturing, agriculture, mining, construction, or commercial sectors. 14 figs., 145 tabs

7 CFR 1230.115 - Submission of annual financial statements.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Submission of annual financial statements. 1230.115... Submission of annual financial statements. State Pork Producer Associations, as defined in § 1230.25, that... financial statements prepared by State association staff members or individuals who prepare annual financial...

Application of annual ring analyses to the detection of smoke damage. I. A methodical contribution to the treatment of annual ring analyses

Energy Technology Data Exchange (ETDEWEB)

Vins, B

1961-01-01

Losses in growth of silvicultural stands caused by smoke can be measured by annual ring analysis. The method is advantageous mainly because the annual gains can be checked far into the past and thus compared with gains before the onset of the pollution. Experience gained in the Krusne Hory area of Czechoslovakia with the methodical processing of 2000 annual ring analyses is reviewed. The principal problem was that more than half the trees exposed to pollution failed to grow annual rings. At first no rings are added from the ground up to a certain height; then the defect spreads all the way into the crowns of the affected trees. This observation is of fundamental importance in the calculation of losses in growth gains due to industrial emissions because hitherto the last annual ring next to the bark was always identified with the test year, while in reality a number of annual rings might already have failed to grow due to the effects of pollution. Errors far exceeding permissible limits might have occurred in the analysis.

75 FR 63805 - Annual Wholesale Trade Survey

Science.gov (United States)

2010-10-18

... on annual sales, e-commerce sales, purchases, total operating expenses, year-end inventories held... wholesale distributors, the Census Bureau will collect data covering sales, e-commerce sales, year-end... manufacturers' sales branches and offices, the Census Bureau will collect data covering annual sales, e-commerce...

Annual report 2000

International Nuclear Information System (INIS)

2001-07-01

Article VI.J of the Agency's Statute requires the Board of Governors to submit 'an annual report to the General Conference concerning the affairs of the Agency and any projects approved by the Agency'. This report covers the period 1 January to 31 December 2000

78 FR 68023 - Annual Wholesale Trade Survey

Science.gov (United States)

2013-11-13

... covering annual sales, e- commerce sales, purchases, total operating expenses, year-end inventories held... Census Bureau will collect data covering sales, e-commerce sales, year-end inventories held inside and... offices, the Census Bureau will collect data covering annual sales, e-commerce sales, year-end inventories...

Annual Change Report 2003/2004

International Nuclear Information System (INIS)

2004-01-01

As part of continuing compliance, the U.S. Environmental Protection Agency (EPA) requires the U.S. Department of Energy (DOE) to provide any change in information since the most recent compliance application. This requirement is identified in Title 40 Code of Federal Regulations (CFR), Section 194.4(b)(4), which states: 'No later than six months after the administrator issues a certification, and at least annually thereafter, the Department shall report to the Administrator, in writing, any changes in conditions or activities pertaining to the disposal system that were not required to be reported by paragraph (b)(3) of this section and that differ from information contained in the most recent compliance application.' In meeting the requirement, the DOE provides an annual report of all changes applicable under the above requirement each November. This annual report informs the EPA of changes to information in the most recent compliance application, or for this report the 1996 Compliance Certification Application (CCA). Significant planned changes must be reported to the EPA prior to implementation by the DOE. In addition, Title 40 CFR, Section 194.4(b)(3) requires that significant unplanned changes be reported to the EPA within 24 hours or ten days, depending on the severity of the activity or condition. To date, there have been no significant unplanned changes to the certification basis. Planned changes have been submitted on an individual basis. All other changes are reported annually. The period covered by this Annual Change Report includes changes that occurred between July 1, 2003, and June 30, 2004. Changes in activities or conditions are reviewed to determine if 40 CFR Section 194.4(b)(3) reporting is necessary. As indicated above, no significant unplanned changes were identified for the time period covered by this report. The enclosed tables list those items identified for reporting under 40 CFR Section 194.4(b)(4). The majority of the changes described in

Annual report 1981

International Nuclear Information System (INIS)

1981-12-01

This annual report contains short descriptions of the work done at the named institute. These concern the study of hyperfine interactions, experiments with synchroton radiation, experiments at storage rings, and experiments at CERN. Furthermore, a list of publications, contributions to conferences and these is presented. (HSI) [de

Annual report 1979

International Nuclear Information System (INIS)

1979-12-01

In this annual report the work done at the named institute is described. This concerns experiments with synchrotron radiations, high energy physics experiments at the PETRA and DORIS storage rings, studies of MFS interactions, and some neutrino experiments at CERN. A list of publications is included. (HSI)

29 CFR 2520.103-10 - Annual report financial schedules.

Science.gov (United States)

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Annual report financial schedules. 2520.103-10 Section 2520... financial schedules. (a) General. The administrator of a plan filing an annual report pursuant to § 2520.103... of the annual report the separate financial schedules described in paragraph (b) of this section. (b...

ANNUAL GENERAL ASSEMBLY

CERN Multimedia

2001-01-01

All members and beneficiaries of the Pension Fund are invited to attend the Annual General Asssembly to be held in the CERN Auditorium on Wednesday 3 October 2001 at 14.30 hrs The Agenda comprises:   Opening Remarks (P. Levaux) Some aspects of risk in a pension fund (C. Cuénoud) Annual Report 2000: Presentation and results (C. Cuénoud) Copies of the Report are available from divisional secretariats. Results of the actuarial reviews (G. Maurin) Questions from members and beneficiaries Persons wishing to ask questions are encouraged to submit them, where possible, in writing in advance, addressed to Mr C. Cuénoud, Administrator of the Fund. Conclusions (P. Levaux) As usual, participants are invited to drinks after the assembly. NB The minutes of the 2000 General Assembly are available from the Administration of the Fund (tel. + 41 22 767 91 94; e-mail Graziella.Praire@cern.ch) The English version will be published next week.

Annual General Asssembly

CERN Document Server

Pension Fund

2005-01-01

All members and beneficiaries of the Pension Fund are invited to attend the Annual General Asssembly to be held in the CERN Council Chamber on Thursday 13 October 2005 at 14:30 The Agenda comprises: Opening Remarks (J. Bezemer) Results and presentation of the Annual Report 2004 - Role of asset classes in pension funds (C. Cuénoud). Copies of the 2004 Report are available from departmental secretariats. Package of measures aiming at equilibrating the Fund - Proposals by the Governing Board (J.-P. Matheys). Questions from members and beneficiaries. Persons wishing to ask questions are encouraged to submit them, where possible, in writing in advance, addressed to Mr C. Cuénoud, Administrator of the Fund. Conclusions (J. Bezemer). As usual, participants are invited to drinks after the assembly. NB The minutes of the 2004 General Assembly are available from the Administration of the Fund (tel.(+4122)767 27 42; e-mail Sophia.Revol@cern.ch)

Annual General Asssembly

CERN Multimedia

2005-01-01

All members and beneficiaries of the Pension Fund are invited to attend the Annual General Asssembly to be held in the CERN Council Chamber on Thursday 13 October 2005 at 14:30 The Agenda comprises: Opening Remarks (J. Bezemer) Results and presentation of the Annual Report 2004 - Role of asset classes in pension funds (C. Cuénoud) Copies of the 2004 Report are available from departmental secretariats. Package of measures aiming at equilibrating the Fund - Proposals by the Governing Board (J.-P. Matheys) Questions from members and beneficiaries Persons wishing to ask questions are encouraged to submit them, where possible, in writing in advance, addressed to Mr C. Cuénoud, Administrator of the Fund. Conclusions (J. Bezemer) As usual, participants are invited to drinks after the assembly. NB The minutes of the 2004 General Assembly are available from the Administration of the Fund (tel.(+4122)767 27 42; e-mail Sophia.Revol@cern.ch)

1998 annual report

International Nuclear Information System (INIS)

1999-01-01

Talisman Energy Inc. is the largest Canadian-based independent oil and gas producer. Its main business activities include exploration, development, production and marketing of natural gas, natural gas liquids and crude oil. Main operating centres are in Canada, the North Sea, Indonesia and Sudan. Talisman Energy is also pursuing a number of high potential exploration ventures in Algeria and Trinidad. The Company has experienced a 30 per cent annual production growth rate over the last five years and has consistently increased its reserve base, while maintaining competitive finding and development costs. This report contains an extensive review of activities and achievements in each of Talisman Energy Inc.'s exploration and operating areas during 1998, a consolidated financial statement, a management discussion and analysis of production and financial performance, and a review of corporate governance. Future prospects are also discussed. Continued growth of 10 to 15 per cent annually over the next two years is anticipated as a result of management's current investment program. tabs

Annual report and accounts 1991-92

International Nuclear Information System (INIS)

1992-01-01

The 1991-1992 Annual Report of Scottish Nuclear Limited includes a brief company profile. Scottish Nuclear, a company owned by the Secretary of State for Scotland, produces over forty per cent of Scotland's total electricity requirement from its Advanced Gas-Cooled Reactors at Hunterston and Torness. The Chairman's Report focuses an operational performance, improvements to public relations procedures and environmental concerns. The Report concludes with the Annual Accounts. (UK)

Metropolitan Optical Networks 1995 Annual Report

DEFF Research Database (Denmark)

Kristensen, Martin; Jouanno, Jean-Marc; Malone, Kevin

1996-01-01

The annual report describes the research carried out in the ACTS-project METON (Metropolitan Optical Networks) in 1995. L.M. Ericsson is prime contractor and 12 partners including DTU is involved in the project.......The annual report describes the research carried out in the ACTS-project METON (Metropolitan Optical Networks) in 1995. L.M. Ericsson is prime contractor and 12 partners including DTU is involved in the project....

A case study of cost-efficient staffing under annualized hours.

Science.gov (United States)

van der Veen, Egbert; Hans, Erwin W; Veltman, Bart; Berrevoets, Leo M; Berden, Hubert J J M

2015-09-01

We propose a mathematical programming formulation that incorporates annualized hours and shows to be very flexible with regard to modeling various contract types. The objective of our model is to minimize salary cost, thereby covering workforce demand, and using annualized hours. Our model is able to address various business questions regarding tactical workforce planning problems, e.g., with regard to annualized hours, subcontracting, and vacation planning. In a case study for a Dutch hospital two of these business questions are addressed, and we demonstrate that applying annualized hours potentially saves up to 5.2% in personnel wages annually.

NAGRA Annual report 2010

International Nuclear Information System (INIS)

2011-04-01

This annual report presents the highlights of the activities carried out by the Swiss National Co-operative for the Disposal of Radioactive Wastes NAGRA during the year 2010. These include reviews by various commissions of the NAGRA co-operative's proposals for possible sites for nuclear waste repositories. Also, the enhancements made concerning information facilities for the general public at the co-operative's rock laboratories are mentioned. The operation of initial satellite-based precision measurement systems for movements in the earth's crust is noted. Organisational aspects and international co-operation are discussed. This annual report also looks at NAGRA's organisational structures and its commercial accounts. Appendices provide details on waste inventories and volumes and publications made in 2010. A selection of relevant internet addresses is also provided

Citizenship and Immigration Services Ombudsman 2015 Annual Report

Data.gov (United States)

Department of Homeland Security — By statute, the Office of the Citizenship and Immigration Services Ombudsman submits an Annual Report to Congress by June 30 of each year. The Ombudsman’s Annual...

Annual report 1983-1984

International Nuclear Information System (INIS)

Porto, V.

1985-01-01

This Annual Report is a resume of the experimental and theoretical low-energy nuclear physics research which is especially concerned with the Pelletron Accelerator, Sao Paulo University, Brazil. (L.C.) [pt

33 CFR 273.17 - Annual budget request.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Annual budget request. 273.17... DEFENSE AQUATIC PLANT CONTROL § 273.17 Annual budget request. The Aquatic Plant Control Program is a... to utilize within the budget year taking into account the foreseeable availability of local funds to...

Annual reports | IDRC - International Development Research Centre

International Development Research Centre (IDRC) Digital Library (Canada)

IDRC publishes an annual report presenting our financial statements and results. It also profiles IDRC-funded researchers, and highlights key projects and achievements. It is the main way we report to Parliament and inform Canadians. Download our most recent annual report, or select from the following list, dating back ...

Petroleum supply annual 1994, Volume 2

International Nuclear Information System (INIS)

1995-06-01

The Petroleum Supply Annual (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1994 through annual and monthly surveys. The PSA is divided into two volumes. This first volume contains four sections: Summary Statistics, Detailed Statistics, Refinery Capacity, and Oxygenate Capacity each with final annual data. The second volume contains final statistics for each month of 1994, and replaces data previously published in the Petroleum Supply Monthly (PSM). The tables in Volumes 1 and 2 are similarly numbered to facilitate comparison between them. Explanatory Notes, located at the end of this publication, present information describing data collection, sources, estimation methodology, data quality control procedures, modifications to reporting requirements and interpretation of tables. Industry terminology and product definitions are listed alphabetically in the Glossary

Riscos e doenças ocupacionais relacionados ao exercício da anestesiologia Riesgos y enfermedades ocupacionales relacionados con el ejercicio de la anestesiología Occupational hazards and diseases related to the practice of anesthesiology

Directory of Open Access Journals (Sweden)

Daniel Volquind

2013-04-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: O exercício da anestesiologia não é isento de riscos para o anestesiologista. Considerada um local de trabalho insalubre em razão dos riscos potenciais que oferece, a sala de operações (SO é o local no qual o anestesiologista passa a maior parte do tempo. Nesta revisão, propomos uma análise dos riscos ocupacionais aos quais estão expostos os anestesiologistas em sua prática diária. CONTEÚDO: Apresentamos a classificação dos riscos e suas relações com as doenças ocupacionais. CONCLUSÃO: O controle dos riscos ocupacionais, aos quais os anestesiologistas são expostos diariamente, se faz necessário para o desenvolvimento de um local de trabalho adequado e com riscos reduzidos para a boa prática da anestesiologia. Isso contribui para a diminuição do absenteísmo, a melhora da assistência prestada ao paciente e da qualidade de vida do anestesiologista.JUSTIFICATIVA Y OBJETIVOS: El ejercicio de la anestesiología no está exento de riesgos para el anestesiólogo. Considerado como un local de trabajo insalubre a causa de los riesgos potenciales a que conlleva, el quirófano es el local en donde el anestesiólogo pasa la mayor parte del tiempo. En esta revisión, proponemos un análisis de los riesgos ocupacionales a los que están expuestos los anestesiólogos en su práctica diaria. CONTENIDO: Presentamos una clasificación de los riesgos y sus relaciones con las enfermedades ocupacionales. CONCLUSIONES: El control de los riesgos ocupacionales a los que están expuestos los anestesiólogos diariamente es necesario para lograr un local de trabajo adecuado y con riesgos reducidos para la buena práctica de la anestesiología, lo que contribuye para la disminución del absentismo, la mejoría de la asistencia prestada al paciente y de la calidad de vida del anestesiólogo.BACKGROUND AND OBJECTIVES: The practice of anesthesiology is not without risks to the anesthesiologist. The operating room (OR, in

Sub-annual paleoenvironmental information evaluated from intensity variations of fluorescent annual layers in a stalagmite from Ryuo-do Cave, Nagasaki Prefecture, western Japan

Science.gov (United States)

Sasaki, Hana; Onishi, Yuri; Ishihara, Yoshiro; Yoshimura, Kazuhisa

2017-04-01

Stalagmites can provide various types of paleoenvironmental information such as information on vegetation and climate changes. Fluorescent annual layers formed by humic substances (mainly fulvic acids: FA) in these stalagmites can also provide a time proxy, and a time series on precipitation. Fluorescence intensity patterns in these annual layers can be classified into symmetric, gradually increasing and gradually decreasing types. Onishi et al. (EGU2016) demonstrated the existence of these fluorescence intensity patterns in the annual layers, and their stratigraphic changes, by numerical simulations, and suggested that the patterns could provide paleoenvironmental information at a sub-annual resolution. In this study, we carried out an analysis of fluorescence intensity patterns in the annual layers of a stalagmite from Ryuo-do Cave, Nagasaki Prefecture, western Japan, and also simulated the patterns in the stalagmite, to obtain paleoenvironmental information. Fluorescence intensity patterns in the annual layers are strongly affected by annual variations in FA concentration and precipitation rates of calcite. As the result of simulations of fluorescence intensity patterns, cumulative variations and various types of pattern are reproduced. These differences are depending on time lags between the variation of the FA concentration in the drip waters, and that of the growth rate of the stalagmite. Co-precipitation models of FA are divided into the "Hiatus model" in which FA are preferentially preserved in the stalagmite when its growth rate is relatively low, and the "Partition coefficient (PC) model" in which FA concentrations in the stalagmite increase when the calcite precipitation rate is relatively high. However, various fluorescence intensity patterns in the annual layers could be formed under a combination or either of both of the models. Fluorescence intensity patterns in an annual layer in the stalagmite from Ryuo-do Cave, Nagasaki Prefecture, western Japan

Uranium industry annual 1994

International Nuclear Information System (INIS)

1995-01-01

The Uranium Industry Annual 1994 (UIA 1994) provides current statistical data on the US uranium industry's activities relating to uranium raw materials and uranium marketing during that survey year. The UIA 1994 is prepared for use by the Congress, Federal and State agencies, the uranium and nuclear electric utility industries, and the public. It contains data for the 10-year period 1985 through 1994 as collected on the Form EIA-858, ''Uranium Industry Annual Survey.'' Data collected on the ''Uranium Industry Annual Survey'' (UIAS) provide a comprehensive statistical characterization of the industry's activities for the survey year and also include some information about industry's plans and commitments for the near-term future. Where aggregate data are presented in the UIA 1994, care has been taken to protect the confidentiality of company-specific information while still conveying accurate and complete statistical data. A feature article, ''Comparison of Uranium Mill Tailings Reclamation in the United States and Canada,'' is included in the UIA 1994. Data on uranium raw materials activities including exploration activities and expenditures, EIA-estimated resources and reserves, mine production of uranium, production of uranium concentrate, and industry employment are presented in Chapter 1. Data on uranium marketing activities, including purchases of uranium and enrichment services, and uranium inventories, enrichment feed deliveries (actual and projected), and unfilled market requirements are shown in Chapter 2

Determining Mean Annual Energy Production

DEFF Research Database (Denmark)

Kofoed, Jens Peter; Folley, Matt

2016-01-01

This robust book presents all the information required for numerical modelling of a wave energy converter, together with a comparative review of the different available techniques. The calculation of the mean annual energy production (MAEP) is critical to the assessment of the levelized cost...... of energy for a wave energy converter or wave farm. Fundamentally, the MAEP is equal to the sum of the product of the power capture of a set of sea-states and their average annual occurrence. In general, it is necessary in the calculation of the MAEP to achieve a balance between computational demand...

12 CFR 411.600 - Semi-annual compilation.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Semi-annual compilation. 411.600 Section 411.600 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES NEW RESTRICTIONS ON LOBBYING Agency Reports § 411.600 Semi-annual compilation. (a) The head of each agency shall collect and compile the...

United Nations Environment Programme. Annual Review 1981.

Science.gov (United States)

United Nations Environment Programme, Nairobi (Kenya).

This edition of the United Nations Environment Programme (UNEP) annual report is structured in three parts. Part 1 focuses on three contemporary problems (ground water, toxic chemicals and human food chains and environmental economics) and attempts to solve them. Also included is a modified extract of "The Annual State of the Environment…

2001 annual report

International Nuclear Information System (INIS)

2002-01-01

This document is the 2001 annual report of the French union of the petroleum industry (UFIP). It summarizes the highlights of the petroleum industry activity in France in 2001 and gives some additional information about the production, refining and distribution of petroleum products in the rest of the world. (J.S.)

SIS - Annual Catch Limit

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Annual Catch Limit (ACL) dataset within the Species Information System (SIS) contains information and data related to management reference points and catch data.

A Novel Method of Evaluating Key Factors for Success in a Multifaceted Critical Care Fellowship Using Data Envelopment Analysis.

Science.gov (United States)

Tiwari, Vikram; Kumar, Avinash B

2018-01-01

The current system of summative multi-rater evaluations and standardized tests to determine readiness to graduate from critical care fellowships has limitations. We sought to pilot the use of data envelopment analysis (DEA) to assess what aspects of the fellowship program contribute the most to an individual fellow's success. DEA is a nonparametric, operations research technique that uses linear programming to determine the technical efficiency of an entity based on its relative usage of resources in producing the outcome. Retrospective cohort study. Critical care fellows (n = 15) in an Accreditation Council for Graduate Medical Education (ACGME) accredited fellowship at a major academic medical center in the United States. After obtaining institutional review board approval for this retrospective study, we analyzed the data of 15 anesthesiology critical care fellows from academic years 2013-2015. The input-oriented DEA model develops a composite score for each fellow based on multiple inputs and outputs. The inputs included the didactic sessions attended, the ratio of clinical duty works hours to the procedures performed (work intensity index), and the outputs were the Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) score and summative evaluations of fellows. A DEA efficiency score that ranged from 0 to 1 was generated for each of the fellows. Five fellows were rated as DEA efficient, and 10 fellows were characterized in the DEA inefficient group. The model was able to forecast the level of effort needed for each inefficient fellow, to achieve similar outputs as their best performing peers. The model also identified the work intensity index as the key element that characterized the best performers in our fellowship. DEA is a feasible method of objectively evaluating peer performance in a critical care fellowship beyond summative evaluations alone and can potentially be a powerful tool to guide individual performance during the fellowship.

ASIST 2002 annual meeting

CERN Multimedia

Peek, R

2003-01-01

Review of discussions and presentations at the American Society for Information Science and Technology 2002 annual meeting. Topics covered included new models of scholarly publishing and the development of the semantic web (1 page).

Annual Report 1981-1982

International Nuclear Information System (INIS)

Porto, V.

1982-01-01

This Annual Report is a resume of the experimental and theoretical nuclear physics research which is especially concerned with the Pelletron Accelerator of the Physical Institute of Sao Paulo University, Brazil. (L.C.) [pt

2002 Annual report: synthesis

International Nuclear Information System (INIS)

2003-01-01

This synthesis of the Annual Report 2002 presents information of the main activities on the scope of the radiation protection and nuclear safety of the Nuclear Regulatory Authority (ARN) of the Argentina during 2002

Scientific annual report 1980

International Nuclear Information System (INIS)

1981-01-01

This annual report contains a collection of the abstracts of the publications concerning research and development in the named institute together with a bibliography about further publications, contributions to conferences and speeches. (HSI) [de

2000 Annual report: synthesis

International Nuclear Information System (INIS)

2001-01-01

This synthesis of the Annual Report 2000 present information of the main activities on the scope of the radiation protection and nuclear safety of the Nuclear Regulatory Authority (NRA) of the Argentina during 2000

2001 Annual report: synthesis

International Nuclear Information System (INIS)

2001-01-01

This synthesis of the Annual Report 2001 presents information of the main activities on the scope of the radiation protection and nuclear safety of the Nuclear Regulatory Authority (ARN) of the Argentina during 2001

Annual environmental monitoring report, January--December 1978

International Nuclear Information System (INIS)

1979-04-01

Environmental monitoring results continue to demonstrate that, except for penetrating radiation, environmental radiological impact due to SLAC operation is not distinguishable from natural environmental sources. During 1978, the maximum neutron dose near the site boundary was 6.6 mrem. This represents about 6.6% of the annual dose from natural sources at this elevation, and 1.3% of the technical standard of 500 mrem per person annually. There have been no measurable increases in radioactivity in ground water attributable to SLAC operations since 1966. Because of major new construction, well water samples were not collected and analyzed during 1978. Construction activities have also temporarily placed our sampling stations for the sanitary and storm sewers out of service. They will be re-established as soon as construction activities permit. Airborne radioactivity released from SLAC continues to make only a negligible environmental impact, and results in a site boundary annual dose of less than 0.01 mrem; this represents less than 0.01% of the annual dose from the natural radiation environment, and about 0.002% of the technical standard

Renewable energy annual 1995

International Nuclear Information System (INIS)

1995-12-01

The Renewable Energy Annual 1995 is the first in an expected series of annual reports the Energy Information Administration (EIA) intends to publish to provide a comprehensive assessment of renewable energy. This report presents the following information on the history, status, and prospects of renewable energy data: estimates of renewable resources; characterizations of renewable energy technologies; descriptions of industry infrastructures for individual technologies; evaluations of current market status; and assessments of near-term prospects for market growth. An international section is included, as well as two feature articles that discuss issues of importance for renewable energy as a whole. The report also contains a number of technical appendices and a glossary. The renewable energy sources included are biomass (wood), municipal solid waste, biomass-derived liquid fuels, geothermal, wind, and solar and photovoltaic

Annual Energy Review 2007

Energy Technology Data Exchange (ETDEWEB)

Seiferlein, Katherine E. [USDOE Energy Information Administration (EIA), Washington, DC (United States)

2008-06-01

The Annual Energy Review (AER) is the Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are data on total energy production, consumption, and trade; overviews of petroleum, natural gas, coal, electricity, nuclear energy, renewable energy, international energy, as well as financial and environment indicators; and data unit conversion tables. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the EIA under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....”

NAGRA Annual report 2010

Energy Technology Data Exchange (ETDEWEB)

NONE

2011-04-15

This annual report presents the highlights of the activities carried out by the Swiss National Co-operative for the Disposal of Radioactive Wastes NAGRA during the year 2010. These include reviews by various commissions of the NAGRA co-operative's proposals for possible sites for nuclear waste repositories. Also, the enhancements made concerning information facilities for the general public at the co-operative's rock laboratories are mentioned. The operation of initial satellite-based precision measurement systems for movements in the earth's crust is noted. Organisational aspects and international co-operation are discussed. This annual report also looks at NAGRA's organisational structures and its commercial accounts. Appendices provide details on waste inventories and volumes and publications made in 2010. A selection of relevant internet addresses is also provided

Renewable energy annual 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-01

The Renewable Energy Annual 1995 is the first in an expected series of annual reports the Energy Information Administration (EIA) intends to publish to provide a comprehensive assessment of renewable energy. This report presents the following information on the history, status, and prospects of renewable energy data: estimates of renewable resources; characterizations of renewable energy technologies; descriptions of industry infrastructures for individual technologies; evaluations of current market status; and assessments of near-term prospects for market growth. An international section is included, as well as two feature articles that discuss issues of importance for renewable energy as a whole. The report also contains a number of technical appendices and a glossary. The renewable energy sources included are biomass (wood), municipal solid waste, biomass-derived liquid fuels, geothermal, wind, and solar and photovoltaic.

2017 Annual Technology Baseline

Energy Technology Data Exchange (ETDEWEB)

Cole, Wesley J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hand, M. M [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Eberle, Annika [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Beiter, Philipp C [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Kurup, Parthiv [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Turchi, Craig S [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Feldman, David J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Margolis, Robert M [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Augustine, Chad R [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Maness, Michael [Formerly NREL; O' Connor, Patrick [Oak Ridge National Laboratory

2018-03-26

Consistent cost and performance data for various electricity generation technologies can be difficult to find and may change frequently for certain technologies. With the Annual Technology Baseline (ATB), the National Renewable Energy Laboratory annually provides an organized and centralized set of such cost and performance data. The ATB uses the best information from the Department of Energy national laboratories' renewable energy analysts as well as information from the Energy Information Administration for fuel-based technologies. The ATB has been reviewed by experts and it includes the following electricity generation technologies: land-based wind, offshore wind, utility-scale solar photovoltaics (PV), commercial-scale solar PV, residential-scale solar PV, concentrating solar power, geothermal power, hydropower, coal, natural gas, nuclear, and conventional biopower. This webinar presentation introduces the 2017 ATB.

Natural gas annual 1992: Supplement: Company profiles

Energy Technology Data Exchange (ETDEWEB)

1994-01-01

The data for the Natural Gas Annual 1991 Supplement : Company Profiles are taken from Form EIA-176, (open quotes) Annual Report of Natural and Supplemental Gas Supply and Disposition (close quotes). Other sources include industry literature and corporate annual reports to shareholders. The companies appearing in this report are major interstate natural gas pipeline companies, large distribution companies, or combination companies with both pipeline and distribution operations. The report contains profiles of 45 corporate families. The profiles describe briefly each company, where it operates, and any important issues that the company faces. The purpose of this report is to show the movement of natural gas through the various States served by the 45 large companies profiled.

Dama annual modulation from electron recoils

OpenAIRE

Foot, R.

2018-01-01

Plasma dark matter, which arises in dissipative dark matter models, can give rise to large annual modulation signals from keV electron recoils. Previous work has argued that the DAMA annual modulation signal might be explained in such a scenario. Detailed predictions are difficult due to the inherent complexities involved in modelling the halo plasma interactions with Earth bound dark matter. Here, we consider a simplified phenomenological model for the dark matter density and temperature nea...

International VLBI Service for Geodesy and Astrometry: 1999 Annual Report

Science.gov (United States)

Vandenberg, Nancy R. (Editor)

1999-01-01

This volume of reports is the 1999 Annual Report of the International VLBI Service for Geodesy and Astrometry -IVS. The individual reports were contributed by VLBI groups in the international geodetic community who constitute the components of IVS. The 1999 Annual Report documents the work of the IVS components for the year ending March 1, 1999, the official inauguration date of IVS. As the newest of the space technique services, IVS decided to publish this Annual Report as a reference to our organization and its components. The entire contents of this Annual Report also appear on the IVS website at: http://ivscc.gsfc.nasa.gov/pub/arl999. The IVS 1999 Annual Report will be a valuable reference for information about IVS and its components. This Annual Report will serve as a baseline from which we can measure the anticipated progress of IVS in coming years.

Annual Reports | Publications | Indian Academy of Sciences

Indian Academy of Sciences (India)

Annual Reports. of the Indian Academy of Sciences. Our Annual Reports since 2000-2001 are freely downloadable. 2016 – 2017. In English. 2015 – 2016. In English. 2014 – 2015. In English | In Hindi. 2013 – 2014. In English | In Hindi. 2012 – 2013. In English | In Hindi. 2011 – 2012. In English | In Hindi. 2010 – 2011.

79th Annual Meeting of the Psychometric Society

CERN Document Server

Bolt, Daniel; Wang, Wen-Chung; Douglas, Jeffrey; Chow, Sy-Miin

2015-01-01

These research articles from the 79th Annual Meeting of the Psychometric Society (IMPS) cover timely quantitative psychology topics, including new methods in item response theory, computerized adaptive testing, cognitive diagnostic modeling, and psychological scaling. Topics within general quantitative methodology include structural equation modeling, factor analysis, causal modeling, mediation, missing data methods, and longitudinal data analysis. These methods will appeal, in particular, to researchers in the social sciences. The 79th annual meeting took place in Madison, WI between July 21nd and 25th, 2014. Previous volumes to showcase work from the Psychometric Society’s Meeting are New Developments in Quantitative Psychology: Presentations from the 77th Annual Psychometric Society Meeting (Springer, 2013) and Quantitative Psychology Research: The 78th Annual Meeting of the Psychometric Society  (Springer, 2015).

80th Annual Meeting of the Psychometric Society

CERN Document Server

Bolt, Daniel; Wang, Wen-Chung; Douglas, Jeffrey; Wiberg, Marie

2016-01-01

The research articles in this volume cover timely quantitative psychology topics, including new methods in item response theory, computerized adaptive testing, cognitive diagnostic modeling, and psychological scaling. Topics within general quantitative methodology include structural equation modeling, factor analysis, causal modeling, mediation, missing data methods, and longitudinal data analysis. These methods will appeal, in particular, to researchers in the social sciences. The 80th annual meeting took place in Beijing, China, between the 12th and 16th of July, 2014. Previous volumes to showcase work from the Psychometric Society’s Meeting are New Developments in Quantitative Psychology: Presentations from the 77th Annual Psychometric Society Meeting (Springer, 2013), Quantitative Psychology Research: The 78th Annual Meeting of the Psychometric Society (Springer, 2015), and Quantitative Psychology Research: The 79th Annual Meeting of the Psychometric Society, Wisconsin, USA, 2014 (Springer, 2015).

20th Annual Systems Engineering Conference, Thursday, Volume 4

Science.gov (United States)

2017-10-26

20th Annual Systems Engineering Conference October 23-26, 2017 | Waterford at Springfield | Springfield, VA NDIA.org/systemsengineering...Conference Program SYSTEMS ENGINEERING CONFERENCE 2 Welcome to the NDIA Systems Engineering Conference On behalf of the National Defense Industrial...Association’s Systems Engineering Division, I would like to extend a very warm welcome to the 20th Annual Systems Engineering Conference. Yes, the 20th Annual

Annual Report 2007

International Nuclear Information System (INIS)

Zielinska, M.; Gawlikowicz, W.

2008-03-01

The Annual Report of the Heavy Ion Laboratory, Warsaw University describes the activities of Laboratory in 2007. The document consist of four parts: '' Laboratory Overview '', '' Experiments and Experimental Set-ups '', '' Experiments Using the Outside Facilities '' and '' General Information on HIL Activities ''. An '' Introduction '' written by director of the Department prof. J. Jastrzebski is also given

Annual Report 2006

International Nuclear Information System (INIS)

Gawlikowicz, W.; Pienkowski, L.

2007-03-01

The Annual Report of the Heavy Ion Laboratory, Warsaw University describes the activities of Laboratory in 2006. The document consist of four parts: 'Laboratory Overview', 'Experiments and Experimental Set-ups', 'Experiments Using the Outside Facilities' and 'General Information on HIL Activities'. An 'Introduction' written by director of the Department prof. J. Jastrzebski is also given

Annual Report 2005

International Nuclear Information System (INIS)

Zielinska, M.; Gawlikowicz, W.; Pienkowski, L.

2006-05-01

The Annual Report of the Heavy Ion Laboratory, Warsaw University describes the activities of Laboratory in 2005. The document consist of four parts: Laboratory Overview, Experiments and Experimental Set-ups, Experiments Using the Outside Facilities and General Information on HIL Activities. An Introduction written by director of the Department prof. J. Jastrzebski is also given

Psychiatry chief resident opinions toward basic and clinical neuroscience training and practice.

Science.gov (United States)

Bennett, Jeffrey I; Handa, Kamna; Mahajan, Aman; Deotale, Pravesh

2014-04-01

The authors queried attendees to a chief resident conference on whether program education and training in neuroscience or in translating neuroscience research into practice is sufficient and what changes are needed. The authors developed and administered a 26-item voluntary questionnaire to each attendee at the Chief Residents' Leadership Conference at the American Psychiatric Association 2013 annual meeting in San Francisco, CA. Out of 94 attendees, 55 completed and returned questionnaires (58.5%). A majority of respondents stated that their program provided adequate training in neuroscience (61.8%); opportunities for neuroscience research existed for them (78.2%), but that their program did not prepare them for translating future neuroscience research findings into clinical practice (78.9%) or educate them on the NIMH Research Domain Criteria (83.3%). A majority of respondents stated that the ACGME should require a specific neuroscience curriculum (79.6%). Chief residents believe that curricular and cultural change is needed in psychiatry residency neuroscience education.

NIRE annual report 1999

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-07-01

The National Institute for Resources and Environment (NIRE) has a R & D concept of 'ecotechnology' that aims to protect the environment from degradation whilst promoting sustainable development. This annual report presents summaries of 32 recent research efforts.

Annual report 2003; Rapport annuel 2003

Energy Technology Data Exchange (ETDEWEB)

NONE

2003-07-01

Delivering products and services to nuclear power plants operators, AREVA operates in every sector of the civilian nuclear power and fuel cycle industry. This annual report 2003 provides, in seven chapters, information on persons responsible for the annual report and for auditing the financial statements, general information on the company and share capital (statute, capital, share trading, dividends), information on company operations, changes and future prospects, assets, financial position and financial performance, corporate governance, recent developments and future prospects. (A.L.B.)

12 CFR 332.5 - Annual privacy notice to customers required.

Science.gov (United States)

2010-01-01

... annually during the continuation of the customer relationship. Annually means at least once in any period... annual notice to that customer by December 31 of year 2. (b)(1) Termination of customer relationship. You... customer concerning that relationship or you sell the credit card receivables without retaining servicing...

12 CFR 216.5 - Annual privacy notice to customers required.

Science.gov (United States)

2010-01-01

... annually during the continuation of the customer relationship. Annually means at least once in any period... annual notice to that customer by December 31 of year 2. (b)(1) Termination of customer relationship. You... customer concerning that relationship or you sell the credit card receivables without retaining servicing...

Germination phenology of some Great Basin native annual forb species

Science.gov (United States)

Tara A. Forbis

2010-01-01

Great Basin native plant communities are being replaced by the annual invasive cheatgrass Bromus tectorum. Cheatgrass exhibits a germination syndrome that is characteristic of facultative winter annuals. Although perennials dominate these communities, native annuals are present at many sites. Germination timing is often an important predictor of competitive...

Pseudomonas fluorescens strains selectively suppress annual bluegrass (Poa annua L.)

Science.gov (United States)

Annual bluegrass (Poa annua L.) is a cool-season annual grass that is a major weed species in turf, turfgrass-seed production, sod production, and golf courses of the western United States. There are few selective herbicides available for the management of annual bluegrass. While the life cycles o...

Institute of Atomic Energy - Annual Report 1998

International Nuclear Information System (INIS)

Swiboda, G.

1999-01-01

This Annual Report of the Institute of Atomic Energy describes the results of the research works carried out at the Institute in 1998. As in the preceding years the authors of the individual scientific reports published in this Annual Report are fully responsible for their content and layout. The Report contains the information on other activities of the Institute as well

Institute of Atomic Energy - Annual Report 1999

International Nuclear Information System (INIS)

Swiboda, G.

2000-01-01

This Annual Report of the Institute of Atomic Energy describes the results of the research works carried out at the Institute at 1999. As in the preceding years the authors of the individual scientific reports published in this Annual Report are fully responsible for their content and layout. The Report contains the information on other activities of the Institute as well

Annual report - LNLS - 1990

International Nuclear Information System (INIS)

1990-01-01

This is the 1990 Annual Report of the LNLS, the upcoming Brazilian Synchrotron Light Source. It discusses its projects, organization as well as the proposed experimental stations. It presents also a list of publications. (A.C.A.S.)

IKO Annual Report 1976

International Nuclear Information System (INIS)

1977-01-01

The IKO Annual Report of 1976 relates their progress in different projects and project fields. The fields covered include electron scattering, pion and muon physics, theory, radio- and nuclear chemistry, technical department, MEA, nuclear reactions and nuclear spectroscopy

EDF - Electricite de France, 2008 annual Results

International Nuclear Information System (INIS)

2009-01-01

The EDF Group is an integrated energy supplier operating in a wide range of electricity-related businesses: generation, transmission, distribution, sale and trading of energy. It is the main operator in the French electricity market and one of the leading electricity groups in Europe. The EDF Group has built a business model balanced between deregulated and regulated operations in France and an international presence. This document is EDF Group's annual Results for 2008. It is made of several reports: The Annual Results press release, the 2008 Annual Results presentation, the 2008 Financial Report, the press releases for the first and third quarters 2008 quarterly financial information, the 2008 Half-year results presentation, the Financial Report for the first half 2008

BIGGEST CZECH BANKS IN THE MIRROR OF ANNUAL REPORTS

Directory of Open Access Journals (Sweden)

Vladislav PAVLAT

2016-02-01

Full Text Available The aim of the Paper is to characterise and analyse the biggest Czech banks Annual reports (ARs. Since 2004, the behaviour of Czech banks has been changing, as can be seen – inter alia - from the big banks´ financial statements and annual reports. During the period of 2007 – 2013 the implementation of IFRS continued and its impact on the institutional structure of banking is visible. From the point of view of banks, annual reports present not only the financial results, but they serve as an important instrument of competition and marketing as well. Comparative analysis of the three Czech leading banks gives a picture of their specific features as reflected in their annual statements.

Annual Report 2000

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

The Institut Laue-Langevin (ILL) is an international research center using neutrons to probe the microscopic structure and dynamics of a broad range of materials. This annual report presents the ILL activities in 2000: the scientific highlights, the Millennium programme and the new developments, the workshops organized by the ILL, the experimental programme and the publications. (A.L.B.)

Annual Report 2000

International Nuclear Information System (INIS)

2000-01-01

The Institut Laue-Langevin (ILL) is an international research center using neutrons to probe the microscopic structure and dynamics of a broad range of materials. This annual report presents the ILL activities in 2000: the scientific highlights, the Millennium programme and the new developments, the workshops organized by the ILL, the experimental programme and the publications. (A.L.B.)

Annual report 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-10-01

The annual report from IKU (Continental Shelf Institute) in Norway deals with the market adjustment of research activities at the institute as a result of offshore cost-cutting policy in the petroleum industry. The market is about to shift focus from volume to competence. In practice, that means buying competence instead of project ideas or proposals

Fourth annual report 1991

International Nuclear Information System (INIS)

1991-01-01

The Independent Radiation Monitoring Scheme for Clwyd began its monitoring programme in Clwyd in 1988. This is the fourth report on the results of the radiation monitoring carried out within Clwyd. The historical reasons for the conception of the Radiation Monitoring Scheme are given in the First Annual Report together with the protocol of operation and detailed sampling and monitoring information. The fourth Annual Report identifies any changes in techniques that have occurred in the last twelve months together with the latest monitoring and analytical data. Samples of air, beach materials, coastal sand and silt, seaweed, meat, fish and milk were taken from various locations within the county. No significant charges in radiation levels were found when compared with data from previous years. The values have remained within the range currently being expected throughout the United Kingdom. (author)

The Importance and Usefulness of Corporate Annual Reports in Malaysia

Directory of Open Access Journals (Sweden)

Nazli Anum Mohd. Ghazali

2010-01-01

Full Text Available The purpose of this study is to examine the perceived importance and usefulness of corporate annual reports in Malaysia and to determine if there is a difference between the perceptions of preparers and users of corporate annual reports. Data for this study were collected using a questionnaire survey conducted in late 2006 and early 2007. Preparers are represented by chief financial officers while users by investment analysts. The mean scores for preparers and users are compared using the independent samples t test and the non-parametric Mann-Whitney test to determine if there are any statistically significant differences in their opinions. The findings reveal that preparers rank the annual report as the most important source of corporate information. Users, on the other hand, rank the annual report as the second most important after the visits to companies. However, the difference in the mean scores of preparers and those of users on the importance of annual reports is not significant at 5 percent level. The difference in the mean scores for the visits to companies is, on the other hand, statistically significant at 5 percent level. An implication for this finding is whether the annual report serves the information needs of analysts for decision-making purposes. An opportunity thus arises for future research to examine information needs of analysts and if there is a gap between information provided in annual reports and that required by analysts.   Keywords: corporate annual reports; disclosure; Malaysia; transparency

The Economic and Workforce Development Program (ED>Net) Annual Report, 2001-02 [and] Addendum to FY 01-02 Annual Report.

Science.gov (United States)

California Community Colleges, Sacramento. Economic Development Coordination Network (EDNet).

This document contains an annual report and its addendum from the Economic and Workforce Development Program of California Community Colleges. The annual report provides an overview of the Program's evaluation processes, regional centers, short-term projects, legislation, strategic plan, etc. It also provides vital facts about the program such as…

Estimated Annual Maintenance Costs for Educational Facilities in Eritrea

DEFF Research Database (Denmark)

Vagnby, Bo Hellisen

Global estimated annual costs for undertaking basic maintenance of all educational facilities in Eritrea.......Global estimated annual costs for undertaking basic maintenance of all educational facilities in Eritrea....

Proceedings of the 29th annual conference of the Canadian Nuclear Association and 10th annual conference of the Canadian Nuclear Society. V. 1-3

Energy Technology Data Exchange (ETDEWEB)

Harvey, M; Fehrenbach, P J [eds.

1990-12-31

The symposium was designed to highlight how the technical information for nuclear energy came to Canada, the effect this information had in Canada in the fields of Physics, Chemistry, Medicine and Nuclear Power. Volume 1 is the combined proceedings of the Canadian Nuclear Association twenty-ninth annual conference and the Canadian Nuclear Society tenth annual conference. Volume 2 is the proceedings of the Canadian Nuclear Association twenty-ninth annual conference, and volume 3 is the proceedings of the Canadian Nuclear Society tenth annual conference.

Proceedings of the 29th annual conference of the Canadian Nuclear Association and 10th annual conference of the Canadian Nuclear Society. V. 1-3

International Nuclear Information System (INIS)

Harvey, M.; Fehrenbach, P.J.

1989-01-01

The symposium was designed to highlight how the technical information for nuclear energy came to Canada, the effect this information had in Canada in the fields of Physics, Chemistry, Medicine and Nuclear Power. Volume 1 is the combined proceedings of the Canadian Nuclear Association twenty-ninth annual conference and the Canadian Nuclear Society tenth annual conference. Volume 2 is the proceedings of the Canadian Nuclear Association twenty-ninth annual conference, and volume 3 is the proceedings of the Canadian Nuclear Society tenth annual conference

78 FR 10180 - Annual Computational Science Symposium; Conference

Science.gov (United States)

2013-02-13

...] Annual Computational Science Symposium; Conference AGENCY: Food and Drug Administration, HHS. ACTION... Pharmaceutical Users Software Exchange (PhUSE), is announcing a public conference entitled ``The FDA/PhUSE Annual Computational Science Symposium.'' The purpose of the conference is to help the broader community align and...

Annual forage cropping-systems for midwestern ruminant livestock production

OpenAIRE

McMillan, John Ernest

2016-01-01

Annual forage cropping systems are a vital aspect of livestock forage production. One area where this production system can be enhanced is the integration of novel annual forages into conventional cropping systems. Two separate projects were conducted to investigate alternative forage options in annual forage production. In the first discussed research trial, two sets of crops were sown following soft red winter wheat (Triticum aestivum L.) grain harvest, at two nitrogen application rates 56 ...

Low-Fidelity Haptic Simulation Versus Mental Imagery Training for Epidural Anesthesia Technical Achievement in Novice Anesthesiology Residents: A Randomized Comparative Study.

Science.gov (United States)

Lim, Grace; Krohner, Robert G; Metro, David G; Rosario, Bedda L; Jeong, Jong-Hyeon; Sakai, Tetsuro

2016-05-01

There are many teaching methods for epidural anesthesia skill acquisition. Previous work suggests that there is no difference in skill acquisition whether novice learners engage in low-fidelity (LF) versus high-fidelity haptic simulation for epidural anesthesia. No study, however, has compared the effect of LF haptic simulation for epidural anesthesia versus mental imagery (MI) training in which no physical practice is attempted. We tested the hypothesis that MI training is superior to LF haptic simulation training for epidural anesthesia skill acquisition. Twenty Post-Graduate Year 2 (PGY-2) anesthesiology residents were tested at the beginning of the training year. After a didactic lecture on epidural anesthesia, they were randomized into 2 groups. Group LF had LF simulation training for epidural anesthesia using a previously described banana simulation technique. Group MI had guided, scripted MI training in which they initially were oriented to the epidural kit components and epidural anesthesia was described stepwise in detail, followed by individual mental rehearsal; no physical practice was undertaken. Each resident then individually performed epidural anesthesia on a partial-human task trainer on 3 consecutive occasions under the direct observation of skilled evaluators who were blinded to group assignment. Technical achievement was assessed with the use of a modified validated skills checklist. Scores (0-21) and duration to task completion (minutes) were recorded. A linear mixed-effects model analysis was performed to determine the differences in scores and duration between groups and over time. There was no statistical difference between the 2 groups for scores and duration to task completion. Both groups showed similarly significant increases (P = 0.0015) in scores over time (estimated mean score [SE]: group MI, 15.9 [0.55] to 17.4 [0.55] to 18.6 [0.55]; group LF, 16.2 [0.55] to 17.7 [0.55] to 18.9 [0.55]). Time to complete the procedure decreased

Acquisition Workforce Annual Report 2006

Data.gov (United States)

General Services Administration — This is the Federal Acquisition Institute's (FAI's) Annual demographic report on the Federal acquisition workforce, showing trends by occupational series, employment...

Acquisition Workforce Annual Report 2008

Data.gov (United States)

General Services Administration — This is the Federal Acquisition Institute's (FAI's) Annual demographic report on the Federal acquisition workforce, showing trends by occupational series, employment...

Annual report 1984-85

International Nuclear Information System (INIS)

1985-01-01

The annual report for Atomic Energy of Canada Limited is presented. An overview of the last year's major events is given and some new areas of expansion are outlined. Financial data for the fiscal year 1984/85 is also given

KTA annual report 1980

International Nuclear Information System (INIS)

The annual report gives an overview of the rulemaking work in the individual fields as well as other activities, such as meetings, international codes of rules, and publications. KTA organization, including its administration and funds is listed. (orig./HP) [de

Annual environmental monitoring report, January--December 1977

International Nuclear Information System (INIS)

1978-05-01

Environmental monitoring results continue to demonstrate that, except for penetrating radiation, environmental radiological impact due to SLAC operation is not distinguishable from natural environmantal sources. During 1977, the maximum neutron dose near the site boundary was 8.2 mrem. This represents about 8.2% of the annual dose from natural sources at this elevation, and 1.6% of the technical standard of 500 mrem per person annually

5 CFR 534.504 - Annual adjustment in pay.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Annual adjustment in pay. 534.504 Section 534.504 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Senior-Level and Scientific and Professional Positions § 534.504 Annual adjustment...

33rd Annual conference and the 23rd annual theoretical seminar of the South African Institute of Physics

International Nuclear Information System (INIS)

1988-01-01

The 33rd annual conference and the 23rd annual theoretical seminar of the South African Institute of Physics was held from 4-8 July 1988 at Rhodes University, Grahamstown. This publication contains only the abstracts of seminars delivered on the conference. The topics that were covered include the various facets of physics such as solid state physics, nuclear and particle physics, optics and spectroscopy, solar-terrestrial physics, eduction, and applied and industrial physics

Electric power annual 1995. Volume I

International Nuclear Information System (INIS)

1996-07-01

The Electric Power Annual presents a summary of electric power industry statistics at national, regional, and State levels. The objective of the publication is to provide industry decisionmakers, government policymakers, analysts, and the general public with data that may be used in understanding U.S. electricity markets. The Electric Power Annual is prepared by the Coal and Electric Data and Renewables Division; Office of Coal, Nuclear, Electric and Alternate Fuels; Energy Information Administration (EIA); U.S. Department of Energy. In the private sector, the majority of the users of the Electric Power Annual are researchers and analysts and, ultimately, individuals with policy- and decisionmaking responsibilities in electric utility companies. Financial and investment institutions, economic development organizations interested in new power plant construction, special interest groups, lobbyists, electric power associations, and the news media will find data in the Electric Power Annual useful. In the public sector, users include analysts, researchers, statisticians, and other professionals with regulatory, policy, and program responsibilities for Federal, State, and local governments. The Congress and other legislative bodies may also be interested in general trends related to electricity at State and national levels. Much of the data in these reports can be used in analytic studies to evaluate new legislation. Public service commissions and other special government groups share an interest in State-level statistics. These groups can also compare the statistics for their States with those of other jurisdictions

Secretary's annual report to Congress

Energy Technology Data Exchange (ETDEWEB)

None

1980-01-01

This second annual report of the DOE covers activities of all elements of the department except the independent FERC, which issues its own annual report. Individual chapters concern a posture statement, conservation, solar and other renewable energy, fossil energy, electric energy, nuclear energy, the environment, defense programs, international programs, general science programs, energy information, economic regulation, energy production, and support operations. The following appendixes are also included: foreign direct investments in US energy sources and supplies, exports of energy resources by foreign companies, major recipients of DOE funding, actions taken regarding disclosure of energy assets by DOE employees, financial assistance programs for alternative fuel demonstration facilities, and 1978 budget summary. 16 figures, 56 tables. (RWR)

EDF - Electricite de France, 2009 annual Results

International Nuclear Information System (INIS)

2010-01-01

The EDF Group is an integrated energy supplier operating in a wide range of electricity-related businesses: generation, transmission, distribution, sale and trading of energy. It is the main operator in the French electricity market and one of the leading electricity groups in Europe. The EDF Group has built a business model balanced between deregulated and regulated operations in France and an international presence. This document is EDF Group's annual Results for 2009. It is made of several reports: The Annual Results press release, the 2009 Annual Results presentation and its appendices of the presentation the press releases for the first and third quarters 2009 quarterly financial information, the presentation of the Sales for the 3rd quarter 2009, the 2009 Half-year results presentation, the Financial Report for the first half 2009

Annual General Meetings

OpenAIRE

2009-01-01

We have produced this information booklet to explain why companies must – by law – hold an Annual General Meeting (AGM). The laws which cover AGMs are known as the Companies Acts. This guide gives only a summary of the rules for AGMs. If you have a concern about the AGM of a particular company, you should get independent legal advice.

Annual Report 2008

Energy Technology Data Exchange (ETDEWEB)

Keeley, N; Skalski, J [The Andrzej Soltan Institute for Nuclear Studies, Swierk-Otwock (Poland)

2009-07-01

The ''Annual Report 2008'' describes activities of Andrzej Soltan Institute for Nuclear Studies in 2008. Report consists of two parts. First one consists of general information about location, management, scientific council, personnel, financial support and conferences while the second one describes the scientific activity of Institute. A Foreword to all report written by Director of the Institute prof. Grzegorz Wrochna is also given.

Annual Report 2010

International Nuclear Information System (INIS)

Palacz, M.; Zielinska, M.

2011-06-01

The Annual Report of the Heavy Ion Laboratory, University of Warsaw describes the activities of Laboratory in 2010. The document consist of four parts: '' Laboratory Overview '', '' Experiments at HIL '', '' Experiments Using the Outside Facilities '' and '' Appendices '' where general information on HIL activities are described. An '' Introduction '' written by director of the Heavy Ion Laboratory prof. K. Rusek is also given.

Annual Report 2004

International Nuclear Information System (INIS)

Swiboda, G.

2005-01-01

The Annual Report of the Institute of Atomic Energy describes the results of the research activities carried out in 2004. The document consist of seven parts: General Information; Operation and safety of MARIA reactor; Radiological protection and monitoring of environment; Nuclear techniques in health and environment protection and in last section the list of published in 2004 papers is presented

Annual Report 2008

International Nuclear Information System (INIS)

Keeley, N.; Skalski, J.

2009-01-01

The ''Annual Report 2008'' describes activities of Andrzej Soltan Institute for Nuclear Studies in 2008. Report consists of two parts. First one consists of general information about location, management, scientific council, personnel, financial support and conferences while the second one describes the scientific activity of Institute. A Foreword to all report written by Director of the Institute prof. Grzegorz Wrochna is also given

NUFFIC Annual Report, 1977.

Science.gov (United States)

Netherlands Universities Foundation for International Co-operation, The Hague.

The 1977 annual report of the Netherlands Universities Foundation for International Cooperation (NUFFIC) considers the following topics: major developments in work and policy; relationships NUFFIC has with other organizations; University Development Cooperation; developments in international education; the functioning of the Consultative Structure…

CSIR Annual report 1963

CSIR Research Space (South Africa)

CSIR

1963-01-01

Full Text Available This report presents the nineteenth annual report of the Council for Scientific and Industrial Research. The report covers the period from the 1st January, 1963, to the 31st December 1963. Balance sheets and statements of income and expenditure...

Sustainability Annual Report 2013

OpenAIRE

2013-01-01

Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

Sustainability Annual Report 2014

OpenAIRE

2014-01-01

Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

Sustainability Annual Report 2017

OpenAIRE

2017-01-01

Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

Sustainability Annual Report 2011

OpenAIRE

2011-01-01

Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

Sustainability Annual Report 2012

OpenAIRE

2012-01-01

Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

Sustainability Annual Report 2015

OpenAIRE

2015-01-01

Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

Sustainability Annual Report 2016

OpenAIRE

2016-01-01

Every year, Virginia Tech releases a sustainability annual report to show the university’s progress in meeting the sustainability goals. The key sustainability metrics these reports cover include: greenhouse gas (GHG) emissions, energy use intensity, alternative transportation use, recycling, and water consumption.

Petroleum marketing annual 1994

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-08-24

The Petroleum Marketing Annual (PMA) provides information and statistical data on a variety of crude oils and refined petroleum products. The publication presents statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysis, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the fob and landed cost of imported crude oil, and the refiners` acquisition cost of crude oil. Refined petroleum product sales data include motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane. The Petroleum Marketing Division, Office of Oil and Gas, Energy Information Administration ensures the accuracy, quality, and confidentiality of the published data in the Petroleum Marketing Annual. For this production, all estimates have been recalculated since their earlier publication in the Petroleum Marketing Monthly (PMM). These calculations made use of additional data and corrections that were received after the PMM publication date.

Petroleum marketing annual 1994

International Nuclear Information System (INIS)

1995-01-01

The Petroleum Marketing Annual (PMA) provides information and statistical data on a variety of crude oils and refined petroleum products. The publication presents statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysis, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the fob and landed cost of imported crude oil, and the refiners' acquisition cost of crude oil. Refined petroleum product sales data include motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane. The Petroleum Marketing Division, Office of Oil and Gas, Energy Information Administration ensures the accuracy, quality, and confidentiality of the published data in the Petroleum Marketing Annual. For this production, all estimates have been recalculated since their earlier publication in the Petroleum Marketing Monthly (PMM). These calculations made use of additional data and corrections that were received after the PMM publication date

Nagra annual report 2013

International Nuclear Information System (INIS)

2014-01-01

This annual report made by the Swiss National Cooperative for the Disposal of Radioactive Waste (NAGRA) takes a look at the cooperative’s activities and work done in 2013. Nagra’s task is recapitulated. Developments in 2013 concerning legislation, inventories of radioactive materials, sectorial planning and scientific and technical aspects are examined. Work done in the rock laboratories, in the public relations sector and consulting areas is looked at. Nagra’s organizational structure with its management, commissions and auditors is commented on and an organigram of the head office is presented. On the financial side of things, the annual financial statement with incomes, cash flow and accumulated accounts is presented as is the report made by the statutory auditors. An appendix to the report contains details on waste inventories and volumes, a list publications made in 2012 as well as Internet addresses and a glossary

Nagra annual report 2013

Energy Technology Data Exchange (ETDEWEB)

NONE

2014-07-01

This annual report made by the Swiss National Cooperative for the Disposal of Radioactive Waste (NAGRA) takes a look at the cooperative’s activities and work done in 2013. Nagra’s task is recapitulated. Developments in 2013 concerning legislation, inventories of radioactive materials, sectorial planning and scientific and technical aspects are examined. Work done in the rock laboratories, in the public relations sector and consulting areas is looked at. Nagra’s organizational structure with its management, commissions and auditors is commented on and an organigram of the head office is presented. On the financial side of things, the annual financial statement with incomes, cash flow and accumulated accounts is presented as is the report made by the statutory auditors. An appendix to the report contains details on waste inventories and volumes, a list publications made in 2012 as well as Internet addresses and a glossary.

Semi-annual Sq-variation in solar activity cycle

Science.gov (United States)

Pogrebnoy, V.; Malosiev, T.

The peculiarities of semi-annual variation in solar activity cycle have been studied. The data from observatories having long observational series and located in different latitude zones were used. The following observatories were selected: Huancayo (magnetic equator), from 1922 to 1959; Apia (low latitudes), from 1912 to 1961; Moscow (middle latitudes), from 1947 to 1965. Based on the hourly values of H-components, the average monthly diurnal amplitudes (a difference between midday and midnight values), according to five international quiet days, were computed. Obtained results were compared with R (relative sunspot numbers) in the ranges of 0-30R, 40-100R, and 140-190R. It was shown, that the amplitude of semi-annual variation increases with R, from minimum to maximum values, on average by 45%. At equatorial Huancayo observatory, the semi-annual Sq(H)-variation appears especially clearly: its maximums take place at periods of equinoxes (March-April, September-October), and minimums -- at periods of solstices (June-July, December-January). At low (Apia observatory) and middle (Moscow observatory) latitudes, the character of semi-annual variation is somewhat different: it appears during the periods of equinoxes, but considerably less than at equator. Besides, with the growth of R, semi-annual variation appears against a background of annual variation, in the form of second peaks (maximum in June). At observatories located in low and middle latitudes, second peaks become more appreciable with an increase of R (March-April and September-October). During the periods of low solar activity, they are insignificant. This work has been carried out with the support from International Scientific and Technology Center (Project #KR-214).

Nuclear Physics Department annual report

International Nuclear Information System (INIS)

1997-07-01

This annual report presents articles and abstracts published in foreign journals, covering the following subjects: nuclear structure, nuclear reactions, applied physics, instrumentation, nonlinear phenomena and high energy physics

Areva 2005 annual report

International Nuclear Information System (INIS)

2005-01-01

This annual report contains information on AREVA's objectives, prospects and strategies, particularly in Chapters 4 and 7, as well as contains information on the markets, market shares and competitive position of the AREVA group. Content: 1 - Person responsible for the annual report and persons responsible for auditing the financial statements; 2 - Information pertaining to the transaction; 3 - General information on the company and share capital: Information on AREVA, Information on share capital and voting rights, Investment certificate trading, Dividends, Organizational chart of the AREVA group, Equity interests, Shareholders' agreements; 4 - Information on company operations, 5 - New developments and future prospects: Overview and strategy of the AREVA group, The Nuclear Power and Transmission and Distribution markets, AREVA group energy businesses, Front End Division, Reactors and Services Division, Back End Division, Transmission and Distribution Division, Major Contracts, The Group's principal sites, AREVA's customers and suppliers, Human resources, Sustainable Development and Continuous Improvement, Capital spending programs, Research and development, intellectual property and brand name programs, Risk and insurance; 6 - Assets - Financial position - financial performance: Analysis of and comments on the Group's financial position and performance, Human Resources report 2005, Environmental report, Consolidated financial statements, Notes to the consolidated financial statements, AREVA SA Financial statements 2005, Notes to the corporate financial statements; 7 - Corporate governance: Composition and functioning of administrative bodies, Executive compensation, Profit-sharing plans, AREVA Values Charter, Annual General Meeting of Shareholders of May 2, 2006; 8 - Recent developments and outlook: Events subsequent to year-end closing for 2005, Outlook

31st Annual conference and the 21st annual theoretical seminar of the South African Institute of Physics

International Nuclear Information System (INIS)

1986-01-01

The 31st annual conference and the 21st annual theoretical seminar of the South African Institute of Physics was held from 7-11 July 1986 at the Rand Afrikaans University, Johannesburg. This publication contains only the abstracts of seminars delivered on the conference. The topics that were covered include the various facets of physics such as solid state physics, nuclear and particle physics, optics and spectroscopy, solar-terrestrial physics, education, and applied and industrial physics

32nd Annual conference and the 22nd annual theoretical seminar of the South African Institute of Physics

International Nuclear Information System (INIS)

1987-01-01

The 32nd annual conference and the 22nd annual theoretical seminar of the South African Institute of Physics was held from 13-17 July 1987 at the University of Natal, Durban. This publication contains only the abstracts of seminars delivered on the conference. The topics that were covered include the various facets of physics such as solid state physics, nuclear and particle physics, optics and spectroscopy, solar-terrestrial physics, education, and applied and industial physics

12 CFR 918.2 - Annual directors' compensation policy.

Science.gov (United States)

2010-01-01

... § 918.3. At a minimum, such policy shall address the activities or functions for which attendance is... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Annual directors' compensation policy. 918.2... HOME LOAN BANKS BANK DIRECTOR COMPENSATION AND EXPENSES § 918.2 Annual directors' compensation policy...

Annual report, 1982

International Nuclear Information System (INIS)

1983-01-01

In 1982 Eldorado Nuclear Ltd. acquired important new sources of uranium in the Wollaston Lake area of northern Saskatchewan by purchasing the shares of Gulf Minerals Canada Ltd. and Uranerz Canada Ltd. Eldorado Nuclear Ltd. is now sole owner of the Rabbit Lake properties, consisting of more than 30 million kg of U 3 O 8 and a mill with a capacity of 2.5 million kg annually. Production records were set at the Port Hope, Ontario, uranium processing plant, and processing capacity continued to expand there and at the new Blind River, Ontario, refinery. The uneconomic Beaverlodge mine in northern Saskatchewan was closed as scheduled. The company participated in the development of the Key Lake project in northern Saskatchewan. This high-grade, open pit mine has reserves containing more than 80 million kg of U 3 O 8 , and will have a production capacity of 5.4 million kg annually when production begins in 1983. Company assets were increased from $618.4 million in 1981 to $875.6 million in 1982; and corporate structure was re-organized to integrate newly-acquired operations. Earnings for 1982 were $4 million

Annual report 1981, annex

International Nuclear Information System (INIS)

1982-01-01

This volume entitled ''Annex to the annual report'' deals in more detail with the scientific works of the I.L.L.: the scientific activity of theoricians; experimental reports on inelastic scattering in simple solids, crystallographic and magnetic structures, fluids and amorphous substances, imperfections, biology, chemistry

CSIR Annual report 1966

CSIR Research Space (South Africa)

CSIR

1966-01-01

Full Text Available This report presents the twenty second annual report of the Council for Scientific and Industrial Research. The report covers the period from the 1st January, 1966, to the 31st December 1966. Balance sheets and statements of income and expenditure...

CSIR Annual report 1968

CSIR Research Space (South Africa)

CSIR

1968-01-01

Full Text Available This report presents the twenty fourth annual report of the Council for Scientific and Industrial Research. The report covers the period from the 1st January, 1968, to the 31st December 1968. Balance sheets and statements of income and expenditure...

CSIR Annual report 1971

CSIR Research Space (South Africa)

CSIR

1971-01-01

Full Text Available This report presents the twenty seventh annual report of the Council for Scientific and Industrial Research. The report covers the period from the 1st January, 1971, to the 31st December 1971. Balance sheets and statements of income and expenditure...

CSIR Annual report 1970

CSIR Research Space (South Africa)

CSIR

1970-01-01

Full Text Available This report presents the twenty sixth annual report of the Council for Scientific and Industrial Research. The report covers the period from the 1st January, 1970, to the 31st December 1970. Balance sheets and statements of income and expenditure...

CSIR Annual report 1969

CSIR Research Space (South Africa)

CSIR

1969-01-01

Full Text Available This report presents the twenty fifth annual report of the Council for Scientific and Industrial Research. The report covers the period from the 1st January, 1969, to the 31st December 1969. Balance sheets and statements of income and expenditure...

Annual report SNET 2003

International Nuclear Information System (INIS)

2004-01-01

This annual report of the SNET (National Society of Electricity and thermic) presents the society activities and the financial report for the year 2003. The society position in the market, the environmental policy, the performance, the workers and financial data are detailed. (A.L.B.)

CSIR Annual report 1967

CSIR Research Space (South Africa)

CSIR

1967-01-01

Full Text Available This report presents the twenty third annual report of the Council for Scientific and Industrial Research. The report covers the period from the 1st January, 1967, to the 31st December 1967. Balance sheets and statements of income and expenditure...

Annual report - ESCELSA - 1999

International Nuclear Information System (INIS)

2000-01-01

The annual report of 1999 of ESCELSA - Brazilian electric power company - introduces the next main topics: state of Espirito Santo; strategic focus; financial performance; relation with investors; energy sales; customers; quality; electric system; investments; people; resources; synergies; awards; outlook; social balancing; and patrimonial balancing

CSIR Annual report 1980

CSIR Research Space (South Africa)

CSIR

1980-01-01

Full Text Available This report presents the thirty-sixth annual report of the CSIR. The report covers the period 1 January, 1980 to 31 December 1980. A balance sheet and statements of income and expenditure for the financial year ended 31st March 1980, certified...

CSIR Annual report 1962

CSIR Research Space (South Africa)

CSIR

1962-01-01

Full Text Available This report presents the eighteenth annual report of the CSIR. The report covers the period 1 January, 1962 to 31 December 1962. A balance sheet and statements of income and expenditure for the financial year ended 31st March 1962, certified...

CSIR Annual report 1983

CSIR Research Space (South Africa)

CSIR

1983-01-01

Full Text Available This report presents the thirty ninth annual report of the CSIR. The report covers the period 1 January, 1983 to 31 December 1983. A balance sheet and statements of income and expenditure for the financial year ended 31st March 1983, certified...

CSIR Annual report 1981

CSIR Research Space (South Africa)

CSIR

1981-01-01

Full Text Available This report presents the thirty seventh annual report of the CSIR. The report covers the period 1 January, 1981 to 31 December 1981. A balance sheet and statements of income and expenditure for the financial year ended 31st March 1981, certified...

CSIR Annual report 1982

CSIR Research Space (South Africa)

CSIR

1982-01-01

Full Text Available This report presents the thirty eighth annual report of the CSIR. The report covers the period 1 January, 1982 to 31 December 1982. A balance sheet and statements of income and expenditure for the financial year ended 31st March 1982, certified...

Annual Performance Report - FY 2011

Science.gov (United States)

This report summarizes OIG activity, performance, results, and challenges, and provides a financial accounting of resources for fiscal year (FY) 2011 compared to our FY 2011 annual performance targets.

EDF - Electricite de France, 2014 annual Results

International Nuclear Information System (INIS)

2015-01-01

The EDF Group is an integrated energy supplier operating in a wide range of electricity-related businesses: generation, transmission, distribution, sale and trading of energy. It is the main operator in the French electricity market and one of the leading electricity groups in Europe. The EDF Group has built a business model balanced between deregulated and regulated operations in France and an international presence. This document is EDF Group's annual Results for 2014. It is made of several reports: the Annual Results press release, the 2014 Annual Results presentation and its appendices, the transcript of the Investors and Analysts conference, the Consolidated financial statements at 31 December 2014, the Statutory Auditors' report, the 2014 Management report and Group results, the 2014 financial annual statements, the 3rd quarter 2014 Sales press release, the 3rd quarter 2014 Sales presentation with its appendices and transcript, the first quarter 2014 Sales press release, the first quarter 2014 Sales presentation with its appendices and transcript, the 2014 Half-year Results press release, the 2014 Half-year Results presentation and its appendices, the transcript of the Investors and Analysts conference, the Consolidated Financial Statements at 30 June 2014, the 2014 Half-year Statutory Auditors' report, the Financial Report for the first half 2014

Syncrude Canada Ltd. 1998 annual report

International Nuclear Information System (INIS)

1999-01-01

Syncrude Canada Ltd. operates the Syncrude Project which is a joint venture of 10 partners responsible for operating the largest crude oil-producing oil sands facility in the world. The facility provides more than 13 per cent of Canada's annual oil requirements. Syncrude's product is Syncrude Sweet Blend (SSB) which is a high quality, light, sweet crude oil. SSB is produced through an integrated process that begins with the surface mining of the oil sands. Annual SSB shipments for 1998 were 76.7 million barrels, the 17th annual record in 20 years of operation. In 1998, construction also began on the second ore train of the North Mine and its associated hydrotransport facilities. The report presents an overview of financial highlights and operating results for 1998, paying appropriate tribute to innovation that has been responsible for the continuous improvements made by the Consortium. The report also expresses the Joint Venture Partners' long-term commitment to applying the latest technology, improving workforce productivity, environmental performance, an even higher quality product, and more cost-effective ways to do business. 2 tabs

29 CFR 1919.74 - Annual examination of derricks.

Science.gov (United States)

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Annual examination of derricks. 1919.74 Section 1919.74... § 1919.74 Annual examination of derricks. (a) In any year in which no quadrennial unit proof test is required, an examination shall be carried out by an accredited person or his authorized representative...

An automated approach for annual layer counting in ice cores

Science.gov (United States)

Winstrup, M.; Svensson, A.; Rasmussen, S. O.; Winther, O.; Steig, E.; Axelrod, A.

2012-04-01

The temporal resolution of some ice cores is sufficient to preserve seasonal information in the ice core record. In such cases, annual layer counting represents one of the most accurate methods to produce a chronology for the core. Yet, manual layer counting is a tedious and sometimes ambiguous job. As reliable layer recognition becomes more difficult, a manual approach increasingly relies on human interpretation of the available data. Thus, much may be gained by an automated and therefore objective approach for annual layer identification in ice cores. We have developed a novel method for automated annual layer counting in ice cores, which relies on Bayesian statistics. It uses algorithms from the statistical framework of Hidden Markov Models (HMM), originally developed for use in machine speech recognition. The strength of this layer detection algorithm lies in the way it is able to imitate the manual procedures for annual layer counting, while being based on purely objective criteria for annual layer identification. With this methodology, it is possible to determine the most likely position of multiple layer boundaries in an entire section of ice core data at once. It provides a probabilistic uncertainty estimate of the resulting layer count, hence ensuring a proper treatment of ambiguous layer boundaries in the data. Furthermore multiple data series can be incorporated to be used at once, hence allowing for a full multi-parameter annual layer counting method similar to a manual approach. In this study, the automated layer counting algorithm has been applied to data from the NGRIP ice core, Greenland. The NGRIP ice core has very high temporal resolution with depth, and hence the potential to be dated by annual layer counting far back in time. In previous studies [Andersen et al., 2006; Svensson et al., 2008], manual layer counting has been carried out back to 60 kyr BP. A comparison between the counted annual layers based on the two approaches will be presented

Annual report 2005

International Nuclear Information System (INIS)

2005-01-01

This annual report of the Group Gaz de France presents the activities for the year 2005 in four main chapters: the group profile, the governance and the challenges; the energy and services display and the infrastructures; the capital opening and some key data; the group collaborators, the energy conservation, the research programs and the future of the gas and the electricity. (A.L.B.)

Annual Report 2008

International Nuclear Information System (INIS)

Zielinska, M.; Gawlikowicz, W.

2009-06-01

The Annual Report of the Heavy Ion Laboratory, University of Warsaw describes the activities of Laboratory in 2008. The document consist of four parts: '' Laboratory Overview '', '' Experiments and Experimental Set-ups '', '' Experiments Using the Outside Facilities '' and '' General Information on HIL Activities ''. An '' Introduction '' written by directors of the Heavy Ion Laboratory: prof. J. Jastrzebski, prof. J. Kownacki and prof. K. Rusek is also given

Nursing Facility Initiative Annual Report

Data.gov (United States)

U.S. Department of Health & Human Services — This annual report summarizes impacts from the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents in 2014. This initiative is designed...

Economic consequences of incident disease: the effect on loss of annual income

DEFF Research Database (Denmark)

Rayce, Signe L; Christensen, Ulla; Hougaard, Charlotte Ø

2008-01-01

AIMS: To estimate the effect of incident disease on loss of annual income on an individual level, to analyse whether loss of job mediates the effect on loss of annual income, to analyse whether an association is modified by socioeconomic position, and to determine whether the effect on annual inc...... on annual income. This might be interpreted as a buffering effect of the welfare policies in relation to the more discriminating demands of the labour market.......AIMS: To estimate the effect of incident disease on loss of annual income on an individual level, to analyse whether loss of job mediates the effect on loss of annual income, to analyse whether an association is modified by socioeconomic position, and to determine whether the effect on annual...... with an increased and equally strong risk for experiencing a loss of annual income corresponding to one income decile (>25,000 DKK) in the year following disease (odds ratio (OR) from 1.37 (95% confidence interval (CI) 1.09-1.72) to 1.57 (95% CI 1.21-2.04)). No significant effect of female AMI was found...

A technique to identify annual growth rings in Eucalyptus grandis using annual measurements of diameter at breast height and gamma ray densitometry

CSIR Research Space (South Africa)

Naidoo, Sasha

2010-06-01

Full Text Available A technique was developed to identify annual growth rings in E. grandis using a combination of annual measurements of diameter at breast height (DBH) from permanent sample plot (PSP) datasets and bark-pith density profiles. By assessing the pattern...

Annual report to Congress, 1998

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-04-01

Section 205 of the Department of Energy Organization Act of 1977 established the Energy Information Administration (EIA). One of the mandates in this legislation is that EIA prepare for Congress an annual report summarizing both activities and information collected and published. EIA`s major 1998 accomplishments are profiled in the body of this edition of the Annual Report to Congress. Appendix A contains abstracts of significant reports issued by EIA in 1998 and a chart of all titles and a list of all feature articles published during the year. Appendix B contains graphs of selected performance measures. Appendix C lists contact information for EIA subject matter specialists. Appendix D lists the major laws which form the basis of EIA`s legislative mandate.

Annual report to Congress 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-07-01

Section 205 of the Department of Energy Organization Act of 1977 established the Energy Information Administration (EIA). One of the mandates in this legislation is that EIA prepare for Congress an annual report summarizing both activities and information collected and published. EIA`s major 1997 accomplishments are profiled in the body of this edition of the Annual Report to Congress. Appendix A contains abstracts of significant reports issued by EIA in 1997, and a chart of all titles and a list of all feature articles published during the year. Appendix B contains graphs of selected performance measures. Appendix C lists contact information for EIA subject matter specialists. Appendix D lists the major laws which form the basis of EIA`s legislative mandate.

Annual Report - ESCELSA - 1997

International Nuclear Information System (INIS)

1998-01-01

The annual report of ESCELSA - Brazilian electric power distribution company - introduces the following main topics: state of Espirito Santo; strategic focus; financial performance; relation with investors; energy sales; market overview; market expansion; customers; technological stream; measuring quality; electric system; investments; protecting the environment; and resource allocation

20th Annual Systems Engineering Conference. Volume 1, Monday-Tuesday

Science.gov (United States)

2017-10-26

20th Annual Systems Engineering Conference October 23-26, 2017 | Waterford at Springfield | Springfield, VA NDIA.org/systemsengineering...Conference Program SYSTEMS ENGINEERING CONFERENCE 2 Welcome to the NDIA Systems Engineering Conference On behalf of the National Defense Industrial...Association’s Systems Engineering Division, I would like to extend a very warm welcome to the 20th Annual Systems Engineering Conference. Yes, the 20th Annual

Annual recertification: fun? Wow!

Science.gov (United States)

Amos, A

1994-01-01

Learning is critical to fostering a knowledge base required for maintaining currency and furthering professional development. In the ever-changing field of nephrology, most skills practised in nursing are considered to be sanctioned medical acts or added nursing skills. Therefore, annual recertification of the skills designated as sanctioned medical acts is an expectation of the College of Nurses of Ontario. The Wellesley Hospital policy indicates one time only or annual approval of the added nursing skills. The article will discuss the use of games as a creative, non-threatening educational tool in the recertification/re-approval process currently in place at The Wellesley Hospital, renal programs. In the past two years, several games or alternative teaching strategies have been utilized to assist the staff in preparing for recertification. This paper will examine the advantages and disadvantages of utilizing alternative teaching formats. Commentary regarding the response of staff nurses, nursing management and education will be highlighted.

International energy annual 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-04-01

The International Energy Annual presents an overview of key international energy trends for production, consumption, imports, and exports of primary energy commodities in over 220 countries, dependencies, and areas of special sovereignty. Also included are population and gross domestic product data, as well as prices for crude oil and petroleum products in selected countries. Renewable energy reported in the International Energy Annual includes hydroelectric power and geothermal, solar, and wind electric power. Also included are biomass electric power for Brazil and the US, and biomass, geothermal, and solar energy produced in the US and not used for electricity generation. This report is published to keep the public and other interested parties fully informed of primary energy supplies on a global basis. The data presented have been largely derived from published sources. The data have been converted to units of measurement and thermal values (Appendices E and F) familiar to the American public. 93 tabs.

Annual Energy Review 2011

Energy Technology Data Exchange (ETDEWEB)

Fichman, Barbara T. [USDOE Energy Information Administration (EIA), Washington, DC (United States)

2012-09-01

The Annual Energy Review (AER) is the U.S. Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are statistics on total energy production, consumption, trade, and energy prices; overviews of petroleum, natural gas, coal, electricity, nuclear energy, and renewable energy; financial and environment indicators; and data unit conversions. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the EIA under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....” The AER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public. EIA welcomes suggestions from readers regarding the content of the AER and other EIA publications.

Estimating annual bole biomass production using uncertainty analysis

Science.gov (United States)

Travis J. Woolley; Mark E. Harmon; Kari B. O' Connell

2007-01-01

Two common sampling methodologies coupled with a simple statistical model were evaluated to determine the accuracy and precision of annual bole biomass production (BBP) and inter-annual variability estimates using this type of approach. We performed an uncertainty analysis using Monte Carlo methods in conjunction with radial growth core data from trees in three Douglas...

39 CFR 6.1 - Regular meetings, annual meeting.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Regular meetings, annual meeting. 6.1 Section 6.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE MEETINGS (ARTICLE VI) § 6.1 Regular meetings, annual meeting. The Board shall meet regularly on a schedule...

25 CFR 227.16 - Crediting advance annual payments.

Science.gov (United States)

2010-04-01

... equal such advance payment; nor will any part of the moneys so paid be refunded to the lessee because of... 25 Indians 1 2010-04-01 2010-04-01 false Crediting advance annual payments. 227.16 Section 227.16... Crediting advance annual payments. In the event of discovery of minerals in paying quantities all advance...

IMP annual report, 1988 (January-December)

International Nuclear Information System (INIS)

1990-06-01

The research activities of Institute of Modern Physics, Academia Sinica of China, during the year of 1988, was summarized in this annual report. A highlight of these activities during the year was the progress of HIRFL project. HIRFL was delivered successfully 50 MeV/A 12 C beam on december 12, 1988. The scientific paper contained in this annual report are concerning to the fundamental scientific research, mainly nuclear physics. The development on experimental technique and the research on application of nuclear techniques have been reported also. It divided into ten parts, more than ninety pieces of short notes were presented

Annual mean sea level and its sensitivity to wind climate

Science.gov (United States)

Gerkema, Theo; Duran Matute, Matias

2017-04-01

Changes in relative mean sea level affect coastal areas in various ways, such as the risk of flooding, the evolution of barrier island systems, or the development of salt marshes. Long-term trends in these changes are partly masked by variability on shorter time scales. Some of this variability, for instance due to wind waves and tides (with the exception of long-period tides), is easily averaged out. In contrast, inter-annual variability is found to be irregular and large, of the order of several decimeters, as is evident from tide gauge records. This is why the climatic trend, typically of a few millimeters per year, can only be reliably identified by examining a record that is long enough to outweigh the inter-annual and decadal variabilities. In this presentation we examine the relation between the annual wind conditions from meteorological records and annual mean sea level along the Dutch coast. To do this, we need reliable and consistent long-term wind records. Some wind records from weather stations in the Netherlands date back to the 19th century, but they are unsuitable for trend analysis because of changes in location, height, surroundings, instrument type or protocol. For this reason, we will use only more recent, homogeneous wind records, from the past two decades. The question then is whether such a relatively short record is sufficient to find a convincing relation with annual mean sea level. It is the purpose of this work to demonstrate that the answer is positive and to suggest methods to find and exploit such a relation. We find that at the Dutch coast, southwesterly winds are dominant in the wind climate, but the west-east direction stands out as having the highest correlation with annual mean sea level. For different stations in the Dutch Wadden Sea and along the coast, we find a qualitatively similar pattern, although the precise values of the correlations vary. The inter-annual variability of mean sea level can already be largely explained by

78 FR 5866 - Pipeline Safety: Annual Reports and Validation

Science.gov (United States)

2013-01-28

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket ID PHMSA-2012-0319] Pipeline Safety: Annual Reports and Validation AGENCY: Pipeline and Hazardous Materials... 2012 gas transmission and gathering annual reports, remind pipeline owners and operators to validate...

ELETRONUCLEAR - Annual report - 1997

International Nuclear Information System (INIS)

1998-01-01

The annual activities report of 1997 of ELETRONUCLEAR - Brazilian company responsible by the electric power generation from the nuclear technology - introduces the next main topics: company vision and mission; energy production and commercialization; investments in the electric power generation; economic and financial situation; social balancing; and patrimonial balancing

Mail Office annual closure

CERN Multimedia

2013-01-01

On the occasion of the annual closure of CERN, there will be no mail distributed on Friday 20 December 2013 but mail will be collected in the morning. Nevertheless, you will still be able to bring your outgoing mail to Building 555-R-002 until 12 noon.  

29 CFR 403.3 - Form of annual financial report-detailed report.

Science.gov (United States)

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Form of annual financial report-detailed report. 403.3... LABOR LABOR-MANAGEMENT STANDARDS LABOR ORGANIZATION ANNUAL FINANCIAL REPORTS § 403.3 Form of annual financial report—detailed report. Every labor organization shall, except as expressly provided otherwise in...

Remedial action programs annual meeting: Meeting notes

International Nuclear Information System (INIS)

1987-01-01

The US Department of Energy Grand Junction Projects Office was pleased to host the 1987 Remedial Action programs Annual Meeting and herein presents notes from that meeting as prepared (on relatively short notice) by participants. These notes are a summary of the information derived from the workshops, case studies, and ad hoc committee reports rather than formal proceedings. The order of the materials in this report follows the actual sequence of presentations during the annual meeting

Annual General Meeting of the Pension Fund

CERN Multimedia

2006-01-01

Annual General Meeting to be held in the CERN Main Auditorium on Wednesday 1st November 2006 at 2.00 p.m. The Agenda will be as follows: Opening Remarks - F. Ferrini Results and presentation of the 2005 Annual Report- Future challenges associated with asset-liability modelling and asset allocation Copies of the 2005 Annual Report are available from departmental secretariats. - C. Cuénoud Recent development of the actuarial position of the Pension Fund - J.-P. Matheys Questions from members and beneficiaries Persons wishing to ask questions are encouraged to submit them in writing in advance, where possible, and addressed to the Fund Administrator Mr C. Cuénoud. Conclusions - F. Ferrini As usual, participants are invited to drinks after the meeting. NB The minutes of the 2005 AGM are available from the Administration of the Fund: Tel: (+4122) 767 27 42 e-mail: Sophia.Revol@cern.ch)

Annual General Meeting of the Pension Fund

CERN Multimedia

2006-01-01

Annual General Meeting to be held in the CERN Main Auditorium on Wednesday 1st November 2006 at 2.00 p.m. The Agenda will be as follows: Opening Remarks - F. Ferrini Results and presentation of the 2005 Annual Report- Future challenges associated with asset-liability modelling and asset allocation Copies of the 2005 Annual Report are available from departmental secretariats. - C. Cuénoud Recent development of the actuarial position of the Pension Fund - J.-P. Matheys Questions from members and beneficiaries Persons wishing to ask questions are encouraged to submit them in writing in advance, where possible, addressed to the Fund's Administrator, Mr C. Cuénoud. Conclusions - F. Ferrini As usual, participants are invited to drinks after the meeting. NB The minutes of the 2005 AGM are available from the Administration of the Fund: Tel: (+4122) 767 27 42 e-mail: Sophia.Revol@cern.ch)

Transportation statistics annual report 2010

Science.gov (United States)

2011-01-01

The Transportation Statistics Annual Report (TSAR) presents data and information compiled by the Bureau of Transportation Statistics (BTS), a component of the U.S. Department of Transportations (USDOTs) Research and Innovative Technology Admini...

Transportation statistics annual report 2009

Science.gov (United States)

2009-01-01

The Transportation Statistics Annual Report (TSAR) presents data and information selected by the Bureau of Transportation Statistics (BTS), a component of the U.S. Department of Transportation's (USDOT's) Research and Innovative Technology Administra...

Annual report ISIS

International Nuclear Information System (INIS)

Biggin, S.

1988-07-01

The paper presents the 1988 Annual Report for ISIS (United Kingdom). A description is given of the accelerator and target station. The capability of ISIS is described including the facilities available and the type of science carried out using the instruments. The development and support activities are outlined, along with the ISIS organisation and user interaction. The appendix contains experimental reports on research work conducted at ISIS. (U.K.)

Annual report 2005

International Nuclear Information System (INIS)

2005-01-01

Areva is a world energy expert on technological solutions for nuclear power generation and electricity transmission and distribution. This 2005 annual report provides information on the Group results in the following domains: information pertaining to the transaction, general information on the company and share capital, information on company operations, new developments and future prospects, assets, financial position, financial performance, corporate governance, recent developments and outlook. (A.L.B.)

Annual report 1980

International Nuclear Information System (INIS)

1980-12-01

In this annual report a survey is given about the research programs of the named institute during 1980. The research concerns experiments with synchrotron radiation, hyperfine structure studies, experiments with the DORIS and PETRA storage rings, and experiments at the CERN accelerators. Furthermore the development of instruments in this institute is described. In addition a list of publications, contributions to conferences, and theses of this institute is given. (HSI)

International VLBI Service for Geodesy and Astrometry 2013 Annual Report

Science.gov (United States)

Baver, Karen D.; Behrend, Dirk; Armstrong, Kyla L.

2014-01-01

This volume of reports is the 2013 Annual Report of the International VLBI Service for Geodesy and Astrometry (IVS). The individual reports were contributed by VLBI groups in the international geodetic and astrometric community who constitute the permanent components of IVS. The IVS 2013 Annual Report documents the work of the IVS components for the calendar year 2013, our fifteenth year of existence. The reports describe changes, activities, and progress of the IVS. Many thanks to all IVS components who contributed to this Annual Report. With the exception of the first section and the last section, the contents of this Annual Report also appear on the IVS Web site at http://ivscc.gsfc.nasa.gov/publications/ar2013.

Annual Change Report 2006/2007

International Nuclear Information System (INIS)

2007-01-01

As part of continuing compliance, the U.S. Environmental Protection Agency (EPA) requires the U.S. Department of Energy (DOE) to provide information on any change in conditions or activities pertaining to the disposal system since the most recent compliance application. This requirement is identified in Title 40 Code of Federal Regulations (CFR), Section 194.4(b)(4), which states: 'No later than six months after the administrator issues a certification, and at least annually thereafter, the Department shall report to the Administrator, in writing, any changes in conditions or activities pertaining to the disposal system that were not required to be reported by paragraph (b)(3) of this section and that differ from information contained in the most recent compliance application.' In meeting the requirement, the DOE provides an annual report each November of all applicable changes under the above requirement. This annual report informs the EPA of changes to information in the most recent compliance recertification (the 2004 Compliance Recertification). Significant planned changes must be reported to the EPA prior to implementation by the DOE. In addition, Title 40 CFR, Section 194.4(b)(3) requires that significant unplanned changes be reported to the EPA within 24 hours or ten days, depending on the severity of the activity or condition. To date, there have been no significant unplanned changes to the certification basis. Planned changes have been submitted on an individual basis. All other changes are reported annually. Changes in activities or conditions are reviewed to determine if 40 CFR Section 194.4(b)(3) reporting is necessary. As indicated above, no significant unplanned changes were identified for the time period covered by this report. The enclosed tables list those items identified for reporting under 40 CFR Section 194.4(b)(4). The majority of the items described in this report are inspections, reports, and modifications to written plans and procedures for

Research laboratories annual report 1994

International Nuclear Information System (INIS)

1996-01-01

The publication is the 1994 annual report of the Israel atomic energy commission in a new format. The report includes three invited papers and a bibliographic list of publications by the commission scientific researches

Research laboratories annual report 1994

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-10-01

The publication is the 1994 annual report of the Israel atomic energy commission in a new format. The report includes three invited papers and a bibliographic list of publications by the commission scientific researches.

77 FR 4568 - Annual Computational Science Symposium; Public Conference

Science.gov (United States)

2012-01-30

...] Annual Computational Science Symposium; Public Conference AGENCY: Food and Drug Administration, HHS... with the Pharmaceutical Users Software Exchange (PhUSE), is announcing a public conference entitled ``The FDA/PhUSE Annual Computational Science Symposium.'' The purpose of the conference is to help the...

BAM - Annual report 1975

International Nuclear Information System (INIS)

1976-06-01

The annual report contains progress and activity reports of the presidential department, the departments metals and metal construction, civil engineering and building activities, organic matter, chemical safety engineering, special fields of materials testing, techniques independent of the type of material, an index, as well as general and statistic statements. (HK) [de

Annual report 1982. Annex

International Nuclear Information System (INIS)

This is the scientific annual report 1982 of the ILL on R and D activities of the different colleges: fundamental and nuclear physics, inelastic scattering in simple solids, crystallographic and magnetic structures, fluids and amorphous substances, imperfections, biology, chemistry, theory. Abstracts of the publications published during the year are presented

Annual report 1991-1992

International Nuclear Information System (INIS)

1992-01-01

The Annual Report 1991-92 contains an update on the NRPB's role in international and national standards, the technical services provided by the NRPB, their work on environmental, biomedical and physical sciences, the status of NRPB publications giving advice, the NRPB's finances, its senior directing staff and finally NRPB members. (UK)

Annual Information Meeting of the Pension Fund | 26 October

CERN Multimedia

2016-01-01

All members and beneficiaries of the Pension Fund are invited to attend the Annual Information Meeting of the Pension Fund.   Meeting to be held in the Main Auditorium on Wednesday 26 October 2016 from 9:30 a.m. to 11:30 a.m. Following a presentation by the Chief Executive Officer of the Fund there will be a Questions and Answers session. Members and Beneficiaries are welcome to send questions in advance of the meeting by post to: Mr Matthew Eyton-Jones “Annual Information Meeting” CEO CERN Pension Fund Office 5-5-012, Postbox C23800 CH- 1211 Geneva 23 - Switzerland Copies of the 2015 Pension Fund Annual Report & Financial Statements are already available in accessible PDF on the Pension Fund website and will also be distributed at the annual meeting. *Coffee and croissants will be served prior to the meeting as of 9:00 a.m.*

Satellite Global and Hemispheric Lower Tropospheric Temperature Annual Temperature Cycle

Directory of Open Access Journals (Sweden)

Michael A. Brunke

2010-11-01

Full Text Available Previous analyses of the Earth’s annual cycle and its trends have utilized surface temperature data sets. Here we introduce a new analysis of the global and hemispheric annual cycle using a satellite remote sensing derived data set during the period 1979–2009, as determined from the lower tropospheric (LT channel of the MSU satellite. While the surface annual cycle is tied directly to the heating and cooling of the land areas, the tropospheric annual cycle involves additionally the gain or loss of heat between the surface and atmosphere. The peak in the global tropospheric temperature in the 30 year period occurs on 10 July and the minimum on 9 February in response to the larger land mass in the Northern Hemisphere. The actual dates of the hemispheric maxima and minima are a complex function of many variables which can change from year to year thereby altering these dates.Here we examine the time of occurrence of the global and hemispheric maxima and minima lower tropospheric temperatures, the values of the annual maxima and minima, and the slopes and significance of the changes in these metrics.  The statistically significant trends are all relatively small. The values of the global annual maximum and minimum showed a small, but significant trend. Northern and Southern Hemisphere maxima and minima show a slight trend toward occurring later in the year. Most recent analyses of trends in the global annual cycle using observed surface data have indicated a trend toward earlier maxima and minima.

Transportation statistics annual report, 2015

Science.gov (United States)

2016-01-01

The Transportation Statistics Annual Report : describes the Nations transportation system, : the systems performance, its contributions to : the economy, and its effects on people and the : environment. This 20th edition of the report is : base...

Transportation statistics annual report, 2013

Science.gov (United States)

2014-01-01

The Transportation Statistics Annual Report : describes the Nations transportation system, : the systems performance, its contributions to : the economy, and its effects on people and the : environment. This 18th edition of the report is : base...

RAND Annual Report 2002 Contents

National Research Council Canada - National Science Library

2002-01-01

... on U.S topics, as described throughout this annual report. But in 2002 we were also more active than ever before in improving the domestic and defense policies of other nations and regions as well...

Conference summaries of the Canadian Nuclear Association 30. annual conference, and the Canadian Nuclear Society 11. annual conference

International Nuclear Information System (INIS)

1990-01-01

This volume contains conference summaries for the 30. annual conference of the Canadian Nuclear Association, and the 11. annual conference of the Canadian Nuclear Society. Topics of discussion include: energy needs and challenges facing the Canadian nuclear industry; the environment and nuclear power; the problems of maintaining and developing industrial capacity; the challenges of the 1990's; programmes and issues for the 1990's; thermalhydraulics; reactor physics and fuel management; nuclear safety; small reactors; fuel behaviour; energy production and the environment; computer applications; nuclear systems; fusion; materials handling; and, reactor components

Petroleum supply annual 1996: Volume 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-06-01

The Petroleum Supply Annual (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1996 through annual and monthly surveys. The PSA is divided into two volumes. This first volume contains three sections: Summary Statistics, Detailed Statistics, and Refinery Capacity; each with final annual data. The summary statistics section show 16 years of data depicting the balance between supply, disposition and ending stocks for various commodities including crude oil, motor gasoline, distillate fuel oil, residual fuel oil, jet fuel propane/propylene, and liquefied petroleum gases. The detailed statistics section provide 1996 detailed statistics on supply and disposition, refinery operations, imports and exports, stocks, and transportation of crude oil and petroleum products. The refinery capacity contain listings of refineries and associated crude oil distillation and downstream capacities by State, as of January 1, 1997, as well as summaries of corporate refinery capacities and refinery storage capacities. In addition, refinery receipts of crude oil by method of transportation for 1996 are provided. Also included are fuels consumed at refineries, and lists of shutdowns, sales, reactivations, and mergers during 1995 and 1996. 16 figs., 59 tabs.

Petroleum supply annual 1996: Volume 1

International Nuclear Information System (INIS)

1997-06-01

The Petroleum Supply Annual (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1996 through annual and monthly surveys. The PSA is divided into two volumes. This first volume contains three sections: Summary Statistics, Detailed Statistics, and Refinery Capacity; each with final annual data. The summary statistics section show 16 years of data depicting the balance between supply, disposition and ending stocks for various commodities including crude oil, motor gasoline, distillate fuel oil, residual fuel oil, jet fuel propane/propylene, and liquefied petroleum gases. The detailed statistics section provide 1996 detailed statistics on supply and disposition, refinery operations, imports and exports, stocks, and transportation of crude oil and petroleum products. The refinery capacity contain listings of refineries and associated crude oil distillation and downstream capacities by State, as of January 1, 1997, as well as summaries of corporate refinery capacities and refinery storage capacities. In addition, refinery receipts of crude oil by method of transportation for 1996 are provided. Also included are fuels consumed at refineries, and lists of shutdowns, sales, reactivations, and mergers during 1995 and 1996. 16 figs., 59 tabs

Comparison of methods for extracting annual cycle with changing amplitude in climate science

Science.gov (United States)

Deng, Q.; Fu, Z.

2017-12-01

Changes of annual cycle gains a growing concern recently. The basic hypothesis regards annual cycle as constant. Climatology mean within a time period is usually used to depict the annual cycle. Obviously this hypothesis contradicts with the fact that annual cycle is changing every year. For the lack of a unified definition about annual cycle, the approaches adopted in extracting annual cycle are various and may lead to different results. The precision and validity of these methods need to be examined. In this work we numerical experiments with known monofrequent annual cycle are set to evaluate five popular extracting methods: fitting sinusoids, complex demodulation, Ensemble Empirical Mode Decomposition (EEMD), Nonlinear Mode Decomposition (NMD) and Seasonal trend decomposition procedure based on loess (STL). Three different types of changing amplitude will be generated: steady, linear increasing and nonlinearly varying. Comparing the annual cycle extracted by these methods with the generated annual cycle, we find that (1) NMD performs best in depicting annual cycle itself and its amplitude change, (2) fitting sinusoids, complex demodulation and EEMD methods are more sensitive to long-term memory(LTM) of generated time series thus lead to overfitting annual cycle and too noisy amplitude, oppositely the result of STL underestimate the amplitude variation (3)all of them can present the amplitude trend correctly in long-time scale but the errors on account of noise and LTM are common in some methods over short time scales.

Proceedings of the Canadian Nuclear Society 12. annual conference

International Nuclear Information System (INIS)

1991-01-01

This volume contains the Proceedings of the seventeen Technical Sessions from the Twelfth Annual Conference of the Canadian Nuclear Society held in Saskatoon, Saskatchewan, June 9 to 12, 1991. As in previous years, the Annual Conference of the Canadian Nuclear Society was held in conjunction with the Annual Conference of the Canadian Nuclear Association. The major topics of discussion included: reactor physics; thermal hydraulics; industrial irradiation; computer applications; fuel channel analysis; small reactors; severe accidents; fuel behaviour under accident conditions; reactor components; safety related computer software; nuclear fuel management; nuclear waste management; and, uranium mining processing

46 CFR 2.10-105 - Prepayment of annual vessel inspection fees.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Prepayment of annual vessel inspection fees. 2.10-105... VESSEL INSPECTIONS Fees § 2.10-105 Prepayment of annual vessel inspection fees. (a) Vessel owners may prepay the annual vessel inspection fee for any period of not less than three years, and not more than...

Annual and seasonal CO2 fluxes from Russian southern taiga soils

International Nuclear Information System (INIS)

Kurganova, I.; Lopes De Gerenyu, V.; Rozanova, L.; Sapronov, D.; Myakshina, T.; Kudeyarov, V.

2003-01-01

Annual and seasonal characteristics of CO 2 emission from five different ecosystems were studied in situ (Russia, Moscow Region) from November 1997 through October 2000. The annual behaviour of the soil respiration rate is influenced by weather conditions during a particular year. Annual CO 2 fluxes from the soils depend on land use of the soils and averaged 684 and 906 g C/m 2 from sandy Albeluvisols (sod-podzolic soils) under forest and grassland, respectively. Annual emission from clay Phaeozems (grey forest soils) was lower and ranged from 422 to 660 g C/m 2 ; the order of precedence was arable 2 fluxes caused by weather conditions ranged from 18% (forest ecosystem on Phaeozems) to 31% (agro-ecosystem). The contribution from the cold period (with snow, November-April) to the annual CO 2 flux was substantial and averaged 21% and 14% for natural and agricultural ecosystems, respectively. The CO 2 fluxes comprised approximately 48-51% in summer, 23-24% in autumn, 18-20% in spring and 7-10% in winter of the total annual carbon dioxide flux