Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health.

Science.gov (United States)

Taşdemir, Zekeriya; Alkan, Banu Arzu

2015-01-01

Understanding the relationship between periodontal disease (PD) and systemic health (SH) is necessary for the accurate diagnosis and treatment of both. The aim of this study was to evaluate the knowledge of medical doctors in Turkey with regard to the association between PD and SH. This study was carried out using self-reported questionnaires that were sent to medical doctors who work at various universities and public and private hospitals in different cities in Turkey. The questionnaires consisted of questions about the demographic information of the medical doctors, as well as the knowledge of those doctors about the relationship between PD and SH. In total, 1,766 responses were received and 90.8% of the participants agreed that there was a relationship between PD and SH. Diabetes mellitus was the most frequent systemic disease (66.8%) known to be related to PD. Of the participants, 56.5% of the medical doctors referred their patients to periodontists for different reasons. Gingival bleeding was the most frequent reason for patient referrals, with 44% of doctors giving such referrals. Doctors who worked in basic medical sciences were significantly less aware of the relationship between PD and SH than the doctors in other specialties. Although the vast majority of the medical doctors reported that they knew the relationship between PD and SH, the findings of this study showed that this awareness was not supported by precise knowledge, and often failed to translate into appropriate clinical practice.

Nesting doctoral students in collaborative North–South partnerships for health systems research

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Svetla Loukanova

2014-07-01

Full Text Available Background: The European Union (EU supports North–South Partnerships and collaborative research projects through its Framework Programmes and Horizon 2020. There is limited research on how such projects can be harnessed to provide a structured platform for doctoral level studies as a way of strengthening health system research capacity in sub-Saharan Africa (SSA. Objective: The aim of this study was to explore the challenges of, and facilitating factors for, ‘nesting’ doctoral students in North–South collaborative research projects. The term nesting refers to the embedding of the processes of recruiting, supervising, and coordinating doctoral students in the overall research plan and processes. Design: This cross-sectional qualitative study was undertaken by the EU-funded QUALMAT Project. A questionnaire was implemented with doctoral students, supervisors, and country principal investigators (PIs, and content analysis was undertaken. Results: Completed questionnaires were received from nine doctoral students, six supervisors, and three country PIs (86% responses rate. The doctoral students from SSA described high expectations about the input they would receive (administrative support, equipment, training, supervision. This contrasted with the expectations of the supervisors for proactivity and self-management on the part of the students. The rationale for candidate selection, and understandings of the purpose of the doctoral students in the project were areas of considerable divergence. There were some challenges associated with the use of the country PIs as co-supervisors. Doctoral student progress was at times impeded by delays in the release of funding instalments from the EU. The paper provides a checklist of essential requirements and a set of recommendations for effective nesting of doctoral students in joint North–South projects. Conclusion: There are considerable challenges to the effective nesting of doctoral students within

Coastal Pacific Doctor Associates: Implementation of a Purchased System

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Schwieger, Dana; McDonald, Michael

2015-01-01

Coastal Pacific Doctor Associates (CPDA) is a multi-physician medical practice located along the west coast. CPDA decided to replace their inadequate and outdated medical office system during a time of tremendous restructuring in the medical software industry. In their impatience, CPDA chose an electronic medical record (EMR) and practice…

Improving doctor-patient communication: content validity examination of a novel urinary system-simulating physical model.

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Hu, WenGang; Song, YaJun; Zhong, Xiao; Feng, JiaYu; Wang, PingXian; Huang, ChiBing

2016-01-01

Effective doctor-patient communication is essential for establishing a successful doctor-patient relationship and implementing high-quality health care. In this study, a novel urinary system-simulating physical model was designed and fabricated, and its content validity for improving doctor-patient communication was examined by conducting a randomized controlled trial in which this system was compared with photographs. A total of 240 inpatients were randomly selected and assigned to six doctors for treatment. After primary diagnosis and treatment had been determined, these patients were randomly divided into the experimental group and the control group. Patients in the experimental group participated in model-based doctor-patient communication, whereas control group patients received picture-based communication. Within 30 min after this communication, a Demographic Information Survey Scale and a Medical Interview Satisfaction Scale (MISS) were distributed to investigate patients' demographic characteristics and their assessments of total satisfaction, distress relief, communication comfort, rapport, and compliance intent. The study results demonstrated that the individual groups were comparable with respect to demographic variables but that relative to patients in the picture-based communication group, patients in the model-based communication group had significantly higher total satisfaction scores and higher ratings for distress relief, communication comfort, rapport, and compliance intent. These results indicate that the physical model is more effective than the pictures at improving doctor-patient communication and patient outcomes. The application of the physical model in doctor-patient communication is helpful and valuable and therefore merits widespread clinical popularization.

Promoting Interdisciplinary Education: The Vienna Doctoral Programme on Water Resource Systems

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Blöschl, Günter; Bucher, Christian; Carr, Gemma; Farnleitner, Andreas; Rechberger, Helmut; Wagner, Wolfgang; Zessner, Matthias

2010-05-01

An interdisciplinary approach is often described as a valuable strategy to assist in overcoming the existing and emerging challenges to water resource management. The development of educational approaches to instil a culture of interdisciplinarity in the future generation of water resource professionals will help to meet this strategic need. The Vienna Doctoral Programme on Water Resource Systems demonstrates how the adoption of an interdisciplinary education framework has been applied to a graduate programme in the water sciences. The interdisciplinary approach aims to provide doctoral research students with an understanding of the wide spectrum of processes relevant to water resource systems. This will enable them to bring together a range of ideas, strategies and methods to their current research and future careers. The education programme also aims to teach the softer skills required for successful interdisciplinary work such as the ability to communicate clearly with non-specialist professionals and the capacity to listen to and accommodate suggestions from experts in different disciplines, which have often not traditionally been grouped together. The Vienna Doctoral Programme achieves these aims through teaching an appreciation for a wide variety of approaches including laboratory analysis, field studies and numerical methods across the fields of hydrology, remote sensing, hydrogeology, structural mechanics, microbiology, water quality and resource management. Teaching takes the form of a detailed study programme on topics such as socio-economic concepts, resource and river basin management, modelling and simulation methods, health related water quality targets, urban water management, spatial data from remote sensing and basics for stochastic mechanics. Courses are also held by internationally recognised top scientists, and a guest scientist seminar series allows doctoral researchers to profit from the expertise of senior researchers from around the world

Challenges to the Doctoral Journey: a Case of Female Doctoral Students from Ethiopia

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Asamenew Demessie Bireda

2015-11-01

Full Text Available This study aimed to investigate some challenges female doctoral students experience in their doctoral journey. The study used a qualitative design and structured interviews. The theoretical framework that guided the study was that of Urie Bronfenbrenner’s ecosystemic theory. A purposely selected sample of five female doctoral students from the University of South Africa Ethiopia campus participated in the study. The results identified three major areas of concern such as: academic, psychosocial and home/work related. Specifically, female doctoral students reported concerns surrounding quality of supervision support, inadequate academic skill, nature or system of education, stress, motivation, isolation, balancing personal and professional life, relationship problems, home and work related concerns. Hence, universities must provide opportunities and resourceful strategies to meet the challenges posed by women scholars in the doctoral journey.

On Doctoral Student Development: Exploring Faculty Mentoring in the Shaping of African American Doctoral Student Success

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Felder, Pamela

2010-01-01

This study examines the influence of faculty mentorship in the shaping of African American doctoral student success. A case analysis framework is used to investigate the belief systems that doctoral students held about their doctoral experience. Data collection involved a one-phase semi-structured interview protocol used to gather information…

Children and their parents assessing the doctor-patient interaction: a rating system for doctors' communication skills.

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Crossley, Jim; Eiser, Christine; Davies, Helena A

2005-08-01

Only a patient and his or her family can judge many of the most important aspects of the doctor-patient interaction. This study evaluates the feasibility and reliability of children and their families assessing the quality of paediatricians' interactions using a rating instrument developed specifically for this purpose. A reliability analysis using generalisability theory on the ratings from 352 doctor-patient interactions across different speciality clinics. Ratings were normally distributed. They were highest for 'overall' performance, and lowest for giving time to discuss the families' agenda. An appropriate sample of adults' ratings provided a reliable score (G = 0.7 with 15 raters), but children's ratings were too idiosyncratic to be reproducible (G = 0.36 with 15 raters). CONCLUSIONS AND FURTHER WORK: Accompanying adults can provide reliable ratings of doctors' interactions with children. Because an adult is usually present at the consultation their ratings provide a highly feasible and authentic approach. Sampling doctors' interactions from different clinics and with patients of both genders provides a universal picture of performance. The method is ideal to measure performance for in-training assessment or revalidation. Further work is in progress to evaluate the educational impact of feeding ratings back to the doctors being assessed, and their use in a range of clinical contexts.

Conceptualising Doctoral Writing as an Affective-political Practice

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James Burford

2017-03-01

Full Text Available Aim/Purpose: This article offers a conceptual summary and critique of existing literature on doctoral writing and emotion. The article seeks to intervene in current debates about doctoral writing by re-positioning it as an affective-political practice Background: Over recent decades public interest in the doctorate has expanded as it has become re-framed as a key component of national success in the global knowledge economy. It is within this context that the practice of doctoral writing has crystallised as an object of interest. While researchers have examined the increased regulation, surveillance, and intensification of doctoral writing, often this work is motivated to develop pedagogies that support students to meet these new expectations. At this point, there has been limited attention to what broad changes to the meanings and practices of doctoral writing feel like for students. Methodology: The paper offers a conceptual review that examines the ways in which doctoral writing tends to be understood. A review of literature in the areas of doctoral writing, doctoral emotion, and critical studies of academic labour was undertaken in order to produce a more comprehensive understanding of the political and emotional dynamics of doctoral writing. Contribution: It is intended that this conceptual research paper help researchers attend to the emotional context of doctoral writing in the current university context. Critical studies of academic work and life are identified as a possible platform for the development of future doctoral education research, and the conceptual tool of “affective-politics” is advanced as a novel frame for approaching doctoral writing research.

Suicide in doctors and wives of doctors.

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Sakinofsky, I

1980-06-01

This paper re-examines the widespread belief that doctors have a proneness for suicide greater than the general population. The Standardized Mortality Ratio for male physicians is 335 and for single women doctors 257. Doctors' wives have an even greater risk: their SMR is 458. These rates for doctors are higher than for most other professional groups (except pharmacists) and the rate for doctors' wives far exceeds that for wives of other professionals. The intrinsic causes of the physician's high occupational mortality include his knowledge of toxicology and ready access to lethal drugs, so that impulsive suicide is more often successful. Professional stress and overwork, particularly the unrelenting responsibility for decisions upon which the lives of others may depend, have been inculpated. These stresses interact with the decline in the doctors' self-respect and with a personality that is prestige-oriented and independent. Some physicians turn in their frustration to alcohol/and or drugs, accelerating the process of deterioration. The high suicide rate in doctors' wives appears to be the result of unrequited needs for caring and dependency which the doctors' career demands and personality deny them.

[The current problems and cross-cultural perspectives of patient-doctor relation: an overview].

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Koch, Eckhardt; Turgut, Tolga

2004-01-01

The success of the treatment in medicine, especially in psychiatry is based on the form and the strength of the patient-doctor relation. This complex and dynamic relation is changing in accordance with the social and technological development of the society. The context of the patient-doctor relation is determined by the present day culture as well as the traditional background. An overview of current patient-doctor relation and of problems that physicians and in particular psychiatrists meet is presented. Physicians have responsibilities in building patient-doctor relation. The ethical and legal aspects of these responsibilities are presented. The former paternalistic type of patient-doctor relation is evolving into a more equal and democratic relation. New problems are being encountered continuously in the changing process. Beside the of the process itself, the effects of progress in medical technology and communication systems on patient-doctor relation and the pressure, put from the insurance companies and/or authorities on physicians, which impair the trust between the physician and his patient, are making the process more difficult. The issues of compliance, sexual harassment and unique problems of patient-doctor relations in psychiatry are the other subtopics in the article. The cross-cultural aspects of patient-doctor relations and encountered clinical problems are discussed with case examples particularly about Turkish immigrants, who live in Germany. Suggestions for psychiatrists in Germany to work out the challenges facing them are presented in the conclusion.

Masculinity in the doctor's office: Masculinity, gendered doctor preference and doctor-patient communication.

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Himmelstein, Mary S; Sanchez, Diana T

2016-03-01

Mortality and morbidity data suggest that men have shorter life expectancies than women and outrank women on several leading causes of death. These gendered disparities may be influenced by psychosocial factors like masculinity. Three studies (Total N=546) examined the role of masculinity in men's doctor choices and doctor-patient interactions. In Studies 1 and 2, men completed measures of masculinity, gender bias, and doctor preference. Using structural equation modeling, we tested the direct relationship between masculinity and male doctor preference and the indirect relationship of masculinity on male doctor preference through an association with gendered competence stereotypes. Participants in Study 3 disclosed symptoms in private followed by disclosure to a male or female interviewer in a clinical setting. Using repeated measures analysis of variance (ANOVA), we examined the interaction among symptom reporting, masculinity and doctor gender, controlling for participant comfort. In Study 1, results suggested that masculinity encouraged choice of a male doctor directly and indirectly via beliefs that men make more competent doctors than women; Study 2 directly replicated the results of Study 1. In Study 3, independent of participant comfort, an interaction between interviewer gender and masculinity emerged such that men scoring higher on masculinity reported symptoms less consistently to male interviewers (relative to higher scoring men reporting to female interviewers); the reverse was found for men scoring low on masculinity. Taken together these studies suggest that masculinity may affect men's health by encouraging choice of a male doctor with whom doctor-patient communication may be impaired. Copyright © 2015 Elsevier Inc. All rights reserved.

Skill set development of doctoral and post-doctoral graduates in life sciences.

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Kanwar, R S

2010-01-01

Doctoral and post-doctoral training programs at leading research universities in the USA are highly important in generating the much needed knowledge in science, technology, engineering, and mathematics for keeping rural and urban economies strong and societies healthy and prosperous. In addition, innovative graduate and post doctoral research programs are the driving engines of the success of U.S. economy and have made the U.S. the most successful model of generating new knowledge in the broader areas of life sciences (and agricultural education, research, and extension). We need to do everything in our power to make these training programs innovative, collaborative, independent, and resourceful so that students are trained in different disciplines making them more flexible within a range of challenges and opportunities. The training programs must empower students to solve complex and interdisciplinary problems of the society in 21st century and make our students competitive within a global economic system, to improve the health of the nation's economy. If our land grant schools and institutions of higher learning are not preparing doctoral students to be globally competitive scientists to create new knowledge and technologies to solve complex and interdisciplinary problems of the 21st century, then either we need to redefine the mission of our land grant system or we risk losing our role to serve the public and industry effectively. Doctoral and post doctoral students should be given the needed skills and experiences to prepare them for tenure track faculty jobs at leading US Universities in the 21st century as well as prepare them for the world outside of academia. I would say minimum competency skills are needed as "bare survival skills" for all doctoral students to become successful after obtaining PhD degrees. Today's PhD students will be working in a global but highly competitive, rapidly changing, and complex world. It is no longer enough to be a good

University strategy for doctoral training: the Ghent University Doctoral Schools.

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Bracke, N; Moens, L

2010-01-01

The Doctoral Schools at Ghent University have a three-fold mission: (1) to provide support to doctoral students during their doctoral research, (2) to foster a quality culture in (doctoral) research, (3) to promote the international and social stature and prestige of the doctorate vis-a-vis potential researchers and the potential labour market. The Doctoral Schools offer top-level specialized courses and transferable skills training to doctoral students as part of their doctoral training programme. They establish mechanisms of quality assurance in doctoral research. The Doctoral Schools initialize and support initiatives of internationalization. They also organize information sessions, promotional events and interaction with the labour market, and as such keep a finger on the pulse of external stakeholders.

Doctors on the move: a European case study on the key characteristics of national recertification systems.

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Sehlbach, Carolin; Govaerts, Marjan J; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

2018-04-17

With increased cross-border movement, ensuring safe and high-quality healthcare has gained primacy. The purpose of recertification is to ensure quality of care through periodically attesting doctors' professional proficiency in their field. Professional migration and facilitated cross-border recognition of qualifications, however, make us question the fitness of national policies for safeguarding patient care and the international accountability of doctors. We performed document analyses and conducted 19 semistructured interviews to identify and describe key characteristics and effective components of 10 different European recertification systems, each representing one case (collective case study). We subsequently compared these systems to explore similarities and differences in terms of assessment criteria used to determine process quality. Great variety existed between countries in terms and assessment formats used, targeting cognition, competence and performance (Miller's assessment pyramid). Recertification procedures and requirements also varied significantly, ranging from voluntary participation in professional development modules to the mandatory collection of multiple performance data in a competency-based portfolio. Knowledge assessment was fundamental to recertification in most countries. Another difference concerned the stakeholders involved in the recertification process: while some systems exclusively relied on doctors' self-assessment, others involved multiple stakeholders but rarely included patients in assessment of doctors' professional competence. Differences between systems partly reflected different goals and primary purposes of recertification. Recertification systems differ substantially internationally with regard to the criteria they apply to assess doctors' competence, their aims, requirements, assessment formats and patient involvement. In the light of professional mobility and associated demands for accountability, we recommend that

EHR adoption among doctors who treat the elderly.

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Yeager, Valerie A; Menachemi, Nir; Brooks, Robert G

2010-12-01

The purpose of this study is to examine Electronic Health Record (EHR) adoption among Florida doctors who treat the elderly. This analysis contributes to the EHR adoption literature by determining if doctors who disproportionately treat the elderly differ from their counterparts with respect to the utilization of an important quality-enhancing health information technology application. This study is based on a primary survey of a large, statewide sample of doctors practising in outpatient settings in Florida. Logistic regression analysis was used to determine whether doctors who treat a high volume of elderly (HVE) patients were different with respect to EHR adoption. Our analyses included responses from 1724 doctors. In multivariate analyses controlling for doctor age, training, computer sophistication, practice size and practice setting, HVE doctors were significantly less likely to adopt EHR. Specifically, compared with their counterparts, HVE doctors were observed to be 26.7% less likely to be utilizing an EHR system (OR=0.733, 95% CI 0.547-0.982). We also found that doctor age is negatively related to EHR adoption, and practice size and doctor computer savvy-ness is positively associated. Despite the fact that EHR adoption has improved in recent years, doctors in Florida who serve the elderly are less likely to adopt EHRs. As long as HVE doctors are adopting EHR systems at slower rates, the elderly patients treated by these doctors will be at a disadvantage with respect to potential benefits offered by this technology. © 2010 Blackwell Publishing Ltd.

The supervision of professional doctorates: experiences of the processes and ways forward.

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Carr, Susan M; Lhussier, Monique; Chandler, Colin

2010-05-01

The doctoral research terrain is changing, as new-styles, for example professional doctorates, are being developed (Park, C., 2005. New variant PhDL the changing nature of the doctorate in the UK. Journal of Higher Education Policy and Management 27(2), 189-207). There is a scarcity of literature aimed at supervisors (Gatfield, T., 2005, An investigation into PhD supervisory management styles: development of a dynamic conceptual model and its managerial implications. Journal of Higher Education Policy and Management 27(3), 311-325) and this is particularly so in relation to professional doctorates. In this position paper we argue that the supervisory approach required for a professional doctorate student is different than that required for a PhD. Professional doctorate students, like PhD students, are required to make an explicit contribution to knowledge. Their emphasis, however, needs to be in producing knowledge that is theoretically sound, original, and of relevance to their practice area. This is of increasing importance within healthcare with the growing emphasis on patient driven translational research. As such, the students and their supervisors face unique challenges of balancing academic requirements with praxis. We suggest this requires specific tools to make explicit the dialogical relationship between a particular project and the cultural, social, educational and political aspects of its environment. We expose the potential of soft systems methodology as a means to highlight the emergent aspects of a doctoral practice development project, their respective and evolving supervisory interactions. This focus of this paper is therefore not about guiding supervision in a managerial sense, but rather at offering methodological suggestions that could underpin applied research at doctoral level. Copyright 2009 Elsevier Ltd. All rights reserved.

Dynamic modeling of patient and physician eye gaze to understand the effects of electronic health records on doctor-patient communication and attention.

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Montague, Enid; Asan, Onur

2014-03-01

The aim of this study was to examine eye gaze patterns between patients and physicians while electronic health records were used to support patient care. Eye gaze provides an indication of physician attention to patient, patient/physician interaction, and physician behaviors such as searching for information and documenting information. A field study was conducted where 100 patient visits were observed and video recorded in a primary care clinic. Videos were then coded for gaze behaviors where patients' and physicians' gaze at each other and artifacts such as electronic health records were coded using a pre-established objective coding scheme. Gaze data were then analyzed using lag sequential methods. Results showed that there are several eye gaze patterns significantly dependent to each other. All doctor-initiated gaze patterns were followed by patient gaze patterns. Some patient-initiated gaze patterns were also followed by doctor gaze patterns significantly unlike the findings in previous studies. Health information technology appears to contribute to some of the new significant patterns that have emerged. Differences were also found in gaze patterns related to technology that differ from patterns identified in studies with paper charts. Several sequences related to patient-doctor-technology were also significant. Electronic health records affect the patient-physician eye contact dynamic differently than paper charts. This study identified several patterns of patient-physician interaction with electronic health record systems. Consistent with previous studies, physician initiated gaze is an important driver of the interactions between patient and physician and patient and technology. Published by Elsevier Ireland Ltd.

The Impact of Doctoral Study on Educational Leaders' Work for Students' Participation in Education Systems and Society

Science.gov (United States)

Taysum, Alison

2013-01-01

This paper examines ways educational leaders engaging with doctoral research have worked for students' participation in education systems. Twenty-four interviews were conducted with educational leaders of schools, colleges, and districts in England and the US doing doctoral research. The findings reveal that the leaders identify US and English…

Feasible utopias in doctoral education

DEFF Research Database (Denmark)

Elliot, Dely; Guccione, Kay; Bengtsen, Søren Smedegaard

-Martek, Chen & McAlpine, 2011). PGRs’ motivation, creativity, resilience and momentum during their long and intense doctoral journey are often strongly sustained by unseen informal structures, social support systems and extra-curricular activities tacitly providing emotional, social, pastoral and academic......Part 1 Abstract Ongoing educational and psycho-social challenges in doctoral education (e.g. psychological distress, attrition and delay in completion) warrant a more comprehensive understanding of the expanded doctoral education context and how the different facets of doctoral support mechanisms......, 2016b; Bengtsen & Barnett, 2017; Bryan & Guccione, 2018; Elliot et al., 2016b, 2016c; Wisker et al., 2017). Yet, there remains a somewhat limited understanding not only of these multifaceted components but how they interact with already existing formal and informal support mechanisms offered...

System dynamics

International Nuclear Information System (INIS)

Kim, Do Hun; Mun, Tae Hun; Kim, Dong Hwan

1999-02-01

This book introduces systems thinking and conceptual tool and modeling tool of dynamics system such as tragedy of single thinking, accessible way of system dynamics, feedback structure and causal loop diagram analysis, basic of system dynamics modeling, causal loop diagram and system dynamics modeling, information delay modeling, discovery and application for policy, modeling of crisis of agricultural and stock breeding products, dynamic model and lesson in ecosystem, development and decadence of cites and innovation of education forward system thinking.

I’m just thinking - How learning opportunities are created in doctoral supervision

DEFF Research Database (Denmark)

Kobayashi, Sofie; Berge, Maria; Grout, Brian William Wilson

for learning. Earlier research into doctoral supervision has been rather vague on how doctoral students learn to carry out research. Empirically, we have based the study on four cases each with one doctoral student and their supervisors. The supervision sessions were captured on video and audio to provide...... for verbatim transcripts that were subsequently analysed. Our results illustrate how supervisors and doctoral students create learning opportunities by varying aspects of research in the discussion. Better understanding of this mechanism whereby learning opportunities are created by bringing aspects......With this paper we aim to contribute towards an understanding of learning dynamics in doctoral supervision by analysing how learning opportunities are created in the interaction. We analyse interaction between supervisors and doctoral students using the notion of experiencing variation as a key...

Combining theories to reach multi-faceted insights into learning opportunities in doctoral supervision

DEFF Research Database (Denmark)

Kobayashi, Sofie; Rump, Camilla Østerberg

The aim of this paper is to illustrate how theories can be combined to explore opportunities for learning in doctoral supervision. While our earlier research into learning dynamics in doctoral supervision in life science research (Kobayashi, 2014) has focused on illustrating learning opportunitie...

Reinventing The Doctor

Directory of Open Access Journals (Sweden)

Moyez Jiwa

2011-07-01

Full Text Available There has been a seismic shift in the lives of people because of technology. People are far better informed than they were in the 1980s and 1990s. Much of this information is available through the media but even more is available and archived on the internet. The forces pushing the internet into health and health care are strong and unstoppable, ensuring that the internet and the choices it offers must be part of the design of our future health care system. We are no longer content to wait in queues as we live at a faster pace than earlier generations — we don’t not have time to wait for appointments months, weeks or even days in advance. The internet offers the prospect of online consultations in the comfort of your own home. The physical examination will change as new devices are developed to allow the necessary sounds and signals emitted by our malfunctioning bodies to be recorded, interpreted and captured at a remote location. Meanwhile, for those who prefer to see a health care practitioner in person the options to consult practitioners other than doctors who can advise on our health is expanding. The reality is we can’t afford to train or pay for all the doctors we need under the current “doctor-knows-best” system of health care. Patients no longer believe the rhetoric and are already voting with their feet. Pharmacists, nurses and other allied health professionals are beginning to play a much greater role in offering relief from symptoms and monitoring of chronic diseases. Of course, the doctor of the future will still need to offer face-to-face consultations to some people most of the time or most people some of the time. The social role doctors play will continue to be important as humans will always need other humans to personally respond to their distress. As doctors reinvent themselves, the internet and the value of time with patients will be the driving forces that move us into a more sustainable future in health care.

Legalization of Tree Doctor System and the Role of KSPP

OpenAIRE

Byeongjin Cha

2017-01-01

In December of 2016, ‘The Forest Protection Act’ was amended partly in The National Assembly and the socalled ‘Tree Doctor Act’ was promulgated. Tree Doctor Act will be enforced from June 28, 2018. Under the new Act, none other than ‘Tree Hospital’ can do disease and pest management work for trees in public living space. The only exclusive qualification for tree hospital is a ‘Tree Doctor’, the government registered license which is newly established by the Act. To become a tree doctor, he/sh...

Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health

OpenAIRE

TAŞDEMIR,Zekeriya; ALKAN,Banu Arzu

2015-01-01

Understanding the relationship between periodontal disease (PD) and systemic health (SH) is necessary for the accurate diagnosis and treatment of both. The aim of this study was to evaluate the knowledge of medical doctors in Turkey with regard to the association between PD and SH. This study was carried out using self-reported questionnaires that were sent to medical doctors who work at various universities and public and private hospitals in different cities in Turkey. The questionnaires co...

Doctors on display: the evolution of television's doctors.

Science.gov (United States)

Tapper, Elliot B

2010-10-01

Doctors have been portrayed on television for over 50 years. In that time, their character has undergone significant changes, evolving from caring but infallible supermen with smoldering good looks and impeccable bedside manners to drug-addicted, sex-obsessed antiheroes. This article summarizes the major programs of the genre and explains the pattern of the TV doctors' character changes. Articulated over time in the many permutations of the doctor character is a complex, constant conversation between viewer and viewed representing public attitudes towards doctors, medicine, and science.

[Influence of patients' attitude on doctors' satisfaction with the doctor-patient relationship].

Science.gov (United States)

Xie, Zheng; Qiu, Ze-qi; Zhang, Tuo-hong

2009-04-18

To describe the doctors' satisfaction of the doctor-patient relationship and find out the influencing factors of the patients, gathering evidence to improve the doctor-patient relationship. This study was a cross-sectional study, in which doctors and nurses in 10 hospitals of Beijing, Shandong and Chongqing were surveyed with structured questionnaires and in-depth interviews. The mean score of the doctors' satisfaction of the doctor-patient relationship was 59.97, which was much lower than the patients'. The patients' socio-demographic characteristics, social economic status (SES) and behavior characteristics influence the interaction of the doctors and the patients. The doctors' satisfaction of the doctor-patient relationship was influenced by the patients' trust. The doctors' perspective is helpful to define the tension and the cause of the doctor-patient relationship. The patients' characteristics have important influence on the doctor-patient relationship. It's necessary to take action on the patients to improve the doctor-patient relationship.

Mechanisms of formation of maladaptation states among internship doctors and approaches to their correction

Directory of Open Access Journals (Sweden)

V. V. Vyun

2016-03-01

Full Text Available A doctor’s adaptation to medical activity has a great influence on the effectiveness of his professional activity. The objective: to explore individual psychological predictors of the formation of maladaptation states of internship doctors for the development of a system for their diagnosis, correction and psychoprophylaxis. A comprehensive clinical-psychological, psychodiagnostic and clinical-anamnestic examination of 213 internship doctors of the first year of training atKharkovNationalMedicalUniversity, 116 women and 97 men, aged 22-25 years old had been conducted. It had been established that internship doctors are characterized by feelings of internal tension and dissatisfaction, decreased mood, irritability, anxiety, long-term uncertain negative emotions, unmotivated fears, self-doubt, doubts about making decisions, decline in intellectual activityin conjunction with increased exhaustion and withdrawal mercurial attention. We have developed a system of medical and psychological support during the professional training period depending on the type of disadaptation. The psychotherapeutic complex in the internship doctors included the use of rational psychotherapy, autogenous training (psychotonic version of Shogham-Mirovsky, art therapy, progressive muscle relaxation by Jacobson, cognitive-behavioral therapy of Beck, autogenous training in the modification of Lebedinsky - Bortnik, etc. were used. The results of a three-year catamnestic study proved the effectiveness of the proposed system of psychotherapeutic correction of disorders of adaptation, positive dynamics of the mental state was noted, the maladaptive states were reduced; 92.6% of the examined recurrences of the violations of adaptation did not occur.

Opportunities to learn scientific thinking in joint doctoral supervision

DEFF Research Database (Denmark)

Kobayashi, Sofie; Grout, Brian William Wilson; Rump, Camilla Østerberg

2015-01-01

Research into doctoral supervision has increased rapidly over the last decades, yet our understanding of how doctoral students learn scientific thinking from supervision is limited. Most studies are based on interviews with little work being reported that is based on observation of actual...... supervision. While joint supervision has become widely used, its learning dynamics remains under-researched and this paper aims to address these gaps in research by exploring learning opportunities in doctoral supervision with two supervisors. The study explores how the tensions in scientific discussion...... between supervisors can become learning opportunities. We combine two different theoretical perspectives, using participation and positioning theory as a sociocultural perspective and variation theory as an individual constructivist perspective on learning. Based on our analysis of a complex episode we...

Patient-doctor relationship: the practice orientation of doctors in Kano.

Science.gov (United States)

Abiola, T; Udofia, O; Abdullahi, A T

2014-01-01

Attitude and orientation of doctors to the doctor-patient relationship has a direct influence on delivery of high quality health- care. No study to the knowledge of these researchers has so far examined the practice orientation of doctors in Nigeria to this phenomenon. The aims of this study were to determine the orientation of Kano doctors to the practice of doctor-patient relationship and physicians' related-factors. Participants were doctors working in four major hospitals (i.e., two federal-owned and two state-owned) servicing Kano State and its environs. The Patient-Practitioner Orientation Scale (PPOS) and a socio-demographic questionnaire were completed by the 214 participants. The PPOS has 18 items and measures three parameters of a total score and two dimension of "sharing" and "caring". The mean age of participants was 31.72 years (standard deviation = 0.87), with 22% being females, 40.7% have been practicing for ≥ 6 years and about two-third working in federal-owned health institution. The Cronbach's alpha of total PPOS scores was 0.733 and that of two sub-scale scores of "sharing" and "caring" were 0.659 and 0.546 respectively. Most of the doctors' orientation (92.5%) was towards doctor-centered (i.e., paternalistic) care, majority (75.2%) upheld the view of not sharing much information and control with patients, and showing little interest in psychosocial concerns of patients (i.e., 'caring'=93.0%). Respondents' characteristics that were significantly associated with high doctor 'caring' relationship orientation were being ≥ 30-year-old and practicing for ≥ 6 years. Working in State-owned hospitals was also significantly associated with high doctor "sharing" orientation. This paper demonstrated why patient-centered medical interviewing should be given top priority in medical training in Nigeria, and particularly for federal health institutions saddled with production of new doctors and further training for practicing doctors.

Promoting interdisciplinary education - the Vienna Doctoral Programme on Water Resource Systems

Science.gov (United States)

Blöschl, G.; Carr, G.; Bucher, C.; Farnleitner, A. H.; Rechberger, H.; Wagner, W.; Zessner, M.

2012-02-01

The Vienna Doctoral Programme on Water Resource Systems (DK-WRS) is a programme that aims to educate students in interdisciplinary water science through cutting edge research at an international level. It is funded by the Austrian Science Fund and designed to run over a period of 12 yr during which 80 doctoral students are anticipated to graduate. This paper reports on our experiences of setting up and implementing the Programme. We identify three challenges: integrating the disciplines, maintaining depth in an interdisciplinary programme, and teaching subjects remote to each student's core expertise. To address these challenges we adopt a number of approaches. We use three levels of instruments to foster integration across the disciplines: joint groups (e.g. a joint study programme), joint science questions (e.g. developed in annual symposia), and joint study sites. To maintain depth we apply a system of quality control including regular feedback sessions, theses by journal publications and international study exchange. For simultaneously teaching students from civil and environmental engineering, biology, geology, chemistry, mathematics we use visually explicit teaching, learning by doing, extra mentoring and by cross relating associated subjects. Our initial assessment of the Programme shows some very positive outcomes. Joint science questions formed between students from various disciplines indicate integration is being achieved. The number of successful publications in top journals suggests that depth is maintained. Positive feedback from the students on the variety and clarity of the courses indicates the teaching strategy is working well. Our experiences have shown that implementing and running an interdisciplinary doctoral programme has its challenges and is demanding in terms of time and human resources but seeing interactions progress and watching people grow and develop their way of thinking in an interdisciplinary environment is a valuable reward.

Relationships of work characteristics to job satisfaction, turnover intention, and burnout among doctors in the district public-private mixed health system of Bangladesh.

Science.gov (United States)

Roy, Ashim; van der Weijden, Trudy; de Vries, Nanne

2017-06-20

Work design integrates work characteristics having organizational, social and job components which influence employees' welfare and also organizational goals. We investigated the effects of work characteristics and other predictors to job satisfaction, turnover intention, and burnout in doctors of the public primary, public secondary and private facilities of the district health system of Bangladesh. A quantitative study using a self-administered questionnaire containing mostly structured items was conducted among the public and private doctors with a sample size of 384 from 29 out of a total 64 districts of Bangladesh during October and November 2015. All variables including work characteristics and outcomes of interest were based on literature and measured on 5-point Likert scale. Multivariate analysis of variance, bivariate correlation, and multiple regression were the models operated through SPSS version-21. A total of 354 doctors responded. No significant differences were found between public primary and secondary level doctors on combined work characteristics and outcomes variables, which however differed significantly between the public and private doctors. Organizational support was the strongest predictor adversely affecting job satisfaction, turnover intention and burnout of both the public and private doctors; private doctors' experienced more support. The effects of health-professional politics on the public doctors were alarming. Work design of the Bangladesh's health system is in need of ample development. Doing so, improvement in organizational supports is crucial; however, other work characteristics components are also important for enhancing doctors' welfare and health system productivity.

The doctor(s) in house: an analysis of the evolution of the television doctor-hero.

Science.gov (United States)

Strauman, Elena C; Goodier, Bethany C

2011-03-01

The medical drama and its central character, the doctor-hero have been a mainstay of popular television. House M.D. offers a new (and problematic) iteration of the doctor-hero. House eschews the generic conventions of the "television doctor" by being neither the idealized television doctor of the past, nor the more recent competent but often fallible physicians in entertainment texts. Instead, his character is a fragmented text which privileges the biomedical over the personal or emotional with the ultimate goal of scientifically uncovering and resolving instances of disease. This article examines the implicit and explicit messages in House M.D. and critically analyzes both the show and its lead character in relation to the traditional medical drama genre that highlights the "doctor-hero" as the central character. While at first House seems to completely violate narrative and generic norms, ultimately the program provides a new form that reinforces the presence of the doctor-hero, but highlights House's character as the central figure who is personally and interpersonally problematic but biomedically effective.

Improved interobserver variation after training of doctors in the Neer system. A randomised trial

DEFF Research Database (Denmark)

Brorson, S; Bagger, J; Sylvest, A

2002-01-01

We investigated whether training doctors to classify proximal fractures of the humerus according to the Neer system could improve interobserver agreement. Fourteen doctors were randomised to two training sessions, or to no training, and asked to categorise 42 unselected pairs of plain radiographs...... of fractures of the proximal humerus according to the Neer system. The mean kappa difference between the training and control groups was 0.30 (95% CI 0.10 to 0.50, p = 0.006). In the training group the mean kappa value for interobserver variation improved from 0.27 (95% CI 0.24 to 0.31) to 0.62 (95% CI 0.......57 to 0.67). The improvement was particularly notable for specialists in whom kappa increased from 0.30 (95% CI 0.23 to 0.37) to 0.79 (95% CI 0.70 to 0.88). These results suggest that formal training in the Neer system is a prerequisite for its use in clinical practice and research....

Women who doctor shop for prescription drugs.

Science.gov (United States)

Worley, Julie; Thomas, Sandra P

2014-04-01

Doctor shopping is a term used to describe a form of diversion of prescription drugs when patients visit numerous prescribers to obtain controlled drugs for illicit use. Gender differences exist in regard to prescription drug abuse and methods of diversion. The purpose of this phenomenological study guided by the existential philosophy of Merleau-Ponty was to understand the lived experience of female doctor shoppers. Interviews were conducted with 14 women, which were recorded, transcribed, and analyzed. Included in the findings are figural aspects of the participants' experience of doctor shopping related to the existential grounds of world, time, body, and others. Four themes emerged from the data: (a) feeding the addiction, (b) networking with addicts, (c) playing the system, and (d) baiting the doctors. The findings suggest several measures that nurses can take to reduce the incidence of doctor shopping and to provide better care for female doctor shoppers.

Health system reforms, violence against doctors and job satisfaction in the medical profession: a cross-sectional survey in Zhejiang Province, Eastern China.

Science.gov (United States)

Wu, Dan; Wang, Yun; Lam, Kwok Fai; Hesketh, Therese

2014-12-31

To explore the factors influencing doctors' job satisfaction and morale in China, in the context of the ongoing health system reforms and the deteriorating doctor-patient relationship. Cross-sectional survey using self-completion questionnaires. The survey was conducted from March to May 2012 among doctors at the provincial, county and primary care levels in Zhejiang Province, China. The questionnaire was completed by 202 doctors. Factors which contributed most to low job satisfaction were low income and long working hours. Provincial level doctors were most dissatisfied while primary care doctors were the least dissatisfied. Three per cent of doctors at high-level hospitals and 27% of those in primary care were satisfied with the salary. Only 7% at high-level hospitals were satisfied with the work hours, compared to 43% in primary care. Less than 10% at high levels were satisfied with the amount of paid vacation time (3%) and paid sick leave (5%), compared with 38% and 41%, respectively, in primary care. Overall, 87% reported that patients were more likely to sue and that patient violence against doctors was increasing. Only 4.5% wanted their children to be doctors. Of those 125 who provided a reason, 34% said poor pay, 17% said it was a high-risk profession, and 9% expressed concerns about personal insecurity or patient violence. Doctors have low job satisfaction overall. Recruitment and retention of doctors have become major challenges for the Chinese health system. Measures must be taken to address this, in order to ensure recruitment and retention of doctors in the future. These measures must first include reduction of doctors' workload, especially at provincial hospitals, partly through incentivisation of appropriate utilisation of primary care, increase in doctors' salary and more effective measures to tackle patient violence against doctors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

The effect of the doctor's sex on the doctor-patient relationship

OpenAIRE

Gray, Judith

1982-01-01

The differences between male and female doctors are investigated, and what patients expect from their doctors is examined. Some conclusions are drawn from the preferences which patients express for male and female doctors and from the different outcomes of male and female doctor-patient interactions.

Choose your doctorate.

Science.gov (United States)

Jolley, Jeremy

2007-02-01

The development of education options for nurses has been inexorable and it is increasingly the case that senior nurses are considering a doctorate as the logical next step in their educational career. Such individuals need to make important decisions as to whether they should embark on a taught doctorate, professional doctorate or a traditional PhD. Each of these options will necessitate a considerable investment in time and money as well as the sacrifice of quality time and spare time over a significant number of years. A doctorate is not for everyone. Those still reading this text may be asking 'could this possibly be for me'? This paper will try to help the reader decide which if any option to take. It is suggested that nurses will now turn to the doctoral degree as their next adventure in academic study. It is argued that this development is not being controlled by management forces and indeed cannot be controlled by them. This last is chiefly because the move towards doctoral education is led by individuals who choose to study for a doctorate simply because they can. The paper considers what choices are available to nurses who wish to pursue a doctoral programme of study. In particular, this paper considers what new developments in doctoral courses are becoming available and what advantage there may be in studying for one of the newer professional doctorates rather than a traditional PhD. The material here is the result of a review of the literature on recent developments in doctoral education for nurses. The existing provision by UK and other universities was also reviewed, the data being collected by an informal review of universities' advertising material. It is inevitable that some nurses who are already qualified to degree and masters degree will take advantage of the doctoral degree opportunities which now newly present themselves. For nurses in practice, the advantages of the professional doctorate is that it is more structured, enables more peer and

Doctors on display: the evolution of television's doctors

OpenAIRE

Tapper, Elliot B.

2010-01-01

Doctors have been portrayed on television for over 50 years. In that time, their character has undergone significant changes, evolving from caring but infallible supermen with smoldering good looks and impeccable bedside manners to drug-addicted, sex-obsessed antiheroes. This article summarizes the major programs of the genre and explains the pattern of the TV doctors' character changes. Articulated over time in the many permutations of the doctor character is a complex, constant conversation...

Radiographers as doctors: A profile of UK doctoral achievement

International Nuclear Information System (INIS)

Snaith, B.; Harris, M.A.; Harris, R.

2016-01-01

Introduction: Radiography aspires to be a research active profession, but there is limited information regarding the number of individuals with, or studying for, a doctoral award. This study aims to profile UK doctoral radiographers; including their chosen award, approach and employment status. Method: This was a prospective cohort study utilising an electronic survey. No formal database of doctoral radiographers existed therefore a snowball sampling method was adopted. The study sample was radiographers (diagnostic and therapeutic) based in the UK who were registered with the Health and Care Professions Council (HCPC) and who held, or were studying for, a doctoral award. Results: A total of 90 unique responses were received within the timescale. The respondents comprised 58 females (64.4%) and the majority were diagnostic radiographers (n = 71/90; 78.9%). The traditional PhD was the most common award, although increasing numbers were pursuing Education or Professional Doctorates. An overall increase in doctoral studies is observed over time, but was greatest amongst those working in academic institutions, with 63.3% of respondents (n = 57/90) working solely within a university, and a further 10% employed in a clinical–academic role (n = 9/90). Conclusion: This study has demonstrated that radiography is emerging as a research active profession, with increasing numbers of radiographers engaged in study at a doctoral level. This should provide a platform for the future development of academic and clinical research. - Highlights: • 90 radiographers were identified as holding, or studying for, a doctoral award. • The PhD is the most common award. • EdD and professional doctorates are increasing in popularity. • Academic staff were more likely to pursue such research training.

2nd International Doctoral Symposium on Applied Computation and Security Systems

CERN Document Server

Cortesi, Agostino; Saeed, Khalid; Chaki, Nabendu

2016-01-01

The book contains the extended version of the works that have been presented and discussed in the Second International Doctoral Symposium on Applied Computation and Security Systems (ACSS 2015) held during May 23-25, 2015 in Kolkata, India. The symposium has been jointly organized by the AGH University of Science & Technology, Cracow, Poland; Ca’ Foscari University, Venice, Italy and University of Calcutta, India. The book is divided into volumes and presents dissertation works in the areas of Image Processing, Biometrics-based Authentication, Soft Computing, Data Mining, Next Generation Networking and Network Security, Remote Healthcare, Communications, Embedded Systems, Software Engineering and Service Engineering.

NATO Advanced Study Institute on International Summer School on Chaotic Dynamics and Transport in Classical and Quantum Systems

CERN Document Server

Collet, P; Métens, S; Neishtadt, A; Zaslavsky, G; Chaotic Dynamics and Transport in Classical and Quantum Systems

2005-01-01

This book offers a modern updated review on the most important activities in today dynamical systems and statistical mechanics by some of the best experts in the domain. It gives a contemporary and pedagogical view on theories of classical and quantum chaos and complexity in hamiltonian and ergodic systems and their applications to anomalous transport in fluids, plasmas, oceans and atom-optic devices and to control of chaotic transport. The book is issued from lecture notes of the International Summer School on "Chaotic Dynamics and Transport in Classical and Quantum Systems" held in Cargèse (Corsica) 18th to the 30th August 2003. It reflects the spirit of the School to provide lectures at the post-doctoral level on basic concepts and tools. The first part concerns ergodicity and mixing, complexity and entropy functions, SRB measures, fractal dimensions and bifurcations in hamiltonian systems. Then, models of dynamical evolutions of transport processes in classical and quantum systems have been largely expla...

Professional and Personal Development in Contemporary Gerontology Doctoral Education

Science.gov (United States)

Ewen, Heidi H.; Rowles, Graham D.; Watkins, John F.

2012-01-01

This article reports on the Gerontology Doctoral Student Assessment Model (GDSAM), a comprehensive web-based system premised on developing an evaluation mechanism attuned to the special requirements of advanced graduate education at the doctoral level. The system focuses on longitudinal tracking of selected dimensions of intellectual,…

[The motivation to become a medical doctor - doctoral students in a formal academic study program compared with those pursuing their doctorate independently].

Science.gov (United States)

Pfeiffer, M; Dimitriadis, K; Holzer, M; Reincke, M; Fischer, M R

2011-04-01

Weight and quality of medical doctoral theses have been discussed in Germany for years. Doctoral study programs in various graduate schools offer opportunities to improve quality of medical doctoral theses. The purpose of this study was to demonstrate distinctions and differences concerning motivation, choice of subject and the dissertation process between doctoral candidates completing the doctoral seminar for doctoral students in the Ludwig-Maximilians-University (LMU) Munich and doctoral candidates doing their doctorate individually. All 4000 medical students of the LMU obtained an online-questionnaire which was completed by 767 students (19 % response rate). The theoretical framework of this study was based upon the Self-Determination-Theory by Deci and Ryan. Doctoral candidates completing the doctoral study program were more intrinsically motivated than doctoral candidates doing their doctorate individually; no difference was found in their extrinsic motivation. In regard to choice of subject and dissertation process the doctoral students in the seminar were distinguished from the individual group by having chosen a more challenging project. They anticipated a demanding dissertation process including conference participation, publishing of papers, etc. Intrinsic motivation correlates positively with choosing a challenging project and a demanding dissertation process. High intrinsic motivation seems to be very important for autonomous scholarly practice. Our results suggest that doctoral study programs have a positive impact on intrinsic motivation and interest in research. © Georg Thieme Verlag KG Stuttgart · New York.

Health system reforms, violence against doctors and job satisfaction in the medical profession: a cross-sectional survey in Zhejiang Province, Eastern China

Science.gov (United States)

Wu, Dan; Wang, Yun; Lam, Kwok Fai; Hesketh, Therese

2014-01-01

Objective To explore the factors influencing doctors’ job satisfaction and morale in China, in the context of the ongoing health system reforms and the deteriorating doctor–patient relationship. Design Cross-sectional survey using self-completion questionnaires. Study setting The survey was conducted from March to May 2012 among doctors at the provincial, county and primary care levels in Zhejiang Province, China. Results The questionnaire was completed by 202 doctors. Factors which contributed most to low job satisfaction were low income and long working hours. Provincial level doctors were most dissatisfied while primary care doctors were the least dissatisfied. Three per cent of doctors at high-level hospitals and 27% of those in primary care were satisfied with the salary. Only 7% at high-level hospitals were satisfied with the work hours, compared to 43% in primary care. Less than 10% at high levels were satisfied with the amount of paid vacation time (3%) and paid sick leave (5%), compared with 38% and 41%, respectively, in primary care. Overall, 87% reported that patients were more likely to sue and that patient violence against doctors was increasing. Only 4.5% wanted their children to be doctors. Of those 125 who provided a reason, 34% said poor pay, 17% said it was a high-risk profession, and 9% expressed concerns about personal insecurity or patient violence. Conclusions Doctors have low job satisfaction overall. Recruitment and retention of doctors have become major challenges for the Chinese health system. Measures must be taken to address this, in order to ensure recruitment and retention of doctors in the future. These measures must first include reduction of doctors’ workload, especially at provincial hospitals, partly through incentivisation of appropriate utilisation of primary care, increase in doctors’ salary and more effective measures to tackle patient violence against doctors. PMID:25552614

Dynamical systems

CERN Document Server

Sternberg, Shlomo

2010-01-01

Celebrated mathematician Shlomo Sternberg, a pioneer in the field of dynamical systems, created this modern one-semester introduction to the subject for his classes at Harvard University. Its wide-ranging treatment covers one-dimensional dynamics, differential equations, random walks, iterated function systems, symbolic dynamics, and Markov chains. Supplementary materials offer a variety of online components, including PowerPoint lecture slides for professors and MATLAB exercises.""Even though there are many dynamical systems books on the market, this book is bound to become a classic. The the

Characterization of doctor-patient communication using heartbeat nonlinear dynamics: A preliminary study using Lagged Poincaré Plots.

Science.gov (United States)

Nardelli, M; Del Piccolo, L; Danzi, Op; Perlini, C; Tedeschi, F; Greco, A; Scilingo, Ep; Valenza, G

2017-07-01

Emphatic doctor-patient communication has been associated with an improved psycho-physiological well-being involving cardiovascular and neuroendocrine responses. Nevertheless, a comprehensive assessment of heartbeat linear and nonlinear/complex dynamics throughout the communication of a life-threatening disease has not been performed yet. To this extent, we here study heart rate variability (HRV) series gathered from 17 subjects while watching a video where an oncologist discloses the diagnosis of a cancer metastasis to a patient. Further 17 subjects watched the same video including additional affective emphatic contents. For the assessment of the two groups, linear heartbeat dynamics was quantified through measures defined in the time and frequency domains, whereas nonlinear/complex dynamics referred to measures of entropy, and combined Lagged Poincare Plots (LPP) and symbolic analyses. Considering differences between the beginning and the end of the video, results from non-parametric statistical tests demonstrated that the group watching emphatic contents showed HRV changes in the LF/HF ratio exclusively. Conversely, the group watching the purely informative video showed changes in vagal activity (i.e., HF power), LF/HF ratio, as well as LPP measures. Additionally, a Support Vector Machine algorithm including HRV nonlinear/complex information was able to automatically discern between groups with an accuracy of 76.47%. We therefore propose the use of heartbeat nonlinear/complex dynamics to objectively assess the empathy level of healthy women.

Doctoral Women: Managing Emotions, Managing Doctoral Studies

Science.gov (United States)

Aitchison, Claire; Mowbray, Susan

2013-01-01

This paper explores the experiences of women doctoral students and the role of emotion during doctoral candidature. The paper draws on the concept of emotional labour to examine the two sites of emotional investment students experienced and managed during their studies: writing and family relationships. Emotion is perceived by many dominant…

Promoting interdisciplinary education − the Vienna Doctoral Programme on Water Resource Systems

Directory of Open Access Journals (Sweden)

W. Wagner

2012-02-01

Full Text Available The Vienna Doctoral Programme on Water Resource Systems (DK-WRS is a programme that aims to educate students in interdisciplinary water science through cutting edge research at an international level. It is funded by the Austrian Science Fund and designed to run over a period of 12 yr during which 80 doctoral students are anticipated to graduate. This paper reports on our experiences of setting up and implementing the Programme. We identify three challenges: integrating the disciplines, maintaining depth in an interdisciplinary programme, and teaching subjects remote to each student's core expertise. To address these challenges we adopt a number of approaches. We use three levels of instruments to foster integration across the disciplines: joint groups (e.g. a joint study programme, joint science questions (e.g. developed in annual symposia, and joint study sites. To maintain depth we apply a system of quality control including regular feedback sessions, theses by journal publications and international study exchange. For simultaneously teaching students from civil and environmental engineering, biology, geology, chemistry, mathematics we use visually explicit teaching, learning by doing, extra mentoring and by cross relating associated subjects. Our initial assessment of the Programme shows some very positive outcomes. Joint science questions formed between students from various disciplines indicate integration is being achieved. The number of successful publications in top journals suggests that depth is maintained. Positive feedback from the students on the variety and clarity of the courses indicates the teaching strategy is working well. Our experiences have shown that implementing and running an interdisciplinary doctoral programme has its challenges and is demanding in terms of time and human resources but seeing interactions progress and watching people grow and develop their way of thinking in an interdisciplinary environment is a

[Corruption risks in relations between doctor and patient ].

Science.gov (United States)

Kolwitz, Marcin; Gąsiorowski, Jakub

2014-01-01

The article describes the problem of corruption occurring in the relationship between doctor and patient. The doctor-patient relationship, including the provision of health services, is one of several potential areas of corruption in the health care system. Among the reasons for the existence of corruption in these relationships are the need to obtain better healthcare for the patient, and higher earnings in the case of a doctor. Indications of corruption are utilitarian (action for personal advantage without ethical aspects), but may also be (actually or in the patient's opinion) the only way to obtain services and save health and even life. Corruption between the doctor and the patient can be limited by better organization of the health care system, including the financing of benefits and education of medical personnel and patients, as well as traditional legal measures, such as prevention or the application of criminal sanctions.

The structure and process of workers' compensation systems and the role of doctors: A comparison of Ontario and Québec.

Science.gov (United States)

Lippel, Katherine; Eakin, Joan M; Holness, D Linn; Howse, Dana

2016-12-01

This study sought to identify impacts of compensation system characteristics on doctors in Québec and Ontario. (i) Legal analysis; (ii) Qualitative methods applied to documentation and individual and group interviews with doctors (34) and other system participants (31); and (iii) Inter-jurisdictional transdisciplinary analysis involving cross-disciplinary comparative and integrative analysis of policy contexts, qualitative data, and the relationship between the two. In both jurisdictions the compensation board controlled decisions on work-relatedness and doctors perceived the bureaucratic process negatively. Gatekeeping roles differed between jurisdictions both in initial adjudication and in dispute processes. Québec legislation gives greater weight to the opinion of the treating physician. These differences affected doctors' experiences. Policy-makers should contextualize the sources of the "evidence" they rely on from intervention research because findings may reflect a system rather than an intervention effect. Researchers should consider policy contexts to both adequately design a study and interpret their results. Am. J. Ind. Med. 59:1070-1086, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Training improves agreement among doctors using the Neer system for proximal humeral fractures in a systematic review

DEFF Research Database (Denmark)

Brorson, Stig; Hróbjartsson, Asbjørn

2008-01-01

OBJECTIVE: To systematically review studies of observer agreement among doctors classifying proximal humeral fractures according to the Neer system. STUDY DESIGN AND SETTING: A systematic review. We searched for observational studies in which doctors classified proximal humeral fractures according......, and the methodological quality was assessed. RESULTS: We included 11 observational studies (88 observers and 468 cases). Mean kappa-values for interobserver agreement ranged from 0.17 to 0.52. Agreement did not improve through selection of experienced observers, advanced imaging modalities, or simplification...

Doctors in Balzac's work.

Science.gov (United States)

Moulin, Thierry

2013-01-01

Balzac wrote his novels during a time of great literary and scientific change. Romanticism gave way to the school of realism, of which Balzac could be considered the founder. It was via realism, where both the positive and negative aspects of life were depicted, that doctors naturally gained a much more active role in novels. In conjunction with this was the development of science and medicine, which fascinated Balzac, also leading to the significant and prevalent role of doctors in his works. His fascination with the sciences led to him to gain many acquaintances and much knowledge in the medical domain, especially in neuropsychiatry and physiology. His fictional doctors, such as Desplein and Bianchon, thus demonstrate considerable knowledge of pathology, physiology, and neuropsychiatry. The doctors in Balzac's novels can be grouped into four categories: provincial doctors, Parisian doctors, country doctors, and military doctors. They were most often fictitious representations of real individuals (e.g. Guillaume Dupuytren), and often symbolize schools of thought which were in vogue at the time. In addition to the accurate scientific depiction of doctors, it must be noted that his doctors not only played an active role in clinically assessing their patients, but also had a sociological role in assessing society; it is through his doctors that Balzac gave his opinion of the world in which he lived. Copyright © 2013 S. Karger AG, Basel.

The development of online doctor reviews in China: an analysis of the largest online doctor review website in China.

Science.gov (United States)

Hao, Haijing

2015-06-01

Since the time of Web 2.0, more and more consumers have used online doctor reviews to rate their doctors or to look for a doctor. This phenomenon has received health care researchers' attention worldwide, and many studies have been conducted on online doctor reviews in the United States and Europe. But no study has yet been done in China. Also, in China, without a mature primary care physician recommendation system, more and more Chinese consumers seek online doctor reviews to look for a good doctor for their health care concerns. This study sought to examine the online doctor review practice in China, including addressing the following questions: (1) How many doctors and specialty areas are available for online review? (2) How many online reviews are there on those doctors? (3) What specialty area doctors are more likely to be reviewed or receive more reviews? (4) Are those reviews positive or negative? This study explores an empirical dataset from Good Doctor website, haodf.com—the earliest and largest online doctor review and online health care community website in China—from 2006 to 2014, to examine the stated research questions by using descriptive statistics, binary logistic regression, and multivariate linear regression. The dataset from the Good Doctor website contained 314,624 doctors across China and among them, 112,873 doctors received 731,543 quantitative reviews and 772,979 qualitative reviews as of April 11, 2014. On average, 37% of the doctors had been reviewed on the Good Doctor website. Gynecology-obstetrics-pediatrics doctors were most likely to be reviewed, with an odds ratio (OR) of 1.497 (95% CI 1.461-1.535), and internal medicine doctors were less likely to be reviewed, with an OR of 0.94 (95% CI 0.921-0.960), relative to the combined small specialty areas. Both traditional Chinese medicine doctors and surgeons were more likely to be reviewed than the combined small specialty areas, with an OR of 1.483 (95% CI 1.442-1.525) and an OR of 1

Doctors Today

LENUS (Irish Health Repository)

Murphy, JFA

2012-03-01

Doctors’ relationship with patients and their role in society is changing. Until the 1960s doctors concentrated on the welfare of patients with less emphasis placed on patients’ rights1. Over recent decades there has been increasing empowerment of the individual across all facets of society including health care. Doctors continue to be perceived as having expertise and authority over medical science. Patients, however, now hold sway over questions of values or preferences. We all must be aware of this change in the doctor- patient interaction. We need to be more aware of the outcomes that patients view as important. The concept of shared decision-making with the patient is now widely appreciated. The process involves a change in mind set particularly for doctors who trained in an earlier era.

[Doctor-patient relationship in the context of a changing society].

Science.gov (United States)

Siebzehner, Miriam Ines; Balik, Chaya; Matalon, Andre

2008-12-01

During the 20th century doctors gained a special status in the medical system, which is about to change as a consequence of a change in the doctor-patient relationship and in the characteristics of the labor market in health care. Some changes correspond with the adoption of business terms within the medical system. The doctor is represented as a supplier of services, while the patient is a consumer. From patient-centered care, the doctor-patient relationship changed to a costumer-supplier of services, as is the case in other fields of the consumer society. This article analyzes the changes in the patterns of the doctor-patient interactions in the light of the changes in society over the last decades such as: the creation of regulations and laws on patients' rights; the establishment of organizations that represent the sick, the distribution of knowledge and information by means of mass communication, changes in the status of the doctors, the academization of other health professionals and changes in the management of health care to a more financially viable approach to the costs of health.

Interpersonal perception in the context of doctor-patient relationships: a dyadic analysis of doctor-patient communication.

Science.gov (United States)

Kenny, David A; Veldhuijzen, Wemke; Weijden, Trudy van der; Leblanc, Annie; Lockyer, Jocelyn; Légaré, France; Campbell, Craig

2010-03-01

Doctor-patient communication is an interpersonal process and essential to relationship-centered care. However, in many studies, doctors and patients are studied as if living in separate worlds. This study assessed whether: 1) doctors' perception of their communication skills is congruent with their patients' perception; and 2) patients of a specific doctor agree with each other about their doctor's communication skills. A cross-sectional study was conducted in three provinces in Canada with 91 doctors and their 1749 patients. Doctors and patients independently completed questions on the doctor's communication skills (content and process) after a consultation. Multilevel modeling provided an estimate of the patient and doctor variance components at both the dyad-level and the doctor-level. We computed correlations between patients' and doctors' perceptions at both levels to assess how congruent they were. Consensus among patients of a specific doctor was assessed using intraclass correlation coefficient (ICC). The mean score of the rating of doctor's skills according to patients was 4.58, and according to doctors was 4.37. The dyad-level variance for the patient was .38 and for the doctor was .06. The doctor-level variance for the patient ratings was .01 and for the doctor ratings, .18. The correlation between both the patients' and the doctors' skills' ratings scores at the dyad-level was weak. At the doctor-level, the correlation was not statistically significant. The ICC for patients' ratings was .03 and for the doctors' ratings .76. Overall, this study suggests that doctors and their patients have a very different perspective of the doctors' communication skills occurring during routine clinical encounters. 2009 Elsevier Ltd. All rights reserved.

Re-Imagining Doctoral Education: Professional Doctorates and beyond

Science.gov (United States)

Lee, Alison; Brennan, Marie; Green, Bill

2009-01-01

Portents of the demise of the Professional Doctorate have emerged in some recent policy and institutional circles in Australia, raising questions about the meaning and relevance of the Professional Doctorate in an era of "league tables" and research assessment in Australia. This article argues that such portents, based largely on narrow…

Doctors and pharmaceutical industry.

Science.gov (United States)

Beran, Roy G

2009-09-01

The pharmaceutical industry is seen as seducing doctors by providing expensive gifts, subsidising travel and underwriting practice expenses in return for those doctors prescribing products that otherwise they would not use. This paints doctors in a very negative light; suggests doctors are available to the highest bidder; implies doctors do not adequately act as independent agents; and that doctors are driven more by self-interest than by patient needs. Similar practices, in other industries, are accepted as normal business behaviour but it is automatically assumed to be improper if the pharmaceutical industry supports doctors. Should the pharmaceutical industry withdraw educational grants then there would be: fewer scientific meetings; reduced attendance at conferences; limited post graduate education; and a depreciated level of maintenance of professional standards. To suggest that doctors prescribe inappropriately in return for largesse maligns their integrity but where there is no scientific reason to choose between different treatments then there can be little argument against selecting the product manufactured by a company that has invested in the doctor and the question arises as to whether this represents bad medicine? This paper will examine what constitutes non-professional conduct in response to inducements by the pharmaceutical industry. It will review: conflict of interest; relationships between doctors and pharma and the consequences for patients; and the need for critical appraisal before automatically decrying this relationship while accepting that there remain those who do not practice ethical medicine.

Relational continuity with primary and secondary care doctors: a qualitative study of perceptions of users of the Catalan national health system.

Science.gov (United States)

Waibel, Sina; Vargas, Ingrid; Coderch, Jordi; Vázquez, María-Luisa

2018-04-10

In the current context of increasingly fragmented healthcare systems where patients are seen by multiple doctors in different settings, patients' relational continuity with one doctor is regaining relevance; however little is known about relational continuity with specialists. The aim of this study is to explore perceptions of relational continuity with primary care and secondary care doctors, its influencing factors and consequences from the viewpoint of users of the Catalan national health system (Spain). We conducted a descriptive-interpretative qualitative study using a two-stage theoretical sample; (i) contexts: three healthcare areas in the Catalan national health system with differing characteristics; (ii) informants: users 18 years or older attended to at both care levels. Sample size (n = 49) was reached by saturation. Data were collected by individual semi-structured interviews, which were audio recorded and transcribed. A thematic content analysis was carried out segmenting data by study area, and leaving room for new categories to emerge from the data. Patients across the areas studied generally experienced consistency of primary care doctors (PCD), alongside some inconsistency of specialists. Consistency of specialists did not seem to be relevant to some patients when their clinical information was shared and used. Patients who experienced consistency and frequent visits with the same PCD or specialist described and valued having established an ongoing relationship characterised by personal trust and mutual accumulated knowledge. Identified consequences were diverse and included, for example, facilitated diagnosis or improved patient-doctor communication. The ascription to a PCD, a health system-related factor, facilitated relational continuity with the PCD, whereas organizational factors (for instance, the size of the primary care centre) favoured consistency of PCD and specialists. Doctor-related factors (for example, high technical competence or

Wanted--doctors who care.

Science.gov (United States)

Lovdal, L T; Pearson, R

1989-03-01

A study was conducted to determine what consumers value in doctors' behavior. Results indicate that consumers in the sample population studied prefer doctors who are friendly and caring as well as those who are technically competent. However, these respondents reported less favorable opinions about doctors' friendliness (i.e., affective behavior) than they did about doctors' competence (i.e., instrumental behavior).

Australian doctors and the visual arts. Part 3. Doctor-artists in Victoria.

Science.gov (United States)

Hamilton, D G

1986-06-09

The contribution of doctors to the visual arts is being discussed in a series of six articles. The first two articles dealt with doctors and the visual arts in New South Wales. In this, the third, doctor-artists in Victoria are discussed.

The Relationships between Doctoral Students’ Perceptions of Supervision and Burnout

Directory of Open Access Journals (Sweden)

Solveig Cornér

2017-06-01

students develop networks both nationally and internationally. Recommendation for Researchers: A recommendation emanating from this research is to put greater emphasis on further investigation of the role of other predictors in burnout in order to enhance doctoral students’ well-being. Impact on Society: A better understanding of factors that promote lower attrition rates and enhance well-being for doctoral students is likely to lead to more efficient use of finacial and intellectual resources in academia and society more broadly. Future Research: Given the results of this study, qualitative interviews might be helpful in mapping out the dynamics that lead to attrition and to identify the mechanisms in the researcher community that support the doctoral students and enhance well-being in their doctoral journey.

The Career Paths of Doctoral Graduates in Austria

Science.gov (United States)

Schwabe, Markus

2011-01-01

Economists and policy makers often emphasise the importance of human capital as a key determinant in the pursuit of economic growth. The highest formal qualification in the educational system is the doctorate, which is attained after the first stage of tertiary education at ISCED 6 level. Doctorate holders play a central role in research and…

A systematic review of burnout among doctors in China: a cultural perspective.

Science.gov (United States)

Lo, Dana; Wu, Florence; Chan, Mark; Chu, Rodney; Li, Donald

2018-01-01

Numerous studies around the world has already suggested that burnout among doctors is a global phenomenon. However, studies for burnout in doctors are relatively limited in Chinese communities when compared to the West. As risk factors, barriers to intervention and strategies combatting burnout in different parts of the world can vary a lot due to different social culture and healthcare system, study with a focus at doctors in China from a cultural perspective is a worthful endeavor. Systematic searches of databases were conducted for papers published in peer-reviewed journals from 2006 to 2016. Selection criteria included practicing doctors in Mainland China and publications written in English or Chinese. Keywords searched including "burnout", "doctors" and "China" in 3 electronic databases has been undergone. Traditional understanding of "work attitude" and "doctors' humanity" from ancient Chinese literature has also been retrieved. Eleven full papers, including 9302 participants, were included in this review. The overall prevalence of burnout symptoms among doctors in China ranged from 66.5 to 87.8%. The review suggested that negative impact of burnout include association with anxiety symptoms and low job satisfaction at the individual doctors' level, and prone to committing medical mistakes affecting patient safety and higher turnover intention at the society/organizational level. Burnout was higher among doctors who worked over 40 h/week, working in tertiary hospitals, on younger age group within the profession (at age 30-40), and with negative individual perception to work and life. The overall prevalence and adverse impact of burnout among doctors in China echo with the findings from Western studies. Young doctors and doctors working in tertiary hospitals are more at risk of burnout, probably related to shift of social culture related to the loss of medical humanities and a weak primary healthcare system. Potential strategies of managing burnout in Chinese

The fluid dynamics of climate

CERN Document Server

Palazzi, Elisa; Fraedrich, Klaus

2016-01-01

This volume provides an overview of the fluid aspects of the climate system, focusing on basic aspects as well as recent research developments. It will bring together contributions from diverse fields of the physical, mathematical and engineering sciences. The volume will be useful to doctorate students, postdocs and researchers working on different aspects of atmospheric, oceanic and environmental fluid dynamics. It will also be of interest to researchers interested in quantitatively understanding how fluid dynamics can be applied to the climate system, and to climate scientists willing to gain a deeper insight into the fluid mechanics underlying climate processes.

The patient-doctor relationship: a synthesis of the qualitative literature on patients' perspectives.

Science.gov (United States)

Ridd, Matthew; Shaw, Alison; Lewis, Glyn; Salisbury, Chris

2009-04-01

The patient-doctor relationship is an important but poorly defined topic. In order to comprehensively assess its significance for patient care, a clearer understanding of the concept is required. To derive a conceptual framework of the factors that define patient-doctor relationships from the perspective of patients. Systematic review and thematic synthesis of qualitative studies. Medline, EMBASE, PsychINFO and Web of Science databases were searched. Studies were screened for relevance and appraised for quality. The findings were synthesised using a thematic approach. From 1985 abstracts, 11 studies from four countries were included in the final synthesis. They examined the patient-doctor relationship generally (n = 3), or in terms of loyalty (n = 3), personal care (n = 2), trust (n = 2), and continuity (n = 1). Longitudinal care (seeing the same doctor) and consultation experiences (patients' encounters with the doctor) were found to be the main processes by which patient-doctor relationships are promoted. The resulting depth of patient-doctor relationship comprises four main elements: knowledge, trust, loyalty, and regard. These elements have doctor and patient aspects to them, which may be reciprocally related. A framework is proposed that distinguishes between dynamic factors that develop or maintain the relationship, and characteristics that constitute an ongoing depth of relationship. Having identified the different elements involved, future research should examine for associations between longitudinal care, consultation experiences, and depth of patient-doctor relationship, and, in turn, their significance for patient care.

Non-EEA-doctors in EEA-countries: doctors or cleaners?

NARCIS (Netherlands)

Herfs, Paul; Kater, L.; Haalboom, J.R.E.

2007-01-01

Background: Migration of non-EEA doctors to EEA-countries has become a common phenomenon. As coordination within the EEA has not yet been established, every EEA-country is re-inventing the wheel of assessment of foreign medical degrees and developing additional programmes for non-EEA doctors. There

Dynamical Systems Conference

CERN Document Server

Gils, S; Hoveijn, I; Takens, F; Nonlinear Dynamical Systems and Chaos

1996-01-01

Symmetries in dynamical systems, "KAM theory and other perturbation theories", "Infinite dimensional systems", "Time series analysis" and "Numerical continuation and bifurcation analysis" were the main topics of the December 1995 Dynamical Systems Conference held in Groningen in honour of Johann Bernoulli. They now form the core of this work which seeks to present the state of the art in various branches of the theory of dynamical systems. A number of articles have a survey character whereas others deal with recent results in current research. It contains interesting material for all members of the dynamical systems community, ranging from geometric and analytic aspects from a mathematical point of view to applications in various sciences.

Dynamic Systems and Control Engineering

International Nuclear Information System (INIS)

Kim, Jong Seok

1994-02-01

This book deals with introduction of dynamic system and control engineering, frequency domain modeling of dynamic system, temporal modeling of dynamic system, typical dynamic system and automatic control device, performance and stability of control system, root locus analysis, analysis of frequency domain dynamic system, design of frequency domain dynamic system, design and analysis of space, space of control system and digital control system such as control system design of direct digital and digitalization of consecutive control system.

Dynamic Systems and Control Engineering

Energy Technology Data Exchange (ETDEWEB)

Kim, Jong Seok

1994-02-15

This book deals with introduction of dynamic system and control engineering, frequency domain modeling of dynamic system, temporal modeling of dynamic system, typical dynamic system and automatic control device, performance and stability of control system, root locus analysis, analysis of frequency domain dynamic system, design of frequency domain dynamic system, design and analysis of space, space of control system and digital control system such as control system design of direct digital and digitalization of consecutive control system.

Talking to Your Doctor

Medline Plus

Full Text Available ... to Your Doctor , National Eye Institute (NEI) Español Aging Planning Your Doctor Visit , NIHSeniorHealth.gov Videos: Talking ... A Guide for Older People , National Institute on Aging (NIA) Talking With Your Doctor Presentation Toolkit , National ...

Drivers and Interpretations of Doctoral Education Today: National Comparisons

DEFF Research Database (Denmark)

Andres, Lesley; Bengtsen, Søren Smedegaard; Castano, Liliana Del Pilar Gallego

2015-01-01

In the last decade, doctoral education has undergone a sea change with several global trends increasingly apparent. Drivers of change include massification and professionalization of doctoral education and the introduction of quality assurance systems. The impact of these drivers, and the forms...... that they take, however, are dependent on doctoral education within a given national context. This paper is frontline in that it contributes to the literature on doctoral education by examining the ways in which these global trends and drivers are being taken up in policies and practices by various countries. We...... do so by comparing recent changes in each of the following countries: Canada, Colombia, Denmark, Finland, the UK, and the USA. Each country case is based on national education policies, policy reports on doctoral education (e.g., OECD and EU policy texts), and related materials. We use the same...

How To Talk to Your Doctor (and Get Your Doctor To Talk to You!). An Educational Workshop on Doctor Patient Communication = Como Hablarle a su Doctor (iY que su doctor le hable a usted!). Un seminario educativo sobre la comunicacion entre el doctor y el paciente.

Science.gov (United States)

Baylor Coll. of Medicine, Houston, TX.

This workshop, written in both English and Spanish, focuses on improving communication between physician and patient. In the workshop, the trainers will talk about "building bridges" between patient and doctor by understanding the doctor's role and his/her duty to the patient. According to the workshop, a person's doctor should…

System Dynamics

Science.gov (United States)

Morecroft, John

System dynamics is an approach for thinking about and simulating situations and organisations of all kinds and sizes by visualising how the elements fit together, interact and change over time. This chapter, written by John Morecroft, describes modern system dynamics which retains the fundamentals developed in the 1950s by Jay W. Forrester of the MIT Sloan School of Management. It looks at feedback loops and time delays that affect system behaviour in a non-linear way, and illustrates how dynamic behaviour depends upon feedback loop structures. It also recognises improvements as part of the ongoing process of managing a situation in order to achieve goals. Significantly it recognises the importance of context, and practitioner skills. Feedback systems thinking views problems and solutions as being intertwined. The main concepts and tools: feedback structure and behaviour, causal loop diagrams, dynamics, are practically illustrated in a wide variety of contexts from a hot water shower through to a symphony orchestra and the practical application of the approach is described through several real examples of its use for strategic planning and evaluation.

Asthma prescribing practices of government and private doctors in Malaysia--a nationwide questionnaire survey.

Science.gov (United States)

Loh, Li-Cher; Wong, Pel-Se

2005-03-01

A self-answered, anonymously completed questionnaire survey was performed between June 2002 and May 2003 where doctors from government and private sectors in Malaysia were invited to participate by post or during medical meetings. One hundred and sixteen government doctors and 110 private doctors provided satisfactorily completed questionnaires (effective respondent rate: 30.1%). The most preferred medications for 'first-line', 'second-line' and 'third-line' treatment were for government doctors: inhaled short-acting beta2-agonist (SABA) (98%), inhaled corticosteroids (CS) (75%), and leukotriene antagonist (52%); and for private doctors: oral SABA (81%), inhaled CS (68%), and oral CS (58%). The first choice inhaler device for most government and private doctors were metered dose inhalers, with cost and personal preferences (for private doctors), and technical ability (for government doctors) as the key considerations when deciding on the choice of device. This benchmark data on the asthma prescribing practices of a healthcare delivery system fully dichotomized into government and private sector, provides evidence for practice differences affected by the nature of the healthcare system, and might have implications on healthcare systems of other countries that share similarities with that of Malaysia.

Interactive Dynamic-System Simulation

CERN Document Server

Korn, Granino A

2010-01-01

Showing you how to use personal computers for modeling and simulation, Interactive Dynamic-System Simulation, Second Edition provides a practical tutorial on interactive dynamic-system modeling and simulation. It discusses how to effectively simulate dynamical systems, such as aerospace vehicles, power plants, chemical processes, control systems, and physiological systems. Written by a pioneer in simulation, the book introduces dynamic-system models and explains how software for solving differential equations works. After demonstrating real simulation programs with simple examples, the author

Nursing doctoral education in Turkey.

Science.gov (United States)

Yavuz, Meryem

2004-10-01

Quality health care is an issue of concern worldwide, and nursing can and must play a major and global role in transforming the healthcare environment. Doctorally prepared nurses are very much needed in the discipline to further develop and expand the science, as well as to prepare its future educators, scholars, leaders, and policy makers. In 1968, the Master of Science in Nursing Program was initiated in Turkey, followed by the Nursing Doctoral Education Program in 1972. Six University Schools of Nursing provide nursing doctoral education. By the graduating year of 2001, 154 students had graduated with the Doctor of Philosophy in Nursing (Ph.D.), and 206 students were enrolled in related courses. Many countries in the world are systematically building various collaborative models in their nursing doctoral education programs. Turkey would like to play an active role in creating collaborative nursing doctoral education programs with other countries. This paper centres on the structure and model of doctoral education for nurses in Turkey. It touches on doctoral programs around the world; describes in detail nursing doctoral education in Turkey, including its program structure, admission process, course units, assessment strategies and dissertation procedure; and discusses efforts to promote Turkey as a potential partner in international initiatives to improve nursing doctoral education.

3rd International Doctoral Symposium on Applied Computation and Security Systems

CERN Document Server

Saeed, Khalid; Cortesi, Agostino; Chaki, Nabendu

2017-01-01

This book presents extended versions of papers originally presented and discussed at the 3rd International Doctoral Symposium on Applied Computation and Security Systems (ACSS 2016) held from August 12 to 14, 2016 in Kolkata, India. The symposium was jointly organized by the AGH University of Science & Technology, Cracow, Poland; Ca’ Foscari University, Venice, Italy; and the University of Calcutta, India. The book is divided into two volumes, Volumes 3 and 4, and presents dissertation works in the areas of Image Processing, Biometrics-based Authentication, Soft Computing, Data Mining, Next-Generation Networking and Network Security, Remote Healthcare, Communications, Embedded Systems, Software Engineering and Service Engineering. The first two volumes of the book published the works presented at the ACSS 2015, which was held from May 23 to 25, 2015 in Kolkata, India.

[Nurse-doctor relationships, reflection of our society].

Science.gov (United States)

Rothier Bautzer, Eliane

Relations between nurses and doctors are a paradigmatic example of the tensions produced by the process of empowerment over the course of the 20th century. The techniques, health policies, organisation of care and the place of the patient within the health system together contribute to the reconfiguration of the partnership relationship between nurses and doctors. These relationships help to define those that these professionals establish with their patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Exploring a shared leadership perspective for NHS doctors.

Science.gov (United States)

Willcocks, Stephen George; Wibberley, Gemma

2015-01-01

The purpose of this paper is to explore involving doctors in shared leadership. It examines the policies that have led to the focus on shared leadership and the implications for practice. This is a conceptual paper, examining policy developments and key literature to understand the move towards shared leadership. It focuses on UK NHS, and in particular doctors, although the concepts will be relevant to other disciplines in healthcare, and healthcare systems in other countries. This paper suggests that the shared-leadership approach for doctors has potential given the nature of clinical practice, the inherently collaborative nature of healthcare and the demands of new healthcare organisations. Health policy reform, generally, will mean that all doctors need to be engaged with leadership, albeit, perhaps, at different levels, and with different degrees of formality. Leadership will remain an important precondition for the success of the reforms. This is likely to be the case for other countries involved in healthcare reform. To highlight the benefits and barriers to shared leadership for doctors. Offers an alternative to traditional approaches to leadership.

Doctoral education in the nuclear sector; La formacion de doctores en el sector nuclear

Energy Technology Data Exchange (ETDEWEB)

Minguez, E.

2013-03-01

Doctoral aducation is a major priority for European universities. In the context of the Bologna Process the importance of doctoral education as the third cycle of higher education and the first stage of a young researchers career, and thus in linking the European Higher Education and Research Areas, was first highlighted in the 2003 Berlin Report. The core component of doctoral training is the advancement of knowledge through original research. considering the need for structured doctoral programs and the need for transparent supervision and assessment, we note that the normal workload of the third cycle in most countries would correspond 3-4 years full time. This is spirit of the new Spanish Doctoral Law. Then, universities should ensure that their doctoral programmes promote interdisciplinary training and the development of transferable skills, thus meeting the needs of the wider employment market. We need to achieve and overall increase in the numbers of doctoral candidates taking up research careers as early stage researchers and also increase the employability as a normal way as it is the case of other advance countries. In Spain, universities with doctoral nuclear programmes and the CIEMAT, with the sponsorship of the nuclear sector, a doctoral school in nuclear science and engineering should be created to enhance the research careers of Young students for the future of nuclear activities in Spain. (Author)

System dynamics with interaction discontinuity

CERN Document Server

Luo, Albert C J

2015-01-01

This book describes system dynamics with discontinuity caused by system interactions and presents the theory of flow singularity and switchability at the boundary in discontinuous dynamical systems. Based on such a theory, the authors address dynamics and motion mechanism of engineering discontinuous systems due to interaction. Stability and bifurcations of fixed points in nonlinear discrete dynamical systems are presented, and mapping dynamics are developed for analytical predictions of periodic motions in engineering discontinuous dynamical systems. Ultimately, the book provides an alternative way to discuss the periodic and chaotic behaviors in discontinuous dynamical systems.

Diagnosing the doctors' departure: survey on sources of dissatisfaction among Irish junior doctors.

LENUS (Irish Health Repository)

Bruce-Brand, R

2012-01-01

There has been a significant decline in the number of applications for non-consultant hospital doctor (NCHD) posts in Ireland over the last 18 months. We conducted an online, anonymous survey of Irish NCHDs to establish levels of satisfaction, sources of dissatisfaction and the major reasons for junior doctors seeking work abroad. 522 NCHDs took the survey, including 64 (12.3%) currently working outside of the Republic. 219 (45.8%) were slightly dissatisfied and 142 (29.7%) were extremely dissatisfied with practising medicine in Ireland. Major sources of dissatisfaction included the state of the health care system, staffing cover for leave and illness, the dearth of consultant posts and the need to move around Ireland. The most important reason for NCHDs wishing to leave was to seek better training and career opportunities abroad.

The Doctorate in the Nordic Countries.

Science.gov (United States)

Kyvik, Svein; Tvede, Olaf

1998-01-01

Overview of research training systems leading to doctoral degrees in Denmark, Finland, Norway, and Sweden emphasizes the structure of postgraduate education, administration and funding, number of students, time to degree, completion rates, labor market, and study abroad. Comparisons to U.S., British, German, and French systems suggests a trend…

Designing an architectural style for dynamic medical Cross-Organizational Workflow management system: an approach based on agents and web services.

Science.gov (United States)

Bouzguenda, Lotfi; Turki, Manel

2014-04-01

This paper shows how the combined use of agent and web services technologies can help to design an architectural style for dynamic medical Cross-Organizational Workflow (COW) management system. Medical COW aims at supporting the collaboration between several autonomous and possibly heterogeneous medical processes, distributed over different organizations (Hospitals, Clinic or laboratories). Dynamic medical COW refers to occasional cooperation between these health organizations, free of structural constraints, where the medical partners involved and their number are not pre-defined. More precisely, this paper proposes a new architecture style based on agents and web services technologies to deal with two key coordination issues of dynamic COW: medical partners finding and negotiation between them. It also proposes how the proposed architecture for dynamic medical COW management system can connect to a multi-agent system coupling the Clinical Decision Support System (CDSS) with Computerized Prescriber Order Entry (CPOE). The idea is to assist the health professionals such as doctors, nurses and pharmacists with decision making tasks, as determining diagnosis or patient data analysis without stopping their clinical processes in order to act in a coherent way and to give care to the patient.

Flexible and mobile doctors as a strategy for capacity problems.

NARCIS (Netherlands)

Heiligers, P.; Vange, N. van der

2003-01-01

Background: Medical specialists in the Netherlands are coping with a high workload and long waiting lists of patients. Most doctors are selfemployed and working in a partnership with colleagues. This system of small companies of doctors is restrictive to mobility and flexibility in careers, because

[Job satisfaction among Norwegian doctors].

Science.gov (United States)

Nylenna, Magne; Aasland, Olaf Gjerløw

2010-05-20

Doctors' job satisfaction has been discussed internationally in recent years based on reports of increasing professional dissatisfaction. We have studied Norwegian doctors' job satisfaction and their general satisfaction with life. A survey was conducted among a representative sample of practicing Norwegian doctors in 2008. The validated 10-item Job Satisfaction Scale was used to assess job satisfaction. 1,072 (65 %) doctors responded. They reported a mean job satisfaction of 5.3 on a scale from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction increased with increasing age. Private practice specialists reported the highest level of job satisfaction (5.8), and general practitioners reported higher job satisfaction (5.5) than hospital doctors (5.1). Among specialty groups, community doctors scored highest (5.6) and doctors in surgical disciplines lowest (5.0). While long working hours was negatively correlated with job satisfaction, the perception of being professionally updated and having part-time affiliation(s) in addition to a regular job were positively correlated with job satisfaction. 52.9 % of doctors reported a very high general satisfaction. Norwegian doctors have a high level of job satisfaction. Satisfaction with life in general is also high and at least in line with that in the Norwegian population.

A Qualitative Examination of Challenges Influencing Doctoral Students in an Online Doctoral Program

Science.gov (United States)

Deshpande, Anant

2016-01-01

The main purpose of the study was to investigate the challenges faced by students in completion of an online doctoral program at the University of Liverpool, Online Doctoral Business Administration program. We analyse the responses of 91 doctoral students in an online DBA program. Based on the exploratory qualitative study themes were developed…

Barefoot Doctors and the "Health Care Revolution" in Rural China: A Study Centered on Shandong Province.

Science.gov (United States)

Xu, Sanchun; Hu, Danian

2017-09-01

Barefoot doctors were rural medical personnel trained en masse, whose emergence and development had a particular political, economic, social, and cultural background. Like the rural cooperative medical care system, the barefoot doctor was a well-known phenomenon in the Cultural Revolution. Complicated regional differences and a lack of reliable sources create much difficulty for the study of barefoot doctors and result in differing opinions of their status and importance. Some scholars greatly admire barefoot doctors, whereas others harshly criticize them. This paper explores the rise and development of barefoot doctors based on a case study of Shandong province. I argue that the promotion of barefoot doctors was a consequence of the medical education revolution and an implementation of the Cultural Revolution in rural public health care, which significantly influenced medical services and development in rural areas. First, barefoot doctors played a significant role in accomplishing the first rural health care revolution by providing primary health care to peasants and eliminating endemic and infectious illnesses. Second, barefoot doctors were the agents who integrated Western and Chinese medicines under the direction of the state. As an essential part of the rural cooperative medical system, barefoot doctor personnel grew in number with the system's implementation. After the Cultural Revolution ended, the cooperative medical system began to disintegrate-a process that accelerated in the 1980s until the system's collapse in the wake of the de-collectivization. As a result, the number of barefoot doctors also ran down steadily. In 1985, "barefoot doctor" as a job title was officially removed from Chinese medical profession, demonstrating that its practice was non-universal and unsustainable. Copyright © 2017 Elsevier Ltd. All rights reserved.

Attitude of nigerian resident doctors towards clinical autopsy.

Science.gov (United States)

Ekanem, V J; Gerry, I E

2007-03-01

It is to the disadvantage of the doctors in training that there is a decline in the rate of clinical autopsy world wide. This decline may to an extent depend on the attitude of the physicians. To evaluate the attitude of resident doctors towards the practice of clinical autopsy and to determine their role in the decline of clinical autopsy. We carried out a survey of the attitude of resident doctors undergoing training in the various clinical departments of our teaching hospital towards clinical autopsy practice. This survey was by means of a structured randomly distributed questionnaire. Questions were asked on their willingness to request for autopsy, the number of autopsies that they have requested for so far, what hinders them from requesting for autopsy, the level of participation at autopsy and the importance of autopsies in the health care delivery system Eighteen (30%) out of 60 resident doctors attributed their inability to request for autopsy on their not being in direct control of the patients, while 16 (26.7%) found it difficult to get consent from the relatives. Seventeen per cent of them gave reason of not being able to obtain report from the pathologist, 13.3% said it was difficult to get pathologist to perform autopsy on time while only 11% said they knew the diagnosis in most of their cases. Almost all the resident doctors (98.5%) agreed that autopsy is a necessary procedure and is important for their training and health care delivery system Autopsy rate can increase if the resident doctors receive more blessings to request for autopsy from their consultants. Increased exposure to autopsies and education with regards to the benefits of autopsies at both the undergraduate and post graduate level will contribute to improvement in the rate of clinical autopsy.

A marketing clinical doctorate programs.

Science.gov (United States)

Montoya, Isaac D; Kimball, Olive M

2007-01-01

Over the past decade, clinical doctorate programs in health disciplines have proliferated amid both support and controversy among educators, professional organizations, practitioners, administrators, and third-party payers. Supporters argue that the explosion of new knowledge and increasing sophistication of technology have created a need for advanced practice models to enhance patient care and safety and to reduce costs. Critics argue that necessary technological advances can be incorporated into existing programs and believe that clinical doctorates will increase health care costs, not reduce them. Despite the controversy, many health disciplines have advanced the clinical doctorate (the most recent is the doctor of nursing practice in 2004), with some professions mandating the doctorate as the entry-level degree (i.e., psychology, pharmacy, audiology, and so on). One aspect of the introduction of clinical doctoral degrees has been largely overlooked, and that is the marketing aspect. Because of marketing considerations, some clinical doctorates have been more successfully implemented and accepted than others. Marketing is composed of variables commonly known as "the four P's of marketing": product, price, promotion, and place. This report explores these four P's within the context of clinical doctorates in the health disciplines.

[Assessment of betahistine dihydrochloride effectiveness in the treatment of disturbance of balance system, based on analysis of doctors and patients questionnaires results].

Science.gov (United States)

Jurkiewicz, Dariusz; Kantor, Ireneusz; Usowski, Jacek

2006-01-01

In balance system assessment there is no single set of tests applicable for all patients. A comprehensive medical history plays a main role in balance assessment. Patients often describe the same disorders in different ways. The aim of our work was to analyze effectiveness of betahistine hydrochloride (Betaserc) treatment on vertigo, nausea, vomiting, tinnitus and progressive hearing loss basing on the medical assessment (interview) performed by doctors and patient's personal questionnaires as well as to collect and accumulate data about balance system disorders. We prepared questionnaires for both doctors and patients. The doctor's questionnaire was divided into three sections. In the first section we included questions about direct cause of visit at the doctor's office. Questions were covering problems regarding balance system disorders (difficulty to keep erect position), vertigo, tinnitus, hearing impairment and other problems. The second section of the questionnaire included assessment of treatment effectiveness through the first 14 days and on the 28th day (a control visit). A third section of the questionnaire was focused on estimation of intensity of balance system disturbances. Patient's questionnaire included everyday self observations of intensity of disturbances within the 14 days observation period. We analyzed data of 980 patients, of the age between 16 and 96 years (mean age--54.1). There were 57.8% females and 42.2% males. From the group of 980 patients we separated a group of patients under 40 and over 60 years of age for additional analysis. Having analyzed doctors questionnaires we noted that the most frequent cause of patients' visits were: vertigo--in 770 people (78.57%), tinnitus--in 708 people (72.24%), disturbance of balance system--in 612 people (62.45%), hearing loss--in 607 people (61.94%) and other problems--in 72 people (7.35%). Patients over 60 years of age described vertigo as rolling and falling (38.92%). Patients under 40 years of

Interventions for improving patients' trust in doctors and groups of doctors.

Science.gov (United States)

Rolfe, Alix; Cash-Gibson, Lucinda; Car, Josip; Sheikh, Aziz; McKinstry, Brian

2014-03-04

Trust is a fundamental component of the patient-doctor relationship and is associated with increased satisfaction, adherence to treatment, and continuity of care. Our 2006 review found little evidence that interventions improve patients' trust in their doctor; therefore an updated search was required to find out if there is further evidence of the effects of interventions that may improve trust in doctors or groups of doctors. To update our earlier review assessing the effects of interventions intended to improve patients' trust in doctors or a group of doctors. In 2003 we searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, EMBASE, Health Star, PsycINFO, CINAHL, LILACS, African Trials Register, African Health Anthology, Dissertation Abstracts International and the bibliographies of studies selected for inclusion. We also contacted researchers active in the field. We updated and re-ran the searches on available original databases (Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library issue 2, 2013), MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), CINAHL (Ebsco)) as well as Proquest Dissertations and Current Contents for the period 2003 to 18 March 2013. Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series of interventions (informative, educational, behavioural, organisational) directed at doctors or patients (or carers) where trust was assessed as a primary or secondary outcome. Two review authors independently extracted data and assessed the risk of bias of included studies. Where mentioned, we extracted data on adverse effects. We synthesised data narratively. We included 10 randomised controlled trials (including 7 new trials) involving 11,063 patients. These studies were all undertaken in North America, and all but two involved primary care.  As expected, there was considerable heterogeneity between

Life Satisfaction and Frequency of Doctor Visits

Science.gov (United States)

Kim, Eric S.; Park, Nansook; Sun, Jennifer K.; Smith, Jacqui; Peterson, Christopher

2015-01-01

Objective Identifying positive psychological factors that reduce health care use may lead to innovative efforts that help build a more sustainable and high quality health care system. Prospective studies indicate that life satisfaction is associated with good health behaviors, enhanced health, and longer life, but little information is available about the association between life satisfaction and health care use. We tested whether higher life satisfaction was prospectively associated with fewer doctor visits. We also examined potential interactions between life satisfaction and health behaviors. Methods Participants were 6,379 adults from the Health and Retirement Study, a prospective and nationally representative panel study of American adults over the age of 50. Participants were tracked for four years. We analyzed the data using a generalized linear model with a gamma distribution and log link. Results Higher life satisfaction was associated with fewer doctor visits. On a six-point life satisfaction scale, each unit increase in life satisfaction was associated with an 11% decrease in doctor visits—after adjusting for sociodemographic factors (RR = 0.89, 95% CI = 0.86 to 0.93). The most satisfied respondents (N=1,121; 17.58%) made 44% fewer doctor visits than the least satisfied (N=182; 2.85%). The association between higher life satisfaction and reduced doctor visits remained even after adjusting for baseline health and a wide range of sociodemographic, psychosocial, and health-related covariates (RR = 0.96, 95% CI = 0.93 to 0.99). Conclusions Higher life satisfaction is associated with fewer doctor visits, which may have important implications for reducing health care costs. PMID:24336427

Life satisfaction and frequency of doctor visits.

Science.gov (United States)

Kim, Eric S; Park, Nansook; Sun, Jennifer K; Smith, Jacqui; Peterson, Christopher

2014-01-01

Identifying positive psychological factors that reduce health care use may lead to innovative efforts that help build a more sustainable and high-quality health care system. Prospective studies indicate that life satisfaction is associated with good health behaviors, enhanced health, and longer life, but little information about the association between life satisfaction and health care use is available. We tested whether higher life satisfaction was prospectively associated with fewer doctor visits. We also examined potential interactions between life satisfaction and health behaviors. Participants were 6379 adults from the Health and Retirement Study, a prospective and nationally representative panel study of American adults older than 50 years. Participants were tracked for 4 years. We analyzed the data using a generalized linear model with a gamma distribution and log link. Higher life satisfaction was associated with fewer doctor visits. On a 6-point life satisfaction scale, each unit increase in life satisfaction was associated with an 11% decrease in doctor visits--after adjusting for sociodemographic factors (relative risk = 0.89, 95% confidence interval = 0.86-0.93). The most satisfied respondents (n = 1121; 17.58%) made 44% fewer doctor visits than did the least satisfied (n = 182; 2.85%). The association between higher life satisfaction and reduced doctor visits remained even after adjusting for baseline health and a wide range of sociodemographic, psychosocial, and health-related covariates (relative risk = 0.96, 95% confidence interval = 0.93-0.99). Higher life satisfaction is associated with fewer doctor visits, which may have important implications for reducing health care costs.

Spin doctoring

OpenAIRE

Vozková, Markéta

2011-01-01

1 ABSTRACT The aim of this text is to provide an analysis of the phenomenon of spin doctoring in the Euro-Atlantic area. Spin doctors are educated people in the fields of semiotics, cultural studies, public relations, political communication and especially familiar with the infrastructure and the functioning of the media industry. Critical reflection of manipulative communication techniques puts spin phenomenon in historical perspective and traces its practical use in today's social communica...

Working with doctors and nurses

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... with doctors and nurses Working with doctors and nurses Answering questions, filling out papers, getting poked and ... to pay? What questions will the doctor or nurse ask? top It’s a good idea to know ...

The doctor as businessman: the changing politics of a cultural icon.

Science.gov (United States)

Stone, D A

1997-04-01

From just after the Civil War, when medicine began to professionalize, until the late 1970s, doctors and policy makers believed that clinical judgment should not be influenced by the financial interests of doctors. Physicians were highly entrepreneurial, and organized medicine fought to preserve their entrepreneurial interests, but the moral norm that justified their autonomy from state regulation was a strict separation of clinical judgment and pecuniary interests. Under managed care, the old norm is reversed. A good doctor takes financial considerations into account in making clinical decisions. Theoretically, doctors should consider measures of cost to society, but in practice, the payment systems of managed care plans induce doctors to consider the impact of each clinical decision on their own income. Because doctors share the risks of insuring patients with managed care plans, they have the same incentives as insurers to avoid patients who are expensively sick. The new cultural image of doctors as entrepreneurs masks their considerable loss of clinical autonomy under managed care. It also serves to persuade doctors to accept managed care arrangements and to persuade insurance consumers and patients to accept reduced benefits from employers and the government.

[Communication within the health care team: doctors and nurses].

Science.gov (United States)

Kollár, János

2016-04-24

Proper communication within the health care team is especially important in terms of creating safe emotional and professional conditions for the team members and for quality healing. The aim of the study is to explore the factors that hinder appropriate communication between doctors and nurses and thus to make the effective elimination of the communication disturbances possible. Investigation in main medical databases and general search engines were used for analysing the phenomenon. It was revealed that communication between doctors and nurses is restrained by factors that can be observed on individual, professional and system levels as well. Role confusion, lack of trust, communication barriers arising from hierarchical inequalities, leadership problems, differences in qualifications, burnout and organizational problems can equally be found amongst them. The effectiveness of communication between nurses and doctors in Hungary is especially strongly influenced by the fear of losing jobs, the financial problems arising from different degree of gratuity and the phenomenon of burnout. Changes on individual, professional and system levels are equally important for significant improvement in the communication between doctors and nurses. Joint trainings based on strong organizational development skills and joint conferences could promote significantly better flow of information, mutual appreciation and harmonization.

Truly random dynamics generated by autonomous dynamical systems

Science.gov (United States)

González, J. A.; Reyes, L. I.

2001-09-01

We investigate explicit functions that can produce truly random numbers. We use the analytical properties of the explicit functions to show that a certain class of autonomous dynamical systems can generate random dynamics. This dynamics presents fundamental differences with the known chaotic systems. We present real physical systems that can produce this kind of random time-series. Some applications are discussed.

Intolerance and Violence Against Doctors.

Science.gov (United States)

Singh, Meharban

2017-10-01

Intolerance and grouse against doctors is a global phenomenon but India seems to lead the world in violence against doctors. According to World Health Organization, about 8-38% healthcare workers suffer physical violence at some point in their careers. Many more are verbally abused or threatened. Public is almost behaving like health sector terrorists. The spate of increasing attacks on doctors by damaging their property and causing physical injury is not acceptable by any civilized society. The public is becoming increasingly intolerant to a large number of social issues because of poor governance and vote bank politics. There is a need to arrest the development of further distrust between doctors and their patients/relatives, otherwise it will compromise all achievements of medical science and adversely affect healing capabilities of doctors. Rude and aggressive behavior of the patients or their family members, and arrogant and lackadaisical approach of the doctor, adversely affects the doctor-patient relationship and the outcome of the patient. The doctors, hospital administration and government must exercise "zero tolerance" with respect to acts of violence against healthcare professionals. It is possible to reduce the incidence of intolerance against doctors but difficult to eliminate it completely. The healthcare providers should demonstrate greater compassion and empathy with improved communication skills. The hospitals must have adequate infrastructure, facilities and staff to handle emergencies without delay and with due confidence and skills. The security of healthcare providers, especially in sensitive areas, should be improved by having adequate number of security guards, frisking facilities, extensive CCTV network and availability of "Quick response team" to handle unruly mob. In case of any grievances for alleged mismanagement, the public should handle the situation in a civilized manner and seek redressal through Medical Protection Act and legal

Persisting Dreams: The Impact of the Doctoral Socialization Process on Latina Post-Doctoral Career Aspirations

OpenAIRE

Westerband, Yamissette

2016-01-01

Latinas are underrepresented within the professorate and within doctoral programs, particularly within Research Intensive Institutions. This dissertation explores how the doctoral socialization process impacts the pipeline from the Ph.D. to scholarly careers for Latinas in Research universities. Given the low numbers of representation and production at the doctoral level for Latinas, what happens when they do enter Ph.D. programs? Their doctoral experience must be marked in one way or anot...

What are System Dynamics Insights?

OpenAIRE

Stave, K.; Zimmermann, N. S.; Kim, H.

2016-01-01

This paper explores the concept of system dynamics insights. In our field, the term “insight” is generally understood to mean dynamic insight, that is, a deep understanding about the relationship between structure and behavior. We argue this is only one aspect of the range of insights possible from system dynamics activities, and describe a broader range of potential system dynamics insights. We also propose an initial framework for discussion that relates different types of system dynamics a...

Failing to retain a new generation of doctors: qualitative insights from a high-income country.

Science.gov (United States)

Humphries, Niamh; Crowe, Sophie; Brugha, Ruairí

2018-02-27

The failure of high-income countries, such as Ireland, to achieve a self-sufficient medical workforce has global implications, particularly for low-income, source countries. In the past decade, Ireland has doubled the number of doctors it trains annually, but because of its failure to retain doctors, it remains heavily reliant on internationally trained doctors to staff its health system. To halve its dependence on internationally trained doctors by 2030, in line with World Health Organisation (WHO) recommendations, Ireland must become more adept at retaining doctors. This paper presents findings from in-depth interviews conducted with 50 early career doctors between May and July 2015. The paper explores the generational component of Ireland's failure to retain doctors and makes recommendations for retention policy and practice. Interviews revealed that a new generation of doctors differ from previous generations in several distinct ways. Their early experiences of training and practice have been in an over-stretched, under-staffed health system and this shapes their decision to remain in Ireland, or to leave. Perhaps as a result of the distinct challenges they have faced in an austerity-constrained health system and their awareness of the working conditions available globally, they challenge the traditional view of medicine as a vocation that should be prioritised before family and other commitments. A new generation of doctors have career options that are also strongly shaped by globalisation and by the opportunities presented by emigration. Understanding the medical workforce from a generational perspective requires that the health system address the issues of concern to a new generation of doctors, in terms of working conditions and training structures and also in terms of their desire for a more acceptable balance between work and life. This will be an important step towards future-proofing the medical workforce and is essential to achieving medical workforce

Identifying poor performance among doctors in NHS organizations.

Science.gov (United States)

Locke, Rachel; Scallan, Samantha; Leach, Camilla; Rickenbach, Mark

2013-10-01

To account for the means by which poor performance among career doctors is identified by National Health Service organizations, whether the tools are considered effective and how these processes may be strengthened in the light of revalidation and the requirement for doctors to demonstrate their fitness to practice. This study sought to look beyond the 'doctor as individual'; as well as considering the typical approaches to managing the practice of an individual, the systems within which the doctor is working were reviewed, as these are also relevant to standards of performance. A qualitative review was undertaken consisting of a literature review of current practice, a policy review of current documentation from 15 trusts in one deanery locality, and 14 semi-structured interviews with respondents with an overview of processes in use. The framework for the analysis of the data considered tools at three levels: individual, team and organizational. Tools are, in the main, reactive--with an individual focus. They rely on colleagues and others to speak out, so their effectiveness is hindered by a reluctance to do so. Tools can lack an evidence base for their use, and there is limited linking of data across contexts and tools. There is more work to be done in evaluating current tools and developing stronger processes. Linkage between data sources needs to be improved and proactive tools at the organizational level need further development to help with the early identification of performance issues. This would also assist in balancing a wider systems approach with a current over emphasis on individual doctors. © 2012 John Wiley & Sons Ltd.

Reexamining the Structure of Hemingway's "The Doctor and the Doctor's Wife."

Science.gov (United States)

Mulvey, James

2003-01-01

Considers how Hemingway's "The Doctor and the Doctor's Wife" is a model of Edgar Allan Poe's aesthetic of the short story. Examines this work on many levels. Concludes that great writers, such as Ernest Hemingway, challenge readers to find the clues, to connect the dots, to pay attention to the "little details." (SG)

Coaching doctoral students

DEFF Research Database (Denmark)

Godskesen, Mirjam Irene; Kobayashi, Sofie

2016-01-01

In this paper we focus on individual coaching carried out by an external coach as a new pedagogical element that can impact doctoral students’ sense of progress in doctoral education. The study used a mixed methods approach in that we draw on quantitative and qualitative data from the evaluation...... impact the supervisor – student relationship in a positive way....

Finding the Right Doctor

Science.gov (United States)

... certified hospital Communicating with Healthcare Professionals for Caregivers Consumer Health Care • Home • Health Insurance Information • Your Healthcare Team Introduction Finding the Right Doctor Talking to Your Doctor Getting a Second ...

Towards a Marketing Communication Recruitment Plan for the Rowan University Educational Leadership Doctoral Program

Science.gov (United States)

Kanyi, Titus Kamau

2009-01-01

Doctoral studies are at the apex of the education system. Attracting, recruiting, enrolling, and graduating the best suited students in doctoral education is, therefore, critical in ensuring the highest academic standards and service to society. Focusing on Rowan University's Doctor of Education (Ed.D.) in Educational Leadership program, this…

Australian doctors and the visual arts. Part 1. Doctor-artists in New South Wales.

Science.gov (United States)

Hamilton, D G

Since Europeans first settled in Australia their doctors have been interested in the visual arts. Some have been hobby painters and sculptors, a few with great distinction. Some have been gallery supporters and administrators. A few have written art books. Some have been outstanding photographers. Of the larger number of doctors who have collected art, only those are mentioned who have made their collections public or have made important donations to galleries. The subject of Australian doctors and the visual arts will be discussed in six articles in this and following issues of the journal. The first deals with doctor-artists in New South Wales.

Spaces of Dynamical Systems

CERN Document Server

Pilyugin, Sergei Yu

2012-01-01

Dynamical systems are abundant in theoretical physics and engineering. Their understanding, with sufficient mathematical rigor, is vital to solving many problems. This work conveys the modern theory of dynamical systems in a didactically developed fashion.In addition to topological dynamics, structural stability and chaotic dynamics, also generic properties and pseudotrajectories are covered, as well as nonlinearity. The author is an experienced book writer and his work is based on years of teaching.

The Rise of Professional Doctorates: Case Studies of the Doctorate in Education in China, Iceland and Australia

Science.gov (United States)

Wildy, Helen; Peden, Sanna; Chan, Karyn

2015-01-01

Doctoral education is going through a period of transition. This transition is evident in the many varieties of doctoral degrees currently offered in higher education institutions worldwide, from the traditional research-based Doctor of Philosophy (PhD) to the Professional Doctorate and the New Route PhD. This article reports on a study which…

Review on Doctoral Dissertation: Drago Pupavac: Logistics operator – the factor of dynamic optimization of global logistics chains

Directory of Open Access Journals (Sweden)

Ratko Zelenika

2007-05-01

Full Text Available The main objective of the scientific research of this doctoral thesis is the effect of the logistics operator in the function of cutting total costs of the global logistics chain. In order to achieve the objective of the research, a number of scientific methods have been applied such as survey methods, methods of dynamic programming and mixed convex programming. Owing to the applied scientific methodology,Drago Pupovac, M.Sc. has successfully interpreted the obtained results by proving that the selective model approach to active participants of the logistics chain gives the logistics operator the insight into potential logistics network, depicts skills of individual operators in the logistics network, specifies logistics activitiesof each logistics venture, provides information on costs of specific logistics activities and in that way proves that it enables logistics operator to optimize logistics chains by protecting them from the demand instability and changes.

Healthy Doctors – Sick Medicine

Directory of Open Access Journals (Sweden)

Olaf Gjerløw Aasland

2015-05-01

Full Text Available Doctors are among the healthiest segments of the population in western countries. Nevertheless, they complain strongly of stress and burnout. Their own explanation is deprofessionalisation: The honourable art of doctoring has been replaced by standardised interventions and production lines; professional autonomy has withered. This view is shared by many medical sociologists who have identified a “golden age of medicine,” or “golden age of doctoring,” starting after World War II and declining around 1970. This article looks at some of the central sociological literature on deprofessionalisation, particularly in a perspective of countervailing powers. It also looks into another rise-and-fall model, proposed by the medical profession itself, where the fall in professional power was generated by the notion that there are no more white spots to explore on the map of medicine. Contemporary doctoring is a case of cognitive dissonance, where the traditional doctor role seems incompatible with modern health care.Keywords: deprofessionalisation, professional autonomy, cognitive dissonance, golden age of doctoring

Perceptions of doctors on being treated by a doctor just completing the house job.

Science.gov (United States)

Ahmad, Amina; Haque Shaikh, Siraj Ul; Tayyab, Muhammad; Gardezi, Javed Raza

2014-12-01

To determine the percentage of medical teachers and fresh doctors who feel that graduating doctors are competent or incompetent to handle common ailments and to evaluate the reasons for their perceptions. Sequential mixed method. First phase extending from December 2010 to December 2011 and second phase was conducted in March 2014. First phase comprised electronic distribution of questionnaire to 100 medical teachers and fresh doctors working in hospitals attached with 5 private and 5 public sector medical colleges of Lahore and Karachi to rate an average house officer on a frequency scale of 1 - 6 and do self-assessment, in case of a fresh doctor. The second phase included interviews of 20 medical teachers to explore justification for their rating in the survey questionnaire and for triangulation of data. Quantitative data was analyzed through SPSS version 15 to calculate frequencies and percentages and interviews were analyzed through quasi-statistical approach. In survey, 38.36% out of 73 medical teachers and 30% out of 20 medical teachers in interviews confirmed their confidence on consulting fresh doctors for common ailments as opposed to 61.64% and 70% respectively, expressing their dissatisfaction. Self-assessment of fresh doctors indicated that 40% are confident in handling common medical conditions as opposed to 33.3% out of 75 respondents, who are not confident about their clinical skills. Faculty and self-assessment of fresh doctors has a fair overlap, indicating room for further improvement in the house job training program.

Stability of dynamical systems

CERN Document Server

Liao, Xiaoxin; Yu, P 0

2007-01-01

The main purpose of developing stability theory is to examine dynamic responses of a system to disturbances as the time approaches infinity. It has been and still is the object of intense investigations due to its intrinsic interest and its relevance to all practical systems in engineering, finance, natural science and social science. This monograph provides some state-of-the-art expositions of major advances in fundamental stability theories and methods for dynamic systems of ODE and DDE types and in limit cycle, normal form and Hopf bifurcation control of nonlinear dynamic systems.ʺ Presents

Talking to Your Doctor

Medline Plus

Full Text Available ... for the doctor’s contact information and their preferred method of communication. Remember that nurses and pharmacists are also good sources of information. How to Talk to your Doctor Talking With Your Doctor , NIH ...

Working as a doctor when chronically ill or disabled: comments made by doctors responding to UK surveys.

Science.gov (United States)

Smith, Fay; Goldacre, Michael J; Lambert, Trevor W

2016-07-01

To report a qualitative study of themes doctors raised spontaneously, in a large-scale prospective cohort study covering many aspects of their medical careers, when referring to their own chronic illness or disability. Questionnaire survey. UK. Questionnaires were sent one, five and 10 years after graduation to 44,539 doctors who qualified between 1993 and 2012 in the UK: 38,613 questionnaires were returned and 11,859 respondents provided comments made by doctors about their training or work. The comments of 123 doctors about their own chronic illness or disability. Main themes raised included poor support for doctors with chronic illness or disability, delays in and changes to careers (either planned ahead or imposed), the impact of pressure at work, difficulties returning to work after illness, limitations on career choices and inadequate careers advice for doctors with chronic illness or disabilities. More needs to be done to ensure that doctors with chronic illness or disability receive appropriate support. Occupational health guidance should be monitored closely, with more support for ill doctors including adjustments to the job, help if needed with morale and mental health, and advice on career options. Further studies should establish the prevalence of long-term health conditions among doctors.

Talking to Your Doctor

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Full Text Available ... You Talking to Your Doctor Science Education Resources Community Resources Clear Health A–Z Publications List More » ... can play an active role in your health care by talking to your doctor. Clear and honest ...

Talking to Your Doctor

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Full Text Available ... Impact of NIH Research Science, Health, and Public Trust You are here Home » Institutes at NIH » NIH ... Your Doctor Plain Language Science, Health, and Public Trust Talking to Your Doctor Part I: Preparing for ...

Doctoral education in the nuclear sector

International Nuclear Information System (INIS)

Minguez, E.

2013-01-01

Doctoral education is a major priority for European universities. In the context of the Bologna Process the importance of doctoral education as the third cycle of higher education and the first stage of a young researchers career, and thus in linking the European Higher Education and Research Areas, was first highlighted in the 2003 Berlin Report. The core component of doctoral training is the advancement of knowledge through original research. considering the need for structured doctoral programs and the need for transparent supervision and assessment, we note that the normal workload of the third cycle in most countries would correspond 3-4 years full time. This is spirit of the new Spanish Doctoral Law. Then, universities should ensure that their doctoral programmes promote interdisciplinary training and the development of transferable skills, thus meeting the needs of the wider employment market. We need to achieve and overall increase in the numbers of doctoral candidates taking up research careers as early stage researchers and also increase the employability as a normal way as it is the case of other advance countries. In Spain, universities with doctoral nuclear programmes and the CIEMAT, with the sponsorship of the nuclear sector, a doctoral school in nuclear science and engineering should be created to enhance the research careers of Young students for the future of nuclear activities in Spain. (Author)

The Content Analysis on Doctoral Thesies in Geomatic Engineering in Turkey

Directory of Open Access Journals (Sweden)

Tahsin BOZTOPRAK

2016-10-01

Full Text Available The purpose of this study is to reach a conclusion based on the synthesis of doctoral dissertations published about surveying (geomatic engineering by using content analysis. For this purpose, 325 doctoral dissertations published in Turkey were analyzed using content analysis technique. As a result of performed analysis, it has been determined that 70.46's% of doctoral dissertations have been published in the last fifteen years. It has been shown that most doctoral dissertations were published by Istanbul Technical University, Yıldız Technical University, Selçuk University and Karadeniz Technical University. Most of the doctorate studies have been carried out in the discipline of public measurements/ land management with the rate of %32.62. 89.54% of the publishing language of the PhD thesis is Turkish, the average number of pages is 156. 68.45% of the PhD thesis advisors have professor doctor title. The most covered subjects are geographic information systems (15.46%, GPS/GNSS (12.36% and satellite image analysis (11.24%.

Talking to Your Doctor

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Full Text Available ... NIH Website NIH Employee Intranet Staff Directory En Español Site Menu Home Health Information Health Info Lines ... Talking With Your Doctor , NIH News in Health Español Talking to Your Doctor , National Eye Institute (NEI) ...

Talking to Your Doctor

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Full Text Available ... Communications & Public Liaison » Clear Communication Clear Communication Clear Communication Health Literacy Clear & Simple Clear Health from NIH Cultural Respect Language Access Talking to Your Doctor Plain Language Science, Health, and Public Trust Talking to Your Doctor ...

Coaching Doctoral Students--A Means to Enhance Progress and Support Self-Organisation in Doctoral Education

Science.gov (United States)

Godskesen, Mirjam; Kobayashi, Sofie

2016-01-01

In this paper we focus on individual coaching carried out by an external coach as a new pedagogical element that can impact doctoral students' sense of progress in doctoral education. The study used a mixed-methods approach in that we draw on quantitative and qualitative data from the evaluation of a project on coaching doctoral students. We…

Dr Oen Boen Ing Patriot doctor, social activist, and doctor of the poor

Directory of Open Access Journals (Sweden)

Ravando Lie

2017-05-01

Full Text Available This article examines the efforts and achievements of Oen Boen Ing, a Tionghoa doctor, to improve the quality of health of the poorer inhabitants of Surakarta. Dr Oen played an important role in five different periods: Dutch colonialism, the Japanese occupation, the Indonesian revolution, Soekarno’s regime, and Suharto’s New Order. Known for being a benevolent doctor, activist, and patriot of the revolution during his life-time, Dr Oen also gave medical assistance to the needy, which famously earned him the accolade of “doctor of the poor”. During the Indonesian revolution, Dr Oen assisted the Student Soldiers (Tentara Pelajar and afterwards was appointed the member of Supreme Advisory Council (Dewan Pertimbangan Agung/DPA by Soekarno in 1949. As a benevolent doctor and activist, Dr Oen is remembered for founding the Panti Kosala Hospital which was renamed to perpetuate his name on 30 October 1983, exactly a year after his passing. When he died, thousands of peoples gathered to pay their final respects to the doctor. He was honoured with a ceremony conducted in the Mangkunegaran Palace. Dr Oen’s name will be eternally respected, especially in Surakarta.

Practices and attitudes of doctors and patients to downward referral in Shanghai, China.

Science.gov (United States)

Yu, Wenya; Li, Meina; Nong, Xin; Ding, Tao; Ye, Feng; Liu, Jiazhen; Dai, Zhixing; Zhang, Lulu

2017-04-03

In China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics. Doctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling. The questionnaire surveyed their sociodemographic characteristics, attitudes towards CHSs and hospitals, understanding of downward referral, recognition of the community first treatment system, and downward referral practices and willingness. Descriptive statistics, χ 2 test and stepwise logistic regression analysis were employed for statistical analysis. Only 20.8% (161/773) of doctors were willing to accept downward referrals, although this proportion was higher among patients (37.6%, 326/866). Doctors' willingness was influenced by education, understanding of downward referral, and perception of health resources in hospitals. Patients' willingness was influenced by marital status, economic factors and recognition of the community first treatment system. Well-educated doctors who do not consider downward referral would increase their workloads and those with a more comprehensive understanding of hospitals and downward referral process were more likely to make a downward referral decision. Single-injury patients fully recognising the community first treatment system were more willing to accept downward referral. Patients' willingness was significantly increased if downward referral was cost-saving. A better medical insurance system was another key factor for patients to accept downward referral decisions, especially for the floating population. To increase the rate of downward referral, the Chinese government should optimise the current referral system and conduct universal publicity for

The Project of the Telemedicine System for a Family Doctors' Practices

National Research Council Canada - National Science Library

Puchala, E

2001-01-01

...). The project offers the potential to improve: access to high-quality primary health care, education of family doctors and patients, This is a project which is realised in collaboration of two scientific partners...

Talking to Your Doctor

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Full Text Available ... Discovery Into Health ® Impact of NIH Research Science, Health, and Public Trust You are here Home » Institutes at NIH » ... Access Talking to Your Doctor Plain Language Science, Health, and Public Trust Talking to Your Doctor Part I: Preparing ...

Dementia - what to ask your doctor

Science.gov (United States)

What to ask your doctor about dementia; Alzheimer disease - what to ask your doctor; Cognitive impairment - what to ask your doctor ... Alzheimer's Association. Dementia Care Practice Recommendations ... in a Home Setting. Updated 2009. Alz.org. www.alz.org/national/ ...

Seeking and using intention of health information from doctors in social media: The effect of doctor-consumer interaction.

Science.gov (United States)

Wu, Tailai; Deng, Zhaohua; Zhang, Donglan; Buchanan, Paula R; Zha, Dongqing; Wang, Ruoxi

2018-07-01

The aim of this study is to investigate how doctor-consumer interaction in social media influences consumers' health information seeking and usage intention. Based on professional-client interaction theory and expectation confirmation theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interaction influence consumers' health information seeking and usage intention through consumer satisfaction and trust towards doctors. To validate our proposed research model, we employed the survey method. The measurement instruments for all constructs were developed based on previous literatures, and 352 valid answers were collected by using these instruments. Our results reveal that consumers' intention to seek health information significantly predicts their intention to use health information from social media. Meanwhile, both consumer satisfaction and trust towards doctors influences consumers' health information seeking and usage intention significantly. With regards to the impact of the interaction between doctors and consumers, the results show that both types of doctor-consumer interaction significantly affect consumer satisfaction and trust towards doctors. The mediation analysis confirms the mediation role of consumer satisfaction and trust towards doctors. Compared with many intentional intervention programs, doctor-consumer interaction can be treated as an effective intervention with low cost to promote consumers' health information seeking and usage. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. At last, consumer satisfaction and trust towards doctors could be considered as the important working mechanisms for the effect of doctor-consumer interaction. Copyright © 2018 Elsevier B.V. All rights reserved.

[Murder of the doctor].

Science.gov (United States)

Lorettu, Liliana; Falchi, Lorenzo; Nivoli, Fabrizia L; Milia, Paolo; Nivoli, Giancarlo; Nivoli, Alessandra M

2015-01-01

To examine possible risk factors for the doctor to be killed by the patient in the clinical practice by examining a series of murders that involved physicians. This aim has been achieved through a retrospective review on clinical cases of doctors killed by patients within the period between 1988 and 2013, in Italy. In this period 18 Italian doctors have been killed in the workplace, with a rate of 0.3/100,000. In 7 cases, the murder resulted in the context of doctor-dissatisfaction; in 7 cases the murder was committed by a psychiatric patient; 1 case in the context of a stalking; 3 cases occurred in a workplace which was not safe enough. Four categories of at-risk contexts have been identified. One category includes a murder in the context of a doctor-dissatisfaction, perceived by patient. The second category concerns murders committed by patients suffering from mental illness. A third category includes homicides in a workplace which is not safe. The last category comprises the murder in the context of stalking. These categories identify specific dangerous situations for physicians, in which are highlighted elements that have played a crucial role in the murder and for which special precautions are suggested preventive.

Nonlinear dynamics non-integrable systems and chaotic dynamics

CERN Document Server

Borisov, Alexander

2017-01-01

This monograph reviews advanced topics in the area of nonlinear dynamics. Starting with theory of integrable systems – including methods to find and verify integrability – the remainder of the book is devoted to non-integrable systems with an emphasis on dynamical chaos. Topics include structural stability, mechanisms of emergence of irreversible behaviour in deterministic systems as well as chaotisation occurring in dissipative systems.

A study of organizational versus individual needs related to recruitment, deployment and promotion of doctors working in the government health system in Odisha state, India.

Science.gov (United States)

Kadam, Shridhar; Nallala, Srinivas; Zodpey, Sanjay; Pati, Sanghamitra; Hussain, Mohammad Akhtar; Chauhan, Abhimanyu Singh; Das, Sovesh; Martineau, Tim

2016-02-24

An effective health workforce is essential for achieving health-related new Sustainable Development Goals. Odisha, one of the states in India with low health indicators, faces challenges in recruiting and retaining health staff in the public sector, especially doctors. Recruitment, deployment and career progression play an important role in attracting and retaining doctors. We examined the policies on recruitment, deployment and promotion for doctors in the state and how these policies were perceived to be implemented. We undertook document review and four key informant interviews with senior state-level officials to delineate the policies for recruitment, deployment and promotion. We conducted 90 in-depth interviews, 86 with doctors from six districts and four at the state level to explore the perceptions of doctors about these policies. Despite the efforts by the Government of Odisha through regular recruitments, a quarter of the posts of doctors was vacant across all institutional levels in the state. The majority of doctors interviewed were unaware of existing government rules for placement, transfer and promotion. In addition, there were no explicit rules followed in placement and transfer. More than half (57%) of the doctors interviewed from well-accessible areas had never worked in the identified hard-to-reach areas in spite of having regulatory and incentive mechanisms. The average length of service before the first promotion was 26 (±3.5) years. The doctors expressed satisfaction with the recruitment process. They stated concerns over delayed first promotion, non-transparent deployment policies and ineffective incentive system. Almost all doctors suggested having time-bound and transparent policies. Adequate and appropriate deployment of doctors is a challenge for the government as it has to align the individual aspirations of employees with organizational needs. Explicit rules for human resource management coupled with transparency in implementation can

Through doctors' eyes: A qualitative study of hospital doctor perspectives on their working conditions.

LENUS (Irish Health Repository)

McGowan, Yvonne

2013-03-11

BACKGROUND: Hospital doctors face significant challenges in the current health care environment, working with staff shortages and cutbacks to health care expenditure, alongside increased demand for health care and increased public expectations. OBJECTIVE: This article analyses challenges faced by junior hospital doctors, providing insight into the experiences of these frontline staff in delivering health services in recessionary times. DESIGN: A qualitative methodology was chosen. METHODS: Semi-structured in-depth interviews were conducted with 20 doctors from urban Irish hospitals. Interviews were recorded via note taking. Full transcripts were analysed thematically using NVivo software. RESULTS: Dominant themes included the following: (1) unrealistic workloads: characterised by staff shortages, extended working hours, irregular and frequently interrupted breaks; (2) fatigue and its impact: the quality of care provided to patients while doctors were sleep-deprived was questioned; however, little reflection was given to any impact this may have had on junior doctors own health; (3) undervalued and disillusioned: insufficient training, intensive workloads and a perceived lack of power to influence change resulted in a sense of detachment among junior doctors. They appeared immune to their surroundings. CONCLUSION: Respondents ascribed little importance to the impact of current working conditions on their own health. They felt their roles were underappreciated and undervalued by policy makers and hospital management. Respondents were concerned with the lack of time and opportunity for training. This study highlighted several \\'red flags\\

[Patients, doctors and the internet].

Science.gov (United States)

Jeannot, Jean Gabriel; Bischoff, Thomas

2015-05-13

The majority of the Swiss population uses the internet to seek information about health. The objective is to be better informed, before or after the consultation. Doctors can advise their information-seeking patients about high quality websites, be it medical portals or websites dedicated to a specific pathology. Doctors should not see the internet as a threat but rather as an opportunity to strengthen the doctor-patient relationship.

Protest of doctors: a basic human right or an ethical dilemma.

Science.gov (United States)

Abbasi, Imran Naeem

2014-03-10

Peaceful protests and strikes are a basic human right as stated in the United Nations' universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors' strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources.In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. There is no single best answer against or in favor of doctors' industrial

Fourth Doctoral Student Assembly

CERN Multimedia

Ingrid Haug

2016-01-01

On 10 May, over 130 PhD students and their supervisors, from both CERN and partner universities, gathered for the 4th Doctoral Student Assembly in the Council Chamber.   The assembly was followed by a poster session, at which eighteen doctoral students presented the outcome of their scientific work. The CERN Doctoral Student Programme currently hosts just over 200 students in applied physics, engineering, computing and science communication/education. The programme has been in place since 1985. It enables students to do their research at CERN for a maximum of three years and to work on a PhD thesis, which they defend at their University. The programme is steered by the TSC committee, which holds two selection committees per year, in June and December. The Doctoral Student Assembly was opened by the Director-General, Fabiola Gianotti, who stressed the importance of the programme in the scientific environment at CERN, emphasising that there is no more rewarding activity than lear...

An analytical comparison of the patient-to-doctor policy and the doctor-to-patient policy in the outpatient clinic

NARCIS (Netherlands)

Hulshof, P.J.H.; Vanberkel, P.T.; Boucherie, Richardus J.; Hans, Elias W.; van Houdenhoven, Mark; van Ommeren, Jan C.W.

Outpatient clinics traditionally organize processes such that the doctor remains in a consultation room, while patients visit for consultation, we call this the Patient-to-Doctor policy. A different approach is the Doctor-to-Patient policy, whereby the doctor travels between multiple consultation

[Free choice of doctors in Germany in retrospect].

Science.gov (United States)

Kunstmann, W; Butzlaff, M; Böcken, J

2002-03-01

Due to discussions on the cost and quality of health care and a new legislation on the German statutory sickness insurance system in 1999, the free choice of doctors has recently become topical. To assess its legitimation for the German health care system, its history and the groups of interest involved should be taken into consideration. Before the period of industrialization no homogeneous pattern of the medical profession existed. In case of illness individuals who lived within reach and were known for their competence in disease matters were approached. However, industrialization destroyed existing social networks, and establishment of new structures of health care in rural as well as metropolitan areas became necessary. The government approached this challenge by structuring medical education, passing regulations on the settlement of doctors and promoting the foundation of statutory sickness funds. The Health Insurance Law of 1883 established a mandatory insurance system for a broad array of industries. As it was the sickness funds' responsibility to provide sufficient resources for medical care, a sick member was tied to the physician under contract with his insurance. After a rapid increase in practising physicians at the end of the 19(th) century, doctors' organisations were eager to gain access to the new market segment of insurance members by calling for the free choice of physicians. The Leipzig association (Hartmannbund) was founded in 1900 to organize strikes of doctors in order to get their goals accepted. After 30 years of conflicts an appeasement was achieved by a presidential emergency law in 1931. It transferred the responsibility for the provision of sufficient health care resources from the sickness funds to the newly created body of the Association of Sickness Fund Physicians (Kassenärztliche Vereinigung) and determined the patients' free choice among licensed sickness fund physicians.

Dynamics of Financial System: A System Dynamics Approach

OpenAIRE

Girish K. Nair; Lewlyn Lester Raj Rodrigues

2013-01-01

There are several ratios which define the financial health of an organization but the importance of Net cash flow, Gross income, Net income, Pending bills, Receivable bills, Debt, and Book value can never be undermined as they give the exact picture of the financial condition. While there are several approaches to study the dynamics of these variables, system dynamics based modelling and simulation is one of the modern techniques. The paper explores this method to simulate the before mentione...

[Patient - doctor relationship from perspective of the Karpman drama triangle].

Science.gov (United States)

Samborska-Sablik, Anna; Sablik, Zbigniew

2016-11-25

Patients' confidence in doctors has been decreased for last years despite successes of Polish medicine. It seems to be related to particular conditions of patient - doctor relationship and patient's negative emotions may frequently burden it from the beginning. They may allow an interpersonal game, the Drama Triangle, to appear in the relationship. 3 persons are typically involved in the game: a victim, a persecutor and a rescuer. All of them neither feel guilty about the situation nor their activities are aimed at solving the crucial problem. It maintains continuation of the game. Both patient and doctor are capable to attend the game as any of the person mentioned above. Authors of the article think frameworks of organization of the health care system should permit doctors not only to tackle main disease but also to devote time individually tailored to patient's emotional problems. © 2016 MEDPRESS.

Penumbra: Doctoral support as drama

DEFF Research Database (Denmark)

Wisker, Gina; Robinson, Gill; Bengtsen, Søren Smedegaard

2017-01-01

Much international doctoral learning research focuses on personal, institutional and learning support provided by supervisors, managed relationships,‘nudging’ robust, conceptual, critical, creative work. Other work focuses on stresses experienced in supervisor-student relationships and doctoral...... journeys. Some considers formal and informal learning communities supporting students on research journeys, and roles played by families, friends and others, sometimes o ering encouragement and sometimes added stress. However, little has been explored concerning often uno cial, largely unrecognised...... sanctioned (‘lightside’), and less well recognised often unsanctioned (‘darkside’) on doctoral research and writing learning journey, instigating questions about doctoral student needs, and the range of support provided, both legitimate, well known, less legitimate. This work concentrates on the ‘darkside’....

Psychiatric Prescribers' Experiences With Doctor Shoppers.

Science.gov (United States)

Worley, Julie; Johnson, Mary; Karnik, Niranjan

2015-01-01

Doctor shopping is a primary method of prescription medication diversion. After opioids, benzodiazepines and stimulants are the next most common prescription medications used nonmedically. Studies have shown that patients who engage in doctor shopping find it fun, exciting, and easy to do. There is a lack of research on the prescriber's perspective on the phenomenon of doctor shopping. This study investigates the experiences of prescribers in psychiatry with patients who engage in doctor shopping. Fifteen prescribers including psychiatrists and psychiatric nurse practitioners working in outpatient psychiatry were interviewed to elicit detailed information about their experiences with patients who engage in doctor shopping. Themes found throughout the interview were that psychiatric prescribers' experience with patients who engage in doctor shopping includes (a) detecting red flags, (b) negative emotional responding, (c) addressing the patient and the problem, and (d) inconsistently implementing precautions. When red flags were detected when prescribing controlled drugs, prescribers in psychiatry experienced both their own negative emotional responses such as disappointment and resentment as well as the negative emotions of the patients such as anger and other extreme emotional responses. Psychiatric prescribers responded to patient's doctor shopping in a variety of ways such as changing their practice, discharging the patients or taking steps to not accept certain patients identified as being at risk for doctor shopping, as well as by talking to the patient and trying to offer them help. Despite experiencing doctor shopping, the prescribers inconsistently implemented precautionary measures such as checking prescription drug monitoring programs. © The Author(s) 2015.

Agency doctorates

International Nuclear Information System (INIS)

1970-01-01

Staff members of the Agency working at the Seibersdorf laboratory are continuing to achieve high academic distinction. Two more - both Austrian - have now been awarded the degree of Doctor of Agriculture. Joachim Kramer, who is 26, graduated from the Hochschule fur Bodenkultur in 1967 with the degree of Diplom-Ingenieur and then started work in the plant breeding and genetics section of the laboratory under the direction of Dr. Knut Mikaelsen. The results of the research work he carried out were accepted as the subject of a thesis for which he has now been granted his doctorate. The doctoral promotion took place on 30 June, at a ceremony attended by Dr. Andre Finkelstein, Deputy Director General for Research and Isotopes. The subject of Dr. Kramer's thesis was a comprehensive study of the mutagenic effects of fast neutrons and gamma rays, and the influence of various modifying factors such as water content, oxygen and metabolic state of seeds at the time of irradiation. This work has contributed significantly to the understanding of the mechanisms by which these two types of ionizing radiation produce mutations in seeds. The knowledge gained will be of great importance in the efficient use of ionizing radiation in practical plant breeding. Paul Wassermann, who is 33 years old, joined the Agency in 1965. He, too, graduated from the Hochschule fur Bodenkultur as Diplom-Ingenieur in agriculture, having graduated with honours previously from the agricultural secondary school at Raumberg, Austria, in 1958. Dr. Wassermann's own words may be used to explain how he came to gain his doctorate. 'In October, 1966, I completed my studies at the Hochschule,' he writes. 'I was employed at the Agency laboratories in Seibersdorf, working in the plant and soils group. Encouraged by the interesting research which was performed there, a thesis entitled 'the Fate of Nitrogen in Submerged Rice Soils' was started, which finally led to the doctor's degree in Agriculture in June this year

The doctoral learning penumbra

DEFF Research Database (Denmark)

Bengtsen, Søren Smedegaard; Robinson, Gill; Wisker, Gina

This paper presents our cross-national research into what we term the ‘doctoral learning penumbra’, which covers the diverse, unnoticed, and often unrecognised forms of help and support that doctoral students draw from during their PhD, and which are vital for completion. Our aim is to better...

Headache - what to ask your doctor

Science.gov (United States)

... Migraine - what to ask your doctor; Tension-type headache - what to ask your doctor; Cluster headache - what to ask your doctor ... How can I tell if the headache I am having is dangerous? What are ... headache ? A migraine headache ? A cluster headache ? What medical ...

Self-Supervised Dynamical Systems

Science.gov (United States)

Zak, Michail

2003-01-01

Some progress has been made in a continuing effort to develop mathematical models of the behaviors of multi-agent systems known in biology, economics, and sociology (e.g., systems ranging from single or a few biomolecules to many interacting higher organisms). Living systems can be characterized by nonlinear evolution of probability distributions over different possible choices of the next steps in their motions. One of the main challenges in mathematical modeling of living systems is to distinguish between random walks of purely physical origin (for instance, Brownian motions) and those of biological origin. Following a line of reasoning from prior research, it has been assumed, in the present development, that a biological random walk can be represented by a nonlinear mathematical model that represents coupled mental and motor dynamics incorporating the psychological concept of reflection or self-image. The nonlinear dynamics impart the lifelike ability to behave in ways and to exhibit patterns that depart from thermodynamic equilibrium. Reflection or self-image has traditionally been recognized as a basic element of intelligence. The nonlinear mathematical models of the present development are denoted self-supervised dynamical systems. They include (1) equations of classical dynamics, including random components caused by uncertainties in initial conditions and by Langevin forces, coupled with (2) the corresponding Liouville or Fokker-Planck equations that describe the evolutions of probability densities that represent the uncertainties. The coupling is effected by fictitious information-based forces, denoted supervising forces, composed of probability densities and functionals thereof. The equations of classical mechanics represent motor dynamics that is, dynamics in the traditional sense, signifying Newton s equations of motion. The evolution of the probability densities represents mental dynamics or self-image. Then the interaction between the physical and

Australian doctors and the visual arts. Part 4. Doctors as supporters of art galleries and artists in Victoria.

Science.gov (United States)

Hamilton, D G

1986-07-07

The contribution of doctors to the visual arts is being discussed in a series of six articles. Doctor-artists in New South Wales and Victoria, and doctors as collectors, donors, gallery supporters and writers in New South Wales, have been discussed in earlier articles. This, the fourth article, deals with doctors as supporters of art galleries and artists in Victoria.

African International Doctoral Students in New Zealand: Englishes, Doctoral Writing and Intercultural Supervision

Science.gov (United States)

Doyle, Stephanie; Manathunga, Catherine; Prinsen, Gerard; Tallon, Rachel; Cornforth, Sue

2018-01-01

While the experiences of international doctoral students, especially those from Asian countries, have been well researched, fewer studies have explored the experiences of African students in Southern countries like Australia and Aotearoa/New Zealand. This article reports on doctoral writing and student and supervisor perspectives on English…

[Life conditions of Togolese doctors].

Science.gov (United States)

Koffi-Tessio, Annick Viwalé; Oniankitan, Owonayo; Mijiyawa, Moustafa

2010-09-01

A study has been carried out by Togolese medical doctors in order to determine the perceived and the real life of their profession. The study, which was transversal, has taken in account a sample of 52 medical doctors made on the basis of a cautious choice. Most of these medical doctors (15 general practitioners, 23 specialists and 14 hospitalo-universitaires) work in the medical cares centres of Lomé. A sheet of survey has permitted the collection of demographic data and data relating to the medical studies and career. The 52 medical doctors included in the study (7 women, 45 men) were between 25 and 59 years old; their age of getting their A-level was between 16 and 23 years old, and that of getting the doctorate diploma between 24 and 37. The length of professional experience stands between 8 months and 27 years. The marital status was specified by 47 of the 52 medical doctors: 13 single, one divorced, and 33 married; 5 of the 7 women who took part in the survey were single and without any child. The love of the profession (65%), the social status it confers (37%) and the honour tied to the profession (27%) were the main motives of choosing the profession. The decision of doing medical studies was taken during secondary studies by 45 of the 52 persons. The faculty of medicine of Lomé has been the study frame to general medicine studies of 35 persons (67%). The low payment (83%), the poverty of the patients (83%), the narrowness of the technical platform (79%), the insufficiency of cares structures in paramedical personnel (67%), the insufficiency of continuing education (60%), and the lack or insufficiency of drugs (58%) were the main problems encountered during their professional experience by the people questioned. 22 medical doctors (43%) have estimated that their profession has given them a particular social status. Only 8 medical doctors have found that the real things they have gone trough in the profession matches with the idea they had, while 32 (62

Shadowing in dynamical systems

CERN Document Server

Pilyugin, Sergei Yu

1999-01-01

This book is an introduction to the theory of shadowing of approximate trajectories in dynamical systems by exact ones. This is the first book completely devoted to the theory of shadowing. It shows the importance of shadowing theory for both the qualitative theory of dynamical systems and the theory of numerical methods. Shadowing Methods allow us to estimate differences between exact and approximate solutions on infinite time intervals and to understand the influence of error terms. The book is intended for specialists in dynamical systems, for researchers and graduate students in the theory of numerical methods.

The Criminal Justice Doctorate: A Study of Doctoral Programs in the United States.

Science.gov (United States)

Felkenes, George T.

Graduates of six institutions were surveyed in an effort to develop a profile of doctoral graduates from institutions that have traditionally offered doctoral programs oriented specifically toward the field of criminal justice. A second research objective was to develop an understanding of the attitudes, frustrations, and utilization patterns of…

Reasons for consulting a doctor on the Internet: Web survey of users of an Ask the Doctor service.

Science.gov (United States)

Umefjord, Göran; Petersson, Göran; Hamberg, Katarina

2003-10-22

In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. To study why individuals choose to consult previously-unknown doctors on the Internet. Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) and 2586 (71%) women, was conducted. We excluded 186 queries from users. The results are based on quantitative and qualitative analysis of the answers to the question "Why did you choose to ask a question at Infomedica's 'Ask the Doctor' service?" 1223 surveys were completed (response rate 36 %). Of the participants in the survey 322 (26%) were male and 901 (74%) female. As major reasons for choosing to consult previously-unknown doctors on the Internet participants indicated: convenience (52%), anonymity (36%), "doctors too busy" (21%), difficult to find time to visit a doctor (16%), difficulty to get an appointment (13%), feeling uncomfortable when seeing a doctor (9%), and not being able to afford a doctors' visit (3%). Further motives elicited through a qualitative analysis of free-text answers were: seeking a second opinion, discontent with previous doctors and a wish for a primary evaluation of a medical problem, asking embarrassing or sensitive questions, seeking information on behalf of relatives, preferring written communication, and (from responses by expatriates, travelers, and others) living far away from regular health care. We found that that an Internet based Ask the Doctor service is primarily consulted because it is convenient, but it may also be of value for individuals with needs that regular health care services have not been able to meet.

When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient-doctor relationship.

Science.gov (United States)

Bell, Sigall K; Mejilla, Roanne; Anselmo, Melissa; Darer, Jonathan D; Elmore, Joann G; Leveille, Suzanne; Ngo, Long; Ralston, James D; Delbanco, Tom; Walker, Jan

2017-04-01

Patient advocates and safety experts encourage adoption of transparent health records, but sceptics worry that shared notes may offend patients, erode trust or promote defensive medicine. As electronic health records disseminate, such disparate views fuel policy debates about risks and benefits of sharing visit notes with patients through portals. Presurveys and postsurveys from 99 volunteer doctors at three US sites who participated in OpenNotes and postsurveys from 4592 patients who read at least one note and submitted a survey. Patients read notes to be better informed and because they were curious; about a third read them to check accuracy. In total, 7% (331) of patients reported contacting their doctor's office about their note. Of these, 29% perceived an error, and 85% were satisfied with its resolution. Nearly all patients reported feeling better (37%) or the same (62%) about their doctor. Patients who were older (>63), male, non-white, had fair/poor self-reported health or had less formal education were more likely to report feeling better about their doctor. Among doctors, 26% anticipated documentation errors, and 44% thought patients would disagree with notes. After a year, 53% believed patient satisfaction increased, and 51% thought patients trusted them more. None reported ordering more tests or referrals. Despite concerns about errors, offending language or defensive practice, transparent notes overall did not harm the patient-doctor relationship. Rather, doctors and patients perceived relational benefits. Traditionally more vulnerable populations-non-white, those with poorer self-reported health and those with fewer years of formal education-may be particularly likely to feel better about their doctor after reading their notes. Further informing debate about OpenNotes, the findings suggest transparent records may improve patient satisfaction, trust and safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already

A study of Computing doctorates in South Africa from 1978 to 2014

Directory of Open Access Journals (Sweden)

Ian D Sanders

2015-12-01

Full Text Available This paper studies the output of South African universities in terms of computing-related doctorates in order to determine trends in numbers of doctorates awarded and to identify strong doctoral study research areas. Data collected from a variety of sources relating to Computing doctorates conferred since the late 1970s was used to compare the situation in Computing with that of all doctorates. The number of Computing doctorates awarded has increased considerably over the period of study. Nearly three times as many doctorates were awarded in the period 2010–2014 as in 2000–2004. The universities producing the most Computing doctorates were either previously “traditional” universities or comprehensive universities formed by amalgamating a traditional research university with a technikon. Universities of technology have not yet produced many doctorates as they do not have a strong research tradition. The analysis of topic keywords using ACM Computing classifications is preliminary but shows that professional issues are dominant in Information Systems, models are often built in Computer Science and several topics, including computing in education, are evident in both IS and CS. The relevant data is in the public domain but access is difficult as record keeping was generally inconsistent and incomplete. In addition, electronic databases at universities are not easily searchable and access to HEMIS data is limited. The database built for this paper is more inclusive in terms of discipline-related data than others.

Use of multimedia messaging system (MMS) by junior doctors for scan image transmission in neurosurgery.

Science.gov (United States)

Ling, Ji Min; Lim, Kim Zhuan; Ng, Wai Hoe

2012-02-01

Multimedia Messaging Service (MMS) is used by neurosurgical residents to transmit scan images to the attending neurosurgeon in conjunction with telephone consultation. This service has been well received by the attending neurosurgeons, who felt that after viewing scan images on their phones, they felt increased confidence in clinical decision making and that it reduced the need for recall to the hospital. The use of MMS can be extended to junior doctors making referrals from regional hospitals with no neurosurgical cover. This study aims to validate the competency of non-neurosurgically trained junior doctors in selecting optimal images to transmit via MMS to the attending neurosurgeon on call. Ten junior doctors with no formal neurosurgical training and five neurosurgical residents were interviewed. They were shown the full complement of images together with relevant clinical history and assessment. They were then asked to make the radiological diagnosis and then select two images for MMS transmission to the attending neurosurgeon that they thought would best aid the neurosurgeon in clinical decision making. The attending neurosurgeon was asked to comment, on each image, whether his management plan would differ if he was shown the entire series of the images. All the images chosen are deemed appropriate, and the decision made based on the MMS images would be similar if the entire series of images were available to the neurosurgeon. However, 7 of 10 junior doctors were unable to read magnetic resonance images of lumbar spine. There was no significant difference in the images chosen by the neurosurgical residents and the junior doctors. It is feasible and safe for junior doctors to utilize MMS to transmit computed tomographic images to a neurosurgeon while making an urgent referral. The images selected are representative of the disease pathology and facilitate clinical decision making. Copyright © 2012 Elsevier Inc. All rights reserved.

Synchronization dynamics of two different dynamical systems

International Nuclear Information System (INIS)

Luo, Albert C.J.; Min Fuhong

2011-01-01

Highlights: → Synchronization dynamics of two distinct dynamical systems. → Synchronization, de-synchronization and instantaneous synchronization. → A controlled pendulum synchronizing with the Duffing oscillator. → Synchronization invariant set. → Synchronization parameter map. - Abstract: In this paper, synchronization dynamics of two different dynamical systems is investigated through the theory of discontinuous dynamical systems. The necessary and sufficient conditions for the synchronization, de-synchronization and instantaneous synchronization (penetration or grazing) are presented. Using such a synchronization theory, the synchronization of a controlled pendulum with the Duffing oscillator is systematically discussed as a sampled problem, and the corresponding analytical conditions for the synchronization are presented. The synchronization parameter study is carried out for a better understanding of synchronization characteristics of the controlled pendulum and the Duffing oscillator. Finally, the partial and full synchronizations of the controlled pendulum with periodic and chaotic motions are presented to illustrate the analytical conditions. The synchronization of the Duffing oscillator and pendulum are investigated in order to show the usefulness and efficiency of the methodology in this paper. The synchronization invariant domain is obtained. The technique presented in this paper should have a wide spectrum of applications in engineering. For example, this technique can be applied to the maneuvering target tracking, and the others.

Aspects of communication in medical life. Doctor-patient communication: differentiation and customization.

Science.gov (United States)

Borţun, D; Matei, C S

2017-01-01

One of the weaknesses of the Romanian medical system is the absence of the communicational culture. This absence is felt at all levels of the healthcare system: doctor-patient relationship, doctor-patient's relatives relationship, labor relations within the medical teams and units, the management of the large hospitals and of the medical institutions from the public administration system and last, but not least, the relationships of these units and institutions with the public opinion and, particularly, with the stakeholders. This paper tackled with some of the principles and values that underlie an efficient communication, the default of which was felt in various domains of the Romanian medical life. They were analyzed from the perspective of the Romanian and international literature and the conclusions drawn might inspire proposals for the improvement of the medical education as well as for the professional development of the Romanian doctors.

Complexity in Dynamical Systems

Science.gov (United States)

Moore, Cristopher David

The study of chaos has shown us that deterministic systems can have a kind of unpredictability, based on a limited knowledge of their initial conditions; after a finite time, the motion appears essentially random. This observation has inspired a general interest in the subject of unpredictability, and more generally, complexity; how can we characterize how "complex" a dynamical system is?. In this thesis, we attempt to answer this question with a paradigm of complexity that comes from computer science, we extract sets of symbol sequences, or languages, from a dynamical system using standard methods of symbolic dynamics; we then ask what kinds of grammars or automata are needed a generate these languages. This places them in the Chomsky heirarchy, which in turn tells us something about how subtle and complex the dynamical system's behavior is. This gives us insight into the question of unpredictability, since these automata can also be thought of as computers attempting to predict the system. In the culmination of the thesis, we find a class of smooth, two-dimensional maps which are equivalent to the highest class in the Chomsky heirarchy, the turning machine; they are capable of universal computation. Therefore, these systems possess a kind of unpredictability qualitatively different from the usual "chaos": even if the initial conditions are known exactly, questions about the system's long-term dynamics are undecidable. No algorithm exists to answer them. Although this kind of unpredictability has been discussed in the context of distributed, many-degree-of -freedom systems (for instance, cellular automata) we believe this is the first example of such phenomena in a smooth, finite-degree-of-freedom system.

Communication Skills in Patient-Doctor Interactions: Learning from Patient Complaints

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Janine W.Y. Kee

2018-06-01

Full Text Available Purpose: Despite communication skills training in medical school, junior doctors continue to demonstrate poor patient-doctor communication skills, where patient unhappiness from the encounter often manifests as patient complaints. We sought to identify crucial communication skills that should be incorporated in the communications curriculum by learning from patient complaints, to explore how the communication lapses occur. Method: 38 cases of anonymized negative patient feedback about junior doctors were analysed using qualitative content analysis. A two-step fine-coding system involving four researchers was employed. Results: Four main themes of communication errors were identified, namely: non-verbal (eye contact, facial expression and paralanguage, verbal (active listening and inappropriate choice of words, and content (poor quantity and quality of information provided; and poor attitudes (lack of respect and empathy. Discussion: Patient-doctor communication is a complex interpersonal interaction that requires an understanding of each party׳s emotional state. We identified important but overlooked communication lapses such as non-verbal paralinguistic elements that should be incorporated into communications curriculum, with an emphasis on dialectical learning. These include integrating these findings into a simulation-based communications module for training doctors at a post-graduate level as well as monitoring and analyzing patient complaints regularly to iteratively update the content of the training module. Beyond these skills training, there is also a need to highlight negative emotions of doctors in future research, as it influences their communication patterns and attitudes towards patients, ultimately shaping how patients perceive them. Keywords: Communication skills training, Patient complaints, Patient negative feedback, Patient-Doctor communication, Residency training

Does a self-referral counselling program reach doctors in need of help? A comparison with the general Norwegian doctor workforce

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Gude Tore

2007-03-01

Full Text Available Abstract Background Doctors have a relatively high degree of emotional distress, but seek help to a lesser degree and at a later stage than other academic groups. This can be deleterious for themselves and for their patients. Prevention programs have therefore been developed but it is unclear to what extent they reach doctors in need of help. This study describes doctors who participated in a self-referrral, easily accessible, stress relieving, counselling program in Norway, and compares them with a nationwide sample of Norwegian doctors. Methods Two hundred and twenty seven (94% of the doctors, 117 women and 110 men, who came to the resort centre Villa Sana, Modum, Norway, between August 2003 and July 2005, agreed to participate in the study. Socio-demographic data, reasons for and ways of help-seeking, sick-leave, symptoms of depression and anxiety, job stress and burnout were assessed by self-reporting questionnaires. Results Forty-nine percent of the Sana doctors were emotionally exhausted (Maslach compared with 25% of all Norwegian doctors. However, they did not differ on empathy and working capacity, the other two dimensions in Maslach's burnout inventory. Seventy-three percent of the Sana doctors could be in need of treatment for depression or anxiety based on their symptom distress scores, compared with 14% of men and 18% of women doctors in Norway. Twenty-one percent of the Sana doctors had a history of suicidal thoughts, including how to commit the act, as compared to 10% of Norwegian doctors in general. Conclusion Sana doctors displayed a higher degree of emotional exhaustion, symptoms of depression and anxiety as well as job related stress, compared with all Norwegian doctors. This may indicate that the program at Villa Sana to a large extent reaches doctors in need of help. The counselling intervention can help doctors to evaluate their professional and private situation, and, when necessary, enhance motivation for seeking adequate

Management of complex dynamical systems

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MacKay, R. S.

2018-02-01

Complex dynamical systems are systems with many interdependent components which evolve in time. One might wish to control their trajectories, but a more practical alternative is to control just their statistical behaviour. In many contexts this would be both sufficient and a more realistic goal, e.g. climate and socio-economic systems. I refer to it as ‘management’ of complex dynamical systems. In this paper, some mathematics for management of complex dynamical systems is developed in the weakly dependent regime, and questions are posed for the strongly dependent regime.

Best practices in doctoral retention: Mentoring

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Judie L. Brill

2014-06-01

Full Text Available  The aim of this critical literature review is to outline best practices in doctoral retention and the successful approach of one university to improve graduation success by providing effective mentorship for faculty and students alike. The focus of this literature review is on distance learning relationships between faculty and doctoral students, regarding retention, persistence, and mentoring models. Key phrases and words used in the search and focusing on mentoring resulted in over 20,000 sources. The search was narrowed to include only doctoral study and mentoring. Research questions of interest were: Why do high attrition rates exist for doctoral students? What are the barriers to retention? What are the benefits of doctoral mentoring? What programs do institutions have in place to reduce attrition? The researchers found a key factor influencing doctoral student retention and success is effective faculty mentorship. In particular, the design of a mentoring and faculty training program to increase retention and provide for success after graduation is important. This research represents a key area of interest in the retention literature, as institutions continue to search for ways to better support students during their doctoral programs and post-graduation. DOI: 10.18870/hlrc.v4i2.186

Joint development of evidence-based medical record by doctors and patients through integrated Chinese and Western medicine on digestive system diseases.

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Li, Bo; Gao, Hong-yang; Gao, Rui; Zhao, Ying-pan; Li, Qing-na; Zhao, Yang; Tang, Xu-dong; Shang, Hong-cai

2016-02-01

Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system. A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases, i.e. PubMed, Excerpt Medica Database, China Biology Medicine disc and China National Knowledge Infrastructure. However, no relevant study on the subjects of interest was identified. Therefore, drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine, we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial. Further, we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders. Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research. The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.

Professional values and reported behaviours of doctors in the USA and UK: quantitative survey

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Rao, Sowmya R; Sibbald, Bonnie; Hann, Mark; Harrison, Stephen; Walter, Alex; Guthrie, Bruce; Desroches, Catherine; Ferris, Timothy G; Campbell, Eric G

2011-01-01

Background The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care. Method 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys. Results UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, pretribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued. Discussion The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour. PMID:21383386

Smart strategies for doctors and doctors-in-training: heuristics in medicine.

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Wegwarth, Odette; Gaissmaier, Wolfgang; Gigerenzer, Gerd

2009-08-01

How do doctors make sound decisions when confronted with probabilistic data, time pressures and a heavy workload? One theory that has been embraced by many researchers is based on optimisation, which emphasises the need to integrate all information in order to arrive at sound decisions. This notion makes heuristics, which use less than complete information, appear as second-best strategies. In this article, we challenge this pessimistic view of heuristics. We introduce two medical problems that involve decision making to the reader: one concerns coronary care issues and the other macrolide prescriptions. In both settings, decision-making tools grounded in the principles of optimisation and heuristics, respectively, have been developed to assist doctors in making decisions. We explain the structure of each of these tools and compare their performance in terms of their facilitation of correct predictions. For decisions concerning both the coronary care unit and the prescribing of macrolides, we demonstrate that sacrificing information does not necessarily imply a forfeiting of predictive accuracy, but can sometimes even lead to better decisions. Subsequently, we discuss common misconceptions about heuristics and explain when and why ignoring parts of the available information can lead to the making of more robust predictions. Heuristics are neither good nor bad per se, but, if applied in situations to which they have been adapted, can be helpful companions for doctors and doctors-in-training. This, however, requires that heuristics in medicine be openly discussed, criticised, refined and then taught to doctors-in-training rather than being simply dismissed as harmful or irrelevant. A more uniform use of explicit and accepted heuristics has the potential to reduce variations in diagnoses and to improve medical care for patients.

Vehicle systems: coupled and interactive dynamics analysis

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Vantsevich, Vladimir V.

2014-11-01

This article formulates a new direction in vehicle dynamics, described as coupled and interactive vehicle system dynamics. Formalised procedures and analysis of case studies are presented. An analytical consideration, which explains the physics of coupled system dynamics and its consequences for dynamics of a vehicle, is given for several sets of systems including: (i) driveline and suspension of a 6×6 truck, (ii) a brake mechanism and a limited slip differential of a drive axle and (iii) a 4×4 vehicle steering system and driveline system. The article introduces a formal procedure to turn coupled system dynamics into interactive dynamics of systems. A new research direction in interactive dynamics of an active steering and a hybrid-electric power transmitting unit is presented and analysed to control power distribution between the drive axles of a 4×4 vehicle. A control strategy integrates energy efficiency and lateral dynamics by decoupling dynamics of the two systems thus forming their interactive dynamics.

The Trouble with Doctoral Aspiration Now

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Burford, James

2018-01-01

This article attends to the affective-political dimensions of doctoral aspiration. It considers why doctoral students continue to hope for an 'academic good life' in spite of the depressed and precarious features of the academic present. The article emerges from 2013 research with ten doctoral students in the Arts and Social Sciences, at a…

Complexified dynamical systems

International Nuclear Information System (INIS)

Bender, Carl M; Holm, Darryl D; Hook, Daniel W

2007-01-01

Many dynamical systems, such as the Lotka-Volterra predator-prey model and the Euler equations for the free rotation of a rigid body, are PT symmetric. The standard and well-known real solutions to such dynamical systems constitute an infinitessimal subclass of the full set of complex solutions. This paper examines a subset of the complex solutions that contains the real solutions, namely those having PT symmetry. The condition of PT symmetry selects out complex solutions that are periodic. (fast track communication)

How physician electronic health record screen sharing affects patient and doctor non-verbal communication in primary care.

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Asan, Onur; Young, Henry N; Chewning, Betty; Montague, Enid

2015-03-01

Use of electronic health records (EHRs) in primary-care exam rooms changes the dynamics of patient-physician interaction. This study examines and compares doctor-patient non-verbal communication (eye-gaze patterns) during primary care encounters for three different screen/information sharing groups: (1) active information sharing, (2) passive information sharing, and (3) technology withdrawal. Researchers video recorded 100 primary-care visits and coded the direction and duration of doctor and patient gaze. Descriptive statistics compared the length of gaze patterns as a percentage of visit length. Lag sequential analysis determined whether physician eye-gaze influenced patient eye gaze, and vice versa, and examined variations across groups. Significant differences were found in duration of gaze across groups. Lag sequential analysis found significant associations between several gaze patterns. Some, such as DGP-PGD ("doctor gaze patient" followed by "patient gaze doctor") were significant for all groups. Others, such DGT-PGU ("doctor gaze technology" followed by "patient gaze unknown") were unique to one group. Some technology use styles (active information sharing) seem to create more patient engagement, while others (passive information sharing) lead to patient disengagement. Doctors can engage patients in communication by using EHRs in the visits. EHR training and design should facilitate this. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Nonautonomous dynamical systems

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Kloeden, Peter E

2011-01-01

The theory of nonautonomous dynamical systems in both of its formulations as processes and skew product flows is developed systematically in this book. The focus is on dissipative systems and nonautonomous attractors, in particular the recently introduced concept of pullback attractors. Linearization theory, invariant manifolds, Lyapunov functions, Morse decompositions and bifurcations for nonautonomous systems and set-valued generalizations are also considered as well as applications to numerical approximations, switching systems and synchronization. Parallels with corresponding theories of control and random dynamical systems are briefly sketched. With its clear and systematic exposition, many examples and exercises, as well as its interesting applications, this book can serve as a text at the beginning graduate level. It is also useful for those who wish to begin their own independent research in this rapidly developing area.

Patients' communication with doctors: a randomized control study of a brief patient communication intervention.

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Talen, Mary R; Muller-Held, Christine F; Eshleman, Kate Grampp; Stephens, Lorraine

2011-09-01

In research on doctor-patient communication, the patient role in the communication process has received little attention. The dynamic interactions of shared decision making and partnership styles which involve active patient communication are becoming a growing area of focus in doctor-patient communication. However, patients rarely know what makes "good communication" with medical providers and even fewer have received coaching in this type of communication. In this study, 180 patients were randomly assigned to either an intervention group using a written communication tool to facilitate doctor-patient communication or to standard care. The goal of this intervention was to assist patients in becoming more effective communicators with their physicians. The physicians and patients both rated the quality of the communication after the office visit based on the patients' knowledge of their health concerns, organizational skills and questions, and attitudes of ownership and partnership. The results supported that patients in the intervention group had significantly better communication with their doctors than patients in the standard care condition. Physicians also rated patients who were in the intervention group as having better overall communication and organizational skills, and a more positive attitude during the office visit. This study supports that helping patients structure their communication using a written format can facilitate doctor-patient communication. Patients can become more adept at describing their health concerns, organizing their needs and questions, and being proactive, which can have a positive effect on the quality of the doctor-patient communication during outpatient office visits. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Do not judge according to appearance: patients' preference of a doctor's face does not influence their assessment of the patient-doctor relationship.

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Lee, Soon-Ho; Chang, Dong-Seon; Kang, O-Seok; Kim, Hwa-Hyun; Kim, Hackjin; Lee, Hyejung; Park, Hi-Joon; Chae, Younbyoung

2012-12-01

The aim of this study was to investigate whether a patient's preference for a doctor's face is associated with better assessments of relational empathy in the patient-doctor relationship after the first clinical consultation. A total of 110 patients enrolled in a traditional Korean medical clinic participated in the study. Patients' preference for doctors' faces was assessed by a two alternative forced choice (2AFC) task, with 60 different pairs of six different Asian male doctors' faces. One of the six doctors then carried out the initial clinical consultation for these patients. The patient-doctor relationship was assessed using the Consultation and Relational Empathy (CARE) measure. The data of all patients' simulated preferences for a doctor's face and their assessment values of a doctor's relational empathy was compared, and no significant correlation was found between both values (r=-0.024, p>0.809). These findings suggest that the perceived empathy in the patient-doctor relationship is not influenced by the patient's preference for a certain doctor's face. The first impression of a doctor is often determined by his appearance and look. However, whether or not the patient particularly prefers a doctor's face does not seem to matter in developing a good patient-doctor relationship.

Chaos for Discrete Dynamical System

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Lidong Wang

2013-01-01

Full Text Available We prove that a dynamical system is chaotic in the sense of Martelli and Wiggins, when it is a transitive distributively chaotic in a sequence. Then, we give a sufficient condition for the dynamical system to be chaotic in the strong sense of Li-Yorke. We also prove that a dynamical system is distributively chaotic in a sequence, when it is chaotic in the strong sense of Li-Yorke.

Work of female rural doctors.

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Wainer, Jo

2004-04-01

To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are

Doctor's perception of doctor-patient relationships in emergency departments: What roles do gender and ethnicity play?

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Borde Theda

2008-04-01

Full Text Available Abstract Background Emergency departments continuously provide medical treatment on a walk-in basis. Several studies investigated the patient's perception of the doctor-patient relationship, but few have asked doctors about their views. Furthermore, the influence of the patient's ethnicity and gender on the doctor's perception remains largely unanswered. Methods Based on data collated in three gynaecology (GYN/internal medicine (INT emergency departments in Berlin, Germany, we evaluated the impact of the patient's gender and ethnicity on the doctors' satisfaction with the course of the treatment they provided. Information was gathered from 2.429 short questionnaires completed by doctors and the medical records of the corresponding patients. Results The patient's ethnicity had a significant impact on the doctors' satisfaction with the doctor-patient relationship. Logistic regression analysis showed that the odds ratio (OR for physician satisfaction was significantly lower for patients of Turkish origin (OR = 2.6 INT and 5.5 GYN than for those of German origin. The main reasons stated were problems with communication and a perceived lack of urgency for emergency treatment. The odds ratios for dissatisfaction due to a lack of language skills were 4.48 (INT and 6.22 (GYN, and those due to perceived lack of urgency for emergency treatment were 0.75 (INT and 0.63 (GYN. Sex differences caused minor variation. Conclusion The results show that good communication despite language barriers is crucial in providing medical care that is satisfactory to both patient and doctors, especially in emergency situations. Therefore the use of professional interpreters for improved communication and the training of medical staff for improved intercultural competence are essential for the provision of adequate health care in a multicultural setting.

Doctoral education in a successful ecological niche

DEFF Research Database (Denmark)

Christensen, Mette Krogh; Lund, Ole

2014-01-01

Scholarly communities are dependent on and often measured by their ability to attract and develop doctoral students. Recent literature suggests that most scholarly communities entail ecological niches in which the doctoral students learn the codes and practices of research. In this article, we...... successful doctoral education because it: 1) fleshes out the professional attitude that is necessary for becoming a successful researcher in the department, 2) shapes and adapts the doctoral students’ desires to grasp and identify with the department’s practices, and 3) provides the doctoral students...... explore the microclimate in an ecological niche of doctoral education. Based on a theoretical definition of microclimate as the emotional atmosphere that ties group members together and affects their actions, we conducted a case study that aimed to describe the key features of the microclimate...

Ergodic theory and dynamical systems

CERN Document Server

Coudène, Yves

2016-01-01

This textbook is a self-contained and easy-to-read introduction to ergodic theory and the theory of dynamical systems, with a particular emphasis on chaotic dynamics. This book contains a broad selection of topics and explores the fundamental ideas of the subject. Starting with basic notions such as ergodicity, mixing, and isomorphisms of dynamical systems, the book then focuses on several chaotic transformations with hyperbolic dynamics, before moving on to topics such as entropy, information theory, ergodic decomposition and measurable partitions. Detailed explanations are accompanied by numerous examples, including interval maps, Bernoulli shifts, toral endomorphisms, geodesic flow on negatively curved manifolds, Morse-Smale systems, rational maps on the Riemann sphere and strange attractors. Ergodic Theory and Dynamical Systems will appeal to graduate students as well as researchers looking for an introduction to the subject. While gentle on the beginning student, the book also contains a number of commen...

Dynamical Systems for Creative Technology

NARCIS (Netherlands)

van Amerongen, J.

2010-01-01

Dynamical Systems for Creative Technology gives a concise description of the physical properties of electrical, mechanical and hydraulic systems. Emphasis is placed on modelling the dynamical properties of these systems. By using a system’s approach it is shown that a limited number of mathematical

[Interpersonal games as a method for doctors' occupational stress].

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Samborska-Sablik, Anna; Sablik, Zbigniew; Gaszyński, Tomasz; Drożdż, Jarosław

2015-03-01

Doctors are frequently expose to stress during their occupational work. It is mainly the result of burdens caused by taking care of patients, dysfunctional arrangements of the health care system and difficult relationships in their workplace. Chronic stress brings negative emotions and they need to cope with them . Doctors, willing to achieve it, may initiate interpersonal games with the hidden motive of restoring their internal balance. Based on transactional analysis, the authors describe some of the games which may be found in doctors' environment: "How to get out of there", "Mine is better than yours", "Scapegoat", "Fault" and "double bind". The outcome of the games may be receiving a support, proving a benefit derived from stress, getting the feeling of being not guilty, justification, or releasing emotions in apparently unintended way. Interpersonal games may help stressed doctors to get rid of internal tension but at the same time they may be a source of stress for other participants in the games. The way to limit their destructive impact is to create such administrative and organizational solutions which allow to make working conditions more friendly. © 2015 MEDPRESS.

Dynamics robustness of cascading systems.

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Jonathan T Young

2017-03-01

Full Text Available A most important property of biochemical systems is robustness. Static robustness, e.g., homeostasis, is the insensitivity of a state against perturbations, whereas dynamics robustness, e.g., homeorhesis, is the insensitivity of a dynamic process. In contrast to the extensively studied static robustness, dynamics robustness, i.e., how a system creates an invariant temporal profile against perturbations, is little explored despite transient dynamics being crucial for cellular fates and are reported to be robust experimentally. For example, the duration of a stimulus elicits different phenotypic responses, and signaling networks process and encode temporal information. Hence, robustness in time courses will be necessary for functional biochemical networks. Based on dynamical systems theory, we uncovered a general mechanism to achieve dynamics robustness. Using a three-stage linear signaling cascade as an example, we found that the temporal profiles and response duration post-stimulus is robust to perturbations against certain parameters. Then analyzing the linearized model, we elucidated the criteria of when signaling cascades will display dynamics robustness. We found that changes in the upstream modules are masked in the cascade, and that the response duration is mainly controlled by the rate-limiting module and organization of the cascade's kinetics. Specifically, we found two necessary conditions for dynamics robustness in signaling cascades: 1 Constraint on the rate-limiting process: The phosphatase activity in the perturbed module is not the slowest. 2 Constraints on the initial conditions: The kinase activity needs to be fast enough such that each module is saturated even with fast phosphatase activity and upstream changes are attenuated. We discussed the relevance of such robustness to several biological examples and the validity of the above conditions therein. Given the applicability of dynamics robustness to a variety of systems, it

Doctors with dyslexia: strategies and support.

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Locke, Rachel; Alexander, Gail; Mann, Richard; Kibble, Sharon; Scallan, Samantha

2017-10-01

Looking beyond dyslexia as an individual doctor's issue requires adjusting a working environment to better serve the needs of doctors with dyslexia. With an increasing number of doctors disclosing dyslexia at medical school, how can educators best provide this support? Our research looks at the impact of dyslexia on clinical practice and the coping strategies used by doctors to minimise the effect. Qualitative data were collected from 14 doctors with dyslexia using semi-structured interviews and by survey. 'In situ' demonstration interviews were conducted in order to understand how dyslexia is managed in the workplace from first-hand experience. Employers and educators who have responsibility for meeting the needs of this group were also consulted. Even in cases of doctors who had a diagnosis, they often did not disclose their dyslexia to their employer. Study participants reported having developed individual ways of coping and devised useful 'workarounds'. Support from employers comes in the form of 'reasonable adjustments', although from our data we cannot be sure that such adjustments contribute to an 'enabling' work environment. Supportive characteristics included the opportunity to shadow others and the time and space to complete paperwork on a busy ward. How can educators best provide support [for doctors with dyslexia]? Doctors with dyslexia need to be helped to feel comfortable enough to disclose. Educators need to challenge any negative assumptions that exist as well as promote understanding about the elements that contribute to a positive working environment. As a result of the research there is now practice available for educators to identify evidence-based strategies and resources. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

A critical ethnography of doctor-patient interaction in southern Iran.

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Sadati, Ahmad Kalateh; Iman, Mohammad Taghi; Lankarani, Kamran Bagheri; Derakhshan, Soghra

2016-01-01

Doctor-patient interaction is a subject with ethical ramifications, besides being an important issue in medical sociology. The main goal of this critical study is to explore the interactional experience of hospital admitted patients. For this reason, the study, carried out in an educational hospital in southern Iran, entailed 156 recorded clinical consultations, 920 hours of participant observation, and six focus groups consisting of patients and their families. The research method used is Critical Ethnography, which was introduced by PF Carspecken. The results showed that negative interactional experience was common among the participants. Six related themes were: doctors' inattentiveness; weak interaction; violation of patients' privacy; unjustified pain; long waiting period and ambiguity; and faceless physicians. According to the participants' observations, poor interaction with doctors has led to these negative experiences. The findings showed that doctors were inconsiderate about patients' concerns and due to this, patients were dissatisfied. Theoretically, this form of fragmented collaboration has deep roots in the framework of modern medicine, but in the context of this study, the intensity of the fragmentation between doctors and patients was observed to be intolerable. To solve this problem, models of patient-centredness and narrative medicine are recommended. In addition, the health system should monitor and evaluate the observance of ethics by physicians.

Epilepsy - what to ask your doctor - adult

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What to ask your doctor about epilepsy - adult; Seizures - what to ask your doctor - adult; Seizure - what to ask your doctor ... call to find more information about driving and epilepsy? What should I discuss with my boss at ...

Open notes: doctors and patients signing on.

Science.gov (United States)

Delbanco, Tom; Walker, Jan; Darer, Jonathan D; Elmore, Joann G; Feldman, Henry J; Leveille, Suzanne G; Ralston, James D; Ross, Stephen E; Vodicka, Elisabeth; Weber, Valerie D

2010-07-20

Few patients read their doctors' notes, despite having the legal right to do so. As information technology makes medical records more accessible and society calls for greater transparency, patients' interest in reading their doctors' notes may increase. Inviting patients to review these notes could improve understanding of their health, foster productive communication, stimulate shared decision making, and ultimately lead to better outcomes. Yet, easy access to doctors' notes could have negative consequences, such as confusing or worrying patients and complicating rather than improving patient-doctor communication. To gain evidence about the feasibility, benefits, and harms of providing patients ready access to electronic doctors' notes, a team of physicians and nurses have embarked on a demonstration and evaluation of a project called OpenNotes. The authors describe the intervention and share what they learned from conversations with doctors and patients during the planning stages. The team anticipates that "open notes" will spread and suggests that over time, if drafted collaboratively and signed by both doctors and patients, they might evolve to become contracts for care.

Learning through inter- and intradisciplinary problem solving: using cognitive apprenticeship to analyse doctor-to-doctor consultation.

Science.gov (United States)

Pimmer, Christoph; Pachler, Norbert; Nierle, Julia; Genewein, Urs

2012-12-01

Today's healthcare can be characterised by the increasing importance of specialisation that requires cooperation across disciplines and specialities. In view of the number of educational programmes for interdisciplinary cooperation, surprisingly little is known on how learning arises from interdisciplinary work. In order to analyse the learning and teaching practices of interdisciplinary cooperation, a multiple case study research focused on how consults, i.e., doctor-to-doctor consultations between medical doctors from different disciplines were carried out: semi-structured interviews with doctors of all levels of seniority from two hospital sites in Switzerland were conducted. Starting with a priori constructs based on the 'methods' underpinning cognitive apprenticeship (CA), the transcribed interviews were analysed according to the principles of qualitative content analysis. The research contributes to three debates: (1) socio-cognitive and situated learning, (2) intra- and interdisciplinary learning in clinical settings, and (3), more generally, to cooperation and problem solving. Patient cases, which necessitate the cooperation of doctors in consults across boundaries of clinical specialisms, trigger intra- as well as interdisciplinary learning and offer numerous and varied opportunities for learning by requesting doctors as well as for on-call doctors, in particular those in residence. The relevance of consults for learning can also be verified from the perspective of CA which is commonly used by experts, albeit in varying forms, degrees of frequency and quality, and valued by learners. Through data analysis a model for collaborative problem-solving and help-seeking was developed which shows the interplay of pedagogical 'methods' of CA in informal clinical learning contexts.

The Dynamical Invariant of Open Quantum System

OpenAIRE

Wu, S. L.; Zhang, X. Y.; Yi, X. X.

2015-01-01

The dynamical invariant, whose expectation value is constant, is generalized to open quantum system. The evolution equation of dynamical invariant (the dynamical invariant condition) is presented for Markovian dynamics. Different with the dynamical invariant for the closed quantum system, the evolution of the dynamical invariant for the open quantum system is no longer unitary, and the eigenvalues of it are time-dependent. Since any hermitian operator fulfilling dynamical invariant condition ...

Understanding doctors' ethical challenges as role virtue conflicts.

Science.gov (United States)

McDougall, Rosalind

2013-01-01

This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral considerations that are overlooked by other approaches to ethical analysis. © 2011 Blackwell Publishing Ltd.

Functional System Dynamics

NARCIS (Netherlands)

Ligterink, N.E.

2007-01-01

Functional system dynamics is the analysis, modelling, and simulation of continuous systems usually described by partial differential equations. From the infinite degrees of freedom of such systems only a finite number of relevant variables have to be chosen for a practical model description. The

[French doctors working in Great Britain: a study of their characteristics and motivations for migration].

Science.gov (United States)

Duverne, A; Carnet, D; d'Athis, P; Quantin, C

2008-10-01

As member states in the European Union now recognize the national qualifications of other member states, doctors will be able to move more freely within Europe according to the opportunities on offer and the constraints imposed by the different health-care systems. The aim of this study is to understand the reasons why French doctors choose to work in Great Britain. A self-completed questionnaire was used to conduct a survey among French doctors registered with the British Medical Council in 2005 who had done their studies in France and for whom the address was correct. The response rate, which was difficult to assess (impossible to distinguish between incorrect addresses and absence of response), was about 37%. The results show that doctors move to Britain for various reasons. In most cases (59%), the decision to emigrate is made for both professional and personal reasons. The second most common profile (29%), including essentially women, comprises those who emigrate to join a spouse. The third profile (12%) concerns those who emigrate for purely professional reasons: this group is made up of men who, for the most part, are disappointed with conditions in the French-hospital system: lack of recognition, poor pay and limited career prospects. Doctors who are dissatisfied with working conditions and low revenues in France seem to find that the National Health Service provides a better environment. Whatever the original reasons for expatriation, doctors particularly appreciate the salaried status, organization of working hours and teamwork, as well as more recognition of the work done. Because of uncertainties in the representativity of the returned questionnaires, the results of our study cannot be generalized to the whole population of French doctors currently working in Britain, but it does bring to light the principal reasons for their move to Britain. Though few doctors emigrate, the trend testifies to the dissatisfaction felt by certain doctors in the French

Understanding Critical Thinking to Create Better Doctors

Science.gov (United States)

Zayapragassarazan, Zayabalaradjane; Menon, Vikas; Kar, Sitanshu Sekhar; Batmanabane, Gitanjali

2016-01-01

Medical students master an enormous body of knowledge, but lack systematic problem solving ability and effective clinical decision making. High profile reports have called for reforms in medical education to create a better generation of doctors who can cope with the system based problems they would encounter in an interdisciplinary and…

International Conference on Dynamical Systems : Theory and Applications

CERN Document Server

2016-01-01

The book is a collection of contributions devoted to analytical, numerical and experimental techniques of dynamical systems, presented at the international conference "Dynamical Systems: Theory and Applications," held in Lódz, Poland on December 7-10, 2015. The studies give deep insight into new perspectives in analysis, simulation, and optimization of dynamical systems, emphasizing directions for future research. Broadly outlined topics covered include: bifurcation and chaos in dynamical systems, asymptotic methods in nonlinear dynamics, dynamics in life sciences and bioengineering, original numerical methods of vibration analysis, control in dynamical systems, stability of dynamical systems, vibrations of lumped and continuous sytems, non-smooth systems, engineering systems and differential equations, mathematical approaches to dynamical systems, and mechatronics.

International Conference on Dynamical Systems : Theory and Applications

CERN Document Server

2016-01-01

The book is the second volume of a collection of contributions devoted to analytical, numerical and experimental techniques of dynamical systems, presented at the international conference "Dynamical Systems: Theory and Applications," held in Lódz, Poland on December 7-10, 2015. The studies give deep insight into new perspectives in analysis, simulation, and optimization of dynamical systems, emphasizing directions for future research. Broadly outlined topics covered include: bifurcation and chaos in dynamical systems, asymptotic methods in nonlinear dynamics, dynamics in life sciences and bioengineering, original numerical methods of vibration analysis, control in dynamical systems, stability of dynamical systems, vibrations of lumped and continuous sytems, non-smooth systems, engineering systems and differential equations, mathematical approaches to dynamical systems, and mechatronics.

Self-supervised dynamical systems

International Nuclear Information System (INIS)

Zak, Michail

2004-01-01

A new type of dynamical systems which capture the interactions via information flows typical for active multi-agent systems is introduced. The mathematical formalism is based upon coupling the classical dynamical system (with random components caused by uncertainties in initial conditions as well as by Langevin forces) with the corresponding Liouville or the Fokker-Planck equations describing evolution of these uncertainties in terms of probability density. The coupling is implemented by information-based supervising forces which fundamentally change the patterns of probability evolution. It is demonstrated that the probability density can approach prescribed attractors while exhibiting such patterns as shock waves, solitons and chaos in probability space. Applications of these phenomena to information-based neural nets, expectation-based cooperation, self-programmed systems, control chaos using terminal attractors as well as to games with incomplete information, are addressed. A formal similarity between the mathematical structure of the introduced dynamical systems and quantum mechanics is discussed

Exploring the Dimensions of Doctor-Patient Relationship in Clinical Practice in Hospital Settings

Directory of Open Access Journals (Sweden)

Saurabh RamBiharilal Shrivastava

2014-05-01

Full Text Available The Doctor-Patient Relationship (DPR is a complex concept in the medical sociology in which patients voluntarily approach a doctor and thus become a part of a contract in which they tends to abide with the doctor’s guidance. Globally, the DPR has changed drastically over the years owing to the commercialization and privatization of the health sector. Furthermore, the dynamics of the DPR has shown a significant change because of the formulation of consumer protection acts; clauses for professional misconduct and criminal negligence; establishment of patient forums and organizations; massive expansion of the mass media sector leading to increase in health awareness among people; and changes in the status of the doctors. Realizing the importance of DPR in the final outcome and quality of life of the patient, multiple measures have been suggested to make a correct diagnosis and enhance healing. To conclude, good DPR is the crucial determinant for a better clinical outcome and satisfaction with the patients, irrespective of the socio-cultural determinants.

[HOLOCAUST DOCTORS SURVIVORS IN ISRAEL 1945-1952: FROM EARLY POSITIONS TO PROFESSIONAL INTEGRATION].

Science.gov (United States)

Herzog, Rachel

2017-04-01

The encounter between Holocaust doctor survivors and the Israeli society was part of the whole encounter between Holocaust survivors and the Israeli society. The present thesis aimed at evaluating the integration process of Holocaust doctor survivors in the Israeli health care system from 1945 until the end of 1952. Between these years about 1350 doctors arrived in Israel, the vast majority of them Holocaust survivors. Their rapid entrance to work provided the healthcare system with professional manpower, contributing their share during a tough period of the nation's history. The doctors themselves gained the opportunity for rapid professional recovery and social integration, all at the same time. The individual contributions of each of these doctors constitute a significant collective contribution. It is an inspiring story of personal and universal human victory. There are similarities between the absorption of all Holocaust survivals in Israel with regard to the motives of immigration and the feelings towards the absorption places and organizations. But Holocaust doctor survivors didn't stay too long and moved out rather quickly. The beginning was difficult. They were absorbed in each of the healthcare fronts, but especially in new clinics established in immigrant-concentrated areas, in hospitals dedicated to lung diseases and in psychiatric hospitals. They started at low professional levels, but as soon as 1952, they could be found in management positions. This was indicative of their professional advancement and the willingness of the medical establishment to absorb and promote.

Did You Hear the One About the Doctor? An Examination of Doctor Jokes Posted on Facebook

OpenAIRE

Davis, Matthew A; Haney, Carol Sue; Weeks, William B; Sirovich, Brenda E; Anthony, Denise L

2014-01-01

Background Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues. Objective We sought to explore doctor-related humor by examining doctor jokes posted on Facebook. Methods We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month o...

Protest of doctors: a basic human right or an ethical dilemma

Science.gov (United States)

2014-01-01

Background Peaceful protests and strikes are a basic human right as stated in the United Nations’ universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Discussion Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors’ strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources. In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. Summary There is no single best answer against or

Proceedings of Arcom Doctoral Workshop Research Methodology

OpenAIRE

Scott, Lloyd

2018-01-01

Editorial Editorial Welcome to this special doctoral workshop on Research Methodology which forms part of what is now a well-established support mechanism for researchers in the discipline of the Built Environment and more particularly construction management. The ARCOM doctoral series, around now for some seventeen years, has addressed many of the diverse research areas that PhD researchers in the discipline have chosen to focus on in their doctoral journey. This doctoral workshop has as ...

Radon house doctor

International Nuclear Information System (INIS)

Nitschke, I.A.; Brennan, T.; Wadach, J.B.; O'Neil, R.

1986-01-01

The term house doctor may be generalized to include persons skilled in the use of instruments and procedures necessary to identify, diagnose, and correct indoor air quality problems as well as energy, infiltration, and structural problems in houses. A radon house doctor would then be a specialist in radon house problems. Valuable experience in the skills necessary to be developed by radon house doctors has recently been gained in an extensive radon monitoring and mitigation program in upstate New York sponsored by Niagara Mohawk Power Corporation and the New York State Energy Research and Development Authority. These skills, to be described in detail in this paper, include: (i) the use of appropriate instruments, (ii) the evaluation of the symptoms of a radon-sick house, (iii) the diagnostic procedures required to characterize radon sources in houses, (iv) the prescription procedures needed to specify treatment of the problem, (v) the supervision of the implementation of the treatment program, (vi) the check-up procedures required to insure the house cured of radon problems. 31 references, 3 tables

Basement and climate controls on proximal depositional systems in continental settings

NARCIS (Netherlands)

Ventra, D.

2011-01-01

This doctoral dissertation discusses the sedimentology and dynamics of selected, modern and ancient clastic depositional systems (alluvial fans and colluvial aprons) at continental basin margins. The focus on single depositional systems gave the opportunity to devote particular attention to

Distinction in Doctoral Education: Using Bourdieu's Tools to Assess the Socialization of Doctoral Students

Science.gov (United States)

Gopaul, Bryan

2011-01-01

This conceptual article uses the tools of Pierre Bourdieu (1977, 1986, 1990) to examine the socialization of doctoral students by suggesting that the processes of doctoral study highlight inequities among students. Using Young's (1990) social justice approach as a framework to complement the ideas of Bourdieu, I demonstrate how aspects of academic…

Child Development and the Coworking of Doctor and Teacher: A Waldorf School Doctor's Perspective.

Science.gov (United States)

Karnow, Gerald F.

This paper draws on the nearly 20 years' experiences of a school doctor working with teachers at the Rudolf Steiner School in New York City to describe general principles of assessing child development in relation to educational progress. The paper contrasts the customary role of school doctors (related to conducting physical examinations for…

Analysing the doctor_patient_computer relationship: the use of video data

Directory of Open Access Journals (Sweden)

Christopher Pearce

2006-12-01

Full Text Available This paper examines the utility of using digital video data in observational studies involving doctors' and patients' use of computers in the consultation. Previous observational studies have used either direct observations or analogue videotapes. We describe a method currently in use in a study examining how doctors, patients and computers interact in the consultation. The study is set in general practice as this is the most clinically computerised section of the Australian healthcare system. Computers are now used for clinical functions in 90% of doctors' surgeries. With this rapid rise of computerisation, concerns have been expressed as to how the computer will affect the doctor_patient relationship. To assess how doctors, patients and computers interact, we have chosen an observational technique, namely to make digital videotapes of actual consultations. This analysis is based on a theoretical framework derived from dramaturgical analysis. Data are gathered from general practitioners who are high-level users of computers, as defined by their use of progress notes, as well as prescribing and test ordering. The subsequent digital data is then transferred onto computer and analysed according to our conceptual framework, making use of video-tagging software.

URGENT NEED OF A DOCTOR

CERN Multimedia

Medical Service

2001-01-01

IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGAD 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European EmergencyCall 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will...

The Cape doctor 1807-1910: perspectives.

Science.gov (United States)

Phillips, Howard

2004-01-01

This chapter contrasts the Cape doctor in 1807 and in 1910, and finds that, in a whole variety of ways, the differences between the two were not of degree but of kind. Underlying this sea-change was the germ revolution of the late Victorian era, which transformed the Cape doctor out of all recognition, thereby laying important foundations for the development of the twentieth-century South African doctor.

Dynamical System Approaches to Combinatorial Optimization

DEFF Research Database (Denmark)

Starke, Jens

2013-01-01

of large times as an asymptotically stable point of the dynamics. The obtained solutions are often not globally optimal but good approximations of it. Dynamical system and neural network approaches are appropriate methods for distributed and parallel processing. Because of the parallelization......Several dynamical system approaches to combinatorial optimization problems are described and compared. These include dynamical systems derived from penalty methods; the approach of Hopfield and Tank; self-organizing maps, that is, Kohonen networks; coupled selection equations; and hybrid methods...... thereof can be used as models for many industrial problems like manufacturing planning and optimization of flexible manufacturing systems. This is illustrated for an example in distributed robotic systems....

Dynamical systems examples of complex behaviour

CERN Document Server

Jost, Jürgen

2005-01-01

Our aim is to introduce, explain, and discuss the fundamental problems, ideas, concepts, results, and methods of the theory of dynamical systems and to show how they can be used in speci?c examples. We do not intend to give a comprehensive overview of the present state of research in the theory of dynamical systems, nor a detailed historical account of its development. We try to explain the important results, often neglecting technical re?nements 1 and, usually, we do not provide proofs. One of the basic questions in studying dynamical systems, i.e. systems that evolve in time, is the construction of invariants that allow us to classify qualitative types of dynamical evolution, to distinguish between qualitatively di?erent dynamics, and to studytransitions between di?erent types. Itis also important to ?nd out when a certain dynamic behavior is stable under small perturbations, as well as to understand the various scenarios of instability. Finally, an essential aspect of a dynamic evolution is the transformat...

Functional System Dynamics

OpenAIRE

Ligterink, N.E.

2007-01-01

Functional system dynamics is the analysis, modelling, and simulation of continuous systems usually described by partial differential equations. From the infinite degrees of freedom of such systems only a finite number of relevant variables have to be chosen for a practical model description. The proper input and output of the system are an important part of the relevant variables.

MADNESS AND METHOD: THE SYSTEM OF DOCTOR TARR AND PROFESSOR FETHER

Directory of Open Access Journals (Sweden)

Luciane Alves Santos

2014-12-01

Full Text Available The present study aims to discuss the theme of madness, comparing the narrator’s perspective in “The System of Doctor Tarr and Professor Fether” (1845 and another short stories by Edgar Allan Poe. The analysis illustrates that science in the 19th century aims to remove the fear of the unknown, dominating the natural world and its laws; and that fiction, the presumptive opposite, represents an extension of the same logic under another name. Some writers denied any obligation of loyalty to scientific rationalism and tried to decipher this problem through the dream and the supernatural. Fantastic works of Gothic fiction – Hoffmann’s novels and some of Poe’s stories – illuminate these points. Poe reinterprets the Gothic in the Victorian Age, with an unnamed and often unreliable narrator that insists on his rationality. The comic and grotesque horror result of the psychology of his characters often descended into madness. 

Adaptive Integration of Nonsmooth Dynamical Systems

Science.gov (United States)

2017-10-11

2017 W911NF-12-R-0012-03: Adaptive Integration of Nonsmooth Dynamical Systems The views, opinions and/or findings contained in this report are those of...Integration of Nonsmooth Dynamical Systems Report Term: 0-Other Email: drum@gwu.edu Distribution Statement: 1-Approved for public release; distribution is...classdrake_1_1systems_1_1_integrator_base.html ; 3) a solver for dynamical systems with arbitrary unilateral and bilateral constraints (the key component of the time stepping systems )- see

The possibility of establishing a doctoral programme in archive studies

Directory of Open Access Journals (Sweden)

Waldemar Chorążyczewski

2013-03-01

Full Text Available Doctor studies have been included into formalised education system as a third cycle studies. In the light of ministerial regulations, the archive studies doctoral program ought to encompass classes on archives, methodology of sciences, didactics of higher education studies, the social role of an academic, conducting student internship. Does this mean, that a doctoral seminar in archive studies is excessive? On the contrary, the seminar seems to be the best place to bequeath knowledge and skills on methodology and the proper attitude of a scholar, in awareness of his or her role in the society.By these standards, the seminar should be understood not solely as a place to forge doctoral theses, but also as a site on which to conduct discussion with one's academic authorities and advisors and guest experts; it also should be the key class, taking up the most of the timetable. The validity of preparing an archivist for the role of a university teacher has been questioned.Both the profile of the doctor courses and observation of their effectiveness has led us to believe informal seminar to be the better way of doctoral education for archive students. Perhaps though, the kind of steps, that must be taken if doctor course on archive studies was to be created, is worth considering. Is there a chance, and, is it worth striving for the archive studies to be an independent department? It would not only mean opening doctor programmes, but also the right confer a PhD degree in Humanities, on the subject of archive studies, and not history, as it has hitherto been done. The archive studies have definite research subject, range and methodology. What is noticeable is a kind of archival sensitivity, that allows for all the users and all the purposes for using the resources to be on equal rights. Archive studies have matured, and it is ready to become an independent academic discipline. Thereby, it can be expected, that at last, it's maturity will be put to good

Butschli Dynamic Droplet System

DEFF Research Database (Denmark)

Armstrong, R.; Hanczyc, M.

2013-01-01

Dynamical oil-water systems such as droplets display lifelike properties and may lend themselves to chemical programming to perform useful work, specifically with respect to the built environment. We present Butschli water-in-oil droplets as a model for further investigation into the development...... reconstructed the Butschli system and observed its life span under a light microscope, observing chemical patterns and droplet behaviors in nearly three hundred replicate experiments. Self-organizing patterns were observed, and during this dynamic, embodied phase the droplets provided a means of introducing...... temporal and spatial order in the system with the potential for chemical programmability. The authors propose that the discrete formation of dynamic droplets, characterized by their lifelike behavior patterns, during a variable window of time (from 30 s to 30 min after the addition of alkaline water...

Toxoplasmosis - Awareness and knowledge among medical doctors in Nigeria.

Science.gov (United States)

Efunshile, Akinwale Michael; Elikwu, Charles John; Jokelainen, Pikka

2017-01-01

Toxoplasma gondii is a zoonotic parasite causing high disease burden worldwide. A One Health approach is needed to understand, prevent, and control toxoplasmosis, while knowledge gaps in the One Health aspects have been identified among medical professionals in earlier studies. As a One Health collaboration between veterinary and medical fields, we surveyed the knowledge on toxoplasmosis among medical doctors in Nigeria. The knowledge questions, which the participants answered without consulting literature and colleagues, covered epidemiological One Health aspects as well as clinical interspecialty aspects of T. gondii infections. Altogether 522 medical doctors from four tertiary hospitals completed the questionnaire. The mean number of correct answers in the knowledge questions was 7.5, and 8.4% of the participants selected at least 12 of the 17 correct answers. The proportion of medical doctors scoring such a high score was significantly higher among those who reported having seen a case of clinical toxoplasmosis than in those who did not. While 62% of the medical doctors participating in our study knew that cats can shed T. gondii in their feces, 36% incorrectly suggested that humans could do that too. That T. gondii infection can be meatborne was known by 69%, but that it can be also waterborne only by 28% of the medical doctors participating in our study. Most of the medical doctors, 78%, knew that clinical toxoplasmosis may involve the central nervous system, while only 37% answered that it can involve the eyes. Our results suggested knowledge gaps, which need to be addressed in Continuous Medical Education. The identified gaps included both intersectoral One Health aspects and interspecialty aspects: For prevention and management of toxoplasmosis, knowing the main transmission routes and that the parasite can affect several organs is relevant.

Female physicist doctoral experiences

OpenAIRE

Katherine P. Dabney; Robert H. Tai

2013-01-01

The underrepresentation of women in physics doctorate programs and in tenured academic positions indicates a need to evaluate what may influence their career choice and persistence. This qualitative paper examines eleven females in physics doctoral programs and professional science positions in order to provide a more thorough understanding of why and how women make career choices based on aspects both inside and outside of school and their subsequent interaction. Results indicate that female...

Quantum dynamics in open quantum-classical systems.

Science.gov (United States)

Kapral, Raymond

2015-02-25

Often quantum systems are not isolated and interactions with their environments must be taken into account. In such open quantum systems these environmental interactions can lead to decoherence and dissipation, which have a marked influence on the properties of the quantum system. In many instances the environment is well-approximated by classical mechanics, so that one is led to consider the dynamics of open quantum-classical systems. Since a full quantum dynamical description of large many-body systems is not currently feasible, mixed quantum-classical methods can provide accurate and computationally tractable ways to follow the dynamics of both the system and its environment. This review focuses on quantum-classical Liouville dynamics, one of several quantum-classical descriptions, and discusses the problems that arise when one attempts to combine quantum and classical mechanics, coherence and decoherence in quantum-classical systems, nonadiabatic dynamics, surface-hopping and mean-field theories and their relation to quantum-classical Liouville dynamics, as well as methods for simulating the dynamics.

[Academician Li Lianda talking about doctors doing scientific research].

Science.gov (United States)

He, Ping; Li, Yi-kui

2015-09-01

At present, Chinese medical field faces with an important problem of how to correctly handle the relationship between medical and scientific research. Academician Li Lianda advocates doctors doing scientific research under the premise of putting the medical work first. He points out that there are many problems in the process of doctors doing scientific research at present such as paying more attention to scientific research than medical care, excessively promoting building scientific research hospital, only paying attention to training scientific talents, research direction be flashy without substance, the medical evaluation system should be improved and so on. Medical, scientific research and teaching are inseparable because improving medical standards depends on scientific research and personnel training. But not all doctors need to take into account of medical treatment, scientific research and teaching in the same degree while not all hospitals need to turn into three-in-one hospital, scientific research hospital or teaching hospital. It must be treated differently according to the actual situation.

Hybrid Doctoral Program: Innovative Practices and Partnerships

Science.gov (United States)

Alvich, Dori; Manning, JoAnn; McCormick, Kathy; Campbell, Robert

2012-01-01

This paper reflects on how one mid-Atlantic University innovatively incorporated technology into the development of a hybrid doctoral program in educational leadership. The paper describes a hybrid doctoral degree program using a rigorous design; challenges of reworking a traditional syllabus of record to a hybrid doctoral program; the perceptions…

Cultural and musical activity among Norwegian doctors.

Science.gov (United States)

Nylenna, Magne; Aasland, Olaf Gjerløw

2013-06-25

The cultural and musical activity of Norwegian doctors was studied in 1993. We wished to re-examine their cultural and musical activity, analyse the development and study the correlation with satisfaction, health and other leisure activities. In the autumn of 2010, a survey was undertaken among a representative sample of economically active Norwegian doctors. The survey asked the same questions as in 1993, and the responses were also compared to the population studies conducted by Statistics Norway. We also used a cultural index that we have developed ourselves. Altogether 1,019 doctors (70%) responded to the survey. They reported a higher level of cultural activity in 2010 than in 1993, measured in terms of reading of non-medical literature and visits to the cinema, theatre and concerts. The doctors engaged in musical activity of their own especially frequently: 58% reported to be able to play an instrument, and 21% reported to play on a regular basis, which is more than among other academic professions. We found a significant correlation between the doctors' level of cultural activity and their job satisfaction, general satisfaction, self-reported health and physical activity. The doctors who engage most frequently in cultural activities are thus most satisfied with their work and with life in general. Furthermore, they also have better self-reported health. Norwegian doctors give priority to cultural and musical activities. The assertion that doctors are particularly fond of music is more than just a myth.

Will Medical Technology Deskill Doctors?

Science.gov (United States)

Lu, Jingyan

2016-01-01

This paper discusses the impact of medical technology on health care in light of the fact that doctors are becoming more reliant on technology for obtaining patient information, making diagnoses and in carrying out treatments. Evidence has shown that technology can negatively affect doctor-patient communications, physical examination skills, and…

Doctorate Program Trains Industrial Chemists.

Science.gov (United States)

Chemical and Engineering News, 1982

1982-01-01

The University of Texas (Dallas) has initiated a new Ph.D. program specifically to train chemists for doctoral level work in industry (Doctor of Chemistry). Participants will complete three research practica (at an industrial site and in two laboratory settings) instead of the traditional dissertation, emphasizing breadth and flexibility in…

Dynamics of glassy systems

International Nuclear Information System (INIS)

Cugliandolo, Leticia F.

2003-09-01

These lecture notes can be read in two ways. The first two Sections contain a review of the phenomenology of several physical systems with slow nonequilibrium dynamics. In the Conclusions we summarize the scenario for this temporal evolution derived from the solution to some solvable models (p spin and the like) that are intimately connected to the mode coupling approach (and similar ones) to super-cooled liquids. At the end we list a number of open problems of great relevance in this context. These Sections can be read independently of the body of the paper where we present some of the basic analytic techniques used to study the out of equilibrium dynamics of classical and quantum models with and without disorder. We start the technical part by briefly discussing the role played by the environment and by introducing and comparing its representation in the equilibrium and dynamic treatment of classical and quantum systems. We next explain the role played by explicit quenched disorder in both approaches. Later on we focus on analytical techniques; we expand on the dynamic functional methods, and the diagrammatic expansions and resummations used to derive macroscopic equations from the microscopic dynamics. We show why the macroscopic dynamic equations for disordered models and those resulting from self-consistent approximations to non-disordered ones coincide. We review some generic properties of dynamic systems evolving out of equilibrium like the modifications of the fluctuation-dissipation theorem, generic scaling forms of the correlation functions, etc. Finally we solve a family of mean-field models. The connection between the dynamic treatment and the analysis of the free-energy landscape of these models is also presented. We use pedagogical examples all along these lectures to illustrate the properties and results. (author)

Did you hear the one about the doctor? An examination of doctor jokes posted on Facebook.

Science.gov (United States)

Davis, Matthew A; Haney, Carol Sue; Weeks, William B; Sirovich, Brenda E; Anthony, Denise L

2014-02-13

Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues. We sought to explore doctor-related humor by examining doctor jokes posted on Facebook. We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month observation period (December 15, 2010 to June 16, 2011). We compared characteristics of so-called jokers to nonjokers and identified the characteristics of jokes that predicted joke success measured by having elicited at least one electronic laugh (eg, an LOL or "laughing out loud") as well as the total number of Facebook "likes" the joke received. Jokers told 156 unique doctor jokes and were the same age as nonjokers but had larger social networks (median Facebook friends 227 vs 132, PFacebook likes (rate ratio [RR] 2.36, 95% CI 0.97-5.74). This study provides insight into the use of social networking sites for research pertaining to health and medicine, including the world of doctor-related humor.

For People with Osteoporosis: How to Find a Doctor

Science.gov (United States)

... With Osteoporosis: How to Find a Doctor For People With Osteoporosis: How to Find a Doctor Isabel ... a doctor with expertise in osteoporosis. For many people, finding a doctor who is knowledgeable about osteoporosis ...

Cholesterol - what to ask your doctor

Science.gov (United States)

... your doctor; What to ask your doctor about cholesterol ... What is my cholesterol level? What should my cholesterol level be? What are HDL ("good") cholesterol and LDL ("bad") cholesterol? Does my cholesterol ...

Dynamical systems, attractors, and neural circuits.

Science.gov (United States)

Miller, Paul

2016-01-01

Biology is the study of dynamical systems. Yet most of us working in biology have limited pedagogical training in the theory of dynamical systems, an unfortunate historical fact that can be remedied for future generations of life scientists. In my particular field of systems neuroscience, neural circuits are rife with nonlinearities at all levels of description, rendering simple methodologies and our own intuition unreliable. Therefore, our ideas are likely to be wrong unless informed by good models. These models should be based on the mathematical theories of dynamical systems since functioning neurons are dynamic-they change their membrane potential and firing rates with time. Thus, selecting the appropriate type of dynamical system upon which to base a model is an important first step in the modeling process. This step all too easily goes awry, in part because there are many frameworks to choose from, in part because the sparsely sampled data can be consistent with a variety of dynamical processes, and in part because each modeler has a preferred modeling approach that is difficult to move away from. This brief review summarizes some of the main dynamical paradigms that can arise in neural circuits, with comments on what they can achieve computationally and what signatures might reveal their presence within empirical data. I provide examples of different dynamical systems using simple circuits of two or three cells, emphasizing that any one connectivity pattern is compatible with multiple, diverse functions.

Women, Men and the Doctorate.

Science.gov (United States)

Centra, John A; Kuykendall, Nancy M.

This study describes the current status and professional development of a sample of women doctorates and compares them to a sample of men who have attained the same educational status. Chapters cover the sample and procedures used; employment patterns; doctorates in academe; publications, income, and job satisfaction; marriage and family life;…

Doctoral Education

DEFF Research Database (Denmark)

Ridder, Hanne Mette Ochsner

2015-01-01

Doctoral education covers the “third cycle” of degrees following the bachelor’s and the master’s degree. The education of researchers is necessary for developing music therapy as a scientific discipline and calls for a certain research culture that not only brings knowledge on research...... with an integration of science and practice. This leads to a description of the principles of problem-based learning as a social constructive approach, problematization, self-directed learning and learning community. The chapter is concluded with an example of a model of doctoral education, the Aalborg model, where...... the coursework, supervision, and curriculum is based on problem-based learning. About the book: 'International Perspectives in Music Therapy Education and Training: Adapting to a Changing World,' the first anthology of its kind, edited by Professor Karen Goodman, brings noted educators from Brazil, Canada...

"Seeing a doctor is just like having a date": a qualitative study on doctor shopping among overactive bladder patients in Hong Kong.

Science.gov (United States)

Siu, Judy Yuen-Man

2014-02-06

Although having a regular primary care provider is noted to be beneficial to health, doctor shopping has been documented as a common treatment seeking behavior among chronically ill patients in different countries. However, little research has been conducted into the reasons behind doctor shopping behavior among patients with overactive bladder, and even less into how this behavior relates to these patients' illness and social experiences, perceptions, and cultural practices. Therefore, this study examines overactive bladder patients to investigate the reasons behind doctor shopping behavior. My study takes a qualitative approach, conducting 30 semi-structured individual interviews, with 30 overactive bladder patients in Hong Kong. My study found six primary themes that influenced doctor shopping behavior: lack of perceived need, convenience, work-provided medical insurance, unpleasant experiences with doctors, searching for a match doctor, and switching between biomedicine and traditional Chinese medicine. Besides the perceptual factors, participants' social environment, illness experiences, personal cultural preference, and cultural beliefs also intertwined to generate their doctor shopping behavior. Due to the low perceived need for a regular personal primary care physician, environmental factors such as time, locational convenience, and work-provided medical insurance became decisive in doctor shopping behavior. Patients' unpleasant illness experiences, stemming from a lack of understanding among many primary care doctors about overactive bladder, contributed to participants' sense of mismatch with these doctors, which induced them to shop for another doctor. Overactive bladder is a chronic bladder condition with very limited treatment outcome. Although patients with overactive bladder often require specialty urology treatment, it is usually beneficial for the patients to receive continuous, coordinated, comprehensive, and patient-centered support from their

Dynamic Stability Experiment of Maglev Systems,

Science.gov (United States)

1995-04-01

This report summarizes the research performed on maglev vehicle dynamic stability at Argonne National Laboratory during the past few years. It also... maglev system, it is important to consider this phenomenon in the development of all maglev systems. This report presents dynamic stability experiments...on maglev systems and compares their numerical simulation with predictions calculated by a nonlinear dynamic computer code. Instabilities of an

Investigation of the relationship between convenient visits and doctors' fatigue using burnout and work engagement scales.

Science.gov (United States)

Matsumoto, Yuuki; Hoshiko, Michiko; Morimatsu, Yoshitaka; Mori, Mihoko; Kushino, Nanae; Ishitake, Tatsuya

2015-01-01

Fatigue caused by high workload is often responsible for the high attrition among doctors, and has contributed to a disruption in community medicine. In order to address this problem, institutional mechanisms at the hospital level are required. Previous studies have shown that systemic measures at the hospital level and a change in the mindset of patients can help manage the problem. "Convenient visits" refer to emergency visits for non-emergency problems. It is an avoidable cause of high workload on doctors. Convenient visits also refer to emergency consultation for non-emergency symptoms. As this is a new phenomenon, its relationship with doctors' fatigue needs further research. We investigated the relationship between convenient visits and doctors' fatigue using burnout and work engagement scales. We selected 44 hospitals, with >200 beds each, in provincial cities of prefectures with a doctor-population ratio lower than the national average. These cities were considered likely to manifest the phenomenon of 24-hour society and include overworked doctors. Ordinance-designated cities were excluded from this study owing to wide population variability. Three doctors from each hospital were randomly selected from among physicians, surgeons, and pediatricians. We distributed questionnaires (a questionnaire concerning convenient visits, Maslach Burnout Inventory-Human Services Survey, and Utrecht Work Engagement Scale) to 132 doctors. Forty-two doctors responded to the survey. The median proportion of convenient visits among emergency visits was 50%. Sixty percent of the doctors surveyed were annoyed by convenient visits. Other doctors indicated good collaboration between the hospitals and communities or that they were not currently annoyed by convenient visits, although they had been annoyed previously. The emotional exhaustion in doctors, who worked in hospitals that did not restrict convenient visits, was significantly higher than in those who worked in hospitals

Dynamical systems

CERN Document Server

Birkhoff, George D

1927-01-01

His research in dynamics constitutes the middle period of Birkhoff's scientific career, that of maturity and greatest power. -Yearbook of the American Philosophical Society The author's great book€¦is well known to all, and the diverse active modern developments in mathematics which have been inspired by this volume bear the most eloquent testimony to its quality and influence. -Zentralblatt MATH In 1927, G. D. Birkhoff wrote a remarkable treatise on the theory of dynamical systems that would inspire many later mathematicians to do great work. To a large extent, Birkhoff was writing about his o

Doctoral Program Selection Using Pairwise Comparisons.

Science.gov (United States)

Tadisina, Suresh K.; Bhasin, Vijay

1989-01-01

The application of a pairwise comparison methodology (Saaty's Analytic Hierarchy Process) to the doctoral program selection process is illustrated. A hierarchy for structuring and facilitating the doctoral program selection decision is described. (Author/MLW)

Doctor and pharmacy shopping for controlled substances.

Science.gov (United States)

Peirce, Gretchen L; Smith, Michael J; Abate, Marie A; Halverson, Joel

2012-06-01

Prescription drug abuse is a major health concern nationwide, with West Virginia having one of the highest prescription drug death rates in the United States. Studies are lacking that compare living subjects with persons who died from drug overdose for evidence of doctor and pharmacy shopping for controlled substances. The study objectives were to compare deceased and living subjects in West Virginia for evidence of prior doctor and pharmacy shopping for controlled substances and to identify factors associated with drug-related death. A secondary data study was conducted using controlled substance, Schedule II-IV, prescription data from the West Virginia Controlled Substance Monitoring Program and drug-related death data compiled by the Forensic Drug Database between July 2005 and December 2007. A case-control design compared deceased subjects 18 years and older whose death was drug related with living subjects for prior doctor and pharmacy shopping. Logistic regression identified factors related to the odds of drug-related death. A significantly greater proportion of deceased subjects were doctor shoppers (25.21% vs. 3.58%) and pharmacy shoppers (17.48% vs. 1.30%) than living subjects. Approximately 20.23% of doctor shoppers were also pharmacy shoppers, and 55.60% of pharmacy shoppers were doctor shoppers. Younger age, greater number of prescriptions dispensed, exposure to opioids and benzodiazepines, and doctor and pharmacy shopping were factors with greater odds of drug-related death. Doctor and pharmacy shopping involving controlled substances were identified, and shopping behavior was associated with drug-related death. Prescription monitoring programs may be useful in identifying potential shoppers at the point of care.

Angina - what to ask your doctor

Science.gov (United States)

What to ask your doctor about angina and heart disease; Coronary artery disease - what to ask your doctor ... the signs and symptoms that I am having angina? Will I always have the same symptoms? What ...

Measuring costs of data collection at village clinics by village doctors for a syndromic surveillance system-a cross sectional survey from China.

Science.gov (United States)

Ding, Yan; Fei, Yang; Xu, Biao; Yang, Jun; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin

2015-07-25

Studies into the costs of syndromic surveillance systems are rare, especially for estimating the direct costs involved in implementing and maintaining these systems. An Integrated Surveillance System in rural China (ISSC project), with the aim of providing an early warning system for outbreaks, was implemented; village clinics were the main surveillance units. Village doctors expressed their willingness to join in the surveillance if a proper subsidy was provided. This study aims to measure the costs of data collection by village clinics to provide a reference regarding the subsidy level required for village clinics to participate in data collection. We conducted a cross-sectional survey with a village clinic questionnaire and a staff questionnaire using a purposive sampling strategy. We tracked reported events using the ISSC internal database. Cost data included staff time, and the annual depreciation and opportunity costs of computers. We measured the village doctors' time costs for data collection by multiplying the number of full time employment equivalents devoted to the surveillance by the village doctors' annual salaries and benefits, which equaled their net incomes. We estimated the depreciation and opportunity costs of computers by calculating the equivalent annual computer cost and then allocating this to the surveillance based on the percentage usage. The estimated total annual cost of collecting data was 1,423 Chinese Renminbi (RMB) in 2012 (P25 = 857, P75 = 3284), including 1,250 RMB (P25 = 656, P75 = 3000) staff time costs and 134 RMB (P25 = 101, P75 = 335) depreciation and opportunity costs of computers. The total costs of collecting data from the village clinics for the syndromic surveillance system was calculated to be low compared with the individual net income in County A.

Australian doctors and the visual arts. Part 2. Doctors as collectors, donors, gallery supporters and writers in New South Wales.

Science.gov (United States)

Hamilton, D G

1986-04-28

The contribution of doctors to the visual arts if being discussed in a series of six articles. The first article dealt with doctor-artists in new South Wales. In this, the second, doctors are discussed as collectors, donors, gallery supporters and writers in this State.

Dynamics of unstable systems

International Nuclear Information System (INIS)

Posch, H.A.; Narnhofer, H.; Thirring, W.

1990-01-01

We study the dynamics of classical particles interacting with attractive Gaussian potentials. This system is thermodynamically not stable and exhibits negative specific heat. The results of the computer simulation of the dynamics are discussed in comparison with various theories. In particular, we find that the condensed phase is a stationary solution of the Vlasov equation, but the Vlasov dynamics cannot describe the collapse. 14 refs., 1 tab., 11 figs. (Authors)

Multibody system dynamics, robotics and control

CERN Document Server

Gerstmayr, Johannes

2013-01-01

The volume contains 19 contributions by international experts in the field of multibody system dynamics, robotics and control. The book aims to bridge the gap between the modeling of mechanical systems by means of multibody dynamics formulations and robotics. In the classical approach, a multibody dynamics model contains a very high level of detail, however, the application of such models to robotics or control is usually limited. The papers aim to connect the different scientific communities in multibody dynamics, robotics and control. Main topics are flexible multibody systems, humanoid robots, elastic robots, nonlinear control, optimal path planning, and identification.

Modular interdependency in complex dynamical systems.

Science.gov (United States)

Watson, Richard A; Pollack, Jordan B

2005-01-01

Herbert A. Simon's characterization of modularity in dynamical systems describes subsystems as having dynamics that are approximately independent of those of other subsystems (in the short term). This fits with the general intuition that modules must, by definition, be approximately independent. In the evolution of complex systems, such modularity may enable subsystems to be modified and adapted independently of other subsystems, whereas in a nonmodular system, modifications to one part of the system may result in deleterious side effects elsewhere in the system. But this notion of modularity and its effect on evolvability is not well quantified and is rather simplistic. In particular, modularity need not imply that intermodule dependences are weak or unimportant. In dynamical systems this is acknowledged by Simon's suggestion that, in the long term, the dynamical behaviors of subsystems do interact with one another, albeit in an "aggregate" manner--but this kind of intermodule interaction is omitted in models of modularity for evolvability. In this brief discussion we seek to unify notions of modularity in dynamical systems with notions of how modularity affects evolvability. This leads to a quantifiable measure of modularity and a different understanding of its effect on evolvability.

"Seeing a doctor is just like having a date": a qualitative study on doctor shopping among overactive bladder patients in Hong Kong

Science.gov (United States)

2014-01-01

Background Although having a regular primary care provider is noted to be beneficial to health, doctor shopping has been documented as a common treatment seeking behavior among chronically ill patients in different countries. However, little research has been conducted into the reasons behind doctor shopping behavior among patients with overactive bladder, and even less into how this behavior relates to these patients’ illness and social experiences, perceptions, and cultural practices. Therefore, this study examines overactive bladder patients to investigate the reasons behind doctor shopping behavior. Methods My study takes a qualitative approach, conducting 30 semi-structured individual interviews, with 30 overactive bladder patients in Hong Kong. Results My study found six primary themes that influenced doctor shopping behavior: lack of perceived need, convenience, work-provided medical insurance, unpleasant experiences with doctors, searching for a match doctor, and switching between biomedicine and traditional Chinese medicine. Besides the perceptual factors, participants’ social environment, illness experiences, personal cultural preference, and cultural beliefs also intertwined to generate their doctor shopping behavior. Due to the low perceived need for a regular personal primary care physician, environmental factors such as time, locational convenience, and work-provided medical insurance became decisive in doctor shopping behavior. Patients’ unpleasant illness experiences, stemming from a lack of understanding among many primary care doctors about overactive bladder, contributed to participants’ sense of mismatch with these doctors, which induced them to shop for another doctor. Conclusions Overactive bladder is a chronic bladder condition with very limited treatment outcome. Although patients with overactive bladder often require specialty urology treatment, it is usually beneficial for the patients to receive continuous, coordinated

The national and international implications of a decade of doctor migration in the Irish context.

LENUS (Irish Health Repository)

Bidwell, Posy

2012-12-17

BACKGROUND: Between 2000 and 2010, Ireland became increasingly dependent on foreign-trained doctors to staff its health system. An inability to train and retain sufficient doctors to meet demand is the primary reason for the dependence on foreign-trained doctors. By 2008 the proportion of foreign-trained doctors was the second highest in the OECD. This increased dependence on international medical migration has both national and international policy implications. METHODS: Registration data were obtained from the Medical Council of Ireland (MCI) for a 10-year period: 2000-2010. Data indicate country of qualification but not nationality. The total number of registrants and entrants (n) was determined for each year. Immigration data were also obtained on the number of work visas issued to doctors. Registration and visa data were then compared in order to estimate doctor migration to Ireland 2000-2010. RESULTS: The proportion of foreign-trained doctors rose from 13.4% of all registered doctors in 2000 to 33.4% by 2010. The largest increase was in foreign-trained doctors from outside the EU, rising from 972 (7.4%) in 2000 to 4740 (25.3%) of registered doctors in 2010. The biggest source country in 2000 was Pakistan. By 2010, South Africa had become the biggest source country. The number of foreign-trained doctors from other EU countries doubled from 780 in 2000 to 1521 in 2010. CONCLUSIONS: Registration data are likely to over-estimate and visa data under-estimate the numbers of doctors actively working in Ireland. However, they serve to illustrate Ireland\\'s rapidly increasing and potentially unsustainable reliance on foreign-trained doctors; and to highlight the need for better data to measure migratory flows. Improved measurement of health worker migration is necessary both for national workforce planning and to fulfil the requirements of the WHO Global Code on the International Recruitment of Health Personnel.

Applying a typology of health worker migration to non-EU migrant doctors in Ireland.

Science.gov (United States)

Humphries, Niamh; McAleese, Sara; Tyrrell, Ella; Thomas, Steve; Normand, Charles; Brugha, Ruairí

2015-06-26

Research on health worker migration in the Irish context has categorized migrant health workers by country or region of training (for example, non-EU nurses or doctors) or recruitment mechanism (for example, actively recruited nurses). This paper applies a new typology of health worker migrants - livelihood, career-oriented, backpacker, commuter, undocumented and returner migrants (European Observatory on Health Systems and Policies and WHO, vol. 2:129-152, 2014) - to the experiences of non-EU migrant doctors in Ireland and tests its utility for understanding health worker migration internationally. The paper draws on quantitative survey (N = 366) and qualitative interview (N = 37) data collected from non-EU migrant doctors in Ireland between 2011 and 2013. Categorizing non-EU migrant doctors in Ireland according to the typology (European Observatory on Health Systems and Policies and WHO, vol. 2:129-152, 2014) offers insight into their differing motivations, particularly on arrival. Findings suggest that the career-oriented migrant is the most common type of doctor among non-EU migrant doctor respondents, accounting for 60 % (N = 220) of quantitative and 54 % (N = 20) of qualitative respondents. The authors propose a modification to the typology via the addition of two additional categories - the family migrant and the safety and security migrant. Employing a typology of health worker migration can facilitate a more comprehensive understanding of the migrant medical workforce, a necessary prerequisite for the development of useful policy tools (European Observatory on Health Systems and Policies and WHO, vol. 2:129-152, 2014). The findings indicate that there is some fluidity between categories, as health worker motivations change over time. This indicates the potential for policy levers to influence migrant health worker decision-making, if they are sufficiently "tuned in" to migrant health worker motivation.

Patient perception of smartphone usage by doctors

Directory of Open Access Journals (Sweden)

Kerry G

2017-03-01

Full Text Available Georgina Kerry,1 Shyam Gokani,2 Dara Rasasingam,2 Alexander Zargaran,3 Javier Ash,2 Aaina Mittal2 1College of Medical and Dental Sciences, University of Birmingham, Birmingham, 2Faculty of Medicine, Imperial College London, London, 3Faculty of Medicine, St George’s University of London, London, UK Abstract: Technological advancements have revolutionized modern medicine and smartphones are now ubiquitous among health care professionals. The ability to look up information promptly is invaluable to doctors and medical students alike, but there is an additional contiguous benefit to patients. Queries can be answered more accurately through fingertip access to evidence-based medicine, and physicians have instant access to emergency care protocols. However, is consideration always extended to the patient’s perception of the use of smartphones by doctors? Do patients know why we use smartphones to assist us in their care? What do they think when they see a doctor using a smartphone?An independent question, conducted within a wider service evaluation (ethical approval not required, full verbal and written electronic consent provided by all patients at St. Mary’s Hospital, London, indicated that although the majority (91.0% of patients owned a smartphone, many (61.6% did not agree that the use of smartphones at work by doctors is professional. This highlights the potential for damage to the doctor–patient relationship. There is a risk that these patients will disconnect with care services with possible detriment to their health. Additionally, it is notable that a larger proportion of those patients aged >70 years found the use of smartphones by doctors at work unprofessional, compared with patients aged <70 years.Adequate communication between the doctor and patient is critical in ensuring that doctors can make use of modern technology to provide the best possible care and that patients are comfortable with this and do not feel isolated or

[Burnout among doctors and its correlations with health, life satisfaction and sleep].

Science.gov (United States)

Németh, Anikó

2016-04-17

Burnout is common among health care providers and doctors. The correlations between burnout and health, psychosomatic symptoms, life satisfaction and sleep were investigated. An online quantitative cross-sectional questionnaire was administered to 186 doctors. Burnout was assessed by the means of the 21-item questionnaire of Pines and Aronson (1981). Data were analysed with chi-square probe, Mann-Whitney test, correlational analysis and linear regression. Level of burnout correlated negatively with age (p = 0.040; r = -0.151), years spent in the health care system (p = 0.027; r = -0.162) and positive well-being (pwell-being (plife satisfaction (p<0.001; r = -0.532). Doctors with burnout reported worse health (p<0.001), more frequent psychosomatic symptoms (p<0.001), tumours (p = 0.007), allergies (p = 0.030), psychiatric disorders (p = 0.025) and sleep disturbances. One-third of the doctors were affected by burnout in the present study. Higher age and having more children served as a protective factor.

Constraint Embedding for Multibody System Dynamics

Science.gov (United States)

Jain, Abhinandan

2009-01-01

This paper describes a constraint embedding approach for the handling of local closure constraints in multibody system dynamics. The approach uses spatial operator techniques to eliminate local-loop constraints from the system and effectively convert the system into tree-topology systems. This approach allows the direct derivation of recursive O(N) techniques for solving the system dynamics and avoiding the expensive steps that would otherwise be required for handling the closedchain dynamics. The approach is very effective for systems where the constraints are confined to small-subgraphs within the system topology. The paper provides background on the spatial operator O(N) algorithms, the extensions for handling embedded constraints, and concludes with some examples of such constraints.

Operationalizing sustainability in urban coastal systems: a system dynamics analysis.

Science.gov (United States)

Mavrommati, Georgia; Bithas, Kostas; Panayiotidis, Panayiotis

2013-12-15

We propose a system dynamics approach for Ecologically Sustainable Development (ESD) in urban coastal systems. A systematic analysis based on theoretical considerations, policy analysis and experts' knowledge is followed in order to define the concept of ESD. The principles underlying ESD feed the development of a System Dynamics Model (SDM) that connects the pollutant loads produced by urban systems' socioeconomic activities with the ecological condition of the coastal ecosystem that it is delineated in operational terms through key biological elements defined by the EU Water Framework Directive. The receiving waters of the Athens Metropolitan area, which bears the elements of typical high population density Mediterranean coastal city but which currently has also new dynamics induced by the ongoing financial crisis, are used as an experimental system for testing a system dynamics approach to apply the concept of ESD. Systems' thinking is employed to represent the complex relationships among the components of the system. Interconnections and dependencies that determine the potentials for achieving ESD are revealed. The proposed system dynamics analysis can facilitate decision makers to define paths of development that comply with the principles of ESD. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Aharonov-Anandan phase of a classical dynamical system seen mathematically as a quantum dynamical system

OpenAIRE

Segre, Gavriel

2005-01-01

It is shown that the non-adiabatic Hannay's angle of an integrable non-degenerate classical hamiltonian dynamical system may be related to the Aharonov-Anandan phase it develops when it is looked mathematically as a quantum dynamical system.

Predictors of Satisfaction With Doctor and Nurse Communication: A National Study.

Science.gov (United States)

McFarland, Daniel C; Johnson Shen, Megan; Holcombe, Randall F

2017-10-01

Prior research indicates that effective communication between medical providers and patients is associated with a number of positive patient outcomes, yet little research has examined how ecological factors (e.g., hospital size, local demographics) influence patients' reported satisfaction with doctor and nurse communication. Given the current emphasis on improving patient satisfaction in hospitals across the United States, understanding these factors is critical to interpreting patient satisfaction and improving patient-centered communication, particularly in diverse and dense populations. As such, this study examined county-level data including population density, population diversity, and hospital structural factors as predictors of patient satisfaction with doctor and nurse communication. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), U.S. Census data, and number of hospital beds were obtained from publicly available Hospital Compare, U.S. Census, and American Hospital Directory websites, respectively. Multivariate regression modeling was performed for the individual dimensions of HCAHPS scores assessing doctor and nurse communication. Standardized partial regression coefficients were used to assess strengths of county-level predictors. County-level factors accounted for 30% and 16% of variability in patient satisfaction with doctor and nurse communication, respectively. College education (β = 0.45) and White ethnicity (β = 0.25) most strongly predicted a favorable rating of doctor and nurse communication, respectively. Primary language (non-English speaking; β = -0.50) most strongly predicted an unfavorable rating of doctor communication, while number of hospital beds (β = -0.16) and foreign-born (β = -0.16) most strongly predicted an unfavorable rating of nurse communication. County-level predictors should be considered when interpreting patient satisfaction with doctor and nurse communication and designing

Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam

Directory of Open Access Journals (Sweden)

Witter Sophie

2011-08-01

Full Text Available Abstract Background Motivation and retention of health workers, particularly in rural areas, is a question of considerable interest to policy-makers internationally. Many countries, including Vietnam, are debating the right mix of interventions to motivate doctors in particular to work in remote areas. The objective of this study was to understand the dynamics of the health labour market in Vietnam, and what might encourage doctors to accept posts and remain in-post in rural areas. Methods This study forms part of a labour market survey which was conducted in Vietnam in November 2009 to February 2010. The study had three stages. This article describes the findings of the first stage - the qualitative research and literature review, which fed into the design of a structured survey (second stage and contingent valuation (third stage. For the qualitative research, three tools were used - key informant interviews at national and provincial level (6 respondents; in-depth interviews of doctors at district and commune levels (11 respondents; and focus group discussions with medical students (15 participants. Results The study reports on the perception of the problem by national level stakeholders; the motivation for joining the profession by doctors; their views on the different factors affecting their willingness to work in rural areas (including different income streams, working conditions, workload, equipment, support and supervision, relationships with colleagues, career development, training, and living conditions. It presents findings on their overall satisfaction, their ranking of different attributes, and willingness to accept different kinds of work. Finally, it discusses recent and possible policy interventions to address the distribution problem. Conclusions Four typical 'directions of travel' are identified for Vietnamese doctors - from lower to higher levels of the system, from rural to urban areas, from preventive to curative health and

Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam.

Science.gov (United States)

Witter, Sophie; Thi Thu Ha, Bui; Shengalia, Bakhuti; Vujicic, Marko

2011-08-17

Motivation and retention of health workers, particularly in rural areas, is a question of considerable interest to policy-makers internationally. Many countries, including Vietnam, are debating the right mix of interventions to motivate doctors in particular to work in remote areas. The objective of this study was to understand the dynamics of the health labour market in Vietnam, and what might encourage doctors to accept posts and remain in-post in rural areas. This study forms part of a labour market survey which was conducted in Vietnam in November 2009 to February 2010. The study had three stages. This article describes the findings of the first stage - the qualitative research and literature review, which fed into the design of a structured survey (second stage) and contingent valuation (third stage). For the qualitative research, three tools were used - key informant interviews at national and provincial level (6 respondents); in-depth interviews of doctors at district and commune levels (11 respondents); and focus group discussions with medical students (15 participants). The study reports on the perception of the problem by national level stakeholders; the motivation for joining the profession by doctors; their views on the different factors affecting their willingness to work in rural areas (including different income streams, working conditions, workload, equipment, support and supervision, relationships with colleagues, career development, training, and living conditions). It presents findings on their overall satisfaction, their ranking of different attributes, and willingness to accept different kinds of work. Finally, it discusses recent and possible policy interventions to address the distribution problem. Four typical 'directions of travel' are identified for Vietnamese doctors - from lower to higher levels of the system, from rural to urban areas, from preventive to curative health and from public to private practice. Substantial differences in

Violence Against Doctors and Nurses in Hospitals in Turkey.

Science.gov (United States)

Kaya, Sidika; Bilgin Demir, İpek; Karsavuran, Seda; Ürek, Duygu; İlgün, Gülnur

2016-01-01

This study shows the rates of violence experienced by doctors and nurses and their ensuing responses including reporting rates and any effects experienced because of the violence. The Survey for Investigating the Violence on Medical Employees was administered to 254 doctors and nurses. Data were analyzed using chi-square and logistic regression analysis. Of the participants, 74.4% had been exposed to some form of violence. Most of the participants, 87.3%, experienced verbal violence; 12.2% experienced physical violence; and 0.5% experienced sexual violence. Logistic regression analysis indicated that married doctors and nurses are at risk of experiencing violence 0.5 times greater when compared with unmarried or widowed doctors and nurses (p = 0.026). The experience of violence differs by hospital type (p = 0.038) and years working in the healthcare industry (p = 0.042). Differences were also found regarding exposure to violence between doctors and nurses in terms of time of day (p = 0.031) and the work being performed (p violence (50.8%) was the healthcare system. Verbal response was the most frequent reaction to violence (24.4%), with loss of occupational performance (58.2%) being the most cited negative outcome. Approximately 9.3% of the victims reported the violence to judicial authorities. A lengthy judicial proceeding was chosen as the most significant hindrance to reporting the violence (45.8%). This study reveals the effects of violence and reporting rates at two hospitals in Turkey, and it implies that underreporting of violence is an important issue. Therefore, hospital management should take measures to increase reporting and take necessary actions when violence is reported.

Talking to Your Doctor (For Teens)

Science.gov (United States)

... problems , weight concerns, depression, suicidal thoughts , and even body odor . You should be able to talk to your doctor about everything, but that's easier said than done. Being examined and questioned about your body can also be intimidating, especially when the doctor ...

Dynamical systems in population biology

CERN Document Server

Zhao, Xiao-Qiang

2017-01-01

This research monograph provides an introduction to the theory of nonautonomous semiflows with applications to population dynamics. It develops dynamical system approaches to various evolutionary equations such as difference, ordinary, functional, and partial differential equations, and pays more attention to periodic and almost periodic phenomena. The presentation includes persistence theory, monotone dynamics, periodic and almost periodic semiflows, basic reproduction ratios, traveling waves, and global analysis of prototypical population models in ecology and epidemiology. Research mathematicians working with nonlinear dynamics, particularly those interested in applications to biology, will find this book useful. It may also be used as a textbook or as supplementary reading for a graduate special topics course on the theory and applications of dynamical systems. Dr. Xiao-Qiang Zhao is a University Research Professor at Memorial University of Newfoundland, Canada. His main research interests involve applied...

Dynamism in Electronic Performance Support Systems.

Science.gov (United States)

Laffey, James

1995-01-01

Describes a model for dynamic electronic performance support systems based on NNAble, a system developed by the training group at Apple Computer. Principles for designing dynamic performance support are discussed, including a systems approach, performer-centered design, awareness of situated cognition, organizational memory, and technology use.…

[Physician's role in "medical drama" pitfall? Reflection of stereotypical images of doctors in context of contemporary doctor's series].

Science.gov (United States)

Köhler, M; Grabsch, C; Zellner, M; Noll-Hussong, M

2014-04-17

In contemporary U.S. doctor's series, the characters are usually represented by good-looking or typical character actors. The aim of our pilot study was to investigate whether the long-term impact of this format on German television viewers could have an influence on the choice of doctor in Germany. Two different groups of people anticipating TV consumption patterns were questioned: a first group of younger adults who knew theTV series was asked to judge their doctor choice using a web-based survey tool with respect to three criteria (sympathy, expertise and own treatment preference). The second group of adults beyond the 40th year of life who need not know theTV series were shown photos of the serial figures. Study participants should select the "doctor" of which they would most likely want to be treated and this based on two predetermined reasons (sympathy or expertise). Our results indicate that stereotypical images of doctors found high approval only in the first group of people, while the participants in the second group decided in majorityfora more realistic representation of average appearance.

q-entropy for symbolic dynamical systems

International Nuclear Information System (INIS)

Zhao, Yun; Pesin, Yakov

2015-01-01

For symbolic dynamical systems we use the Carathéodory construction as described in (Pesin 1997 Dimension Theory in Dynamical Systems, ConTemporary Views and Applications (Chicago: University of Chicago Press)) to introduce the notions of q-topological and q-metric entropies. We describe some basic properties of these entropies and in particular, discuss relations between q-metric entropy and local metric entropy. Both q-topological and q-metric entropies are new invariants respectively under homeomorphisms and metric isomorphisms of dynamical systems. (paper)

The Professional Doctorate in Nursing: A Position Paper

Science.gov (United States)

Newman, Margaret A.

1975-01-01

The need for family-centered health care could be met by nurses now if they had a professional doctorate and the recognition and authority that go with it. The author distinguishes between an academic doctorate (Preparation for scholars) and a professional doctorate (a practice degree). (Author/BP)

Multiple and multidimensional transitions from trainee to trained doctor: a qualitative longitudinal study in the UK.

Science.gov (United States)

Gordon, Lisi; Jindal-Snape, Divya; Morrison, Jill; Muldoon, Janine; Needham, Gillian; Siebert, Sabina; Rees, Charlotte

2017-12-01

To explore trainee doctors' experiences of the transition to trained doctor, we answer three questions: (1) What multiple and multidimensional transitions (MMTs) are experienced as participants move from trainee to trained doctor? (2) What facilitates and hinders doctors' successful transition experiences? (3) What is the impact of MMTs on trained doctors? A qualitative longitudinal study underpinned by MMT theory. Four training areas (health boards) in the UK. 20 doctors, 19 higher-stage trainees within 6 months of completing their postgraduate training and 1 staff grade, associate specialist or specialty doctor, were recruited to the 9-month longitudinal audio-diary (LAD) study. All completed an entrance interview, 18 completed LADs and 18 completed exit interviews. Data were analysed cross-sectionally and longitudinally using thematic Framework Analysis. Participants experienced a multiplicity of expected and unexpected, positive and negative work-related transitions (eg, new roles) and home-related transitions (eg, moving home) during their trainee-trained doctor transition. Factors facilitating or inhibiting successful transitions were identified at various levels: individual (eg, living arrangements), interpersonal (eg, presence of supportive relationships), systemic (eg, mentoring opportunities) and macro (eg, the curriculum provided by Medical Royal Colleges). Various impacts of transitions were also identified at each of these four levels: individual (eg, stress), interpersonal (eg, trainees' children spending more time in childcare), systemic (eg, spending less time with patients) and macro (eg, delayed start in trainees' new roles). Priority should be given to developing supportive relationships (both formal and informal) to help trainees transition into their trained doctor roles, as well as providing more opportunities for learning. Further longitudinal qualitative research is now needed with a longer study duration to explore transition journeys for

Richard W. Ziolkowski Receives Honorary Doctorate

DEFF Research Database (Denmark)

Breinbjerg, Olav

2012-01-01

At the annual Commemoration of the Technical University of Denmark (DTU) on April 27, 2012, Prof. Richard W. Ziolkowski, University of Arizona (UoA), received DTU's highest academic degree, the Honorary Doctor degree: Doctor Technices Honoris Causa (Figure 1). Prof. Ziolkowski has been a close...

The fractional dynamics of quantum systems

Science.gov (United States)

Lu, Longzhao; Yu, Xiangyang

2018-05-01

The fractional dynamic process of a quantum system is a novel and complicated problem. The establishment of a fractional dynamic model is a significant attempt that is expected to reveal the mechanism of fractional quantum system. In this paper, a generalized time fractional Schrödinger equation is proposed. To study the fractional dynamics of quantum systems, we take the two-level system as an example and derive the time fractional equations of motion. The basic properties of the system are investigated by solving this set of equations in the absence of light field analytically. Then, when the system is subject to the light field, the equations are solved numerically. It shows that the two-level system described by the time fractional Schrödinger equation we proposed is a confirmable system.

Dynamics of vehicle-road coupled system

CERN Document Server

Yang, Shaopu; Li, Shaohua

2015-01-01

Vehicle dynamics and road dynamics are usually considered to be two largely independent subjects. In vehicle dynamics, road surface roughness is generally regarded as random excitation of the vehicle, while in road dynamics, the vehicle is generally regarded as a moving load acting on the pavement. This book suggests a new research concept to integrate the vehicle and the road system with the help of a tire model, and establishes a cross-subject research framework dubbed vehicle-pavement coupled system dynamics. In this context, the dynamics of the vehicle, road and the vehicle-road coupled system are investigated by means of theoretical analysis, numerical simulations and field tests. This book will be a valuable resource for university professors, graduate students and engineers majoring in automotive design, mechanical engineering, highway engineering and other related areas. Shaopu Yang is a professor and deputy president of Shijiazhuang Tiedao University, China; Liqun Chen is a professor at Shanghai Univ...

Session 6: Dynamic Modeling and Systems Analysis

Science.gov (United States)

Csank, Jeffrey; Chapman, Jeffryes; May, Ryan

2013-01-01

These presentations cover some of the ongoing work in dynamic modeling and dynamic systems analysis. The first presentation discusses dynamic systems analysis and how to integrate dynamic performance information into the systems analysis. The ability to evaluate the dynamic performance of an engine design may allow tradeoffs between the dynamic performance and operability of a design resulting in a more efficient engine design. The second presentation discusses the Toolbox for Modeling and Analysis of Thermodynamic Systems (T-MATS). T-MATS is a Simulation system with a library containing the basic building blocks that can be used to create dynamic Thermodynamic Systems. Some of the key features include Turbo machinery components, such as turbines, compressors, etc., and basic control system blocks. T-MAT is written in the Matlab-Simulink environment and is open source software. The third presentation focuses on getting additional performance from the engine by allowing the limit regulators only to be active when a limit is danger of being violated. Typical aircraft engine control architecture is based on MINMAX scheme, which is designed to keep engine operating within prescribed mechanical/operational safety limits. Using a conditionally active min-max limit regulator scheme, additional performance can be gained by disabling non-relevant limit regulators

Nonlinear transport of dynamic system phase space

International Nuclear Information System (INIS)

Xie Xi; Xia Jiawen

1993-01-01

The inverse transform of any order solution of the differential equation of general nonlinear dynamic systems is derived, realizing theoretically the nonlinear transport for the phase space of nonlinear dynamic systems. The result is applicable to general nonlinear dynamic systems, with the transport of accelerator beam phase space as a typical example

IN URGENT NEED OF A DOCTOR

CERN Multimedia

Medical Service

2001-01-01

IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

Stochastic runaway of dynamical systems

International Nuclear Information System (INIS)

Pfirsch, D.; Graeff, P.

1984-10-01

One-dimensional, stochastic, dynamical systems are well studied with respect to their stability properties. Less is known for the higher dimensional case. This paper derives sufficient and necessary criteria for the asymptotic divergence of the entropy (runaway) and sufficient ones for the moments of n-dimensional, stochastic, dynamical systems. The crucial implication is the incompressibility of their flow defined by the equations of motion in configuration space. Two possible extensions to compressible flow systems are outlined. (orig.)

Reasons for Consulting a Doctor on the Internet: Web Survey of Users of an Ask the Doctor Service

OpenAIRE

Umefjord, Göran; Petersson, Göran; Hamberg, Katarina

2003-01-01

Background In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. Objective To study why individuals choose to consult previously-unknown doctors on the Internet. Methods Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) a...

Cultural initiation of medical doctors.

Science.gov (United States)

Zsinkó-Szabó, Zoltán; Lázár, Imre

2013-12-01

Eighteen years experience of teaching medical anthropology at a Hungarian medical school offers insight into the dynamics of interference between the rationalist epistemological tradition of biomedicine as one of the central paradigms of modernism and the cultural relativism of medical anthropology, as cultural anthropology is considered to be one of the generators of postmodern thinking. Tracing back the informal "prehistory" of our Institute, we can reveal its psychosomatic, humanistic commitment and critical basis as having represented a kind of counterculture compared with the technocrats of state-socialist Hungary's health ideology. The historical change and socio-cultural transition in Hungary after 1989 was accompanied by changes in the medical system as well as in philosophy and in the structure of the teaching of social sciences. The developing pluralism in the medical system together with the pluralism of social ideologies allowed the substitution of the dogmatic Marxist-Leninist framework with the more pragmatic and empiricist behavioral sciences including medical sociology and medical anthropology. The conflict between the initiation function of the hard preclinical training of the first two years, and the reflective, relativistic and critical narrative on "biomedicine as culture bound entity" constructed by medical anthropology during the second year of medical training is discussed. We also submit our fieldwork data gained as a result of a two year investigation period focusing on diverse initiation types of "would be" physicians. The main proportion of our data derives from individual semi structured deep interviews together with focus group interviews carried out with medical students of upper years. Finally, the role of medical anthropology in the "rite of passage" of becoming a medical doctor is summarized, paying attention to their field work reports and the risks and gains in this process.

State Level Review of Doctoral Programs in Texas.

Science.gov (United States)

Whittington, Nil

Review of doctoral degree programs in Texas public colleges and universities is discussed. Attention is directed to review procedures and strengths and weaknesses in the state's doctoral programs in educational psychology, counseling and guidance, and student personnel services. Doctoral programs were reviewed because of their high cost and a…

Doctor-patient communication in the e-health era.

Science.gov (United States)

Weiner, Jonathan P

2012-08-28

The digital revolution will have a profound impact on how physicians and health care delivery organizations interact with patients and the community at-large. Over the coming decades, face-to-face patient/doctor contacts will become less common and exchanges between consumers and providers will increasingly be mediated by electronic devices.In highly developed health care systems like those in Israel, the United States, and Europe, most aspects of the health care and consumer health experience are becoming supported by a wide array of technology such as electronic and personal health records (EHRs and PHRs), biometric & telemedicine devices, and consumer-focused wireless and wired Internet applications.In an article in this issue, Peleg and Nazarenko report on a survey they fielded within Israel's largest integrated delivery system regarding patient views on the use of electronic communication with their doctors via direct-access mobile phones and e-mail. A previous complementary paper describes the parallel perspectives of the physician staff at the same organization. These two surveys offer useful insights to clinicians, managers, researchers, and policymakers on how best to integrate e-mail and direct-to-doctor mobile phones into their practice settings. These papers, along with several other recent Israeli studies on e-health, also provide an opportunity to step back and take stock of the dramatic impact that information & communication technology (ICT) and health information technology (HIT) will have on clinician/patient communication moving forward.The main goals of this commentary are to describe the scope of this issue and to offer a framework for understanding the potential impact that e-health tools will have on provider/patient communication. It will be essential that clinicians, managers, policymakers, and researchers gain an increased understanding of this trend so that health care systems around the globe can adapt, adopt, and embrace these rapidly

Doctor-patient communication in the e-health era

Directory of Open Access Journals (Sweden)

Weiner Jonathan P

2012-08-01

Full Text Available Abstract The digital revolution will have a profound impact on how physicians and health care delivery organizations interact with patients and the community at-large. Over the coming decades, face-to-face patient/doctor contacts will become less common and exchanges between consumers and providers will increasingly be mediated by electronic devices. In highly developed health care systems like those in Israel, the United States, and Europe, most aspects of the health care and consumer health experience are becoming supported by a wide array of technology such as electronic and personal health records (EHRs and PHRs, biometric & telemedicine devices, and consumer-focused wireless and wired Internet applications. In an article in this issue, Peleg and Nazarenko report on a survey they fielded within Israel's largest integrated delivery system regarding patient views on the use of electronic communication with their doctors via direct-access mobile phones and e-mail. A previous complementary paper describes the parallel perspectives of the physician staff at the same organization. These two surveys offer useful insights to clinicians, managers, researchers, and policymakers on how best to integrate e-mail and direct-to-doctor mobile phones into their practice settings. These papers, along with several other recent Israeli studies on e-health, also provide an opportunity to step back and take stock of the dramatic impact that information & communication technology (ICT and health information technology (HIT will have on clinician/patient communication moving forward. The main goals of this commentary are to describe the scope of this issue and to offer a framework for understanding the potential impact that e-health tools will have on provider/patient communication. It will be essential that clinicians, managers, policymakers, and researchers gain an increased understanding of this trend so that health care systems around the globe can adapt, adopt

The brain as a dynamic physical system.

Science.gov (United States)

McKenna, T M; McMullen, T A; Shlesinger, M F

1994-06-01

The brain is a dynamic system that is non-linear at multiple levels of analysis. Characterization of its non-linear dynamics is fundamental to our understanding of brain function. Identifying families of attractors in phase space analysis, an approach which has proven valuable in describing non-linear mechanical and electrical systems, can prove valuable in describing a range of behaviors and associated neural activity including sensory and motor repertoires. Additionally, transitions between attractors may serve as useful descriptors for analysing state changes in neurons and neural ensembles. Recent observations of synchronous neural activity, and the emerging capability to record the spatiotemporal dynamics of neural activity by voltage-sensitive dyes and electrode arrays, provide opportunities for observing the population dynamics of neural ensembles within a dynamic systems context. New developments in the experimental physics of complex systems, such as the control of chaotic systems, selection of attractors, attractor switching and transient states, can be a source of powerful new analytical tools and insights into the dynamics of neural systems.

Doctoral Education in Nursing: Future Directions

Science.gov (United States)

Downs, Florence S.

1978-01-01

Problems that confront nursing education and the quality of doctoral preparation are discussed in this article and include the steep rise in requests from nurses for admission into doctoral programs and tight university budgets; other concerns are the development of scholars and sharing research findings. (TA)

System dynamics and control with bond graph modeling

CERN Document Server

Kypuros, Javier

2013-01-01

Part I Dynamic System ModelingIntroduction to System DynamicsIntroductionSystem Decomposition and Model ComplexityMathematical Modeling of Dynamic SystemsAnalysis and Design of Dynamic SystemsControl of Dynamic SystemsDiagrams of Dynamic SystemsA Graph-Centered Approach to ModelingSummaryPracticeExercisesBasic Bond Graph ElementsIntroductionPower and Energy VariablesBasic 1-Port ElementsBasic 2-Ports ElementsJunction ElementsSimple Bond Graph ExamplesSummaryPracticeExercisesBond Graph Synthesis and Equation DerivationIntroductionGeneral GuidelinesMechanical TranslationMechanical RotationElectrical CircuitsHydraulic CircuitsMixed SystemsState Equation DerivationState-Space RepresentationsAlgebraic Loops and Derivative CausalitySummaryPracticeExercisesImpedance Bond GraphsIntroductionLaplace Transform of the State-Space EquationBasic 1-Port ImpedancesImpedance Bond Graph SynthesisJunctions, Transformers, and GyratorsEffort and Flow DividersSign ChangesTransfer Function DerivationAlternative Derivation of Transf...

Job satisfaction of village doctors during the new healthcare reforms in China.

Science.gov (United States)

Zhang, Xiaoyan; Fang, Pengqian

2016-04-01

Objective China launched new healthcare reforms in 2009 and several policies targeted village clinics, which affected village doctors' income, training and duties. The aim of the present study was to assess village doctors' job satisfaction during the reforms and to explore factors affecting job satisfaction. Methods Using a stratified multistage cluster sampling process, 935 village doctors in Jiangxi Province were surveyed with a self-administered questionnaire that collected demographic information and contained a job satisfaction scale and questions regarding their work situation and individual perceptions of the new healthcare reforms. Descriptive analysis, Pearson's Chi-squared test and binary logistic regression were used to identify village doctors' job satisfaction and the factors associated with their job satisfaction. Results Only 12.72% of village doctors were either satisfied or very satisfied with their jobs and the top three items leading to dissatisfaction were pay and the amount of work that had to be done, opportunities for job promotion and work conditions. Marriage, income, intention to leave, satisfaction with learning and training, social status, relationship with patients and satisfaction with the new healthcare reforms were significantly associated with job satisfaction (Pjob satisfaction. For future healthcare reforms, policy makers should pay more attention to appropriate remuneration and approaches that incentivise village doctors to achieve the goals of the health reforms. What is known about the topic? Village doctors act as gatekeepers at the bottom tier of the rural health system. However, the policies of the new healthcare reform initiatives in China were centred on improving the quality of care delivered to the rural population and reducing fast-growing medical costs. There have been limited studies on village doctors' reactions to these reforms. What does this paper add? The findings of the present study indicate that in the

DYNAMICS OF FINANCIAL SYSTEM: A SYSTEM DYNAMICS APPROACH

Directory of Open Access Journals (Sweden)

Girish K Nair

2013-01-01

Full Text Available There are several ratios which define the financial health of an organization but the importance of Net cash flow, Gross income, Net income, Pending bills, Receivable bills, Debt, and Book value can never be undermined as they give the exact picture of the financial condition. While there are several approaches to study the dynamics of these variables, system dynamics based modelling and simulation is one of the modern techniques. The paper explores this method to simulate the before mentioned parameters during production capacity expansion in an electronic industry. Debt and Book value have shown a non-linear pattern of variation which is discussed. The model can be used by the financial experts as a decision support tool in arriving at conclusions in connection to the expansion plans of the organization.

An Axiomatic Representation of System Dynamics

CERN Document Server

Baianu, I

2004-01-01

An axiomatic representation of system dynamics is introduced in terms of categories, functors, organismal supercategories, limits and colimits of diagrams. Specific examples are considered in Complex Systems Biology, such as ribosome biogenesis and Hormonal Control in human subjects. "Fuzzy" Relational Structures are also proposed for flexible representations of biological system dynamics and organization.

Controlling chaos in discontinuous dynamical systems

International Nuclear Information System (INIS)

Danca, Marius-F.

2004-01-01

In this paper we consider the possibility to implement the technique of changes in the system variables to control the chaos introduced by Gueemez and Matias for continuous dynamical systems to a class of discontinuous dynamical systems. The approach is realized via differential inclusions following the Filippov theory. Three practical examples are considered

Solar System Dynamics

Science.gov (United States)

Wisdom, Jack

2002-01-01

In these 18 years, the research has touched every major dynamical problem in the solar system, including: the effect of chaotic zones on the distribution of asteroids, the delivery of meteorites along chaotic pathways, the chaotic motion of Pluto, the chaotic motion of the outer planets and that of the whole solar system, the delivery of short period comets from the Kuiper belt, the tidal evolution of the Uranian arid Galilean satellites, the chaotic tumbling of Hyperion and other irregular satellites, the large chaotic variations of the obliquity of Mars, the evolution of the Earth-Moon system, and the resonant core- mantle dynamics of Earth and Venus. It has introduced new analytical and numerical tools that are in widespread use. Today, nearly every long-term integration of our solar system, its subsystems, and other solar systems uses algorithms that was invented. This research has all been primarily Supported by this sequence of PGG NASA grants. During this period published major investigations of tidal evolution of the Earth-Moon system and of the passage of the Earth and Venus through non-linear core-mantle resonances were completed. It has published a major innovation in symplectic algorithms: the symplectic corrector. A paper was completed on non-perturbative hydrostatic equilibrium.

Dynamical systems in classical mechanics

CERN Document Server

Kozlov, V V

1995-01-01

This book shows that the phenomenon of integrability is related not only to Hamiltonian systems, but also to a wider variety of systems having invariant measures that often arise in nonholonomic mechanics. Each paper presents unique ideas and original approaches to various mathematical problems related to integrability, stability, and chaos in classical dynamics. Topics include… the inverse Lyapunov theorem on stability of equilibria geometrical aspects of Hamiltonian mechanics from a hydrodynamic perspective current unsolved problems in the dynamical systems approach to classical mechanics

Fault diagnosis for dynamic power system

International Nuclear Information System (INIS)

Thabet, A.; Abdelkrim, M.N.; Boutayeb, M.; Didier, G.; Chniba, S.

2011-01-01

The fault diagnosis problem for dynamic power systems is treated, the nonlinear dynamic model based on a differential algebraic equations is transformed with reduced index to a simple dynamic model. Two nonlinear observers are used for generating the fault signals for comparison purposes, one of them being an extended Kalman estimator and the other a new extended kalman filter with moving horizon with a study of convergence based on the choice of matrix of covariance of the noises of system and measurements. The paper illustrates a simulation study applied on IEEE 3 buses test system.

Looking Back at Doctoral Education in South Africa

Science.gov (United States)

Herman, Chaya

2017-01-01

This article provides a quantitative picture of doctoral education in South Africa up to 2010, from the time the first doctorate was awarded in 1899. It identifies the different institutional profiles and emphases of doctoral graduation in South African universities at various periods of time in the context of economic, political and social…

Systems-Dynamic Analysis for Neighborhood Study

Science.gov (United States)

Systems-dynamic analysis (or system dynamics (SD)) helps planners identify interrelated impacts of transportation and land-use policies on neighborhood-scale economic outcomes for households and businesses, among other applications. This form of analysis can show benefits and tr...

Intergroup communication between hospital doctors: implications for quality of patient care.

Science.gov (United States)

Hewett, David G; Watson, Bernadette M; Gallois, Cindy; Ward, Michael; Leggett, Barbara A

2009-12-01

Hospitals involve a complex socio-technical health system, where communication failures influence the quality of patient care. Research indicates the importance of social identity and intergroup relationships articulated through power, control, status and competition. This study focused on interspecialty communication among doctors for patients requiring the involvement of multiple specialist departments. The paper reports on an interview study in Australia, framed by social identity and communication accommodation theories of doctors' experiences of managing such patients, to explore the impact of communication. Interviews were undertaken with 45 doctors working in a large metropolitan hospital, and were analysed using Leximancer (text mining software) and interpretation of major themes. Findings indicated that intergroup conflict is a central influence on communication. Contested responsibilities emerged from a model of care driven by single-specialty ownership of the patient, with doctors allowed to evade responsibility for patients over whom they had no sense of ownership. Counter-accommodative communication, particularly involving interpersonal control, appeared as important for reinforcing social identity and winning conflicts. Strategies to resolve intergroup conflict must address structural issues generating an intergroup climate and evoke interpersonal salience to moderate their effect.

Exporting doctoral education: experience of a state-supported university.

Science.gov (United States)

Stoskopf, Carleen H; Xirasagar, Sudha; Han, Whiejong M; Snowdon, Sonja

2007-01-01

There is a demand for non-traditional doctoral education in healthcare management and policy among many countries in support of their health system reform efforts. Healthcare professionals need retooling to provide stewardship to complex new health financing systems. Most health service leaders are mid career professionals and cannot transplant themselves to study on American university campuses. They demand high quality programs, designed to enable most coursework to be completed overseas. Aided by recent distance education technology, the University of South Carolina's Department of Health Services Policy and Management developed and provides doctoral programs for working professionals in Taiwan and South Korea with a minimal and convenient campus attendance requirement. This paper presents the experience of setting up the programs, management, quality control, and benefits for both students overseas and for our Department's mission and on-campus programs. Our experience is that there are many challenges, but it is also rewarding from academic, scholarly, and financial perspectives.

[A comparative study on Koii (public doctor) system and its effect on public health in colonial Taiwan and Korea].

Science.gov (United States)

Moon, Myungki

2014-08-01

Koii(Public Doctor) System introduced into Taiwan in 1896 for the purpose of filling up medical vacuum of rural area and therefore spreading modern medical system all over Taiwan, was transplanted in 1913 into Colonial Korea for the same purpose. In terms of system itself Koii system in both areas were almost the same, but quite different in practices. First, Koiis in Taiwan was forced to write concrete medical report every month on the medical situation in the area under jurisdiction, whereas to those in Korea writing monthly report was not so compulsory. This difference resulted in some gaps in the quality of medical statistics of the two areas. Second, Unlike their counterparts in Korea, Koiis in Taiwan organized their own associations both locally and nationally and it helped to build up their own networks and share informations on medical situation including informations on infectious diseases. Third, Koiis in Taiwan formed more harmonious relationship between Taiwanese Police than their counterparts in Korea, which helped them to execute various medical activities in more comfortable environment. Taiwanese People went to medical institutions a lot more frequently than Korean People, and this difference was basically derived from the quite different density of Koii assignment in both areas. Korean People had to spend more time and money to utilize modern medical institutions than Taiwanese People did. The different density of Koii assignment also affected the results of prevention and eradication of infectious diseases; in Taiwan plague and small-pox has been successfully controled, whereas Chosun Government general was not so successful in controling infectious diseases including small-pox. Small-pox infected in Korea was about 6 times to Taiwan, and the number of death by small-pox was 9 times to Taiwan. One of the keys to this difference is the different role of Koiis. In Korea, Koiis could do little thing about infectious diseases mainly because of

Information Processing Capacity of Dynamical Systems

Science.gov (United States)

Dambre, Joni; Verstraeten, David; Schrauwen, Benjamin; Massar, Serge

2012-07-01

Many dynamical systems, both natural and artificial, are stimulated by time dependent external signals, somehow processing the information contained therein. We demonstrate how to quantify the different modes in which information can be processed by such systems and combine them to define the computational capacity of a dynamical system. This is bounded by the number of linearly independent state variables of the dynamical system, equaling it if the system obeys the fading memory condition. It can be interpreted as the total number of linearly independent functions of its stimuli the system can compute. Our theory combines concepts from machine learning (reservoir computing), system modeling, stochastic processes, and functional analysis. We illustrate our theory by numerical simulations for the logistic map, a recurrent neural network, and a two-dimensional reaction diffusion system, uncovering universal trade-offs between the non-linearity of the computation and the system's short-term memory.

Information Processing Capacity of Dynamical Systems

Science.gov (United States)

Dambre, Joni; Verstraeten, David; Schrauwen, Benjamin; Massar, Serge

2012-01-01

Many dynamical systems, both natural and artificial, are stimulated by time dependent external signals, somehow processing the information contained therein. We demonstrate how to quantify the different modes in which information can be processed by such systems and combine them to define the computational capacity of a dynamical system. This is bounded by the number of linearly independent state variables of the dynamical system, equaling it if the system obeys the fading memory condition. It can be interpreted as the total number of linearly independent functions of its stimuli the system can compute. Our theory combines concepts from machine learning (reservoir computing), system modeling, stochastic processes, and functional analysis. We illustrate our theory by numerical simulations for the logistic map, a recurrent neural network, and a two-dimensional reaction diffusion system, uncovering universal trade-offs between the non-linearity of the computation and the system's short-term memory. PMID:22816038

Attractors for discrete periodic dynamical systems

Science.gov (United States)

John E. Franke; James F. Selgrade

2003-01-01

A mathematical framework is introduced to study attractors of discrete, nonautonomous dynamical systems which depend periodically on time. A structure theorem for such attractors is established which says that the attractor of a time-periodic dynamical system is the unin of attractors of appropriate autonomous maps. If the nonautonomous system is a perturbation of an...

A Pathophysiological Model-Driven Communication for Dynamic Distributed Medical Best Practice Guidance Systems.

Science.gov (United States)

Hosseini, Mohammad; Jiang, Yu; Wu, Poliang; Berlin, Richard B; Ren, Shangping; Sha, Lui

2016-11-01

There is a great divide between rural and urban areas, particularly in medical emergency care. Although medical best practice guidelines exist and are in hospital handbooks, they are often lengthy and difficult to apply clinically. The challenges are exaggerated for doctors in rural areas and emergency medical technicians (EMT) during patient transport. In this paper, we propose the concept of distributed executable medical best practice guidance systems to assist adherence to best practice from the time that a patient first presents at a rural hospital, through diagnosis and ambulance transfer to arrival and treatment at a regional tertiary hospital center. We codify complex medical knowledge in the form of simplified distributed executable disease automata, from the thin automata at rural hospitals to the rich automata in the regional center hospitals. However, a main challenge is how to efficiently and safely synchronize distributed best practice models as the communication among medical facilities, devices, and professionals generates a large number of messages. This complex problem of patient diagnosis and transport from rural to center facility is also fraught with many uncertainties and changes resulting in a high degree of dynamism. A critically ill patient's medical conditions can change abruptly in addition to changes in the wireless bandwidth during the ambulance transfer. Such dynamics have yet to be addressed in existing literature on telemedicine. To address this situation, we propose a pathophysiological model-driven message exchange communication architecture that ensures the real-time and dynamic requirements of synchronization among distributed emergency best practice models are met in a reliable and safe manner. Taking the signs, symptoms, and progress of stroke patients transported across a geographically distributed healthcare network as the motivating use case, we implement our communication system and apply it to our developed best practice

Quantitative Preparation in Doctoral Education Programs: A Mixed-Methods Study of Doctoral Student Perspectives on their Quantitative Training

Directory of Open Access Journals (Sweden)

Sarah L Ferguson

2017-07-01

Full Text Available Aim/Purpose: The purpose of the current study is to explore student perceptions of their own doctoral-level education and quantitative proficiency. Background: The challenges of preparing doctoral students in education have been discussed in the literature, but largely from the perspective of university faculty and program administrators. The current study directly explores the student voice on this issue. Methodology: Utilizing a sequential explanatory mixed-methods research design, the present study seeks to better understand doctoral-level education students’ perceptions of their quantitative methods training at a large public university in the southwestern United States. Findings: Results from both phases present the need for more application and consistency in doctoral-level quantitative courses. Additionally, there was a consistent theme of internal motivation in the responses, suggesting students perceive their quantitative training to be valuable beyond their personal interest in the topic. Recommendations for Practitioners: Quantitative methods instructors should emphasize practice in their quantitative courses and consider providing additional support for students through the inclusion of lab sections, tutoring, and/or differentiation. Pre-testing statistical ability at the start of a course is also suggested to better meet student needs. Impact on Society: The ultimate goal of quantitative methods in doctoral education is to produce high-quality educational researchers who are prepared to apply their knowledge to problems and research in education. Results of the present study can inform faculty and administrator decisions in doctoral education to best support this goal. Future Research: Using the student perspectives presented in the present study, future researchers should continue to explore effective instructional strategies and curriculum design within education doctoral programs. The inclusion of student voice can strengthen

Stress in doctors and dentists who teach.

Science.gov (United States)

Rutter, Harry; Herzberg, Joe; Paice, Elisabeth

2002-06-01

To explore the relationship between a teaching role and stress in doctors and dentists who teach. Medline, PubMed, BIDS database for social sciences literature, and the ERIC database for educational literature were searched using the key words 'stress' or 'burnout' with the terms doctor, physician, dentist, teacher, lecturer, academic staff, and university staff. Other books and journals known to the authors were also used. Many studies have shown high levels of stress in doctors, dentists, teachers, and lecturers. A large number of factors are implicated, including low autonomy, work overload, and lack of congruence between power and responsibility. Doctors and dentists who take on a teaching role in addition to their clinical role may increase their levels of stress, but there is also evidence that this dual role may reduce job-related stress. Working as a doctor or dentist may entail higher levels of stress than are experienced by the general population. In some situations adding in the role of teacher reduces this stress, but more research is needed to explain this finding.

Epilepsy - what to ask your doctor - child

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What to ask your doctor about epilepsy - child; Seizures - what to ask your doctor - child ... should I discuss with my child's teachers about epilepsy? Will my child need to take medicines during ...

The Plight of the Woman Doctoral Student

Science.gov (United States)

Holmstrom, Engin Inel; Holmstrom, Robert W.

1974-01-01

This study investigated factors underlying discrimination against woman doctoral students. Analyses revealed that faculty attitudes and behavior toward woman doctoral students contributed significantly to their emotional stresses and self-doubts. (Author/NE)

Surviving the Doctoral Years

Directory of Open Access Journals (Sweden)

Scott P. Kerlin

1995-11-01

Full Text Available This article probes the implications of neo-conservative public education policies for the future of the academic profession through a detailed examination of critical issues shaping contemporary doctoral education in U.S. and Canadian universities. Institutional and social factors such as financial retrenchment, declining support for affirmative action, downward economic mobility, a weak academic labor market for tenure-track faculty, professional ethics in graduate education, and backlash against women's progress form the backdrop for analysis of the author's survey of current doctoral students' opinions about funding, support, the job market, and quality of learning experiences.

Dynamical system approach to phyllotaxis

DEFF Research Database (Denmark)

D'ovidio, Francesco; Mosekilde, Erik

2000-01-01

and not a dynamical system, mainly because new active elements are added at each step, and thus the dimension of the "natural" phase space is not conserved. Here a construction is presented by which a well defined dynamical system can be obtained, and a bifurcation analysis can be carried out. Stable and unstable...... of the Jacobian, and thus the eigenvalues, is given. It is likely that problems of the above type often arise in biology, and especially in morphogenesis, where growing systems are modeled....

System dynamics modelling of situation awareness

CSIR Research Space (South Africa)

Oosthuizen, R

2015-11-01

Full Text Available . The feedback loops and delays in the Command and Control system also contribute to the complex dynamic behavior. This paper will build on existing situation awareness models to develop a System Dynamics model to support a qualitative investigation through...

Attracting and retaining doctors in rural Nepal.

Science.gov (United States)

Shankar, P R

2010-01-01

In Nepal, a number of private sector medical schools have opened recently; although sufficient numbers of doctors are graduating there continues to be a doctor shortage in rural areas. This article analysed the rural doctor shortage in Nepal and reviewed the international literature for strategies that may be suitable for use in Nepal. Original research articles, reviews, magazine articles and project reports dealing with Nepal and other developing countries during the period 1995 to 2010 were sourced via Google, Google Scholar and Pubmed. Full text access was obtained via WHO's HINARI database. The health workforce in Nepal is unevenly distributed resulting in doctor shortages in rural areas. The recent introduction of mandatory rural service for scholarship students was aimed to reduce the loss of medical graduates to developed nations. High tuition fees in private medical schools and low Government wages prevent recent graduates from taking up rural positions, and those who do face many challenges. Potential corrective strategies include community-based medical education, selecting rural-background medical students, and providing a partial or complete tuition fee waiver for medical students who commit to rural service. Traditional healers and paramedical staff can also be trained for and authorized to provide rural health care. A range of strategies developed elsewhere could be used in Nepal, especially community-oriented medical education that involves rural doctors in training medical students. The reimbursement of tuition fees, assistance with relocation, and provision of opportunities for academic and professional advancement for rural doctors should also be considered. Government investment in improving working conditions in rural Nepal would assist rural communities to attract and retain doctors.

Dynamical critical phenomena in driven-dissipative systems.

Science.gov (United States)

Sieberer, L M; Huber, S D; Altman, E; Diehl, S

2013-05-10

We explore the nature of the Bose condensation transition in driven open quantum systems, such as exciton-polariton condensates. Using a functional renormalization group approach formulated in the Keldysh framework, we characterize the dynamical critical behavior that governs decoherence and an effective thermalization of the low frequency dynamics. We identify a critical exponent special to the driven system, showing that it defines a new dynamical universality class. Hence critical points in driven systems lie beyond the standard classification of equilibrium dynamical phase transitions. We show how the new critical exponent can be probed in experiments with driven cold atomic systems and exciton-polariton condensates.

Concussion - what to ask your doctor - child

Science.gov (United States)

What to ask your doctor about concussion - child; Mild brain injury - what to ask your doctor - child ... What type of symptoms or problems will my child have? Will my child have problems thinking or ...

Parameterizing Coefficients of a POD-Based Dynamical System

Science.gov (United States)

Kalb, Virginia L.

2010-01-01

A method of parameterizing the coefficients of a dynamical system based of a proper orthogonal decomposition (POD) representing the flow dynamics of a viscous fluid has been introduced. (A brief description of POD is presented in the immediately preceding article.) The present parameterization method is intended to enable construction of the dynamical system to accurately represent the temporal evolution of the flow dynamics over a range of Reynolds numbers. The need for this or a similar method arises as follows: A procedure that includes direct numerical simulation followed by POD, followed by Galerkin projection to a dynamical system has been proven to enable representation of flow dynamics by a low-dimensional model at the Reynolds number of the simulation. However, a more difficult task is to obtain models that are valid over a range of Reynolds numbers. Extrapolation of low-dimensional models by use of straightforward Reynolds-number-based parameter continuation has proven to be inadequate for successful prediction of flows. A key part of the problem of constructing a dynamical system to accurately represent the temporal evolution of the flow dynamics over a range of Reynolds numbers is the problem of understanding and providing for the variation of the coefficients of the dynamical system with the Reynolds number. Prior methods do not enable capture of temporal dynamics over ranges of Reynolds numbers in low-dimensional models, and are not even satisfactory when large numbers of modes are used. The basic idea of the present method is to solve the problem through a suitable parameterization of the coefficients of the dynamical system. The parameterization computations involve utilization of the transfer of kinetic energy between modes as a function of Reynolds number. The thus-parameterized dynamical system accurately predicts the flow dynamics and is applicable to a range of flow problems in the dynamical regime around the Hopf bifurcation. Parameter

[The virtuous doctor in cinema: the final examination].

Science.gov (United States)

Figueroa, Gustavo

2014-10-01

The virtuous doctor has subscribed an oath and by subscribing to this solemn promise, he is committed to live in accordance with the purposes, obligations and virtues established in the medical profession. Cinematic art has shown only a superficial interest in complex aspects of medical profession. An exception is Ingmar Bergman's film "Wild Strawberries", where Professor Isak Borg, a widowed 76-year-old physician, is to be awarded the Doctor Jubilaris degree, 50 years after he received his doctorate at Lund University. During the trip, Isak is forced by a nightmare to reevaluate his professional life as not being a virtuous doctor.

Stochastic Thermodynamics: A Dynamical Systems Approach

Directory of Open Access Journals (Sweden)

Tanmay Rajpurohit

2017-12-01

Full Text Available In this paper, we develop an energy-based, large-scale dynamical system model driven by Markov diffusion processes to present a unified framework for statistical thermodynamics predicated on a stochastic dynamical systems formalism. Specifically, using a stochastic state space formulation, we develop a nonlinear stochastic compartmental dynamical system model characterized by energy conservation laws that is consistent with statistical thermodynamic principles. In particular, we show that the difference between the average supplied system energy and the average stored system energy for our stochastic thermodynamic model is a martingale with respect to the system filtration. In addition, we show that the average stored system energy is equal to the mean energy that can be extracted from the system and the mean energy that can be delivered to the system in order to transfer it from a zero energy level to an arbitrary nonempty subset in the state space over a finite stopping time.

Dynamics of the diffusive DM-DE interaction – Dynamical system approach

Energy Technology Data Exchange (ETDEWEB)

Haba, Zbigniew [Institute of Theoretical Physics, University of Wroclaw, Plac Maxa Borna 9, 50-204 Wrocław (Poland); Stachowski, Aleksander; Szydłowski, Marek, E-mail: zhab@ift.uni.wroc.pl, E-mail: aleksander.stachowski@uj.edu.pl, E-mail: marek.szydlowski@uj.edu.pl [Astronomical Observatory, Jagiellonian University, Orla 171, 30-244 Krakow (Poland)

2016-07-01

We discuss dynamics of a model of an energy transfer between dark energy (DE) and dark matter (DM) . The energy transfer is determined by a non-conservation law resulting from a diffusion of dark matter in an environment of dark energy. The relativistic invariance defines the diffusion in a unique way. The system can contain baryonic matter and radiation which do not interact with the dark sector. We treat the Friedman equation and the conservation laws as a closed dynamical system. The dynamics of the model is examined using the dynamical systems methods for demonstration how solutions depend on initial conditions. We also fit the model parameters using astronomical observation: SNIa, H ( z ), BAO and Alcock-Paczynski test. We show that the model with diffuse DM-DE is consistent with the data.

Skills and Competences of a Doctor of Engineering

Directory of Open Access Journals (Sweden)

Michael H. W. Hoffmann

2011-12-01

Full Text Available Not only in Europe but also on other continents, it is felt that a reform of the doctoral phase in tertiary education is necessary. To make this reform a success, it is necessary to first define the skills and competences of a doctor in general and of a doctor of engineering in particular to dispose of measurable criteria for the outcomes of the reform. These criteria are intended to foster not only an academic career but also careers in industry and administration, i.e. to support the careers of future chief executives. It is also presented how these skills and competences are seen by industrial companies as well as by the young Doctors of Engineering. Finally, it is discussed how existing methods might be reformed to further improve the doctoral phase at and in cooperation with universities.

Reconceptualizing Learning as a Dynamical System.

Science.gov (United States)

Ennis, Catherine D.

1992-01-01

Dynamical systems theory can increase our understanding of the constantly evolving learning process. Current research using experimental and interpretive paradigms focuses on describing the attractors and constraints stabilizing the educational process. Dynamical systems theory focuses attention on critical junctures in the learning process as…

Newborn jaundice - what to ask your doctor

Science.gov (United States)

Jaundice - what to ask your doctor; What to ask your doctor about newborn jaundice ... What causes jaundice in a newborn child? How common is newborn jaundice? Will the jaundice harm my child? What are the ...

Doctors' health: obstacles and enablers to returning to work.

Science.gov (United States)

Cohen, D; Rhydderch, M; Reading, P; Williams, S

2015-08-01

For doctors returning to work after absence due to ill-health or performance concerns, the obstacles can seem insurmountable. Doctors' perspectives of these obstacles have been investigated. To support them more effectively, the perspectives of organizations that interact with such doctors should also be considered. To explore the obstacles and enablers to doctors' return to work after long-term absence from the perspective of key organizations involved in assessment and support. We identified organizations operating in the field of doctors' health, well-being and performance. We conducted semi-structured, 30-45 min telephone interviews with representatives of the organizations, exploring problems that they had encountered that were experienced by doctors with health or performance concerns returning to work after absence of a month or longer. We analysed our field notes using theoretical analysis. We conducted 11 telephone interviews. Data analysis identified four key themes of obstacles and enablers to returning to work: 'communication', 'return to work', 'finance and funding' and 'relationships and engagement'. Sub-themes relating to the organization and the individual also emerged. Organizations responsible for supporting doctors back to work reported poor communication as a significant obstacle to doctors returning to work after illness. They also reported differences between specialities, employing organizations, occupational health departments and human resources in terms of knowledge and expertise in supporting doctors with complex issues. Clear communication channels, care pathways and support processes, such as workplace advocates, were perceived as strong enablers to return to work for doctors after long-term absence. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Introduction to turbulent dynamical systems in complex systems

CERN Document Server

Majda, Andrew J

2016-01-01

This volume is a research expository article on the applied mathematics of turbulent dynamical systems through the paradigm of modern applied mathematics. It involves the blending of rigorous mathematical theory, qualitative and quantitative modeling, and novel numerical procedures driven by the goal of understanding physical phenomena which are of central importance to the field. The contents cover general framework, concrete examples, and instructive qualitative models. Accessible open problems are mentioned throughout. Topics covered include: · Geophysical flows with rotation, topography, deterministic and random forcing · New statistical energy principles for general turbulent dynamical systems, with applications · Linear statistical response theory combined with information theory to cope with model errors · Reduced low order models · Recent mathematical strategies for online data assimilation of turbulent dynamical systems as well as rigorous results for finite ensemble Kalman filters The volume wi...

The quality of doctoral nursing education in South Africa

Directory of Open Access Journals (Sweden)

Siedine K. Coetzee

2015-07-01

Full Text Available Background: The number of doctoral programmes in nursing has multiplied rapidly throughout the world. This has led to widespread concern about nursing doctoral education, specifically with regard to the quality of curricula and faculty, as well as to the availability of appropriate institutional resources. In South Africa, no study of these issues has been conducted at a national level. Objective: To explore and describe the quality of nursing doctoral education in South Africa from the perspectives of deans, faculty, doctoral graduates and students. Method: A cross-sectional survey design was used. All deans (N = 15; n = 12, faculty (N = 50; n = 26, doctoral graduates (N = 43; n = 26 and students (N = 106; n = 63 at South African nursing schools that offer a nursing doctoral programme (N = 16; n = 15 were invited to participate. Data were collected by means of structured email-mediated Quality of Nursing Doctoral Education surveys. Results: Overall, the graduate participants scored their programme quality most positively of all the groups and faculty scored it most negatively. All of the groups rated the quality of their doctoral programmes as good, but certain problems related to the quality of resources, students and faculty were identified. Conclusion: These evaluations, by the people directly involved in the programmes, demonstrated significant differences amongst the groups and thus provide valuable baseline data for building strategies to improve the quality of doctoral nursing education in South Africa.

Patient‑doctor relationship: The practice orientation of doctors in Kano

African Journals Online (AJOL)

2013-08-19

Aug 19, 2013 ... relationship borders mainly on patients' satisfaction[12‑16] from either the .... Female. 47 (22.0). Marital status. Single. 87 (40.7). Married. 127 (59.3) ... doctors' place of work was only statistically significant in the “sharing” ...

Is networking different with doctors working part-time? Differences in social networks of part-time and full-time doctors.

Science.gov (United States)

Heiligers, Phil J M; de Jong, Judith D; Groenewegen, Peter P; Hingstman, Lammert; Völker, Beate; Spreeuwenberg, Peter

2008-10-04

Part-time working is a growing phenomenon in medicine, which is expected to influence informal networks at work differently compared to full-time working. The opportunity to meet and build up social capital at work has offered a basis for theoretical arguments. Twenty-eight teams of medical specialists in the Netherlands, including 226 individuals participated in this study. Interviews with team representatives and individual questionnaires were used. Data were gathered on three types of networks: relationships of consulting, communication and trust. For analyses, network and multilevel applications were used. Differences between individual doctors and between teams were both analysed, taking the dependency structure of the data into account, because networks of individual doctors are not independent. Teams were divided into teams with and without doctors working part-time. Contrary to expectations we found no impact of part-time working on the size of personal networks, neither at the individual nor at the team level. The same was found regarding efficient reachability. Whereas we expected part-time doctors to choose their relations as efficiently as possible, we even found the opposite in intended relationships of trust, implying that efficiency in reaching each other was higher for full-time doctors. But we found as expected that in mixed teams with part-time doctors the frequency of regular communication was less compared to full-time teams. Furthermore, as expected the strength of the intended relationships of trust of part-time and full-time doctors was equally high. From these findings we can conclude that part-time doctors are not aiming at efficiency by limiting the size of networks or by efficient reachability, because they want to contact their colleagues directly in order to prevent from communication errors. On the other hand, together with the growth of teams, we found this strategy, focussed on reaching all colleagues, was diminishing. And our data

Some problems of dynamical systems on three dimensional manifolds

International Nuclear Information System (INIS)

Dong Zhenxie.

1985-08-01

It is important to study the dynamical systems on 3-dimensional manifolds, its importance is showing up in its close relation with our life. Because of the complication of topological structure of Dynamical systems on 3-dimensional manifolds, generally speaking, the search for 3-dynamical systems is not easier than 2-dynamical systems. This paper is a summary of the partial result of dynamical systems on 3-dimensional manifolds. (author)

Dynamic Reconfiguration in Mobile Systems

NARCIS (Netherlands)

Smit, Gerardus Johannes Maria; Glesner, Manfred; Zipf, Peter; Smit, L.T.; Havinga, Paul J.M.; Heysters, P.M.; Renovell, Michel; Rosien, M.A.J.

Dynamically reconfigurable systems have the potential of realising efficient systems as well as providing adaptability to changing system requirements. Such systems are suitable for future mobile multimedia systems that have limited battery resources, must handle diverse data types, and must operate

Doctors in court, honour, and professional ethics: two scandals in Imperial Germany.

Science.gov (United States)

Maehle, Andreas-Holger

2011-01-01

Comparing two public medical affairs which involved disciplinary proceedings and libel actions, one from Bavaria and one from Prussia, this article analyzes the dynamics behind legal conflicts over doctors' professional ethics in Imperial Germany. In both the case of Dr Maurice Hutzler, who committed suicide after conflicts with senior colleagues at the Gisela Children's Hospital and a sentence of the court of honour of the Munich Medical District Society, and the Berlin "patient trade" affair, in which the medical professors Ernst von Leyden, Hermann Senator, Karl Anton Ewald and Carl Posner were accused of having made payments to middlemen for bringing them lucrative private patients, notions of personal and professional honour played a central role. The Munich case highlighted shortcomings of the Bavarian medical court of honour system, which was less developed than its Prussian counterpart. The analysis of the two cases suggests that the ethics of medical practice in early twentieth-century Germany should be viewed as part of a culture of honour.

Understanding and Modeling Teams As Dynamical Systems

Science.gov (United States)

Gorman, Jamie C.; Dunbar, Terri A.; Grimm, David; Gipson, Christina L.

2017-01-01

By its very nature, much of teamwork is distributed across, and not stored within, interdependent people working toward a common goal. In this light, we advocate a systems perspective on teamwork that is based on general coordination principles that are not limited to cognitive, motor, and physiological levels of explanation within the individual. In this article, we present a framework for understanding and modeling teams as dynamical systems and review our empirical findings on teams as dynamical systems. We proceed by (a) considering the question of why study teams as dynamical systems, (b) considering the meaning of dynamical systems concepts (attractors; perturbation; synchronization; fractals) in the context of teams, (c) describe empirical studies of team coordination dynamics at the perceptual-motor, cognitive-behavioral, and cognitive-neurophysiological levels of analysis, and (d) consider the theoretical and practical implications of this approach, including new kinds of explanations of human performance and real-time analysis and performance modeling. Throughout our discussion of the topics we consider how to describe teamwork using equations and/or modeling techniques that describe the dynamics. Finally, we consider what dynamical equations and models do and do not tell us about human performance in teams and suggest future research directions in this area. PMID:28744231

Dynamic MR imaging of the musculoskeletal system

International Nuclear Information System (INIS)

Shah, A.S.; Hylton, H.; Hentz, V.R.; Schattner, P.

1991-01-01

This paper reports on dynamic MR imaging which is an MR technique that allows imaging of the musculoskeletal system in motion. Current methods for observing the articulation of muscles and joints are limited to acquisition of stationary images at different spatial orientations. These images are then replayed from computer memory to simulate motion. Unlike stationary acquisition, dynamic MR imaging allows the volume of interest to be subjected to motion and dynamic stress, which is important for detecting stress-induced pathology. To demonstrate the utility of dynamic MR imaging, a system for imaging a moving wrist has been developed. The system consists of apparatus capable of providing simultaneous radialulnar deviation and flexion-extension, and hardware for system control and acquisition gating. The apparatus is mounted on the patient bed and is transferable to a variety of standard clinical MR imaging systems. Images were obtained during motion, and the ability of dynamic MR imaging to accurately image the moving wrist with very little motion artifact was demonstrated

Partial dynamical systems, fell bundles and applications

CERN Document Server

Exel, Ruy

2017-01-01

Partial dynamical systems, originally developed as a tool to study algebras of operators in Hilbert spaces, has recently become an important branch of algebra. Its most powerful results allow for understanding structural properties of algebras, both in the purely algebraic and in the C*-contexts, in terms of the dynamical properties of certain systems which are often hiding behind algebraic structures. The first indication that the study of an algebra using partial dynamical systems may be helpful is the presence of a grading. While the usual theory of graded algebras often requires gradings to be saturated, the theory of partial dynamical systems is especially well suited to treat nonsaturated graded algebras which are in fact the source of the notion of "partiality". One of the main results of the book states that every graded algebra satisfying suitable conditions may be reconstructed from a partial dynamical system via a process called the partial crossed product. Running in parallel with partial dynamica...

Dynamical systems on 2- and 3-manifolds

CERN Document Server

Grines, Viacheslav Z; Pochinka, Olga V

2016-01-01

This book provides an introduction to the topological classification of smooth structurally stable diffeomorphisms on closed orientable 2- and 3-manifolds.The topological classification is one of the main problems of the theory of dynamical systems and the results presented in this book are mostly for dynamical systems satisfying Smale's Axiom A. The main results on the topological classification of discrete dynamical systems are widely scattered among many papers and surveys. This book presents these results fluidly, systematically, and for the first time in one publication. Additionally, this book discusses the recent results on the topological classification of Axiom A diffeomorphisms focusing on the nontrivial effects of the dynamical systems on 2- and 3-manifolds. The classical methods and approaches which are considered to be promising for the further research are also discussed. < The reader needs to be familiar with the basic concepts of the qualitative theory of dynamical systems which are present...

Critical and Creative Thinking Nexus: Learning Experiences of Doctoral Students

Science.gov (United States)

Brodin, Eva M.

2016-01-01

Critical and creative thinking constitute important learning outcomes at doctoral level across the world. While the literature on doctoral education illuminates this matter through the lens of experienced senior researchers, the doctoral students' own perspective is missing. Based upon interviews with 14 doctoral students from four disciplines at…

Narcissistic group dynamics of multiparty systems

NARCIS (Netherlands)

Schruijer, S.G.L.

2015-01-01

Purpose – This paper aims to introduce and illustrate the notion of narcissistic group dynamics. It is claimed that narcissism does not simply reside within individuals but can be characteristic of groups and social systems. In this case, the focus is on narcissistic dynamics in multiparty systems.

Nonlinear dynamics of fractional order Duffing system

International Nuclear Information System (INIS)

Li, Zengshan; Chen, Diyi; Zhu, Jianwei; Liu, Yongjian

2015-01-01

In this paper, we analyze the nonlinear dynamics of fractional order Duffing system. First, we present the fractional order Duffing system and the numerical algorithm. Second, nonlinear dynamic behaviors of Duffing system with a fixed fractional order is studied by using bifurcation diagrams, phase portraits, Poincare maps and time domain waveforms. The fractional order Duffing system shows some interesting dynamical behaviors. Third, a series of Duffing systems with different fractional orders are analyzed by using bifurcation diagrams. The impacts of fractional orders on the tendency of dynamical motion, the periodic windows in chaos, the bifurcation points and the distance between the first and the last bifurcation points are respectively studied, in which some basic laws are discovered and summarized. This paper reflects that the integer order system and the fractional order one have close relationship and an integer order system is a special case of fractional order ones.

Dynamics of Open Systems with Affine Maps

International Nuclear Information System (INIS)

Zhang Da-Jian; Liu Chong-Long; Tong Dian-Min

2015-01-01

Many quantum systems of interest are initially correlated with their environments and the reduced dynamics of open systems are an interesting while challenging topic. Affine maps, as an extension of completely positive maps, are a useful tool to describe the reduced dynamics of open systems with initial correlations. However, it is unclear what kind of initial state shares an affine map. In this study, we give a sufficient condition of initial states, in which the reduced dynamics can always be described by an affine map. Our result shows that if the initial states of the combined system constitute a convex set, and if the correspondence between the initial states of the open system and those of the combined system, defined by taking the partial trace, is a bijection, then the reduced dynamics of the open system can be described by an affine map. (paper)

The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis.

Science.gov (United States)

Mills, Edward J; Kanters, Steve; Hagopian, Amy; Bansback, Nick; Nachega, Jean; Alberton, Mark; Au-Yeung, Christopher G; Mtambo, Andy; Bourgeault, Ivy L; Luboga, Samuel; Hogg, Robert S; Ford, Nathan

2011-11-23

To estimate the lost investment of domestically educated doctors migrating from sub-Saharan African countries to Australia, Canada, the United Kingdom, and the United States. Human capital cost analysis using publicly accessible data. Sub-Saharan African countries. Nine sub-Saharan African countries with an HIV prevalence of 5% or greater or with more than one million people with HIV/AIDS and with at least one medical school (Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe), and data available on the number of doctors practising in destination countries. The financial cost of educating a doctor (through primary, secondary, and medical school), assuming that migration occurred after graduation, using current country specific interest rates for savings converted to US dollars; cost according to the number of source country doctors currently working in the destination countries; and savings to destination countries of receiving trained doctors. In the nine source countries the estimated government subsidised cost of a doctor's education ranged from $21,000 (£13,000; €15,000) in Uganda to $58,700 in South Africa. The overall estimated loss of returns from investment for all doctors currently working in the destination countries was $2.17bn (95% confidence interval 2.13bn to 2.21bn), with costs for each country ranging from $2.16m (1.55m to 2.78m) for Malawi to $1.41bn (1.38bn to 1.44bn) for South Africa. The ratio of the estimated compounded lost investment over gross domestic product showed that Zimbabwe and South Africa had the largest losses. The benefit to destination countries of recruiting trained doctors was largest for the United Kingdom ($2.7bn) and United States ($846m). Among sub-Saharan African countries most affected by HIV/AIDS, lost investment from the emigration of doctors is considerable. Destination countries should consider investing in measurable training for source countries and strengthening of their

Encouraging formative assessments of leadership for foundation doctors.

Science.gov (United States)

Hadley, Lindsay; Black, David; Welch, Jan; Reynolds, Peter; Penlington, Clare

2015-08-01

Clinical leadership is considered essential for maintaining and improving patient care and safety in the UK, and is incorporated in the curriculum for all trainee doctors. Despite the growing focus on the importance of leadership, and the introduction of the Medical Leadership Competency Framework (MLCF) in the UK, leadership education for doctors in training is still in its infancy. Assessment is focused on clinical skills, and trainee doctors receive very little formal feedback on their leadership competencies. In this article we describe the approach taken by Health Education Kent, Sussex and Surrey (HEKSS) to raise the profile of leadership amongst doctors in training in the South Thames Foundation School (STFS). An annual structured formative assessment in leadership for each trainee has been introduced, supported by leadership education for both trainees and their supervisors in HEKSS trusts. We analysed over 500 of these assessments from the academic year 2012/13 for foundation doctors in HEKSS trusts, in order to assess the quality of the feedback. From the analysis, potential indicators of more effective formative assessments were identified. These may be helpful in improving the leadership education programme for future years. There is a wealth of evidence to highlight the importance and value of formative assessments; however, particularly for foundation doctors, these have typically been focused on assessing clinical capabilities. This HEKSS initiative encourages doctors to recognise leadership opportunities at the beginning of their careers, seeks to help them understand the importance of acquiring leadership skills and provides structured feedback to help them improve. Leadership education for doctors in training is still in its infancy. © 2015 John Wiley & Sons Ltd.

[The Web: a help or a labyrinth for doctors?].

Science.gov (United States)

Demoor-Goldschmidt, C; Massard, C

2010-10-01

Internet, unknown there fifteen years, has become commonly used today to communicate and exchange all types of information. Concerning medical points, this network is full of data and has become indispensable to physicians. The biomedical knowledge base is changing so fast that it is impossible for a doctor to know everything about everything. Specialists are increasingly specialized but must keep aware of developments in medical knowledge and above all must be able to search quickly and effectively in a given time. To stay informed, they have several means of which the most common are reading the press, Continuing Medical Education and now Internet. Unfortunately, the richness of the Web is also its main fault so we must have the knowledges for searching, analyzing, among the flood of documents available if we do not want to be caught by the screen. Internet usage is done by two approaches: the pull: dynamic approach to information retrieval and the push: passive process of receiving documents. Most doctors have not been trained to use this tool although it became their main source of knowledge and research. This article aims to outline the main ways to learn about a specific topic by giving some tips for saving time.

Doctor's Orders

Institute of Scientific and Technical Information of China (English)

VALERIE SARTOR

2010-01-01

@@ "To become a doctor is like becoming a bomb expert:It takes a long time to learn this skill; you must use care and intuition; and you must understand that your work has grave consequences for those around you,"said Amgalan Gamazhapov,an advanced medical student who studies traditional Chinese and Mongolian medicine at the Inner Mongolia Medical University.

Doctor-Shopping Behavior among Patients with Eye Floaters

Directory of Open Access Journals (Sweden)

Gow-Lieng Tseng

2015-07-01

Full Text Available Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM, was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters.

Doctor-Shopping Behavior among Patients with Eye Floaters.

Science.gov (United States)

Tseng, Gow-Lieng; Chen, Cheng-Yu

2015-07-13

Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM), was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers) who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters.

Evaluation of doctoral nursing programs in Japan by faculty members and their educational and research activities.

Science.gov (United States)

Arimoto, Azusa; Gregg, Misuzu F; Nagata, Satoko; Miki, Yuko; Murashima, Sachiyo

2012-07-01

Evaluation of doctoral programs in nursing is becoming more important with the rapid increase in the programs in Japan. This study aimed to evaluate doctoral nursing programs by faculty members and to analyze the relationship of the evaluation with educational and research activities of faculty members in Japan. Target settings were all 46 doctoral nursing programs. Eighty-five faculty members from 28 programs answered the questionnaire, which included 17 items for program evaluation, 12 items for faculty evaluation, 9 items for resource evaluation, 3 items for overall evaluations, and educational and research activities. A majority gave low evaluations for sources of funding, the number of faculty members and support staff, and administrative systems. Faculty members who financially supported a greater number of students gave a higher evaluation for extramural funding support, publication, provision of diverse learning experiences, time of supervision, and research infrastructure. The more time a faculty member spent on advising doctoral students, the higher were their evaluations on the supportive learning environment, administrative systems, time of supervision, and timely feedback on students' research. The findings of this study indicate a need for improvement in research infrastructure, funding sources, and human resources to achieve quality nursing doctoral education in Japan. Copyright © 2011 Elsevier Ltd. All rights reserved.

Find a Doctor

Science.gov (United States)

... Manager Book Appointments Getting Care When on Active Duty Getting Care When Traveling What's Covered Health Care Dental Care ... Manager Book Appointments Getting Care When on Active Duty Getting Care When Traveling Bread Crumbs Home Find a Doctor ...

Dynamics of Variable Mass Systems

Science.gov (United States)

Eke, Fidelis O.

1998-01-01

This report presents the results of an investigation of the effects of mass loss on the attitude behavior of spinning bodies in flight. The principal goal is to determine whether there are circumstances under which the motion of variable mass systems can become unstable in the sense that their transverse angular velocities become unbounded. Obviously, results from a study of this kind would find immediate application in the aerospace field. The first part of this study features a complete and mathematically rigorous derivation of a set of equations that govern both the translational and rotational motions of general variable mass systems. The remainder of the study is then devoted to the application of the equations obtained to a systematic investigation of the effect of various mass loss scenarios on the dynamics of increasingly complex models of variable mass systems. It is found that mass loss can have a major impact on the dynamics of mechanical systems, including a possible change in the systems stability picture. Factors such as nozzle geometry, combustion chamber geometry, propellant's initial shape, size and relative mass, and propellant location can all have important influences on the system's dynamic behavior. The relative importance of these parameters on-system motion are quantified in a way that is useful for design purposes.

[Doctoral thesis projects for medical students? Retrospective estimation of the fraction of successfully completed medical doctoral thesis projects at Witten/Herdecke University].

Science.gov (United States)

Scharfenberg, Janna; Schaper, Katharina; Krummenauer, Frank

2014-01-01

The German "Dr med" plays a specific role in doctoral thesis settings since students may start the underlying doctoral project during their studies at medical school. If a Medical Faculty principally encourages this approach, then it should support the students in performing the respective projects as efficiently as possible. Consequently, it must be ensured that students are able to implement and complete a doctoral project in parallel to their studies. As a characteristic efficiency feature of these "Dr med" initiatives, the proportion of doctoral projects successfully completed shortly after graduating from medical school is proposed and illustrated. The proposed characteristic can be estimated by the time period between the state examination (date of completion of the qualifying medical examination) and the doctoral examination. Completion of the doctoral project "during their medical studies" was then characterised by a doctoral examination no later than 12 months after the qualifying medical state examination. To illustrate the estimation and interpretation of this characteristic, it was retrospectively estimated on the basis of the full sample of all doctorates successfully completed between July 2009 and June 2012 at the Department of Human Medicine at the Faculty of Health of the University of Witten/Herdecke. During the period of investigation defined, a total number of 56 doctoral examinations were documented, 30 % of which were completed within 12 months after the qualifying medical state examination (95% confidence interval 19 to 44 %). The median duration between state and doctoral examination was 27 months. The proportion of doctoral projects completed parallel to the medical studies increased during the investigation period from 14 % in the first year (July 2009 till June 2010) to 40 % in the third year (July 2011 till June 2012). Only about a third of all "Dr med" projects at the Witten/Herdecke Faculty of Health were completed during or close to

Australian doctors and the visual arts. Part 5. Doctor-artists in South Australia, Tasmania, Western Australia and Queensland.

Science.gov (United States)

Hamilton, D G

1986-11-17

The contributions of Australian doctors to the visual arts are being described in a series of six articles. Work from doctors in New South Wales and Victoria has been covered previously. Now activities in South Australia, Tasmania, Western Australia, Queensland and the Northern Territory are presented.

Gender variations in specialties among medical doctors working in ...

African Journals Online (AJOL)

Background: Gender variations exist in the choice of specialties among ... as it affects the distribution of doctors in public health institutions and patient care. ... For female doctors,pediatrics was the topmost specialty (25%) followed by ... Keywords: Gender variation,Specialties,Doctors,Public healthcare,Health workforce ...

Tuberculosis in medical doctors – a study of personal experiences ...

African Journals Online (AJOL)

Background. The concurrent TB and HIV epidemics in sub-Saharan Africa place all healthcare workers (HCWs) at increased risk of exposure to Mycobacterium tuberculosis. Aim. This study explores personal experiences, attitudes and perceptions of medical doctors following treatment for TB within the healthcare system.

Dynamic simulation of LMFBR systems

International Nuclear Information System (INIS)

Agrawal, A.K.; Khatib-Rahbar, M.

1980-01-01

This review article focuses on the dynamic analysis of liquid-metal-cooled fast breeder reactor systems in the context of protected transients. Following a brief discussion on various design and simulation approaches, a critical review of various models for in-reactor components, intermediate heat exchangers, heat transport systems and the steam generating system is presented. A brief discussion on choice of fuels as well as core and blanket system designs is also included. Numerical considerations for obtaining system-wide steady-state and transient solutions are discussed, and examples of various system transients are presented. Another area of major interest is verification of phenomenological models. Various steps involved in the code and model verification are briefly outlined. The review concludes by posing some further areas of interest in fast reactor dynamics and safety. (author)

The Doctorate in Chemistry. Carnegie Essays on the Doctorate: Chemistry.

Science.gov (United States)

Breslow, Ronald

The Carnegie Foundation commissioned a collection of essays as part of the Carnegie Initiative on the Doctorate (CID). Essays and essayists represent six disciplines that are part of the CID: chemistry, education, English, history, mathematics, and neuroscience. Intended to engender conversation about the conceptual foundation of doctoral…

Constraint Embedding Technique for Multibody System Dynamics

Science.gov (United States)

Woo, Simon S.; Cheng, Michael K.

2011-01-01

Multibody dynamics play a critical role in simulation testbeds for space missions. There has been a considerable interest in the development of efficient computational algorithms for solving the dynamics of multibody systems. Mass matrix factorization and inversion techniques and the O(N) class of forward dynamics algorithms developed using a spatial operator algebra stand out as important breakthrough on this front. Techniques such as these provide the efficient algorithms and methods for the application and implementation of such multibody dynamics models. However, these methods are limited only to tree-topology multibody systems. Closed-chain topology systems require different techniques that are not as efficient or as broad as those for tree-topology systems. The closed-chain forward dynamics approach consists of treating the closed-chain topology as a tree-topology system subject to additional closure constraints. The resulting forward dynamics solution consists of: (a) ignoring the closure constraints and using the O(N) algorithm to solve for the free unconstrained accelerations for the system; (b) using the tree-topology solution to compute a correction force to enforce the closure constraints; and (c) correcting the unconstrained accelerations with correction accelerations resulting from the correction forces. This constraint-embedding technique shows how to use direct embedding to eliminate local closure-loops in the system and effectively convert the system back to a tree-topology system. At this point, standard tree-topology techniques can be brought to bear on the problem. The approach uses a spatial operator algebra approach to formulating the equations of motion. The operators are block-partitioned around the local body subgroups to convert them into aggregate bodies. Mass matrix operator factorization and inversion techniques are applied to the reformulated tree-topology system. Thus in essence, the new technique allows conversion of a system with

Dynamics of Shape Memory Alloy Systems, Phase 2

Science.gov (United States)

2015-12-22

Nonlinear Dynamics and Chaos in Systems with Discontinuous Support Using a Switch Model”, DINAME 2005 - XI International Conference on Dynamic Problems in...AFRL-AFOSR-CL-TR-2016-0003 Dynamics of Shape Memory Alloy Systems , Phase 2 Marcelo Savi FUNDACAO COORDENACAO DE PROJETOS PESQUISAS E EEUDOS TECNOL...release. 2 AFOSR FINAL REPORT Grant Title: Nonlinear Dynamics of Shape Memory Alloy Systems , Phase 2 Grant #: FA9550-11-1-0284 Reporting Period

Parametric Resonance in Dynamical Systems

CERN Document Server

Nijmeijer, Henk

2012-01-01

Parametric Resonance in Dynamical Systems discusses the phenomenon of parametric resonance and its occurrence in mechanical systems,vehicles, motorcycles, aircraft and marine craft, and micro-electro-mechanical systems. The contributors provide an introduction to the root causes of this phenomenon and its mathematical equivalent, the Mathieu-Hill equation. Also included is a discussion of how parametric resonance occurs on ships and offshore systems and its frequency in mechanical and electrical systems. This book also: Presents the theory and principles behind parametric resonance Provides a unique collection of the different fields where parametric resonance appears including ships and offshore structures, automotive vehicles and mechanical systems Discusses ways to combat, cope with and prevent parametric resonance including passive design measures and active control methods Parametric Resonance in Dynamical Systems is ideal for researchers and mechanical engineers working in application fields such as MEM...

Doctors and romance: not only of interest to Mills and Boon readers.

Science.gov (United States)

Callister, Paul; Badkar, Juthika; Didham, Robert

2009-06-01

Internationally there is a growing demand for health services. Skilled health workers, including doctors, have a high degree of international mobility and New Zealand (NZ) stands out internationally in terms of the significant flows of doctors in and out of the country. Through changes in training of doctors in NZ and migration flows, there have been major shifts in the composition of the medical workforce in NZ since the mid-1980s. Studies of the changing nature of the medical workforce often focus on gender and migration separately as well as only considering doctors as individuals. The aim of this exploratory study is to examine the living arrangements of doctors, the composition of migrant doctors who are coming to NZ, and to understand the educational and employment status of the partners of doctors. This study is a descriptive analysis primarily using census data from 1986 through to 2006 and immigration data collected by the Department of Labour. Half of the female medical doctors approved for residence through the Skilled/Business stream migrated independently, while for male doctors less than athird came to NZ independently. Male migrant doctors were more likely to be partnered. Census data showed that people with medical backgrounds tend to partner with each other. However, these relationships are changing, as more women become doctors. In 1986 about 14% of male doctors had a nurse or midwife as a partner and nearly 9% had a doctor partner. By 2006 the proportion of partners of male doctors who were also doctors had risen to 16%, higher than the 9% who were nurses. For female doctors the changes are more dramatic. In 1986, 42% of female doctors in relationships had a doctor as a partner. By 2006, female doctors had increased substantially, but the percentage with a doctor partner had dropped to under athird. Well-qualified couples where one or both are doctors, have a greater propensityto live in main urban areas. Through official reports and extensive

Dynamical analysis of a cubic Liénard system with global parameters (II)

Science.gov (United States)

Chen, Hebai; Chen, Xingwu

2016-06-01

In this paper, we continue to study the global dynamics of a cubic Liénard system for global parameters in the case of three equilibria to follow (2015 Nonlinearity 28 3535-62), which deals with the case of two equilibria. We first analyse qualitative properties of all equilibria and judge the existences of limit cycles and homoclinic loops and their numbers. Then we obtain the bifurcation diagram and all phase portraits as our main results. Based on these results, in the case of three equilibria a positive answer to conjecture 3.2 of (1998 Nonlinearity 11 1505-19), which is about the existence of some function whose graph is exactly the surface of double limit cycles, is obtained. Moreover, a parameter region for the nonexistence of figure-eight loops is given theoretically to compensate for previous numerical results and is illustrated numerically. Supported by NSFC 11471228, 11572263, the Fundamental Research Funds for the Central Universities and Cultivation Foundation of Excellent Doctoral Dissertation of Southwest Jiaotong University (2015).

Doctor Down

Directory of Open Access Journals (Sweden)

N.V. Nagornaya

2013-09-01

Full Text Available The article presents the biographical data of John Langdon Down, his invaluable contribution to the development of rehabilitation programs for children with Down syndrome. The basis of these programs was the socialization of people with intellectual disabilities. In doctor Down’s rehabilitation center there were used methods, including health care, education, physical education, the formation of correct behavior.

Doctoral Dissertation Defences: Performing Ambiguity between Ceremony and Assessment

NARCIS (Netherlands)

van der Heide, Arjen; Rufas, Alix; Supper, Alexandra

2016-01-01

Dissertation defenses are ambiguous affairs, which mark both the end of a long process of doctoral education and the inauguration of a doctoral candidate into a body of experts. At Maastricht University (and other Dutch universities), the decision to award a doctoral degree is made on the basis of

Automated planning through abstractions in dynamic and stochastic environments

OpenAIRE

Martínez Muñoz, Moisés

2016-01-01

Mención Internacional en el título de doctor Generating sequences of actions - plans - for an automatic system, like a robot, using Automated Planning is particularly diflicult in stochastic and/or dynamic environments. These plans are composed of actions whose execution, in certain scenarios, might fail, which in tum prevents the execution of the rest of the actions in the plan. Also, in some environments, plans must he generated fast, hoth at the start of the execution and after every ex...

On the Interplay between Order Parameter Dynamics and System Parameter Dynamics in Human Perceptual-Cognitive-Behavioral Systems.

Science.gov (United States)

Frank, T D

2015-04-01

Previous research has demonstrated that perceiving, thinking, and acting are human activities that correspond to self-organized patterns. The emergence of such patterns can be completely described in terms of the dynamics of the pattern amplitudes, which are referred to as order parameters. The patterns emerge at bifurcations points when certain system parameters internal and external to a human agent exceed critical values. At issue is how one might study the order parameter dynamics for sequences of consecutive, emergent perceptual, cognitive, or behavioral activities. In particular, these activities may in turn impact the system parameters that have led to the emergence of the activities in the first place. This interplay between order parameter dynamics and system parameter dynamics is discussed in general and formulated in mathematical terms. Previous work that has made use of this two-tiered framework of order parameter and system parameter dynamics are briefly addressed. As an application, a model for perception under functional fixedness is presented. Finally, it is argued that the phenomena that emerge in this framework and can be observed when human agents perceive, think, and act are just as likely to occur in pattern formation systems of the inanimate world. Consequently, these phenomena do not necessarily have a neurophysiological basis but should instead be understood from the perspective of the theory of self-organization.

Nonlinear Dynamics, Chaotic and Complex Systems

Science.gov (United States)

Infeld, E.; Zelazny, R.; Galkowski, A.

2011-04-01

Part I. Dynamic Systems Bifurcation Theory and Chaos: 1. Chaos in random dynamical systems V. M. Gunldach; 2. Controlling chaos using embedded unstable periodic orbits: the problem of optimal periodic orbits B. R. Hunt and E. Ott; 3. Chaotic tracer dynamics in open hydrodynamical flows G. Karolyi, A. Pentek, T. Tel and Z. Toroczkai; 4. Homoclinic chaos L. P. Shilnikov; Part II. Spatially Extended Systems: 5. Hydrodynamics of relativistic probability flows I. Bialynicki-Birula; 6. Waves in ionic reaction-diffusion-migration systems P. Hasal, V. Nevoral, I. Schreiber, H. Sevcikova, D. Snita, and M. Marek; 7. Anomalous scaling in turbulence: a field theoretical approach V. Lvov and I. Procaccia; 8. Abelian sandpile cellular automata M. Markosova; 9. Transport in an incompletely chaotic magnetic field F. Spineanu; Part III. Dynamical Chaos Quantum Physics and Foundations Of Statistical Mechanics: 10. Non-equilibrium statistical mechanics and ergodic theory L. A. Bunimovich; 11. Pseudochaos in statistical physics B. Chirikov; 12. Foundations of non-equilibrium statistical mechanics J. P. Dougherty; 13. Thermomechanical particle simulations W. G. Hoover, H. A. Posch, C. H. Dellago, O. Kum, C. G. Hoover, A. J. De Groot and B. L. Holian; 14. Quantum dynamics on a Markov background and irreversibility B. Pavlov; 15. Time chaos and the laws of nature I. Prigogine and D. J. Driebe; 16. Evolutionary Q and cognitive systems: dynamic entropies and predictability of evolutionary processes W. Ebeling; 17. Spatiotemporal chaos information processing in neural networks H. Szu; 18. Phase transitions and learning in neural networks C. Van den Broeck; 19. Synthesis of chaos A. Vanecek and S. Celikovsky; 20. Computational complexity of continuous problems H. Wozniakowski; Part IV. Complex Systems As An Interface Between Natural Sciences and Environmental Social and Economic Sciences: 21. Stochastic differential geometry in finance studies V. G. Makhankov; Part V. Conference Banquet

PREFACE: Dynamics of low-dimensional systems Dynamics of low-dimensional systems

Science.gov (United States)

Bernasconi, M.; Miret-Artés, S.; Toennies, J. P.

2012-03-01

With the development of techniques for high-resolution inelastic helium atom scattering (HAS), electron scattering (EELS) and neutron spin echo spectroscopy, it has become possible, within approximately the last thirty years, to measure the dispersion curves of surface phonons in insulators, semiconductors and metals. In recent years, the advent of new experimental techniques such as 3He spin-echo spectroscopy, scanning inelastic electron tunnel spectroscopy, inelastic x-ray scattering spectroscopy and inelastic photoemission have extended surface phonon spectroscopy to a variety of systems. These include ultra-thin metal films, adsorbates at surface and elementary processes where surface phonons play an important role. Other important directions have been actively pursued in the past decade: the dynamics of stepped surfaces and clusters grown on metal surfaces, due to their relevance in many dynamical and chemical processes at surfaces, including heterogeneous catalysis; clusters; diffusion etc. The role of surface effects in these processes has been conjectured since the early days of surface dynamics, although only now is the availability of ab initio approaches providing those conjectures with a microscopic basis. Last but not least, the investigation of non-adiabatic effects, originating for instance from the hybridization (avoided crossing) of the surface phonons branches with the quasi 1D electron-hole excitation branch, is also a challenging new direction. Furthermore, other elementary oscillations such as surface plasmons are being actively investigated. The aforementioned experimental breakthroughs have been accompanied by advances in the theoretical study of atom-surface interaction. In particular, in the past decade first principles calculations based on density functional perturbation theory have boosted the theoretical study of the dynamics of low-dimensional systems. Phonon dispersion relations of clean surfaces, the dynamics of adsorbates, and the

Dynamic memory management for embedded systems

CERN Document Server

Atienza Alonso, David; Poucet, Christophe; Peón-Quirós, Miguel; Bartzas, Alexandros; Catthoor, Francky; Soudris, Dimitrios

2015-01-01

This book provides a systematic and unified methodology, including basic principles and reusable processes, for dynamic memory management (DMM) in embedded systems.  The authors describe in detail how to design and optimize the use of dynamic memory in modern, multimedia and network applications, targeting the latest generation of portable embedded systems, such as smartphones. Coverage includes a variety of design and optimization topics in electronic design automation of DMM, from high-level software optimization to microarchitecture-level hardware support. The authors describe the design of multi-layer dynamic data structures for the final memory hierarchy layers of the target portable embedded systems and how to create a low-fragmentation, cost-efficient, dynamic memory management subsystem out of configurable components for the particular memory allocation and de-allocation patterns for each type of application.  The design methodology described in this book is based on propagating constraints among de...

Nonautonomous dynamical systems in the life sciences

CERN Document Server

Pötzsche, Christian

2013-01-01

Nonautonomous dynamics describes the qualitative behavior of evolutionary differential and difference equations, whose right-hand side is explicitly time dependent. Over recent years, the theory of such systems has developed into a highly active field related to, yet recognizably distinct from that of classical autonomous dynamical systems. This development was motivated by problems of applied mathematics, in particular in the life sciences where genuinely nonautonomous systems abound. The purpose of this monograph is to indicate through selected, representative examples how often nonautonomous systems occur in the life sciences and to outline the new concepts and tools from the theory of nonautonomous dynamical systems that are now available for their investigation.

IDRC Doctoral Research Awards 2018 | IDRC - International ...

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

2018-05-30

May 30, 2018 ... You must be enrolled at a Canadian university at the doctoral level ... IDRC Doctoral Research Awards are intended to promote the capacity and growth of ... including academic training, local language capacity, professional ... funding opportunity to support Canadian-African research teams studying Ebola.

Differential growth in doctor-patient communications skills

NARCIS (Netherlands)

M van Es, Judith; Wieringa-de Waard, Margreet; Visser, Mechteld R. M.

2013-01-01

Although doctor-patient communication is considered a core competency for medical doctors, the effect of training has not been unequivocally established. Moreover, knowledge about the variance in the growth of different skills and whether certain patterns in growth can be detected could help us to

Diarrhea - what to ask your doctor - child

Science.gov (United States)

What to ask your doctor about diarrhea - child; Loose stools - what to ask your doctor - child ... FOODS What foods can make my child's diarrhea worse? How should I prepare the foods for my child? If my child is still breastfeeding or bottle feeding, do I ...

LOCAL ENTROPY FUNCTION OF DYNAMICAL SYSTEM

Directory of Open Access Journals (Sweden)

İsmail TOK

2013-05-01

Full Text Available In this work, we first,define the entropy function of the topological dynamical system and investigate basic properties of this function without going into details. Let (X,A,T be a probability measure space and consider P = { pl5p2,...,pn} a finite measurable partition of all sub-sets of topological dynamical system (X,T.Then,the quantity H (P = ^ zpt is called the i=1 entropy function of finite measurable partition P.Where f-1 log t if 0 0.If diam(P < s,then the quantity L^ (T = h^ (T - h^ (T,P is called a local entropy function of topological dynamical system (X,T . In conclusion, Let (X,T and (Y,S be two topological dynamical system. If TxS is a transformation defined on the product space (XxY,TxS with (TxS(x , y = (Tx,Sy for all (x,y X x Y.Then L ^^ (TxS = L^d(T + L (S .and, we prove some fundamental properties of this function.

The feminisation of Canadian medicine and its impact upon doctor productivity.

Science.gov (United States)

Weizblit, Nataly; Noble, Jason; Baerlocher, Mark Otto

2009-05-01

We examined the differences in work patterns between female and male doctors in Canada to gain insight into the effect of an increased number of female doctors on overall doctor productivity. Data on the practice profiles of female and male doctors across Canada were extracted from the 2007 National Physician Survey. A doctor productivity measure, 'work hours per week per population' (WHPWPP), was created, based on the number of weekly doctor hours spent providing direct patient care per 100,000 citizens. The predicted WHPWPP was calculated for a hypothetical time-point when the female and male doctor populations reach equilibrium. The differences in current and predicted WHPWPP were then analysed. Female medical students currently (2007) outnumber male medical students (at 57.8% of the medical student population). The percentage of practising doctors who are women is highest in the fields of paediatrics, obstetrics and gynaecology, psychiatry and family practice. Female doctors work an average of 47.5 hours per week (giving 30.0 hours of direct patient care), compared with 53.8 hours worked by male doctors (35.0 hours of direct patient care) (P work less on call hours per week and see fewer patients while on-call. Female doctors are also more likely to take parental leave or a leave of absence (P work patterns described in the present study persist, an overall decrease in doctor productivity is to be anticipated.

The social gradient in doctor-patient communication

Directory of Open Access Journals (Sweden)

Verlinde Evelyn

2012-03-01

Full Text Available Abstract Objective In recent years, the importance of social differences in the physician-patient relationship has frequently been the subject of research. A 2002 review synthesised the evidence on this topic. Considering the increasing importance of social inequalities in health care, an actualization of this review seemed appropriate. Methods A systematic search of literature published between 1965 and 2011 on the social gradient in doctor-patient communication. In this review social class was determined by patient's income, education or occupation. Results Twenty original research papers and meta-analyses were included. Social differences in doctor-patient communication were described according to the following classification: verbal behaviour including instrumental and affective behaviour, non-verbal behaviour and patient-centred behaviour. Conclusion This review indicates that the literature on the social gradient in doctor-patient communication that was published in the last decade, addresses new issues and themes. Firstly, most of the found studies emphasize the importance of the reciprocity of communication. Secondly, there seems to be a growing interest in patient's perception of doctor-patient communication. Practice implications By increasing the doctors' awareness of the communicative differences and by empowering patients to express concerns and preferences, a more effective communication could be established.

Barriers facing junior doctors in rural practice.

Science.gov (United States)

Smith, Deborah M

2005-01-01

Early postgraduate, or junior doctors, are still required to practise in rural and remote communities, and they continue to face numerous issues and difficulties. Within the hospital setting, exposure to rural practice appears to be very limited during internship, and also to some extent, during the second postgraduate year and beyond. This is a major issue for those required to undertake country relieving, rural terms or who will be bonded to rural and remote practice for several years after internship. This research investigated the current issues and difficulties faced by junior doctors, required to undertake rural and remote practice in Queensland, Australia. An exploratory study was undertaken. Primary data were collected through semi-structured interviews held with key stakeholders. Stakeholders included: directors of clinical training; medical educators; junior doctors; rural practitioners; academic rural practitioners; and medical administrators. Of the 23 people approached, a total of 19 agreed to be interviewed. The response rate was 82.6%. Similar to the issues identified in the literature, there are currently a number of barriers influencing the ability of junior doctors to practise competently and confidently when undertaking practice in rural and remote communities. Minimal clinical experience, lack of supervision and on-site support, inadequate orientation and uninformed expectations, limited access to relevant education, and the influence of isolation, results in an overall lack of preparation both professionally and personally. When asked, respondents supported the identification of core skills and knowledge, and integration of these and other issues affecting rural practice, into their hospital-based programs. Current hospital-based education and training programs were not adequately preparing junior doctors for rural and remote practice. It was commented that orientation and education, with a rural emphasis, could assist junior doctors in their

PROBLEM OF FORMATION OF THE SYSTEMIC PHILOSOPHY OF THE DOCTOR

Directory of Open Access Journals (Sweden)

T. V. Novikova

2014-01-01

Full Text Available he problem is to translate medical knowledge into the philosophy of the specialist so that he has learned to see mentally not only the thinnest biological structures, but also to feel their displays in scales of a holistic organism. To achieve such effect, special translators are required. For their creation the biomedical knowledge is considered from the viewpoint of sciences about systems: cybernetics, synergetics, nonlinear dynamics, management theory. Examples: model of homeostasis support in terms of the management theory, the adaptation as a series of recombinations of functional systems in the space of compensatory-adaptive reactions, notion of an information resource of adaptive behavior, understanding of structural disorganization of a membrane of the red blood cells as of a universal model of reaction of a holistic organism. For substantiation the possibility to solve the task representation systemic world outlook and systems thinking are introduced, model of self-organization in the system of specialist knowledge and psychology of creative thinking have been involved.

The complex thinking and prospect of actions of future doctors

Directory of Open Access Journals (Sweden)

Patrícia Segtowich

2011-12-01

Full Text Available This paper aims at discussing prospects of actions manifested by future doctors in the beginning of their doctoral training. The research started through my involvement in the ambit of doctoral education in the curriculum component Epistemological Basis of Research on Education in Science and Mathematics, offered in the Postgraduate Course in Science and Mathematics Education, at Federal University of Pori (UFPA in 2010 academic year. At these meetings, the teachers trainers requested the doctoral students, in pairs, to elaborate three questions about the following positioning: "HOW DO I SEE MYSELF AS A DOCTOR?" These questions were discussed by all the doctoral students and subsequently reduced to five to be answered by all individually. The responses to this questionnaire provided the data for this research. The answers revealed that doctoral students are not tied to methodologies or unique processes, this positioning being demonstrated through prospects of performance in ways that were diverse and interactive

Modeling the Dynamic Digestive System Microbiome†

OpenAIRE

Estes, Anne M.

2015-01-01

“Modeling the Dynamic Digestive System Microbiome” is a hands-on activity designed to demonstrate the dynamics of microbiome ecology using dried pasta and beans to model disturbance events in the human digestive system microbiome. This exercise demonstrates how microbiome diversity is influenced by: 1) niche availability and habitat space and 2) a major disturbance event, such as antibiotic use. Students use a pictorial key to examine prepared models of digestive system microbiomes to determi...

Optimal reduction of flexible dynamic system

International Nuclear Information System (INIS)

Jankovic, J.

1994-01-01

Dynamic system reduction is basic procedure in various problems of active control synthesis of flexible structures. In this paper is presented direct method for system reduction by explicit extraction of modes included in reduced model form. Criterion for optimal system discrete approximation in synthesis reduced dynamic model is also presented. Subjected method of system decomposition is discussed in relation to the Schur method of solving matrix algebraic Riccati equation as condition for system reduction. By using exposed method procedure of flexible system reduction in addition with corresponding example is presented. Shown procedure is powerful in problems of active control synthesis of flexible system vibrations

Scenario development, qualitative causal analysis and system dynamics

Directory of Open Access Journals (Sweden)

Michael H. Ruge

2009-02-01

Full Text Available The aim of this article is to demonstrate that technology assessments can be supported by methods such as scenario modeling and qualitative causal analysis. At Siemens, these techniques are used to develop preliminary purely qualitative models. These or parts of these comprehensive models may be extended to system dynamics models. While it is currently not possible to automatically generate a system dynamics models (or vice versa, obtain a qualitative simulation model from a system dynamics model, the two thechniques scenario development and qualitative causal analysis provide valuable indications on how to proceed towards a system dynamics model. For the qualitative analysis phase, the Siemens – proprietary prototype Computer – Aided Technology Assessment Software (CATS supportes complete cycle and submodel analysis. Keywords: Health care, telecommucations, qualitative model, sensitivity analysis, system dynamics.

Individual medication management system (IMMS) as a proposition of obeying the doctor's recommendation with pharmacist cooperation.

Science.gov (United States)

Waszyk-Nowaczyk, Magdalena; Simon, Marek; Matwij, Karolina

2012-01-01

The pharmacist is an expert with the knowledge of drugs, who has a possibility to follow the patient's individual pharmacotherapy, which is the basis of the pharmaceutical care programme. The implementation of the Individual Medication Management System (IMMS) may be one of the proposals which will enable an analysis of the course of pharmacotherapy and elimination of drug problems, which are the chief goals of pharmaceutical care. In order to determine community pharmacy patients' degree of interest in the IMMS and to evaluate the degree of patients' discipline concerning the application of doctors' recommendations they were given an anonymous questionnaire. The research was done from August 2009 to May 2010 on a sample of 179 people selected at random. They were patients of community pharmacies in Poznań, where 70% were women and 30% were men, all of them aged between 20 and 85 years. The individual age groups were: 20-40 years--27.0%, 41-50 years--10.8%, 51-64 years--43.6%, 65 years or more--18.6%. The patients' education was as follows: primary--4.7%, vocational--8.0%, secondary--31.0%, incomplete university--12.0% and university--44.3%. The chi2 and Fisher-Freeman-Halton tests were used for statistical analysis of the results. Each time the level of statistical significance was assumed at p system. However, it was mostly women and respondents with university education that were the most interested in it. More than 50% of the patients aged 20-40 years and those aged over 65 years indicate the purposefulness of the systems. It is mainly the group aged 20-40 years that confirms facilitation in following the doctor's recommendations (p = 0.02). The respondents indicated their interest and confirmed the purposefulness of the IMMS mainly due to the fact that it helps to avoid drug-related problems resulting from omitting doses and helps to keep the dosage time and frequency in a long-term therapy. The research confirms the fact that individualized therapy will

Dynamics and control of technical systems

CERN Document Server

Balthazar, José M; Kaczmarczyk, Stefan

2014-01-01

The main topics of this Special Issue are linear and, mainly, nonlinear dynamics, chaos and control of systems and structures and their applications in different field of science and engineering. According to the goal of the Special Issue, the selected contributions are divided into three major parts: ""Vibration Problems in Vertical Transportation Systems"", ""Nonlinear Dynamics, Chaos and Control of Elastic Structures"" and ""New Strategies and Challenges for Aerospace and Ocean Structures Dynamics and Control"". The discussion of real problems in aerospace and how these problems can be unde

Dynamics of Information Systems

CERN Document Server

Hirsch, Michael J; Murphey, Robert

2010-01-01

Our understanding of information and information dynamics has outgrown classical information theory. This book presents the research explaining the importance of information in the evolution of a distributed or networked system. It presents techniques for measuring the value or significance of information within the context of a system

Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms

OpenAIRE

Soares, Deanne S.; Chan, Lewis

2016-01-01

Background Stress in doctors adversely affects decision-making, memory, information-recall and attention, thereby negatively impacting upon the provision of safe and high quality patient care. As such, stress in doctors has been subject to increasing scientific scrutiny and has amassed greater public awareness in recent years. The aims of this study are to describe stress levels and the psychological wellbeing of current junior medical officers (JMOs), and to compare this to their predecessor...

[Effect of doctor-patient communication education on oral clinical practice].

Science.gov (United States)

Wang, Yi; Tang, Yu; He, Yan; Zhu, Ya-qin

2012-08-01

To evaluate the effect of doctor-patient communication education on dental clinical practice. The process of 61 dental interns' clinical practice was divided into two stages. The dental interns were taught with traditional teaching method in the first stage. Doctor-patient communication and communication skill training were added to the second stage. Scale of medical student's doctor-patient communication behavior was used to evaluate the dental interns' behavior by themselves after two stages. The SEGUE frame work was used to evaluate the dental interns' behavior by teachers after two stages. All statistical analysis was performed using SPSS 13.0 software package. The result of scale of medical student's doctor-patient communication behavior was analyzed using Fisher exact test or Chi-square test. The score of the SEGUE frame work was analyzed using Student's t test. The result of Scale of medical student's doctor-patient communication behavior showed only 37.71% of dental interns could establish good doctor-patient relationship in the first stage. After doctor-patient communication and communication skill training, the percentage became 75.4%. The result of the SEGUE frame work showed the score was raised from 16.066±3.308 to 21.867±2.456, and a significant difference was found between the two stages. Doctor-Patient communication education can improve dental interns' communication skills and help to establish a good doctor-patient relationship.

The Keys to Success in Doctoral Studies: A Preimmersion Course.

Science.gov (United States)

Salani, Deborah; Albuja, Laura Dean; Azaiza, Khitam

2016-01-01

This article will review an innovative on-line preimmersion course for a hybrid doctor of nursing practice (DNP) program and a traditional face-to-face doctor of philosophy nursing program. The doctoral candidates include both postbaccalaureate and postmaster's students. The authors of the preimmersion course developed and initiated the course in order to address various issues that have surfaced in discussions between students and faculty. Examples of common themes identified include writing skills, statistics, life-work-school balance, and navigating instructional technology. Doctoral studies may pose challenges to students studying nursing, in regard to academic rigor and experiencing on-line education for the first time, especially for students who have been out of school for an extended amount of time or are not accustomed to a nontraditional classroom; thus, having a preimmersion course established may facilitate a smooth transition to rigorous academic studies in a hybrid program. The course, which was developed and delivered through Blackboard, a learning management system, includes the following 9 preimmersion modules: academic strategies (learning styles, creating an effective PowerPoint presentation), library support (introduction to the university library, literature review tutorial, and citation styles), mindfulness, wellness, statistics essentials, writing express, DNP capstone, netiquette, and DNP/doctor of philosophy mentorship. Each module consists of various tools that may promote student success in specific courses and the programs in general. The purpose of designing the preimmersion course is to decrease attrition rates and increase success of the students. While the majority of students have succeeded in their coursework and been graduated from the program, the authors of this article found that many students struggled with the work, life, and school balance. Future work will include the evaluation of results from graduate students enrolled in

Doctor of Professional Counseling: The Next Step

Science.gov (United States)

Southern, Stephen; Cade, Rochelle; Locke, Don W.

2012-01-01

Professional doctorates have been established in the allied health professions by clinicians seeking the highest levels of independent practice. Allied health professional doctorates include nursing practice (DNP), occupational therapy (OTD), psychology (PsyD), social work (DSW), and marriage and family therapy (DMFT). Lessons learned from the…

Do doctors need statistics? Doctors' use of and attitudes to probability and statistics.

Science.gov (United States)

Swift, Louise; Miles, Susan; Price, Gill M; Shepstone, Lee; Leinster, Sam J

2009-07-10

There is little published evidence on what doctors do in their work that requires probability and statistics, yet the General Medical Council (GMC) requires new doctors to have these skills. This study investigated doctors' use of and attitudes to probability and statistics with a view to informing undergraduate teaching.An email questionnaire was sent to 473 clinicians with an affiliation to the University of East Anglia's Medical School.Of 130 respondents approximately 90 per cent of doctors who performed each of the following activities found probability and statistics useful for that activity: accessing clinical guidelines and evidence summaries, explaining levels of risk to patients, assessing medical marketing and advertising material, interpreting the results of a screening test, reading research publications for general professional interest, and using research publications to explore non-standard treatment and management options.Seventy-nine per cent (103/130, 95 per cent CI 71 per cent, 86 per cent) of participants considered probability and statistics important in their work. Sixty-three per cent (78/124, 95 per cent CI 54 per cent, 71 per cent) said that there were activities that they could do better or start doing if they had an improved understanding of these areas and 74 of these participants elaborated on this. Themes highlighted by participants included: being better able to critically evaluate other people's research; becoming more research-active, having a better understanding of risk; and being better able to explain things to, or teach, other people.Our results can be used to inform how probability and statistics should be taught to medical undergraduates and should encourage today's medical students of the subjects' relevance to their future careers. Copyright 2009 John Wiley & Sons, Ltd.

The master degree: A critical transition in STEM doctoral education

Science.gov (United States)

Lange, Sheila Edwards

The need to broaden participation in the nation's science, technology, engineering, and mathematics (STEM) undergraduate and graduate programs is currently a matter of national urgency. The small number of women and underrepresented minorities (URM) earning doctoral degrees in STEM is particularly troubling given significant increases in the number of students earning master's degrees since 1990. In the decade between 1990 and 2000, the total number of master's recipients increased by 42%. During this same time period, the number of women earning master's degrees increased by 56%, African Americans increased by 132%, American Indians by 101%, Hispanics by 146%, and Asian Americans by 117% (Syverson, 2003). Growth in underrepresented group education at the master's level raises questions about the relationship between master's and doctoral education. Secondary data analysis of the Survey of Earned Doctorates (SED) was used to examine institutional pathways to the doctorate in STEM disciplines and transitions from master's to doctoral programs by race and gender. While the study revealed no significant gender differences in pathways, compared to White and Asian American students, URM students take significantly different pathways to the doctorate. URM students are significantly more likely to earn the bachelor's, master's, and doctoral degrees at three different institutions. Their path is significantly more likely to include earning a master's degree en route to the doctorate. Further, URM students are more likely to experience transition between the master's and doctoral degrees, and the transitions are not limited to those who earn master's degrees at master's-only institutions. These findings suggest that earning a master's degree is more often a stepping stone to the doctorate for URM students. Master's degree programs, therefore, have the potential to be a valuable resource for policymakers and graduate programs seeking to increase the diversity of URM students

Lectures on chaotic dynamical systems

CERN Document Server

Afraimovich, Valentin

2002-01-01

This book is devoted to chaotic nonlinear dynamics. It presents a consistent, up-to-date introduction to the field of strange attractors, hyperbolic repellers, and nonlocal bifurcations. The authors keep the highest possible level of "physical" intuition while staying mathematically rigorous. In addition, they explain a variety of important nonstandard algorithms and problems involving the computation of chaotic dynamics. The book will help readers who are not familiar with nonlinear dynamics to understand and appreciate sophisticated modern dynamical systems and chaos. Intended for courses in either mathematics, physics, or engineering, prerequisites are calculus, differential equations, and functional analysis.

OBSERVING LYAPUNOV EXPONENTS OF INFINITE-DIMENSIONAL DYNAMICAL SYSTEMS.

Science.gov (United States)

Ott, William; Rivas, Mauricio A; West, James

2015-12-01

Can Lyapunov exponents of infinite-dimensional dynamical systems be observed by projecting the dynamics into ℝ N using a 'typical' nonlinear projection map? We answer this question affirmatively by developing embedding theorems for compact invariant sets associated with C 1 maps on Hilbert spaces. Examples of such discrete-time dynamical systems include time- T maps and Poincaré return maps generated by the solution semigroups of evolution partial differential equations. We make every effort to place hypotheses on the projected dynamics rather than on the underlying infinite-dimensional dynamical system. In so doing, we adopt an empirical approach and formulate checkable conditions under which a Lyapunov exponent computed from experimental data will be a Lyapunov exponent of the infinite-dimensional dynamical system under study (provided the nonlinear projection map producing the data is typical in the sense of prevalence).

Dynamic screening and electron dynamics in low-dimensional metal systems

International Nuclear Information System (INIS)

Silkin, V.M.; Quijada, M.; Vergniory, M.G.; Alducin, M.; Borisov, A.G.; Diez Muino, R.; Juaristi, J.I.; Sanchez-Portal, D.; Chulkov, E.V.; Echenique, P.M.

2007-01-01

Recent advances in the theoretical description of dynamic screening and electron dynamics in metallic media are reviewed. The time-dependent building-up of screening in different situations is addressed. Perturbative and non-perturbative theories are used to study electron dynamics in low-dimensional systems, such as metal clusters, image states, surface states and quantum wells. Modification of the electronic lifetimes due to confinement effects is analyzed as well

Forecasting the regional distribution and sufficiency of physicians in Japan with a coupled system dynamics-geographic information system model.

Science.gov (United States)

Ishikawa, Tomoki; Fujiwara, Kensuke; Ohba, Hisateru; Suzuki, Teppei; Ogasawara, Katsuhiko

2017-09-12

In Japan, the shortage of physicians has been recognized as a major medical issue. In our previous study, we reported that the absolute shortage will be resolved in the long term, but maldistribution among specialties will persist. To address regional shortage, several Japanese medical schools increased existing quota and established "regional quotas." This study aims to assist policy makers in designing effective policies; we built a model for forecasting physician numbers by region to evaluate future physician supply-demand balances. For our case study, we selected Hokkaido Prefecture in Japan, a region displaying disparities in healthcare services availability between urban and rural areas. We combined a system dynamics (SD) model with geographic information system (GIS) technology to analyze the dynamic change in spatial distribution of indicators. For Hokkaido overall and for each secondary medical service area (SMSA) within the prefecture, we analyzed the total number of practicing physicians. For evaluating absolute shortage and maldistribution, we calculated sufficiency levels and Gini coefficient. Our study covered the period 2010-2030 in 5-year increments. According to our forecast, physician shortage in Hokkaido Prefecture will largely be resolved by 2020. Based on current policies, we forecast that four SMSAs in Hokkaido will continue to experience physician shortages past that date, but only one SMSA would still be understaffed in 2030. The results show the possibility that diminishing imbalances between SMSAs would not necessarily mean that regional maldistribution would be eliminated, as seen from the sufficiency levels of the various SMSAs. Urgent steps should be taken to place doctors in areas where our forecasting model predicts that physician shortages could occur in the future.

Role of the family doctor in the management of adults with obesity: a scoping review

Science.gov (United States)

Elmitt, Nicholas; Haelser, Emily; Douglas, Kirsty A

2018-01-01

Objectives Obesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute methodology. Setting Primary care. Adult patients. Included papers Peer-reviewed and grey literature with the keywords obesity, primary care and family doctors. All literature published up to September 2015. 3294 non-duplicate papers were identified and 225 articles included after full-text review. Primary and secondary outcome measures Data were extracted on the family doctors’ involvement in different aspects of management, and whether whole person and person-centred care were explicitly mentioned. Results 110 papers described interventions in primary care and family doctors were always involved in diagnosing obesity and often in recruitment of participants. A clear description of the provider involved in an intervention was often lacking. It was difficult to determine if interventions took account of whole person and person-centredness. Most opinion papers and clinical overviews described an extensive role for the family doctor in management; in contrast, research on current practices depicted obesity as undermanaged by family doctors. International guidelines varied in their description of the role of the family doctor with a more extensive role suggested by guidelines from family medicine organisations. Conclusions There is a disconnect between how family doctors are involved in primary care interventions, the message in clinical overviews and opinion papers, and observed current practice of family doctors. The role of family doctors in international guidelines for obesity may reflect the strength of primary care in the originating health system. Reporting of primary care interventions could be improved by enhanced descriptions of the providers involved and explanation

Obstacles to Success--Doctoral Student Attrition in South Africa

Science.gov (United States)

Herman, Chaya

2011-01-01

The article explores doctoral attrition in South Africa, investigating and comparing the attributions of attrition of doctoral students and PhD programme leaders. The article is based on secondary data analysis of two large studies on doctoral education in South Africa. The main point of the article is that the different understandings of the…

Dynamic analysis of floating wave energy generation system with mooring system

International Nuclear Information System (INIS)

Choi, Gyu Seok; Sohn, Jeong Hyun

2013-01-01

In this study, dynamic behaviors of a wave energy generation system (WEGS) that converts wave energy into electric energy are analyzed using multibody dynamics techniques. Many studies have focused on reducing the effects of a mooring system on the motion of a WEGS. Several kinematic constraints and force elements are employed in the modeling stage. Three dimensional wave load equations are used to implement wave loads. The dynamic behaviors of a WEGS are analyzed under several wave conditions by using MSC/ADAMS, and the rotating speed of the generating shaft is investigated for predicting the electricity capacity. The dynamic behaviors of a WEGS with a mooring system are compared with those of a WEGS without a mooring system. Stability evaluation of a WEGS is carried out through simulation under extreme wave load

Brazilian doctors' perspective on the second opinion strategy before a C-section.

Science.gov (United States)

Osis, Maria José Duarte; Cecatti, José Guilherme; de Pádua, Karla Simônia; Faúndes, Anibal

2006-04-01

To describe the opinion of doctors who participated in the Latin American Study on Cesarean section in Brazil regarding the second opinion strategy when faced with the decision of performing a C-section. Seventy-two doctors from the hospitals where the study took place (where the second opinion was routinely sought) and 70 from the control group answered a pre-tested self-administered structured questionnaire. Descriptive tables were prepared based on the frequency of relevant variables on opinion of physicians regarding: effectiveness of the application of the second opinion strategy; on whether they would recommend implementation of this strategy and reasons for not recommending it in private institutions; feasibility of the strategy implementation and reasons for not considering this implementation feasible in private institutions. Half of the doctors from the intervention hospitals (50%) and about two thirds of those in the control group (65%) evaluated the second opinion as being or having the potential of being effective/very effective in their institutions. The great majority of those interviewed from both intervention and control hospitals considered this strategy feasible in public (87% and 95% respectively) but not in private hospitals (64% and 70% respectively), mainly because in the latter the doctors would not accept interference from a colleague in their decision-making process. Although the second opinion strategy was perceived as effective in reducing C-section rates, doctors did not regard it feasible outside the public health system in Brazil.

The hundredth Gentner Doctoral Student has started at CERN

CERN Multimedia

CERN Bulletin

2016-01-01

Almost ten years after the start of the programme in 2007, the hundredth Gentner Doctoral Student started his PhD at CERN.   The hundredth Gentner Doctoral Student, Christian Zimmer, in front of the AEgIS detector in the AD hall, where he will spend a significant portion of the next 3 years. In 2007, the German Gentner Doctoral Student Programme was established at CERN, named in honour of the celebrated nuclear physicist Wolfgang Gentner, President of the CERN Council from 1972-74. On 1 July 2016, the 100th Gentner Doctoral Student, Christian Zimmer, started his PhD at CERN, where he will work on setting up the sympathetic laser cooling of antiprotons at the AEgIS experiment. CERN’s Doctoral Student Programme has been running for many years, with 200 students currently enrolled. The Gentner programme is fully integrated into the general CERN Doctoral Student Programme, but is entirely funded by the German Federal Ministry of Education and Research (BMBF). The programme sponsors 30 to 40...

On the Theory of Nonlinear Dynamics and its Applications in Vehicle Systems Dynamics

DEFF Research Database (Denmark)

True, Hans

1999-01-01

We present a brief outline of nonlinear dynamics and its applications to vehicle systems dynamics problems. The concept of a phase space is introduced in order to illustrate the dynamics of nonlinear systems in a way that is easy to perceive. Various equilibrium states are defined...... of nonlinear dynamics in vehicle simulations is discussed, and it is argued that it is necessary to know the equilibrium states of the full nonlinear system before the simulation calculations are performed......., and the important case of multiple equilibrium states and their dependence on a parameter is discussed. It is argued that the analysis of nonlinear dynamic problems always should start with an analysis of the equilibrium states of the full nonlinear problem whereby great care must be taken in the choice...

CIVIL LIABILITY OF DOCTORS AND THEIR INSURANCE (MALPRACTICE

Directory of Open Access Journals (Sweden)

Gârbo Viorica Irina

2013-07-01

Full Text Available Malpractice insurance of medical staff is probably the oldest professional liability insurance underwritten in the insurance market in Romania. The aim of our research is to theoretically examine in a qualitative inquiry the usefulness of insurance completion by the practitioners from the Romanian health system at both state and private, in order to improve a best practice medical insurance. The medical profession is practiced in Romania under the Code of Medical Ethics 30 March 2012 prepared in code that complies with international standards contained in the Geneva Declaration of 1948, as amended by the World Medical Association and the International Code of Medical Ethics. The forms of medical liability are: disciplinary, administrative, civil and criminal and only the civil liability can be taken into insurance because only it meets the conditions of insurability. Once we explain in general and the insurance liability in particular we show articles of the Romanian Civil Code which establishes the obligation the one that caused an injury to a third person for the repair or indemnify and conditions provided by the Civil Code as an act to be considered liability. Then we refer to situations where the patient may be damaged through the fault of the doctor or the doctor unit operates. The object of malpractice insurance is loss of money that the insured would have to pay a patient whom he caused injury as a result of acts or deeds of negligence committed to, during and in relation to professional activity. Risks taken in the insurance are personal injury, illness or death of the patient and / or moral damages. Regarding the excluded risks we have presented an overview of the more common contracts underwritten by Romanian insurance companies. We show the way of underwriting, the insured sums of the standard insurance and the additional one which subscribes moral damages, to companies in Romania agreed by bodies which organize and supervise the

Dynamic Systems Modeling in Educational System Design & Policy

Science.gov (United States)

Groff, Jennifer Sterling

2013-01-01

Over the last several hundred years, local and national educational systems have evolved from relatively simple systems to incredibly complex, interdependent, policy-laden structures, to which many question their value, effectiveness, and direction they are headed. System Dynamics is a field of analysis used to guide policy and system design in…

Agency doctorates

Energy Technology Data Exchange (ETDEWEB)

NONE

1970-07-01

Mr. Wen-chuan Li of China has become the first student to obtain a doctor's degree as a result of research work carried out in the Agency. Mr. Li, who is 33, graduated as a Bachelor of Agriculture at Taiwan Provincial Chung-hsing University in 1960 and in 1966 was granted a fellowship to study mutations in plant breeding at the Agency's Seibersdorf Laboratory near Vienna, under the direction of Dr. Knut Mikaelsen, a professor of the University of Bergen. The Hochschule fur Bodenkultur of Vienna accepted the research as being suitable for a thesis and have now granted the degree of Doctor of Agriculture. The subject of the thesis was modifying factors influencing the mutagenic effects of alkylating agents as compared with ionizing radiations in barley. Alkylating agents are involved in the use of chemicals as a means of changing the characteristics of seeds to bring about changes aimed at improving the quality of crops. Mr. Li's work is regarded as a significant contribution to the understanding of the mechanics by which mutations are induced, to the efficient use of chemicals and ionizing radiations in practical applications, and to the efforts of the Agency in collaboration with the Food and Agriculture Organization to benefit food supplies. Mr. Li has now completed his fellowship with the Agency and has been appointed an Assistant Professor in Plant Breeding at Taiwan Provincial Chung-hsing University. The photograph, taken in the plastic hot house at Seibersdorf, shows him studying rice plants grown from seeds subjected to irradiation. Another noteworthy achievement is that of Mr. Karl-Franz Lacina, a security guard at the Agency's headquarters. At the age of 50 he has been accorded the degree of Doctor of Philosophy at Vienna University, the result of six years' work in his leisure time. The major subject was Arabic, with French and philosophy as supporting subject. (author)

Agency doctorates

International Nuclear Information System (INIS)

1970-01-01

Mr. Wen-chuan Li of China has become the first student to obtain a doctor's degree as a result of research work carried out in the Agency. Mr. Li, who is 33, graduated as a Bachelor of Agriculture at Taiwan Provincial Chung-hsing University in 1960 and in 1966 was granted a fellowship to study mutations in plant breeding at the Agency's Seibersdorf Laboratory near Vienna, under the direction of Dr. Knut Mikaelsen, a professor of the University of Bergen. The Hochschule fur Bodenkultur of Vienna accepted the research as being suitable for a thesis and have now granted the degree of Doctor of Agriculture. The subject of the thesis was modifying factors influencing the mutagenic effects of alkylating agents as compared with ionizing radiations in barley. Alkylating agents are involved in the use of chemicals as a means of changing the characteristics of seeds to bring about changes aimed at improving the quality of crops. Mr. Li's work is regarded as a significant contribution to the understanding of the mechanics by which mutations are induced, to the efficient use of chemicals and ionizing radiations in practical applications, and to the efforts of the Agency in collaboration with the Food and Agriculture Organization to benefit food supplies. Mr. Li has now completed his fellowship with the Agency and has been appointed an Assistant Professor in Plant Breeding at Taiwan Provincial Chung-hsing University. The photograph, taken in the plastic hot house at Seibersdorf, shows him studying rice plants grown from seeds subjected to irradiation. Another noteworthy achievement is that of Mr. Karl-Franz Lacina, a security guard at the Agency's headquarters. At the age of 50 he has been accorded the degree of Doctor of Philosophy at Vienna University, the result of six years' work in his leisure time. The major subject was Arabic, with French and philosophy as supporting subject. (author)

Talking to Your Doctor

Medline Plus

Full Text Available ... You Talking to Your Doctor Science Education Resources Community Resources Clear Health A–Z Publications List More ... & Compliance Grants News/Blog Contracts Loan Repayment More » ...

Talking With Your Doctor: MedlinePlus Health Topic

Science.gov (United States)

... Doctor (For Teens) (Nemours Foundation) Also in Spanish Working with doctors and nurses (Department of Health and Human Services, Office on Women's Health) Seniors Living with Multiple Health Problems: What Older Adults ...

Logical entropy of quantum dynamical systems

Directory of Open Access Journals (Sweden)

Ebrahimzadeh Abolfazl

2016-01-01

Full Text Available This paper introduces the concepts of logical entropy and conditional logical entropy of hnite partitions on a quantum logic. Some of their ergodic properties are presented. Also logical entropy of a quantum dynamical system is dehned and ergodic properties of dynamical systems on a quantum logic are investigated. Finally, the version of Kolmogorov-Sinai theorem is proved.

Dynamical entropy for infinite quantum systems

International Nuclear Information System (INIS)