WorldWideScience

Sample records for effective physician retention

  1. A core city problem: recruitment and retention of salaried physicians.

    Science.gov (United States)

    Paxton, G S; Sbarbaro, J A; Nossaman, N

    1975-03-01

    The professional and personal characteristics of all physicians recruited into a large urban governmentally sponsored health system were evaluated and correlated to staff retention and loss. The results were tabulated for 84 physicians, approximately 90 per cent of the physician work force, over a three-year period. Eighty per cent resided in either Denver or the state of Colorado prior to entry. This is further reflected in a significant percentage being enrolled in the local medical school or training programs prior to entry. These facts suggest a possible source of manpower for beginning programs. Twenty-six per cent came from private practice, 32 per cent from the military and 14 per cent from the Public Health Service. The turnover rate averaged 6.2 per cent per year, with 4.4 per cent being initiated by the physician and 1.8 per cent leaving because of administrative pressure. Data from other studies are reviewed. Factors which appear to influence retention positively were residency training (pediatricians), sex (females), age (over 38) and those with team experience. These factors suggest directions as to the type of physician who, if recruited, tend to reduce turnover. The establishment of a group practice atmosphere with rewards for clinical skills and the offering of unusual specialty opportunities are proposed as positive factors in the retention of staff.

  2. Navy Speciality Physician Study: Historical Overview, Retention Analysis, and Synopsis of Current Civilian-Sector Practices

    National Research Council Canada - National Science Library

    Christensen, Eric

    2002-01-01

    .... The objective of the study was to further explore retention of Navy physicians, by identifying and tracking critical indicators of Navy physician retention, to provide BUMED information for improving...

  3. Physician recruitment and retention in Manitoba: results from a survey of physicians' preferences for rural jobs.

    Science.gov (United States)

    Witt, Julia

    2017-01-01

    Rural recruitment and retention continues to present challenges to health workforce planners. This paper reports and analyzes the results of a survey sent to physicians in Manitoba, eliciting their opinions regarding rural jobs. A survey was sent to all physicians in Manitoba. Part 1 of the survey included questions about background and demographic information; part 2 was a set of job satisfaction questions regarding respondents' current job; and part 3 included 2 sets of stated-choice questions eliciting preferences for a set of attributes relevant to rural recruitment and retention. Of the 2487 physicians who received surveys, 561 (22.6%) responded. Respondents indicated that income, hours worked and on-call frequency are very important: overall job satisfaction increased with income and decreased with hours worked. Income, hours and on-call frequency were ranked "very important" by the largest proportions of physicians. The estimated compensation for on-call more frequent than 1-in-4 was very high (82% of average income), and additional hours worked were worth $183 per hour. Other attributes that were important included professional interaction, housing availability and community incentives during the first year, which were valued at 11%-31% of annual income. Work-life balance is a key consideration for rural jobs, and there are incentives that can compensate for less desirable attributes.

  4. Using the theory of reasoned action to model retention in rural primary care physicians.

    Science.gov (United States)

    Feeley, Thomas Hugh

    2003-01-01

    Much research attention has focused on medical students', residents', and physicians' decisions to join a rural practice, but far fewer studies have examined retention of rural primary care physicians. The current review uses Fishbein and Ajzen's Theory of Reasoned Action (TRA) to organize the literature on the predictors and correlates of retention of rural practicing physicians. TRA suggests turnover behavior is directly predicted by one's turnover intentions, which are, in turn, predicted by one's attitudes about rural practice and perceptions of salient others' (eg, spouse's) attitudes about rural practice and rural living. Narrative literature review of scholarship in predicting and understanding predictors and correlates of rural physician retention. The TRA model provides a useful conceptual model to organize the literature on rural physician retention. Physicians' subjective norms regarding rural practice are an important source of influence in the decision to remain or leave one's position, and this relation should be more fully examined in future research.

  5. Evaluating perceptions of community-based physicians from a high-retention clerkship.

    Science.gov (United States)

    Gillies, Ralph A; Jester, David M; Hobbs, Joseph

    2005-10-01

    This study's objective was to ascertain factors contributing to high retention of community-based sites and their physicians in a 3-decade-old family medicine clerkship. Focus groups were conducted with community-based physicians from the Medical College of Georgia's family medicine clerkship. Transcripts were analyzed using an iterative process regarding physicians' initial and ongoing motivations for participating in the clerkship. Thirteen physicians participated. Six themes were generated: family medicine promotion, valued role of teaching, leadership style, clerkship ownership, resources, and challenges. In addition to intrinsic motivators such as valuing the role of teaching the next generation of physicians and promoting the family medicine specialty, the participative leadership style of a clerkship may be an important factor in physicians' decision to teach in a clerkship. The physicians in this study described having collegial working relationships with the clerkship leaders and receiving consistent support in implementing objectives. Physicians attributed their high level of involvement and investment as a product of being respected partners in defining the clerkship. Financial support and teaching resources were also considered salient. A follow-up study with a larger population is warranted to support the importance of leadership style and other external motivating factors toward a clerkship's physician retention.

  6. Career satisfaction and retention of a sample of women physicians who work reduced hours.

    Science.gov (United States)

    Barnett, Rosalind C; Gareis, Karen C; Carr, Phyllis L

    2005-03-01

    To better understand the career satisfaction and factors related to retention of women physicians who work reduced hours and are in dual-earner couples in comparison to their full-time counterparts. Survey of a random sample of female physicians between 25 and 50 years of age working within 25 miles of Boston, whose names were obtained from the Board of Registration in Medicine in Massachusetts. Interviewers conducted a 60-minute face-to-face closed-ended interview after interviewees completed a 20-minute mailed questionnaire. Fifty-one full-time physicians and 47 reduced hours physicians completed the study; the completion rate was 49.5%. The two groups were similar in age, years as a physician, mean household income, number of children, and presence of an infant in the home. Reduced hours physicians in this sample had a different relationship to experiences in the family than full-time physicians. (1) When reduced hours physicians had low marital role quality, there was an associated lower career satisfaction; full-time physicians report high career satisfaction regardless of their marital role quality. (2) When reduced hours physicians had low marital role or parental role quality, there was an associated higher intention to leave their jobs than for full-time physicians; when marital role or parental role quality was high, there was an associated lower intention to leave their jobs than for full-time physicians. (3) When reduced hours physicians perceived that work interfering with family was high, there was an associated greater intention to leave their jobs that was not apparent for full-time physicians. Women physicians in this sample who worked reduced hours had stronger relationships between family experiences (marital and parental role quality and work interference with family) and professional outcomes than had their full-time counterparts. Both career satisfaction and intention to leave their employment are correlated with the quality of home life for

  7. Why doctors choose small towns: a developmental model of rural physician recruitment and retention.

    Science.gov (United States)

    Hancock, Christine; Steinbach, Alan; Nesbitt, Thomas S; Adler, Shelley R; Auerswald, Colette L

    2009-11-01

    Shortages of health care professionals have plagued rural areas of the USA for more than a century. Programs to alleviate them have met with limited success. These programs generally focus on factors that affect recruitment and retention, with the supposition that poor recruitment drives most shortages. The strongest known influence on rural physician recruitment is a "rural upbringing," but little is known about how this childhood experience promotes a return to rural areas, or how non-rural physicians choose rural practice without such an upbringing. Less is known about how rural upbringing affects retention. Through twenty-two in-depth, semi-structured interviews with both rural- and urban-raised physicians in northeastern California and northwestern Nevada, this study investigates practice location choice over the life course, describing a progression of events and experiences important to rural practice choice and retention in both groups. Study results suggest that rural exposure via education, recreation, or upbringing facilitates future rural practice through four major pathways. Desires for familiarity, sense of place, community involvement, and self-actualization were the major motivations for initial and continuing small-town residence choice. A history of strong community or geographic ties, either urban or rural, also encouraged initial rural practice. Finally, prior resilience under adverse circumstances was predictive of continued retention in the face of adversity. Physicians' decisions to stay or leave exhibited a cost-benefit pattern once their basic needs were met. These results support a focus on recruitment of both rural-raised and community-oriented applicants to medical school, residency, and rural practice. Local mentorship and "place-specific education" can support the integration of new rural physicians by promoting self-actualization, community integration, sense of place, and resilience. Health policy efforts to improve the physician

  8. A Comparison of the J-1 Visa Waiver and Loan Repayment Programs in the Recruitment and Retention of Physicians in Rural Nebraska.

    Science.gov (United States)

    Opoku, Samuel T; Apenteng, Bettye A; Lin, Ge; Chen, Li-Wu; Palm, David; Rauner, Thomas

    2015-01-01

    There is a dearth of literature evaluating the effectiveness of programs aimed at recruiting and retaining physicians in rural Nebraska. Taking advantage of the Nebraska Health Professional Tracking System, this study attempts to comparatively assess the effectiveness of the J-1 visa waiver and state loan repayment programs in the recruitment and retention of physicians in rural Nebraska. A mixed methods approach was used. We tracked 240 physicians who enrolled in the J-1 visa waiver and state loan repayment programs between 1996 and 2012 until 2013. In addition, key informant interviews were conducted to obtain perspectives on the recruitment and retention of physicians in rural Nebraska through the 2 programs. Results from multilevel survival regression analysis indicated that physicians enrolled in the J-1 visa waiver program were more likely to leave rural Nebraska when compared with those enrolled in the state loan repayment program. Participants in the qualitative study, however, cautioned against declaring one program as superior over the other, given that the 2 programs addressed different needs for different communities. In addition, results suggested that fostering the integration of physicians and their families into rural communities might be a way of enhancing retention, regardless of program. The findings from this study highlight the complexity of recruitment and retention issues in rural Nebraska and suggest the need for more holistic and family-centered approaches to addressing these issues. © 2015 National Rural Health Association.

  9. Motivation and Retention of Physicians in Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan

    Directory of Open Access Journals (Sweden)

    Sayed Masoom Shah

    2016-08-01

    Full Text Available Background: Workforce motivation and retention is important for the functionality and quality of service delivery in health systems of developing countries. Despite huge primary healthcare (PHC infrastructure, Pakistan’s health indicators are not impressive; mainly because of under-utilization of facilities and low patient satisfaction. One of the major underlying issues is staff absenteeism. The study aimed to identify factors affecting retention and motivation of doctors working in PHC facilities of Pakistan. Methods: An exploratory study was conducted in a rural district in Khyber Puktunkhwa (KP province, in Pakistan. A conceptual framework was developed comprising of three organizational, individual, and external environmental factors. Qualitative research methods comprising of semi-structured interviews with doctors working in basic health units (BHUs and in-depth interviews with district and provincial government health managers were used. Document review of postings, rules of business and policy actions was also conducted. Triangulation of findings was carried out to arrive at the final synthesis. Results: Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies and medical facilities contributed to lack of motivation among both male and female doctors. The physicians accepted government jobs in BHUs with a belief that these jobs were more secure, with convenient working hours. Male physicians seemed to be more motivated because they faced less challenges than their female counterparts in BHUs especially during relocations. Overall, the organizational factors emerged as the most significant whereby human resource policy, career growth structure, performance appraisal and monetary benefits played an important role. Gender and marital status of female doctors was regarded as most important individual factor affecting retention and motivation of female doctors in BHUs

  10. Motivation and Retention of Physicians in Primary Healthcare Facilities: A Qualitative Study From Abbottabad, Pakistan.

    Science.gov (United States)

    Shah, Sayed Masoom; Zaidi, Shehla; Ahmed, Jamil; Rehman, Shafiq Ur

    2016-04-09

    Workforce motivation and retention is important for the functionality and quality of service delivery in health systems of developing countries. Despite huge primary healthcare (PHC) infrastructure, Pakistan's health indicators are not impressive; mainly because of under-utilization of facilities and low patient satisfaction. One of the major underlying issues is staff absenteeism. The study aimed to identify factors affecting retention and motivation of doctors working in PHC facilities of Pakistan. An exploratory study was conducted in a rural district in Khyber Puktunkhwa (KP) province, in Pakistan. A conceptual framework was developed comprising of three organizational, individual, and external environmental factors. Qualitative research methods comprising of semi-structured interviews with doctors working in basic health units (BHUs) and in-depth interviews with district and provincial government health managers were used. Document review of postings, rules of business and policy actions was also conducted. Triangulation of findings was carried out to arrive at the final synthesis. Inadequate remuneration, unreasonable facilities at residence, poor work environment, political interference, inadequate supplies and medical facilities contributed to lack of motivation among both male and female doctors. The physicians accepted government jobs in BHUs with a belief that these jobs were more secure, with convenient working hours. Male physicians seemed to be more motivated because they faced less challenges than their female counterparts in BHUs especially during relocations. Overall, the organizational factors emerged as the most significant whereby human resource policy, career growth structure, performance appraisal and monetary benefits played an important role. Gender and marital status of female doctors was regarded as most important individual factor affecting retention and motivation of female doctors in BHUs. Inadequate remuneration, unreasonable

  11. Professional, generational, and gender differences in perception of organisational values among Israeli physicians and nurses: Implications for retention.

    Science.gov (United States)

    Warshawski, Sigalit; Barnoy, Sivia; Kagan, Ilya

    2017-11-01

    The global health workforce today is more age diverse than ever before and spans three generations: baby boomers, X and Y generations. Each generation has a distinct set of characteristics, values, and beliefs. This diversity can lead to increased creativity and a greater richness of values and skills, but at the same time it can also lead to value clashes, disrespect, and conflicts. This study aimed to examine professional, generational, and gender differences in the perception of the importance of organisational values among nurses and physicians working in both hospitals and outpatient clinics in Israel. Data were collected from a large sample of nurses and physicians (N = 603) from 11 hospitals and community services across Israel. The participants completed a self-administered questionnaire rating the perceived importance of 20 organisational values, such as leadership, risk-taking, competition, power, and collaboration. The five values ranked most important were performance quality, cooperation, commitment, effectiveness, and efficiency. The five values ranked least important were competition, marketing, power, risk-taking, and assertiveness. Significant value differences were found by profession, generation, and gender. Nurses scored efficiency, assertiveness, risk-taking, power, and marketing higher than physicians did. The Y generation scored power higher and marketing lower than the two older generations. Women ranked the values of cooperation, commitment, innovativeness, vision, and marketing significantly higher than men did. Understanding differences between professions, generations, and gender is a useful first step in improving employees' job satisfaction, productivity, and retention.

  12. Managing Chemotherapy Side Effects: Swelling (Fluid Retention)

    Science.gov (United States)

    N ational C ancer I nstitute Managing Chemotherapy Side Effects Swelling (Fluid retention) “My hands and feet were swollen and puffy. My nurse helped me understand why I had to stop eating salty ...

  13. Assessment of factors influencing retention in the Philippine National Rural Physician Deployment Program

    Directory of Open Access Journals (Sweden)

    Leonardia Juan

    2012-11-01

    Full Text Available Abstract Background The ‘Doctors to the Barrios’ (DTTB Program was launched in 1993 in response to the shortage of doctors in remote communities in the Philippines. While the Program has attracted physicians to work in such areas for the prescribed 2-year period, ongoing monitoring shows that very few chose to remain there for longer and be absorbed by their Local Government Unit (LGU. This assessment was carried out to explore the reasons for the low retention rates and to propose possible strategies to reverse the trend. Methods A mixed methods approach was used comprising a self-administered questionnaire for members of the current cohort of DTTBs, and oral interviews with former DTTBs. Results Among former DTTBs, the wish to serve rural populations was the most widely cited motivation. By comparison, among the current cohort of DTTBs, more than half joined the Program due to return of service obligations; a quarter to help rural populations, and some out of an interest in public health. Those who joined the Program to return service experienced significantly less satisfaction, whilst those who joined out of an interest in public health were significantly more satisfied with their rural work. Those who graduated from medical schools in the National Capital Region were significantly more critical about their compensation and perceived there to be fewer options for leisure in rural areas. With regard to the factors impeding retention, lack of support from the LGU was most frequently mentioned, followed by concerns about changes in compensation upon absorption by the LGU, family issues and career advancement. Conclusions Through improved collaboration with the Department of Health, LGUs need to strengthen the support provided to DTTBs. Priority could be given to those acting out of a desire to help rural populations or having an interest in public health, and those who have trained outside of the National Capital Region. Whether physicians

  14. Physician recruitment and retention in New Brunswick: a medical student perspective

    Directory of Open Access Journals (Sweden)

    Mariah Giberson

    2016-10-01

    Full Text Available Background: Physician recruitment and retention is a priority for many Canadian provinces. Each province is unique in terms of recruitment strategies and packages offered; however, little is known about how medical students evaluate these programs. The purpose of the current study was to determine which factors matter most to New Brunswick (NB medical students when considering their location of future practice. Method: A survey of NB medical students was conducted. Descriptive statistics were produced and a linear regression model was developed to study factors predictive of a student’s expressed willingness to practice in NB. Results:  158 medical students completed the online survey, which is a response rate of 55%. Job availability and spouse’s ability to work in the province were ranked as the top factors in deciding where to practice. In the final regression model, factors predictive of an expressed desire to practice in NB include being female, living in NB prior to medical school, attending medical school at Université de Sherbrooke, participation in the NB Preceptorship program, and a desire to practice family medicine. Conclusions: This study provides insight into what medical students consider when deciding where to practice. This research may be used to inform physician recruitment efforts and guide future research into medical education and policy.

  15. Studying physician effects on patient outcomes: physician interactional style and performance on quality of care indicators.

    Science.gov (United States)

    Franks, Peter; Jerant, Anthony F; Fiscella, Kevin; Shields, Cleveland G; Tancredi, Daniel J; Epstein, Ronald M

    2006-01-01

    Many prior studies which suggest a relationship between physician interactional style and patient outcomes may have been confounded by relying solely on patient reports, examining very few patients per physician, or not demonstrating evidence of a physician effect on the outcomes. We examined whether physician interactional style, measured both by patient report and objective encounter ratings, is related to performance on quality of care indicators. We also tested for the presence of physician effects on the performance indicators. Using data on 100 US primary care physician (PCP) claims data on 1,21,606 of their managed care patients, survey data on 4746 of their visiting patients, and audiotaped encounters of 2 standardized patients with each physician, we examined the relationships between claims-based quality of care indicators and both survey-derived patient perceptions of their physicians and objective ratings of interactional style in the audiotaped standardized patient encounters. Multi-level models examined whether physician effects (variance components) on care indicators were mediated by patient perceptions or objective ratings of interactional style. We found significant physician effects associated with glycohemoglobin and cholesterol testing. There was also a clinically significant association between better patient perceptions of their physicians and more glycohemoglobin testing. Multi-level analyses revealed, however, that the physician effect on glycohemoglobin testing was not mediated by patient perceived physician interaction style. In conclusion, similar to prior studies, we found evidence of an apparent relationship between patient perceptions of their physician and patient outcomes. However, the apparent relationships found in this study between patient perceptions of their physicians and patient care processes do not reflect physician style, but presumably reflect unmeasured patient confounding. Multi-level modeling may contribute to better

  16. The Causal Effects of Grade Retention on Behavioral Outcomes

    Science.gov (United States)

    Martorell, Paco; Mariano, Louis T.

    2018-01-01

    This study examines the impact of grade retention on behavioral outcomes under a comprehensive assessment-based student promotion policy in New York City. To isolate the causal effect of grade retention, we implement a fuzzy regression discontinuity (RD) design that exploits the fact that grade retention is largely determined by whether a student…

  17. Effects of fire ash on soil water retention

    NARCIS (Netherlands)

    Stoof, C.R.; Wesseling, J.G.; Ritsema, C.J.

    2010-01-01

    Despite the pronounced effect of fire on soil hydrological systems, information on the direct effect of fire on soil water retention characteristics is limited and contradictory. To increase understanding in this area, the effect of fire on soil water retention was evaluated using laboratory burning

  18. Investing in Community-Based Education to Improve the Quality, Quantity, and Retention of Physicians in Three African Countries

    Science.gov (United States)

    Talib, Zohray Moolani; Baingana, Rhona Kezabu; Sagay, Atiene Solomon; Van Schalkwyk, Susan Camille; Mehtsun, Sinit; Kiguli-Malwadde, Elsie

    2014-01-01

    Context The Medical Education Partnership Initiative (MEPI) is a $US 130 million program funded by the United States government supporting 13 African medical schools to increase the quantity, quality, and retention of physicians in underserved areas. This paper examines how community-based education (CBE) is evolving at MEPI schools to achieve these goals. Methods We utilized data from the first two years of site visits and surveys to characterize CBE efforts across the MEPI network and provide detailed descriptions of three models of CBE among the MEPI programs. Results There is widespread investment in CBE, with considerable diversity in the goals and characteristics of training activities among MEPI schools. Three examples described here show how schools are strengthening and evaluating different models of CBE to achieve MEPI goals. In Nigeria, students are being sent for clinical rotations to community hospitals to offload the tertiary hospital. In Uganda, the consistency and quality of teaching in CBE is being strengthened by adopting a competency-based curriculum and developing criteria for community sites. At Stellenbosch University in South Africa, students are now offered an elective year-long comprehensive rural immersion experience. Despite the diversity in CBE models, all schools are investing in e-learning and faculty development. Extensive evaluations are planned to examine the impact of CBE strategies on the health workforce and health services. Discussion The MEPI program is stimulating an evolution in CBE among African medical schools to improve the quality, quantity, and retention of physicians. Identifying the strategies within CBE that are reproducible, scalable and optimize outcomes will be instructive for health professions training programs across the continent. PMID:24200732

  19. Wind Effects on Retention Time in Highway Ponds

    DEFF Research Database (Denmark)

    Bentzen, Thomas Ruby; Larsen, Torben; Rasmussen, Michael R.

    2007-01-01

    is to evaluate the quality of long term simulations based on historical rain series of the pollutant discharges from roads and highways. The idea of this paper is to evaluate the effects of wind on the retention time and compare the retention time for the situation of a spatial uniform wind shear stress...... with the situation of a "real" spatial non-uniform shear stress distribution on the surface of the pond. The result of this paper shows that wind plays a dominant role for the retention time and flow pattern. Furthermore, the results shows that the differences in retention time between the use of uniform and non...

  20. Wind Effects on Retention Time in Highway Ponds

    DEFF Research Database (Denmark)

    Bentzen, Thomas Ruby; Larsen, Torben; Rasmussen, Michael R.

    2008-01-01

    is to evaluate the quality of long term simulations based on historical rain series of the pollutant discharges from roads and highways. The idea of this paper is to evaluate the effects of wind on the retention time and compare the retention time for the situation of a spatial uniform wind shear stress...... with the situation of a "real" spatial non-uniform shear stress distribution on the surface of the pond. The result of this paper shows that wind plays a dominant role for the retention time and flow pattern. Furthermore, the results shows that the differences in retention time between the use of uniform and non...

  1. Treatment of chemical warfare agent casualties: retention of knowledge and self-perceived competency among military physicians and paramedics.

    Science.gov (United States)

    Shiyovich, Arthur; Statlender, Liran; Abu-Tailakh, Muhammad; Plakht, Ygal; Shrot, Shai; Kassirer, Michael

    2015-06-01

    Specialized training of medical teams for chemical warfare agent (CWA) events is important to save lives. We aimed to evaluate the retention of knowledge (ROK) and self-perceived competency (SPC) of military medical personnel in delivering treatment during CWA events. A questionnaire and a multiple-choice examination were sent to military physicians and paramedics, evaluating their CWA, ROK, and SPC (study group [SG]). Their assessment was compared to medical personnel immediately post training (reference group [RG]). SG was subdivided into two groups: G1 ≤ 1 year and G2 > 1 year, past training. Overall, 135 participants responded (35-RG, 65% physicians). Self-reported ROK and SPC were significantly higher in RG compared to SG and in G1 compared to G2. Test scores were higher in RG compared to SG, but similar in G1 and G2 groups. SPC was lower compared to ROK in the entire cohort and subgroups. A moderate correlation was found between the self-and test-assessed scores (Pearson correlation coefficient 0.45, p ROK. Thus, we recommend CWA refresher training at least every year. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  2. ACOG Committee Opinion No. 587: Effective patient-physician communication.

    Science.gov (United States)

    2014-02-01

    Physicians' ability to effectively and compassionately communicate information is key to a successful patient-physician relationship. The current health care environment demands increasing clinical productivity and affords less time with each patient, which can impede effective patient-physician communication. The use of patient-centered interviewing, caring communication skills, and shared decision making improves patient-physician communication. Involving advanced practice nurses or physician assistants may improve the patient's experience and understanding of her visit. Electronic communication with established patients also can enhance the patient experience in select situations.

  3. Emotional and psychological effects of physician-assisted suicide and euthanasia on participating physicians.

    Science.gov (United States)

    Stevens, Kenneth R

    2006-01-01

    This is a review and evaluation of medical and public literature regarding the reported emotional and psychological effects of participation in physician-assisted suicide (PAS) and euthanasia on the involved physicians. Articles in medical journals, legislative investigations and the public press were obtained and reviewed to determine what has been reported regarding the effects on physicians who have been personally involved in PAS and euthanasia. The physician is centrally involved in PAS and euthanasia, and the emotional and psychological effects on the participating physician can be substantial. The shift away from the fundamental values of medicine to heal and promote human wholeness can have significant effects on many participating physicians. Doctors describe being profoundly adversely affected, being shocked by the suddenness of the death, being caught up in the patient's drive for assisted suicide, having a sense of powerlessness, and feeling isolated. There is evidence of pressure on and intimidation of doctors by some patients to assist in suicide. The effect of countertransference in the doctor-patient relationship may influence physician involvement in PAS and euthanasia. Many doctors who have participated in euthanasia and/or PAS are adversely affected emotionally and psychologically by their experiences.

  4. Effectiveness of a Unique Support Group for Physicians in a Physician Health Program.

    Science.gov (United States)

    Sanchez, Luis T; Candilis, Philip J; Arnstein, Fredrick; Eaton, Judith; Barnes Blood, Diana; Chinman, Gary A; Bresnahan, Linda R

    2016-01-01

    State Physician Health Programs (PHPs) assess, support, and monitor physicians with mental, behavioral, medical, and substance abuse problems. Since their formation in the 1970s, PHPs have offered support groups following the 12-step model for recovery from substance use disorders (SUDs). However, few programs have developed support groups for physicians without SUDs. This study at the Massachusetts PHP (Physician Health Services Inc.) represents the first effort to survey physician attitudes concerning a unique support group that goes beyond classic addiction models. The group was initiated because of the observation that physicians with problems other than SUDs did not fit easily into the 12-step framework. It was hypothesized that such a group would be effective in helping participants control workplace stress, improve professional and personal relationships, and manage medical and psychiatric difficulties. With a response rate of 43% (85 respondents), the survey identified a strong overall impact of the Physician Health Services Inc. support group, identifying positive effects in all areas of personal and professional life: family and friends, wellness, professional relationships, and career. Respondents identified the role of the facilitator as particularly important, underscoring the facilitator's capacity to welcome participants, manage interactions, set limits, and maintain a supportive emotional tone. The implications for physician health extend from supporting a broader application of this model to using a skilled facilitator to manage groups intended to reduce the stress and burnout of present-day medical practice. The results encourage PHPs, hospitals, medical practices, and physician groups to consider implementing facilitated support groups as an additional tool for maintaining physician health.

  5. Effective Retention Strategies for Diverse Employees.

    Science.gov (United States)

    Musser, Linda R.

    2001-01-01

    Discusses methods to determine why employees leave or stay, based on experiences at Pennsylvania State University libraries. Considers retention tools that work best to retain diverse employees, including mentoring, networking, career and learning opportunities, balance between work and home life, a welcoming climate, and support for research.…

  6. The effect of explicit financial incentives on physician behavior.

    Science.gov (United States)

    Armour, B S; Pitts, M M; Maclean, R; Cangialose, C; Kishel, M; Imai, H; Etchason, J

    2001-05-28

    Managed care organizations use explicit financial incentives to influence physicians' use of resources. This has contributed to concerns regarding conflicts of interest for physicians and adverse effects on the quality of patient care. In light of recent publicized legislative and legal battles about this issue, we reviewed the literature and analyzed studies that examine the effect of these explicit financial incentives on the behavior of physicians. The method used to undertake the literature review followed the approach set forth in the Cochrane Collaboration handbook. Our literature review revealed a paucity of data on the effect of explicit financial incentives. Based on this limited evidence, explicit incentives that place individual physicians at financial risk appear to be effective in reducing physician resource use. However, the empirical evidence regarding the effectiveness of bonus payments on physician resource use is mixed. Similarly, our review revealed mixed effects of the influence of explicit financial incentives on the quality of patient care. The effect of explicit financial incentives on physician behavior is complicated by a lack of understanding of the incentive structure by the managed care organization and the physician. The lack of a universally acceptable definition of quality renders it important that future researchers identify the term explicitly.

  7. Military physician recruitment and retention: a survey of students at the Uniformed Services University of the Health Sciences.

    Science.gov (United States)

    Holmes, Samuel L; Lee, Daniel J; Charny, Grigory; Guthrie, Jeff A; Knight, John G

    2009-05-01

    Recent strategies employed in response to military physician recruitment shortfalls have consisted of increasing financial incentives for students in the Health Professions Scholarship Program (HPSP) while offering no increased incentive for attendance at the Uniformed Services University of the Health Sciences (USUHS). To gauge the impact of these incentive increases on the decision of medical students to attend USUHS, a prospective e-mail survey of current USUHS medical students was conducted. The survey was distributed to 674 USUHS medical students from all four class years, of which 41% responded. Students were asked to prioritize incentives and disincentives for military service and USUHS, as well as respond to whether recent incentives applied solely to the HPSP would have affected their decision to attend USUHS. Data were assessed using a weighted scale with responses ranked highest receiving a score of 3, responses ranked second receiving a weighted score of 2, and those ranked third receiving a weighted score of 1. The total weighted sum for each question response across the respondent population was then tallied in aggregate and assigned a weighted score to identify factors consistently ranked highest among the students. Patriotic duty and serving uniformed personnel were ranked most appealing about military service. Combat and deployment considerations were ranked least appealing about military service. Also of note, numerous survey comment box responses highlighted the perceived advantages of pooling resources between the two programs to benefit military medical student recruitment and training. Survey results suggested that current enhanced financial incentives and shorter service obligation offered by the HPSP make attendance of USUHS less appealing for current USUHS students and may negatively impact recruitment and retention of USUHS medical officers. Commensurate incentives such as promotion and credit for time in service while attending USUHS were

  8. Continuing Dermatology Education for Rural Physician Assistants in Ghana: An Assessment of Needs and Effectiveness.

    Science.gov (United States)

    Truong, Amanda; Cobb, Nadia M; Hawkes, Jason E; Adjase, Emmanuel T; Goldgar, David E; Powell, Douglas L; Lewis, Bethany K H

    2018-03-01

    To assess the effectiveness of lectures for continuing medical education (CME) in dermatology in a global health setting and to determine provider and patient demographics of physician assistants (PAs) practicing in rural Ghana. Physician assistants from Ghana who attended dermatology lectures at the International Seminar for Physician Assistants in 2011 or 2014 were included in this study. Surveys were administered to participants to determine dermatology resource availability, commonly encountered skin diseases, and management practices. Quizzes were administered before and after CME dermatology lectures to assess short-term retention of lecture material. In all, 353 PAs participated in this study. Physician assistants reported seeing an average of 55 patients per day. The most commonly seen skin diseases were infections, with antifungals and antibiotics being the most commonly prescribed medications. Dermatology-related complaints represented 9.5% of total clinic visits. Among practicing PAs, 23.2% reported having internet access. A total of 332 PAs completed the quizzes, and a statistically significant increase in test scores was noted in postlecture quizzes. This study reinforces the importance of dermatology education for PAs practicing in rural areas of Ghana and lends insight to critical topics for dermatology curriculum development. In addition, the increase in test scores after CME sessions suggests that lectures are an effective tool for short-term retention of dermatology-related topics. Our study indicates that as the need for health workers increases globally and a paradigm shift away from the traditional physician model of care occurs, dermatology training of PAs is not only important but also achievable.

  9. FRAMING EFFECTS ON PHYSICIANS' JUDGMENT AND DECISION MAKING.

    Science.gov (United States)

    Bui, Thanh C; Krieger, Heather A; Blumenthal-Barby, Jennifer S

    2015-10-01

    This study aimed to assess physicians' susceptibility to framing effects in clinical judgment and decision making. A survey was administered online to 159 general internists in the United States. Participants were randomized into two groups, in which clinical scenarios varied in their framings: frequency vs percentage, with cost information vs without, female patient vs male patient, and mortality vs survival. Results showed that physicians' recommendations for patients in hypothetical scenarios were significantly different when the predicted probability of the outcomes was presented in frequency versus percentage form and when it was presented in mortality rate vs survival rate of the same magnitude. Physicians' recommendations were not different for other framing effects.

  10. Guidelines for Improving Entry Into and Retention in Care and Antiretroviral Adherence for Persons With HIV: Evidence-Based Recommendations From an International Association of Physicians in AIDS Care Panel

    Science.gov (United States)

    Thompson, Melanie A.; Mugavero, Michael J.; Amico, K. Rivet; Cargill, Victoria A.; Chang, Larry W.; Gross, Robert; Orrell, Catherine; Altice, Frederick L.; Bangsberg, David R.; Bartlett, John G.; Beckwith, Curt G.; Dowshen, Nadia; Gordon, Christopher M.; Horn, Tim; Kumar, Princy; Scott, James D.; Stirratt, Michael J.; Remien, Robert H.; Simoni, Jane M.; Nachega, Jean B.

    2014-01-01

    Description After HIV diagnosis, timely entry into HIV medical care and retention in that care are essential to the provision of effective antiretroviral therapy (ART). ART adherence is among the key determinants of successful HIV treatment outcome and is essential to minimize the emergence of drug resistance. The International Association of Physicians in AIDS Care convened a panel to develop evidence-based recommendations to optimize entry into and retention in care and ART adherence for people with HIV. Methods A systematic literature search was conducted to produce an evidence base restricted to randomized, controlled trials and observational studies with comparators that had at least 1 measured biological or behavioral end point. A total of 325 studies met the criteria. Two reviewers independently extracted and coded data from each study using a standardized data extraction form. Panel members drafted recommendations based on the body of evidence for each method or intervention and then graded the overall quality of the body of evidence and the strength for each recommendation. Recommendations Recommendations are provided for monitoring of entry into and retention in care, interventions to improve entry and retention, and monitoring of and interventions to improve ART adherence. Recommendations cover ART strategies, adherence tools, education and counseling, and health system and service delivery interventions. In addition, they cover specific issues pertaining to pregnant women, incarcerated individuals, homeless and marginally housed individuals, and children and adolescents, as well as substance use and mental health disorders. Recommendations for future research in all areas are also provided. PMID:22393036

  11. Developing a More Effective Recruitment and Retention Model.

    Science.gov (United States)

    Janke, Walter; Kelly, Gary

    The purpose of a project was to develop a model for more effective recruitment and retention of people of color in the Associate Degree Interior Design and Diploma Interior Design Assistant Program at Milwaukee Area Technical College (MATC), Wisconsin. During Activity One, individuals in MATC's Student Development and High School Relations…

  12. Effect of differentiated instructional strategies on students' retention ...

    African Journals Online (AJOL)

    The effect of differentiated instructional strategies on students' retention in geometry in senior secondary schools was examined. The study employed experimental research design of pretest, posttest control group. The area of this study is Abuja Municipal Area Council, the Federal Capital Territory. The target population ...

  13. Dimensionality and Its Effect on Retention and Visual Scanning.

    Science.gov (United States)

    Abed, Farough

    1994-01-01

    Describes a study of eighth graders that compared the effects of two-dimensional and three-dimensional illustrated texts on eye movement strategies and on retention of information. Results are reported that support earlier research findings that realism in illustrations is not necessarily facilitating and may even be distracting. (Contains 19…

  14. New Estimates of the Effect of Unemployment on Enlisted Retention

    Science.gov (United States)

    1985-07-01

    S14cw’tity lafication) New Estimates of the Effect of Umemployment on Enlisted Retention 12. PERSONAL AUTHOR(S) Ile, TYPE OF REPORT 3b~. TIME COVERED...wider swings in the umemployment rate during recent years, relative military pay has played at least as important a role as the unemployment rate in

  15. Redundancy Effect on Retention of Vocabulary Words Using Multimedia Presentation

    Science.gov (United States)

    Samur, Yavuz

    2012-01-01

    This study was designed to examine the effect of the redundancy principle in a multimedia presentation constructed for foreign language vocabulary learning on undergraduate students' retention. The underlying hypothesis of this study is that when the students are exposed to the material in multiple ways through animation, concurrent narration,…

  16. An MBA: the utility and effect on physicians' careers.

    Science.gov (United States)

    Parekh, Selene G; Singh, Bikramjit

    2007-02-01

    Higher economic, legislative, legal, and administrative constraints in health-care services in the United States have led to an increase in physician dissatisfaction and a decrease in physician morale. In this study, we attempted to understand the motivation for a physician to enroll in a business school, and to discover the utility of the Master of Business Administration degree and how it changed the career path for the practicing clinician. We conducted a retrospective study in which a twenty-seven-question survey was distributed by the United States Postal Service and by e-mail to 161 physician graduates of three East Coast business schools. The results were evaluated, and a statistical analysis was performed. Eighty-seven physicians (54%) responded. Eight surveys were discarded because of incomplete data or stray marks, leaving seventy-nine surveys. The average age of the respondents was 41.4 years. The major motivations for going back to school included learning the business aspects of the health-care system (fifty-three respondents; 67%) and obtaining a more interesting job (forty-one respondents; 52%). The time that the respondents allocated for health-care-related activities before and after obtaining the degree was 58.3% and 31.8%, respectively, for patient care (p administrative responsibilities (p principles (thirty-three; 42%), working within a team (twenty-seven; 34%), and negotiating effectively (twenty-five; 32%). Sixty-four physicians (81%) believed that their business degree had been very useful or essential in the advancement of their careers. Many physicians decide to acquire a Master of Business Administration degree to understand the business of medicine. After they complete the degree program, their practice patterns substantially change, which is reflected particularly by an increase in time spent on administrative responsibilities. In order for physicians to overcome the multifaceted challenges of the evolving health-care system, it is

  17. Market effects on electronic health record adoption by physicians.

    Science.gov (United States)

    Abdolrasulnia, Maziar; Menachemi, Nir; Shewchuk, Richard M; Ginter, Peter M; Duncan, W Jack; Brooks, Robert G

    2008-01-01

    Despite the advantages of electronic health record (EHR) systems, the adoption of these systems has been slow among community-based physicians. Current studies have examined organizational and personal barriers to adoption; however, the influence of market characteristics has not been studied. The purpose of this study was to measure the effects of market characteristics on EHR adoption by physicians. Generalized hierarchal linear modeling was used to analyze EHR survey data from Florida which were combined with data from the Area Resource File and the Florida Office of Insurance Regulation. The main outcome variable was self-reported use of EHR by physicians. A total of 2,926 physicians from practice sizes of 20 or less were included in the sample. Twenty-one percent (n = 613) indicated that they personally and routinely use an EHR system in their practice. Physicians located in counties with higher physician concentration were found to be more likely to adopt EHRs. For every one-unit increase in nonfederal physicians per 10,000 in the county, there was a 2.0% increase in likelihood of EHR adoption by physicians (odds ratio = 1.02, confidence interval = 1.00-1.03). Health maintenance organization penetration rate and poverty level were not found to be significantly related to EHR adoption. However, practice size, years in practice, Medicare payer mix, and measures of technology readiness were found to independently influence physician adoption. Market factors play an important role in the diffusion of EHRs in small medical practices. Policy makers interested in furthering the adoption of EHRs must consider strategies that would enhance the confidence of users as well as provide financial support in areas with the highest concentration of small medical practices and Medicare beneficiaries. Health care leaders should be cognizant of the market forces that enable or constrain the adoption of EHR among their practices and those of their competitors.

  18. Designing a physician leadership development program based on effective models of physician education.

    Science.gov (United States)

    Hopkins, Joseph; Fassiotto, Magali; Ku, Manwai Candy; Mammo, Dagem; Valantine, Hannah

    2017-02-02

    Because of modern challenges in quality, safety, patient centeredness, and cost, health care is evolving to adopt leadership practices of highly effective organizations. Traditional physician training includes little focus on developing leadership skills, which necessitates further training to achieve the potential of collaborative management. The aim of this study was to design a leadership program using established models for continuing medical education and to assess its impact on participants' knowledge, skills, attitudes, and performance. The program, delivered over 9 months, addressed leadership topics and was designed around a framework based on how physicians learn new clinical skills, using multiple experiential learning methods, including a leadership active learning project. The program was evaluated using Kirkpatrick's assessment levels: reaction to the program, learning, changes in behavior, and results. Four cohorts are evaluated (2008-2011). Reaction: The program was rated highly by participants (mean = 4.5 of 5). Learning: Significant improvements were reported in knowledge, skills, and attitudes surrounding leadership competencies. Behavior: The majority (80%-100%) of participants reported plans to use learned leadership skills in their work. Improved team leadership behaviors were shown by increased engagement of project team members. All participants completed a team project during the program, adding value to the institution. Results support the hypothesis that learning approaches known to be effective for other types of physician education are successful when applied to leadership development training. Across all four assessment levels, the program was effective in improving leadership competencies essential to meeting the complex needs of the changing health care system. Developing in-house programs that fit the framework established for continuing medical education can increase physician leadership competencies and add value to health care

  19. Effective recruitment and retention strategies in community health programs.

    Science.gov (United States)

    McCann, Jennifer; Ridgers, Nicola D; Carver, Alison; Thornton, Lukar E; Teychenne, Megan

    2013-08-01

    The aim of this project was to identify effective recruitment and retention strategies used by health-promotion organisations that focus on increasing physical activity and improving nutrition within the local community. Semistructured telephone or face-to-face interviews with 25 key informants from stakeholder organisations were conducted. Key informants discussed strategies used by their organisation to effectively recruit and retain participants into community-based healthy eating and/or physical activity programs. Transcribed data were analysed with NVivo software. Effective recruitment strategies included word of mouth, links with organisations, dissemination of printed materials, media, referrals, cross-promotion of programs and face-to-face methods. Effective retention strategies included encouraging a sense of community ownership, social opportunities, recruiting a suitable leader and offering flexibility and support. Fees and support for recruiting and retaining participants was also identified. This study provides novel insights to a greatly under researched topic in the field of health promotion. There are two key take-home messages from the present study that are applicable to health practitioners as well as developers and deliverers of community health-promotion programs: (1) it is imperative that all community health organisations report on the effectiveness of their recruitment and retention, both successes and failures; and (2) there is a clear need to tailor the recruitment and retention approach to the target population and the setting the program is occurring in. SO WHAT? These findings provide important insights for the development of future community-based healthy eating and physical activity programs.

  20. Identifying research priorities for effective retention strategies in clinical trials.

    Science.gov (United States)

    Kearney, Anna; Daykin, Anne; Shaw, Alison R G; Lane, Athene J; Blazeby, Jane M; Clarke, Mike; Williamson, Paula; Gamble, Carrol

    2017-08-31

    The failure to retain patients or collect primary-outcome data is a common challenge for trials and reduces the statistical power and potentially introduces bias into the analysis. Identifying strategies to minimise missing data was the second highest methodological research priority in a Delphi survey of the Directors of UK Clinical Trial Units (CTUs) and is important to minimise waste in research. Our aim was to assess the current retention practices within the UK and priorities for future research to evaluate the effectiveness of strategies to reduce attrition. Seventy-five chief investigators of NIHR Health Technology Assessment (HTA)-funded trials starting between 2009 and 2012 were surveyed to elicit their awareness about causes of missing data within their trial and recommended practices for improving retention. Forty-seven CTUs registered within the UKCRC network were surveyed separately to identify approaches and strategies being used to mitigate missing data across trials. Responses from the current practice surveys were used to inform a subsequent two-round Delphi survey with registered CTUs. A consensus list of retention research strategies was produced and ranked by priority. Fifty out of seventy-five (67%) chief investigators and 33/47 (70%) registered CTUs completed the current practice surveys. Seventy-eight percent of trialists were aware of retention challenges and implemented strategies at trial design. Patient-initiated withdrawal was the most common cause of missing data. Registered CTUs routinely used newsletters, timeline of participant visits, and telephone reminders to mitigate missing data. Whilst 36 out of 59 strategies presented had been formally or informally evaluated, some frequently used strategies, such as site initiation training, have had no research to inform practice. Thirty-five registered CTUs (74%) participated in the Delphi survey. Research into the effectiveness of site initiation training, frequency of patient contact

  1. Effect of Grade Retention in First Grade on Psychosocial Outcomes

    OpenAIRE

    Wu, Wei; West, Stephen G.; Hughes, Jan N.

    2010-01-01

    In a 4-year longitudinal study, the authors investigated effects of retention in first grade on children’s externalizing and internalizing behaviors; social acceptance; and behavioral, cognitive, and affective engagement. From a large multiethnic sample (n = 784) of children below the median on literacy at school entrance, 124 retained children were matched with 251 promoted children on the basis of propensity scores (probability of being retained in first grade estimated from 72 baseline var...

  2. Direct-to-consumer pharmaceutical advertising: physician and public opinion and potential effects on the physician-patient relationship.

    Science.gov (United States)

    Robinson, Andrew R; Hohmann, Kirsten B; Rifkin, Julie I; Topp, Daniel; Gilroy, Christine M; Pickard, Jeffrey A; Anderson, Robert J

    2004-02-23

    Previous studies have shown that direct-to-consumer (DTC) pharmaceutical advertising can influence consumer behavior and that many physicians have negative views of these advertisements. Physician and public opinions about these advertisements and how they may affect the physician-patient relationship are not well established. Mail survey of 523 Colorado physicians and 261 national physicians and telephone survey of 500 Colorado households asking respondents to rate their agreement with statements about DTC advertising. Most physicians tended to view DTC advertisements negatively, indicating that such advertisements rarely provide enough information on cost (98.7%), alternative treatment options (94.9%), or adverse effects (54.8%). Most also believed that DTC advertisements affected interactions with patients by lengthening clinical encounters (55.9%), leading to patient requests for specific medications (80.7%), and changing patient expectations of physicians' prescribing practices (67.0%). Only 29.0% of public respondents agreed that DTC advertising is a positive trend in health care and 28.6% indicated that advertisements make them better informed about medical problems; fewer indicated that advertisements motivated them to seek care (10.5%) or led them to request specific medications from their physicians (13.3%). Most physicians have negative views of DTC pharmaceutical advertising and see several potential effects of these advertisements on the physician-patient relationship. Many public respondents have similarly negative views, and only a few agree that they change their expectations of or interactions with physicians. While these advertisements may be influencing only a few consumers, it seems that the impact on physicians and their interactions with patients may be significant.

  3. Nosewitness Identification: Effects of Lineup Size and Retention Interval.

    Science.gov (United States)

    Alho, Laura; Soares, Sandra C; Costa, Liliana P; Pinto, Elisa; Ferreira, Jacqueline H T; Sorjonen, Kimmo; Silva, Carlos F; Olsson, Mats J

    2016-01-01

    Although canine identification of body odor (BO) has been widely used as forensic evidence, the concept of nosewitness identification by human observers was only recently put to the test. The results indicated that BOs associated with male characters in authentic crime videos could later be identified in BO lineup tests well above chance. To further evaluate nosewitness memory, we assessed the effects of lineup size (Experiment 1) and retention interval (Experiment 2), using a forced-choice memory test. The results showed that nosewitness identification works for all lineup sizes (3, 5, and 8 BOs), but that larger lineups compromise identification performance in similarity to observations from eye- and earwitness studies. Also in line with previous eye- and earwitness studies, but in disagreement with some studies on odor memory, Experiment 2 showed significant forgetting between shorter retention intervals (15 min) and longer retention intervals (1-week) using lineups of five BOs. Altogether this study shows that identification of BO in a forensic setting is possible and has limits and characteristics in line with witness identification through other sensory modalities.

  4. Thermal effect on water retention curve of bentonite: experiment and thermodynamic modeling

    International Nuclear Information System (INIS)

    Qin Bing; Chen Zhenghai; Sun Faxin; Liu Yuemiao; Wang Ju

    2012-01-01

    The thermal effects on water retention curve of GMZ bentonite were investigated experimentally and theoretically. Water retention tests were conducted on GMZ bentonite at five temperatures ranging from 20℃ to 100℃. Test results showed that the water retention capacity and the hysteresis of the water retention curve decreased with increasing temperature, and that the water retention curves at different temperatures were almost parallel to each other. Based on the thermodynamics of sorption, a model was established to describe the temperature influence on the water retention curve. The model was validated by comparing the model predictions and the test results. (authors)

  5. Physician leadership styles and effectiveness: an empirical study.

    Science.gov (United States)

    Xirasagar, Sudha; Samuels, Michael E; Stoskopf, Carleen H

    2005-12-01

    The authors study the association between physician leadership styles and leadership effectiveness. Executive directors of community health centers were surveyed (269 respondents; response rate = 40.9 percent) for their perceptions of the medical director's leadership behaviors and effectiveness, using an adapted Multifactor Leadership Questionnaire (43 items on a 0-4 point Likert-type scale), with additional questions on demographics and the center's clinical goals and achievements. The authors hypothesize that transformational leadership would be more positively associated with executive directors' ratings of effectiveness, satisfaction with the leader, and subordinate extra effort, as well as the center's clinical goal achievement, than transactional or laissez-faire leadership. Separate ordinary least squares regressions were used to model each of the effectiveness measures, and general linear model regression was used to model clinical goal achievement. Results support the hypothesis and suggest that physician leadership development using the transformational leadership model may result in improved health care quality and cost control.

  6. effect of differentiated instructional strategies on students' retention

    African Journals Online (AJOL)

    PROF EKWUEME

    show that retention ability was significantly higher in the experimental group ... Differentiated instruction, Lecture , Cognitive Achievement ,Retention ability, Geometry. ... thinking. Based on this knowledge, differentiated instruction applies an ...

  7. Helium effects on tungsten surface morphology and deuterium retention

    International Nuclear Information System (INIS)

    Ueda, Y.; Peng, H.Y.; Lee, H.T.; Ohno, N.; Kajita, S.; Yoshida, N.; Doerner, R.; De Temmerman, G.; Alimov, V.; Wright, G.

    2013-01-01

    Recent experimental results on tungsten surface morphology, especially nano-structure (fuzz), induced by helium plasma exposure at temperatures between 1000 K and 2000 K are reviewed. This structure was firstly reported in 2006. In this review, most of experimental results reported so far including characteristics and formation conditions of the nano-structure in both linear plasma devices and magnetic confinement devices, erosion and arcing by steady-state plasma exposure and ELM-like pulsed heat or pulsed plasma exposure by a laser and a plasma gun are summarized. In addition, He effects on D retention under simultaneous D/He irradiation on tungsten are presented

  8. The Effect of Supplemental Instruction on Retention: A Bivariate Probit Model

    Science.gov (United States)

    Bowles, Tyler J.; Jones, Jason

    2004-01-01

    Single equation regression models have been used to test the effect of Supplemental Instruction (SI) on student retention. These models, however, fail to account for the two salient features of SI attendance and retention: (1) both SI attendance and retention are categorical variables, and (2) are jointly determined endogenous variables. Adopting…

  9. The Effect of Pricing and Advertising on Customer Retention in a Liberalizing Market

    NARCIS (Netherlands)

    Polo, Yolanda; Javier Sese, F.; Verhoef, Peter C.

    This study investigates the drivers of customer retention in a liberalizing market. The authors address key, retention issues that allow them to contribute to existing retention research in several critical ways. They (1) examine the effects of pricing and mass advertising, (2) account for (new

  10. The Effect of Pricing and Advertising on Customer Retention in a Liberalizing Market

    NARCIS (Netherlands)

    Polo, Yolanda; Javier Sese, F.; Verhoef, Peter C.

    2011-01-01

    This study investigates the drivers of customer retention in a liberalizing market. The authors address key, retention issues that allow them to contribute to existing retention research in several critical ways. They (1) examine the effects of pricing and mass advertising, (2) account for (new

  11. Physicians' Job Satisfaction.

    African Journals Online (AJOL)

    AmL

    doctors and retention of the existing doctors, in addition to the ... an employee's well-being Examples of job resources are job ..... increase physician job satisfaction for ensuring the .... both pay and benefits physicians at private hospitals.

  12. The effectiveness of ERC advanced life support (ALS) provider courses for the retention of ALS knowledge.

    Science.gov (United States)

    Fischer, Henrik; Strunk, Guido; Neuhold, Stephanie; Kiblböck, Daniel; Trimmel, Helmut; Baubin, Michael; Domanovits, Hans; Maurer, Claudia; Greif, Robert

    2012-02-01

    Out-of-hospital emergency physicians in Austria need mandatory emergency physician training, followed by biennial refresher courses. Currently, both standardized ERC advanced life support (ALS) provider courses and conventional refresher courses are offered. This study aimed to compare the retention of ALS-knowledge of out-of-hospital emergency physicians depending on whether they had or had not participated in an ERC-ALS provider course since 2005. Participants (n=807) from 19 refresher courses for out-of-hospital emergency physicians answered eight multiple-choice questions (MCQ) about ALS based on the 2005 ERC guidelines. The pass score was 75% correct answers. A multivariate logistic regression analyzed differences in passing scores between those who had previously participated in an ERC-ALS provider course and those who had not. Age, gender, regularity of working as an out-of-hospital emergency physician and the self-reported number of real resuscitation efforts within the last 6months were entered as control variables. Out-of-hospital emergency physicians who had previously attended an ERC-ALS provider course had a significantly higher chance of passing the MCQ test (OR=1.60, p=0.015). Younger age (OR=0.95, pERC-ALS provider course since 2005 had a higher retention of ALS knowledge compared to non-ERC-ALS course participants. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Effects of various methodologic strategies: survey response rates among Canadian physicians and physicians-in-training.

    Science.gov (United States)

    Grava-Gubins, Inese; Scott, Sarah

    2008-10-01

    To increase the overall 2007 response rate of the National Physician Survey (NPS) from the survey's 2004 rate of response with the implementation of various methodologic strategies. Physicians were stratified to receive either a long version (12 pages) or a short version (6 pages) of the survey (38% and 62%, respectively). Mixed modes of contact were used-58% were contacted by e-mail and 42% by regular mail-with multiple modes of contact attempted for nonrespondents. The self-administered, confidential surveys were distributed in either English or French. Medical residents and students received e-mail surveys only and were offered a substantial monetary lottery incentive for completing their surveys. A professional communications firm assisted in marketing the survey and delivered advance notification of its impending distribution. Canada. A total of 62 441 practising physicians, 2627 second-year medical residents, and 9162 medical students in Canada. Of the practising physicians group, 60 811 participants were eligible and 19 239 replied, for an overall 2007 study response rate of 31.64% (compared with 35.85% in 2004). No difference in rate of response was found between the longer and shorter versions of the survey. If contacted by regular mail, the response rate was 34.1%; the e-mail group had a response rate of 29.9%. Medical student and resident response rates were 30.8% and 27.9%, respectively (compared with 31.2% and 35.6% in 2004). Despite shortening the questionnaires, contacting more physicians by e-mail, and enhancing marketing and follow-up, the 2007 NPS response rate for practising physicians did not surpass the 2004 NPS response rate. Offering a monetary lottery incentive to medical residents and students was also unsuccessful in increasing their response rates. The role of surveys in gathering information from physicians and physicians-in-training remains problematic. Researchers need to investigate alternative strategies for achieving higher rates of

  14. Effect of hydraulic retention time on continuous biocatalytic calcification reactor

    International Nuclear Information System (INIS)

    Isik, Mustafa; Altas, Levent; Kurmac, Yakup; Ozcan, Samet; Oruc, Ozcan

    2010-01-01

    High calcium concentrations in the wastewaters are problematic, because they lead to clogging of pipelines, boilers and heat exchangers through scaling (as carbonate, sulfate or phosphate precipitates), or malfunctioning of aerobic and anaerobic reactors. As a remedy to this problem, the industry typically uses chemical crystallization reactors which are efficient but often require complex monitoring and control and, as a drawback, can give rise to highly alkaline effluents. Biomineralization are emerging as alternative mechanisms for the removal of calcium from aqueous environments. Biocatalytic calcification reactors (BCR) utilize microbial urea hydrolysis by bacteria for the removal of calcium, as calcite, from industrial wastewater. Hydraulic retention time (HRT) effect on calcium removal was studied with a continuous feed BCR reactor treating a simulated pulp paper wastewater. Study showed that HRT is important parameter and HRT of 5-6 h is optimum for calcium removal from calcium-rich wastewaters.

  15. Effect of Retention Time on Biogas Production from Poultry ...

    African Journals Online (AJOL)

    A study was carried out on different retention times in the anaerobic fermentation of slurry from poultry droppings and cassava peels. The system adopted in this work was batch-type. Daily gas production fell slightly from 130 to 32 litres as retention time was increased from 10 to 40 days for poultry droppings. For cassava ...

  16. The Effect of Graduate Education Timing on the Retention of Surface Warfare Officers

    Science.gov (United States)

    2016-03-01

    significance of graduate education timing within the SWO community and its effect on retention and job performance. Job performance is measured as promotion...d. Marriage Marital status was used in previous studies of SWO retention and is included within this study (Abunaz & Tobrun, 2012). Three binary...the Navy or to separate such as demand for billets variation across years, private sector job opportunities. 44 Figure 5. Basic Retention Model

  17. Are Flunkers Social Outcasts? A Multilevel Study of Grade Retention Effects on Same-Grade Friendships

    Science.gov (United States)

    Demanet, Jannick; Van Houtte, Mieke

    2016-01-01

    We examine the association between grade retention and the number of same-grade friendships. Moreover, we investigate the effect of a school's proportion of retained students on these friendships and the moderating effect of this school characteristic on the relationship between retention and the number of same-grade friendships. Multilevel…

  18. Cognitive and Other Strategies to Mitigate the Effects of Fatigue. Lessons from Staff Physicians Working in Intensive Care Units.

    Science.gov (United States)

    Henrich, Natalie; Ayas, Najib T; Stelfox, Henry T; Peets, Adam D

    2016-09-01

    Fatigue is common among physicians and adversely affects their performance. To identify strategies that attending physicians use when fatigued to maintain clinical performance in the intensive care unit (ICU). We conducted a qualitative study using focus groups and structured interviews of attending ICU physicians working in academic centers in Canada. In three focus group meetings, we engaged a total of 11 physicians to identify strategies used to prevent and cope with fatigue. In the focus groups, 21 cognitive strategies were identified and classified into 9 categories (minimizing number of tasks, using techniques to improve retention of details, using a structured approach to patient care, asking for help, improving opportunities for focusing, planning ahead, double-checking, adjusting expectations, and modulating alertness). In addition, various lifestyle strategies were mentioned as important in preventing fatigue (e.g., protecting sleep before call, adequate exercise, and limiting alcohol). Telephone interviews were then conducted (n = 15 physicians) with another group of intensivists. Structured questions were asked about the strategies identified in the focus groups that were most useful during ICU activities. In the interviews, the most useful and frequently used strategies were prioritizing tasks that need to be done immediately and postponing tasks that can wait, working systematically, using a structured approach, and avoiding distractions. ICU physicians reported using a variety of deliberate cognitive and lifestyle strategies to prevent and cope with fatigue. Given the low cost and intuitive nature of the majority of these strategies, further investigations should be done to better characterize their effectiveness in improving performance.

  19. RETENTION TIME EFFECT ON METAL REMOVAL BY PEAT COLUMNS

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, E

    2007-02-28

    The potential use of a peat bed to treat the H-12 Outfall discharge to bring it to new compliance limits was previously investigated and reported utilizing a 7 hour retention time. The influence of retention time (contact time) of water with peat moss on the removal of copper from the water was investigated under laboratory conditions using vertical flow peat moss columns. Reduction of the necessary retention time has a large influence on the design sizing of any peat bed that would be constructed to treat the H-12 discharge on a full scale basis. Retention times of 5 hours, 3 hours and 1 hour were tested to determine the copper removal by the peat columns using vertical flow. Water samples were collected after 4, 8, 12, and 16 water volumes had passed through the columns and analyzed for a suite of metals, with quantitative emphasis on copper. Laboratory results indicated that copper removal was very high at each of the 3 retention times tested, ranging from 99.6 % removal at 5 and 3 hours to 98.8% removal at 1 hour. All these values are much lower that the new compliance limit for the outfall. The results also indicated that most divalent metals were removed to their normal reporting detection limit for the analytical methods used, including zinc. Lead levels in the H-12 discharge used in this study were below PQL in all samples analyzed. While each of the retention times studied removed copper very well, there were indications that 1 hour is probably too short for an operational, long-term facility. At that retention time, there was about 6% compaction of the peat in the column due to the water velocity, and this may affect long term hydraulic conductivity of the peat bed. At that retention time, copper concentration in the effluent was higher than the other times tested, although still very low. Because of the potential compacting and somewhat reduced removal efficiency at a 1 hour retention time, it would be prudent to design to at least a 3 hour retention

  20. Effect of vitamin C on copper retention in young men

    International Nuclear Information System (INIS)

    Jacob, R.A.; Omaye, S.T.; Skala, J.H.; Taylor, P.C.; Turnlund, J.R.

    1986-01-01

    Previous work suggests that supplemental ascorbic acid (AA) may inhibit intestinal copper absorption by stabilizing the less absorbable cuprous state. The authors studied copper absorption in healthy men (age 19-32) fed a constant diet with different amounts of ascorbic acid supplements. The 6 men were confined to a metabolic unit for the entire 14 week study. The basal diet consisted of a 7 day rotating menu which provided an average of 2.1 mg Cu/d and was adequate in all other nutrients except AA (5 mg/d). The basal diet was supplemented with either zero, 60, or 600 mg of AA daily, added to grape juice and consumed at each meal. All feces were collected. Blood was taken weekly for monitoring AA and copper status. Copper absorption was determined by both balance and 65 Cu stable isotope techniques. As determined by fecal Cu excretion, varying intakes of AA between 0.1 to 10 times the RDA had no significant effect on copper retention. This is consistent with the lack of change in serum ceruloplasmin and serum Cu throughout the study

  1. Facebook: an effective tool for participant retention in longitudinal research.

    Science.gov (United States)

    Mychasiuk, R; Benzies, K

    2012-09-01

    Facebook is currently one of the world's most visited websites, and home to millions of users who access their accounts on a regular basis. Owing to the website's ease of accessibility and free service, demographic characteristics of users span all domains. As such, Facebook may be a valuable tool for locating and communicating with participants in longitudinal research studies. This article outlines the benefit gained in a longitudinal follow-up study, of an intervention programme for at-risk families, through the use of Facebook as a search engine. Using Facebook as a resource, we were able to locate 19 participants that were otherwise 'lost' to follow-up, decreasing attrition in our study by 16%. Additionally, analysis indicated that hard-to-reach participants located with Facebook differed significantly on measures of receptive language and self-esteem when compared to their easier-to-locate counterparts. These results suggest that Facebook is an effective means of improving participant retention in a longitudinal intervention study and may help improve study validity by reaching participants that contribute differing results. © 2011 Blackwell Publishing Ltd.

  2. Timing of quizzes during learning: Effects on motivation and retention.

    Science.gov (United States)

    Healy, Alice F; Jones, Matt; Lalchandani, Lakshmi A; Tack, Lindsay Anderson

    2017-06-01

    This article investigates how the timing of quizzes given during learning impacts retention of studied material. We investigated the hypothesis that interspersing quizzes among study blocks increases student engagement, thus improving learning. Participants learned 8 artificial facts about each of 8 plant categories, with the categories blocked during learning. Quizzes about 4 of the 8 facts from each category occurred either immediately after studying the facts for that category (standard) or after studying the facts from all 8 categories (postponed). In Experiment 1, participants were given tests shortly after learning and several days later, including both the initially quizzed and unquizzed facts. Test performance was better in the standard than in the postponed condition, especially for categories learned later in the sequence. This result held even for the facts not quizzed during learning, suggesting that the advantage cannot be due to any direct testing effects. Instead the results support the hypothesis that interrupting learning with quiz questions is beneficial because it can enhance learner engagement. Experiment 2 provided further support for this hypothesis, based on participants' retrospective ratings of their task engagement during the learning phase. These findings have practical implications for when to introduce quizzes in the classroom. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. The contributions of encoding, retention, and recall to the Hebb effect.

    Science.gov (United States)

    Oberauer, Klaus; Meyer, Nadine

    2009-10-01

    The article reports an experiment testing whether the Hebb repetition effect-the gradual improvement of immediate serial recall when the same list is repeated several times-depends on overt recall of the repeated lists. Previous reports which suggest that recall is critical confound the recall manipulation with retention interval. The present experiment orthogonally varies retention interval (0 or 9 s) and whether the list is to be recalled after the retention interval. Hebb repetition learning is assessed in a final test phase. A repetition effect was obtained in all four experimental conditions; it was larger for recalled than non-recalled lists, whereas retention interval had no effect. The results show that encoding is sufficient to generate cumulative long-term learning, which is strengthened by recall. Rehearsal, if it takes place in the retention interval at all, does not have the same effect on long-term learning as overt recall.

  4. Employer retention strategies and their effect on nurses' job satisfaction and intent to stay.

    Science.gov (United States)

    Ellenbecker, Carol Hall; Samia, Linda; Cushman, Margaret J; Porell, Frank W

    2007-01-01

    Faced with a nursing shortage and anticipated increase in demand, home care agencies are implementing retention strategies with little knowledge of their effectiveness. The purpose of this study is to describe the strategies implemented and their effect on nurse job satisfaction and intention to leave. Data were collected from a random sample of 123 New England agencies during in-person interviews. Most agencies reported implementing multiple recruitment and retention strategies. Regression results suggest that the effects of employer retention strategy on nurses' intent to stay are the indirect result of its effects on job satisfaction. The only retention intervention that made a statistically significant difference in job satisfaction was shared governance, and no retention strategy directly affected nurses' intention to stay in their jobs.

  5. The effects of information framing on the practices of physicians.

    Science.gov (United States)

    McGettigan, P; Sly, K; O'Connell, D; Hill, S; Henry, D

    1999-10-01

    The presentation format of clinical trial results, or the "frame," may influence perceptions about the worth of a treatment. The extent and consistency of that influence are unclear. We undertook a systematic review of the published literature on the effects of information framing on the practices of physicians. Relevant articles were retrieved using bibliographic and electronic searches. Information was extracted from each in relation to study design, frame type, parameter assessed, assessment scale, clinical setting, intervention, results, and factors modifying the frame effect. Twelve articles reported randomized trials investigating the effect of framing on doctors' opinions or intended practices. Methodological shortcomings were numerous. Seven papers investigated the effect of presenting clinical trial results in terms of relative risk reduction, or absolute risk reductions or the number needing to be treated; gain/loss (positive/negative) terms were used in four papers; verbal/numeric terms in one. In simple clinical scenarios, results expressed in relative risk reduction or gain terms were viewed most positively by doctors. Factors that reduced the impact of framing included the risk of causing harm, preexisting prejudices about treatments, the type of decision, the therapeutic yield, clinical experience, and costs. No study investigated the effect of framing on actual clinical practice. While a framing effect may exist, particularly when results are presented in terms of proportional or absolute measures of gain or loss, it appears highly susceptible to modification, and even neutralization, by other factors that influence doctors' decision making. Its effects on actual clinical practice are unknown.

  6. Physicians' perspectives of managing tensions around dimensions of effective communication in the emergency department.

    Science.gov (United States)

    Dean, Marleah; Oetzel, John G

    2014-01-01

    The purpose of this study was to explore emergency department (ED) physicians' perspectives of guidelines for effective communication. More specifically, the ways in which physicians manage the tensions among effective communication dimensions framed by relational dialectics theory are examined. This study used in-depth interviews with 17 ED physicians and 70 hours of observations to identify five dimensions of effective communication: efficiency, clarity/accuracy, relevance, comprehension, and rapport. Two communication tensions resulted from these dimensions: efficiency versus rapport and efficiency versus comprehension. In almost all instances, physicians chose efficient communication at the expense of comprehension or rapport. In addition, there was a tension between patient and physician perspectives of clarity and relevance that physicians tended to resolve by emphasizing what was relevant and clear from their own perspective. Implications for managing tensions in terms of efficiency and a physician-centered approach are discussed.

  7. The Effect of Internal Salary Increment Distributions on Retention Behaviors of Western New York Teachers

    Science.gov (United States)

    Patterson, Michele M.

    2013-01-01

    This is a study of district internal salary distribution practices and its effect on retention. The study is a replication study as recommended by Jacobson (1986) and Lankford and Wyckoff (1997) whereby their research shows the prevalence of "back loading" and ineffectiveness relative to retention. In the case of this study, the…

  8. The Effects of Elaboration and Rehearsal on Long-Term Retention of Shape Names by Kindergarteners

    Science.gov (United States)

    Gallimore, Ronald; And Others

    1977-01-01

    Elaboration and overt rehearsal are compared as instructional paradigms for memory retention. Superior long-term retention was produced in the elaboration condition when the initial acquisition effects were statistically removed. Short-term data suggest acquisition was complexly affected by experimental condition, I.Q., and task. Elaboration…

  9. Examining the Effects of Institutional and Cohort Characteristics on Retention Rates

    Science.gov (United States)

    Pike, Gary R.; Graunke, Steven S.

    2015-01-01

    Despite being criticized as unrepresentative and misleading, retention and graduation rates are an important part of college-search web sites and accountability systems, and they frequently have been used as indicators of institutional quality and effectiveness in educational research. Retention and graduation rates are often compared over time…

  10. Effects of Program and Patient Characteristics on Retention of Drug Treatment Patients.

    Science.gov (United States)

    Hser, Yih-Ing; Joshi, Vandana; Maglione, Margaret; Chou, Chih Ping; Anglin, M. Douglas

    2001-01-01

    Studied the effects of program and patient characteristics on patient retention in residential, out-patient, and methadone maintenance drug treatment programs. Data for 26,047 patients in 87 programs show that threshold retention rates were generally low for all 3 program types, although program practice and service provision played important…

  11. Retention of Esperanto Is Affected by Delay-Interval Task and Item Closure: A Partial Resolution of the Delay-Retention Effect

    Science.gov (United States)

    Brosvic, Gary M.; Epstein, Michael L.; Dihoff, Roberta E.; Cook, Michael L.

    2006-01-01

    The present studies were undertaken to examine the effects of manipulating delay-interval task (Study 1) and timing of feedback (Study 2) on acquisition and retention. Participants completed a 100-item cumulative final examination, which included 50 items from each laboratory examination, plus 50 entirely new items. Acquisition and retention were…

  12. Continuing medical education effect on physician knowledge application and psychomotor skills: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines.

    Science.gov (United States)

    O'Neil, Kevin M; Addrizzo-Harris, Doreen J

    2009-03-01

    Recommendations for optimizing continuing medical education (CME) effectiveness in improving physician application of knowledge and psychomotor skills are needed to guide the development of processes that effect physician change and improve patient care. The guideline panel reviewed evidence tables and a comprehensive review of the effectiveness of CME developed by The Johns Hopkins Evidence-based Practice Center for the Agency for Healthcare Research and Quality (AHRQ Evidence Report). The panel considered studies relevant to the effect of CME on physician knowledge application and psychomotor skill development. From the 136 studies identified in the systematic review, 15 articles, 12 addressing physician application of knowledge and 3 addressing psychomotor skills, were identified and reviewed. Recommendations for optimizing CME were developed using the American College of Chest Physicians guideline grading system. The preponderance of evidence demonstrated improvement in physician application of knowledge with CME. The quality of evidence did not allow specific recommendations regarding optimal media or educational techniques or the effectiveness of CME in improving psychomotor skills. CME is effective in improving physician application of knowledge. Multiple exposures and longer durations of CME are recommended to optimize educational outcomes.

  13. Magnetite effect in radionuclide retention : cesium, strontium, molybdenum and selenium

    International Nuclear Information System (INIS)

    Rovira, M.; Casas, I.; Gimenez, J.; Clarens, F.; Pablo, J. de

    2004-01-01

    In this work we have investigated the interaction of magnetite with cesium, strontium, molybdenum and selenium, in the frame of radionuclide retention by canister corrosion products. For each radionuclide, the retention on magnetite has been studied as a function of pH and the mass/ volume ratio. The experimental results have been modeled by means of Surface Complexation Models (SCM), that constitute a tool that allows an approach to sorption mechanisms in a wide range of experimental conditions taking into account electrostatic interactions at the mineral-water interface.(Author)

  14. Effect of Retention Time on Biogas Production from Poultry ...

    African Journals Online (AJOL)

    JPC

    Daily gas production fell slightly from 130 to 32 litres as retention time was ... The continuing energy crisis has reawakened interest in the anaerobic ... and hydrogen sulfide (H2S2): 0.3 vol.%. ..... Nigerian Journal of Solar Energy 15: 80 – 85.

  15. The Effect of Instant Messaging on Lecture Retention

    Science.gov (United States)

    McVaugh, Nathan Kant

    2012-01-01

    The impact of instant message interruptions via computer on immediate lecture retention for college students was examined. While watching a 24-minute video of a classroom lecture, students received various numbers of related-to-lecture ("Is consistent use of the eye contact method necessary for success?") versus not-related-to lecture…

  16. The Effect of Entrepreneurial Orientation on Teacher Satisfaction and Retention

    Science.gov (United States)

    Thibault, Melissa Rihm

    2016-01-01

    Teacher turnover is a costly problem. Since teacher working conditions influence teacher's satisfaction and career intentions, managers may theoretically increase teacher satisfaction and retention by fostering a school environment supportive of the highly-trained professional. Entrepreneurial Orientation is an organizational construct correlated…

  17. The effect of reimbursement on medical decision making: do physicians alter treatment in response to a managed care incentive?

    Science.gov (United States)

    Melichar, Lori

    2009-07-01

    The empirical literature that explores whether physicians respond to financial incentives has not definitively answered the question of whether physicians alter their treatment behavior at the margin. Previous research has not been able to distinguish that part of a physician response that uniformly alters treatment of all patients under a physician's care from that which affects some, but not all of a physician's patients. To explore physicians' marginal responses to financial incentives while accounting for the selection of physicians into different financial arrangements where others could not, I use data from a survey of physician visits to isolate the effect that capitation, a form of reimbursement wherein physicians receive zero marginal revenue for a range of physician provided services, has on the care provided by a physician. Fixed effects regression results reveal that physicians spend less time with their capitated patients than with their non-capitated patients.

  18. Environmental Effects on Data Retention in Flash Cells

    Science.gov (United States)

    Katz, Rich; Flowers, David; Bergevin, Keith

    2017-01-01

    Flash technology is being utilized in fuzed munition applications and, based on the development of digital logic devices in the commercial world, usage of flash technology will increase. Antifuse technology, prevalent in non-volatile field programmable gate arrays (FPGAs), will eventually be phased out as new devices have not been developed for approximately a decade. The reliance on flash technology presents a long-term reliability issue for both DoD and NASA safety- and mission-critical applications. A thorough understanding of the data retention failure modes and statistics associated with Flash data retention is of vital concern to the fuze safety community. A key retention parameter for a flash cell is the threshold voltage (VTH), which is an indirect indicator of the amount of charge stored on the cells floating gate. This paper will present the results of our on-going tests: long-term storage at 150 C for a small population of devices, neutron radiation exposure, electrostatic discharge (ESD) testing, and the trends of large populations (over 300 devices for each condition) exposed to three difference temperatures: 25 C, 125 C, and 150 C.

  19. Effects of sodium polyacrylate on water retention and infiltration capacity of a sandy soil

    OpenAIRE

    Zhuang, Wenhua; Li, Longguo; Liu, Chao

    2013-01-01

    Based on the laboratory study, the effects of sodium polyacrylate (SP) was investigated at 5 rates of 0, 0.08, 0.2, 0.5, and 1%, on water retention, saturated hydraulic conductivity(Ks), infiltration characteristic and water distribution profiles of a sandy soil. The results showed that water retention and available water capacity effectively increased with increasing SP rate. The Ks and the rate of wetting front advance and infiltration under certain pond infiltration was significantly reduc...

  20. Gas bubble retention and its effect on waste properties: Retention mechanisms, viscosity, and tensile and shear strengths

    International Nuclear Information System (INIS)

    Gauglitz, P.A.; Rassat, S.D.; Powell, M.R.

    1995-08-01

    Several of the underground nuclear storage tanks at Hanford have been placed on a flammable gas watch list, because the waste is either known or suspected to generate, store, and episodically release flammable gases. Because retention and episodic release of flammable gases from these tanks containing radioactive waste slurries are critical safety concerns, Pacific Northwest Laboratory (PNL) is studying physical mechanisms and waste properties that contribute to the episodic gas release from these storage tanks. This study is being conducted for Westinghouse Hanford Company as part of the PNL Flammable Gas project. Previous investigations have concluded that gas bubbles are retained by the slurry or sludge that has settled at the bottom of the tanks; however, the mechanisms responsible for the retention of these bubbles are not well understood. Understanding the rheological behavior of the waste, particularly of the settled sludge, is critical to characterizing the tendency of the waste to retain gas bubbles and the dynamics of how these bubbles are released from the waste. The presence of gas bubbles is expected to affect the rheology of the sludge, specifically its viscosity and tensile and shear strengths, but essentially no literature data are available to assess the effect of bubbles. The objectives of this study were to conduct experiments and develop theories to understand better how bubbles are retained by slurries and sludges, to measure the effect of gas bubbles on the viscosity of simulated slurries, and to measure the effect of gas bubbles on the tensile and shear strengths of simulated slurries and sludges. In addition to accomplishing these objectives, this study developed correlations, based on the new experimental data, that can be used in large-scale computations of waste tank physical phenomena

  1. Gas bubble retention and its effect on waste properties: Retention mechanisms, viscosity, and tensile and shear strengths

    Energy Technology Data Exchange (ETDEWEB)

    Gauglitz, P.A.; Rassat, S.D.; Powell, M.R. [and others

    1995-08-01

    Several of the underground nuclear storage tanks at Hanford have been placed on a flammable gas watch list, because the waste is either known or suspected to generate, store, and episodically release flammable gases. Because retention and episodic release of flammable gases from these tanks containing radioactive waste slurries are critical safety concerns, Pacific Northwest Laboratory (PNL) is studying physical mechanisms and waste properties that contribute to the episodic gas release from these storage tanks. This study is being conducted for Westinghouse Hanford Company as part of the PNL Flammable Gas project. Previous investigations have concluded that gas bubbles are retained by the slurry or sludge that has settled at the bottom of the tanks; however, the mechanisms responsible for the retention of these bubbles are not well understood. Understanding the rheological behavior of the waste, particularly of the settled sludge, is critical to characterizing the tendency of the waste to retain gas bubbles and the dynamics of how these bubbles are released from the waste. The presence of gas bubbles is expected to affect the rheology of the sludge, specifically its viscosity and tensile and shear strengths, but essentially no literature data are available to assess the effect of bubbles. The objectives of this study were to conduct experiments and develop theories to understand better how bubbles are retained by slurries and sludges, to measure the effect of gas bubbles on the viscosity of simulated slurries, and to measure the effect of gas bubbles on the tensile and shear strengths of simulated slurries and sludges. In addition to accomplishing these objectives, this study developed correlations, based on the new experimental data, that can be used in large-scale computations of waste tank physical phenomena.

  2. Effect of ceramic membrane channel diameter on limiting retentate protein concentration during skim milk microfiltration.

    Science.gov (United States)

    Adams, Michael C; Barbano, David M

    2016-01-01

    Our objective was to determine the effect of retentate flow channel diameter (4 or 6mm) of nongraded permeability 100-nm pore size ceramic membranes operated in nonuniform transmembrane pressure mode on the limiting retentate protein concentration (LRPC) while microfiltering (MF) skim milk at a temperature of 50°C, a flux of 55 kg · m(-2) · h(-1), and an average cross-flow velocity of 7 m · s(-1). At the above conditions, the retentate true protein concentration was incrementally increased from 7 to 11.5%. When temperature, flux, and average cross-flow velocity were controlled, ceramic membrane retentate flow channel diameter did not affect the LRPC. This indicates that LRPC is not a function of the Reynolds number. Computational fluid dynamics data, which indicated that both membranes had similar radial velocity profiles within their retentate flow channels, supported this finding. Membranes with 6-mm flow channels can be operated at a lower pressure decrease from membrane inlet to membrane outlet (ΔP) or at a higher cross-flow velocity, depending on which is controlled, than membranes with 4-mm flow channels. This implies that 6-mm membranes could achieve a higher LRPC than 4-mm membranes at the same ΔP due to an increase in cross-flow velocity. In theory, the higher LRPC of the 6-mm membranes could facilitate 95% serum protein removal in 2 MF stages with diafiltration between stages if no serum protein were rejected by the membrane. At the same flux, retentate protein concentration, and average cross-flow velocity, 4-mm membranes require 21% more energy to remove a given amount of permeate than 6-mm membranes, despite the lower surface area of the 6-mm membranes. Equations to predict skim milk MF retentate viscosity as a function of protein concentration and temperature are provided. Retentate viscosity, retentate recirculation pump frequency required to maintain a given cross-flow velocity at a given retentate viscosity, and retentate protein

  3. Effect of emergency physician burnout on patient waiting times.

    Science.gov (United States)

    De Stefano, Carla; Philippon, Anne-Laure; Krastinova, Evguenia; Hausfater, Pierre; Riou, Bruno; Adnet, Frederic; Freund, Yonathan

    2018-04-01

    Burnout is common in emergency physicians. This syndrome may negatively affect patient care and alter work productivity. We seek to assess whether burnout of emergency physicians impacts waiting times in the emergency department. Prospective study in an academic ED. All patients who visited the main ED for a 4-month period in 2016 were included. Target waiting times are assigned by triage nurse to patients on arrival depending on their severity. The primary endpoint was an exceeded target waiting time for ED patients. All emergency physicians were surveyed by a psychologist to assess their level of burnout using the Maslach Burnout Inventory. We defined the level of burnout of the day in the ED as the mean burnout level of the physicians working that day (8:30 to the 8:30 the next day). A logistic regression model was performed to assess whether burnout level of the day was independently associated with prolonged waiting times, along with previously reported predictors. Target waiting time was exceeded in 7524 patients (59%). Twenty-six emergency physicians were surveyed. Median burnout score was 35 [Interquartile (24-49)]. A burnout level of the day higher than 35 was independently associated with an exceeded target waiting time (adjusted odds ratio 1.54, 95% confidence interval 1.39-1.70), together with previously reported predictors (i.e., day of the week, time of the day, trauma, age and daily census). Burnout of emergency physicians was independently associated with a prolonged waiting time for patients visiting the ED.

  4. The influence of age on the effectiveness of DTPA in reducing 141Ce retention in rats

    International Nuclear Information System (INIS)

    Kargacin, B.; Kostial, K.; Landeka, M.

    1983-01-01

    The influence of age on the effectiveness of chelation treatment in reducing retention of radioactive cerium was studied in two- and six-week-old albino rats. 141 Ce was administered intraperitoneally, followed immediately and after 24 and 48 hours by intraperitoneal administration of the tri-sodium calcium salt of diethylenetriaminepentaacetic acid-Na 3 (CaDTPA) at 380 μmol/kg body weight. The whole-body retention was determined 2, 4 and 6 days after radiocerium administration, when the animals were killed and the organ retention was determined. The chelation therapy significantly reduced the whole-body retention of radiocerium. This treatment was however twice as effective in older as in younger animals. (author)

  5. Inadequate physician knowledge of the effects of diet on blood lipids and lipoproteins.

    Directory of Open Access Journals (Sweden)

    Sciamanna Christopher

    2003-12-01

    Full Text Available Abstract Background To assess the nutrition knowledge of physicians on the basic effects of diet on blood lipids and lipoproteins. Methods Anonymous mailed dietary knowledge surveys to 6000 randomly selected physicians in the United States licensed in either Internal Medicine or Cardiology. Results Response rate: 16% (n = 639. Half of the physicians did not know that canola oil and 26% did not know olive oil were good sources of monounsaturated fat. Ninety-three percent (84% of cardiologists vs. 96% of internists; p Conclusions If physicians are to implement dietary and cholesterol management guidelines, they will likely need to become more knowledgeable about nutrition.

  6. The Effect of Perceptual Learning on L2 Vocabulary Learning and Retention

    OpenAIRE

    BEDİR, Gülay; BEKTAŞ BEDİR, Sevgi

    2018-01-01

    It is thought that learning styles have an effecton learning foreign language. This study aims to determine effects ofperceptual learning styles on L2 vocabulary learning and retention. Learningstyle preferences were assessed in the current study through the section ofCohen et al.’s Learning Style Survey (LSS) corresponding to the perceptualmodalities and achievement tests developed by the researcher was used to assessvocabulary learning and retention. And an open-ended question is tried toan...

  7. Effect of Abutment Modification and Cement Type on Retention of Cement-Retained Implant Supported Crowns

    OpenAIRE

    Farzin, Mitra; Torabi, Kianoosh; Ahangari, Ahmad Hasan; Derafshi, Reza

    2014-01-01

    Objective: Provisional cements are commonly used to facilitate retrievability of cement-retained fixed implant restorations; but compromised abutment preparation may affect the retention of implant-retained crowns.The purpose of this study was to investigate the effect of abutment design and type of luting agent on the retentive strength of cement-retained implant restorations. Materials and Method: Two prefabricated abutments were attached to their corresponding analogs and embedded in an ac...

  8. Semantic Information Activated during Retrieval Contributes to Later Retention: Support for the Mediator Effectiveness Hypothesis of the Testing Effect

    Science.gov (United States)

    Carpenter, Shana K.

    2011-01-01

    Previous research has proposed that tests enhance retention more than do restudy opportunities because they promote the effectiveness of mediating information--that is, a word or concept that links a cue to a target (Pyc & Rawson, 2010). Although testing has been shown to promote retention of mediating information that participants were asked…

  9. Effects of Physician Payment Reform on Provision of Home Dialysis

    Science.gov (United States)

    Erickson, Kevin F.; Winkelmayer, Wolfgang C.; Chertow, Glenn M.; Bhattacharya, Jay

    2016-01-01

    Objectives Patients with end-stage renal disease can receive dialysis at home or in-center. In 2004 the Centers for Medicare and Medicaid Services reformed physician payment for in-center hemodialysis care from a capitated to a tiered fee-for-service model, augmenting physician payment for frequent in-center visits. We evaluated whether payment reform influenced dialysis modality assignment. Study Design Cohort study of patients starting dialysis in the US in the three years before and after payment reform. Methods We conducted difference-in-difference analyses comparing patients with Traditional Medicare coverage (who were affected by the policy) to others with Medicare Advantage (who were unaffected by the policy). We also examined whether the policy had a more pronounced influence on dialysis modality assignment in areas with lower costs of traveling to dialysis facilities. Results Patients with Traditional Medicare coverage experienced a 0.7% (95% CI 0.2%–1.1%; p=0.003) reduction in the absolute probability of home dialysis use following payment reform compared to patients with Medicare Advantage. Patients living in areas with larger dialysis facilities (where payment reform made in-center hemodialysis comparatively more lucrative for physicians) experienced a 0.9% (95% CI 0.5%–1.4%; ppayment model for dialysis care resulted in fewer patients receiving home dialysis. This area of policy failure highlights the importance of considering unintended consequences of future physician payment reform efforts. PMID:27355909

  10. Effects of physician payment reform on provision of home dialysis.

    Science.gov (United States)

    Erickson, Kevin F; Winkelmayer, Wolfgang C; Chertow, Glenn M; Bhattacharya, Jay

    2016-06-01

    Patients with end-stage renal disease can receive dialysis at home or in-center. In 2004, CMS reformed physician payment for in-center hemodialysis care from a capitated to a tiered fee-for-service model, augmenting physician payment for frequent in-center visits. We evaluated whether payment reform influenced dialysis modality assignment. Cohort study of patients starting dialysis in the United States in the 3 years before and the 3 years after payment reform. We conducted difference-in-difference analyses comparing patients with traditional Medicare coverage (who were affected by the policy) to others with Medicare Advantage (who were unaffected by the policy). We also examined whether the policy had a more pronounced influence on dialysis modality assignment in areas with lower costs of traveling to dialysis facilities. Patients with traditional Medicare coverage experienced a 0.7% (95% CI, 0.2%-1.1%; P = .003) reduction in the absolute probability of home dialysis use following payment reform compared with patients with Medicare Advantage. Patients living in areas with larger dialysis facilities (where payment reform made in-center hemodialysis comparatively more lucrative for physicians) experienced a 0.9% (95% CI, 0.5%-1.4%; P home dialysis use following payment reform compared with patients living in areas with smaller facilities (where payment reform made in-center hemodialysis comparatively less lucrative for physicians). The transition from a capitated to a tiered fee-for-service payment model for in-center hemodialysis care resulted in fewer patients receiving home dialysis. This area of policy failure highlights the importance of considering unintended consequences of future physician payment reform efforts.

  11. Effect of periodic deuterium ion irradiation on deuterium retention and blistering in Tungsten

    Directory of Open Access Journals (Sweden)

    M. Oya

    2017-08-01

    Full Text Available The effect of periodic irradiation on Deuterium (D retention and blistering in Tungsten (W was investigated. W samples were exposed to D plasma at a fixed fluence while varying the irradiation cycle number (1-shot, 2-shots and 3-shots. Exposure energy and flux were ∼50eV and ∼1 ×1022 D m−2 s−1, respectively. Sample temperatures were 537K and 643K. At 573K, D retention and blister density decreased with increasing number of irradiation cycle. In contrast at 643K, D retention showed no dependence on number of irradiation cycle. Therefore, sample temperature during irradiation is an important parameter in comparing the results of continuous and periodic irradiation, especially in studies involving extremely-high-flux (>1024 D m−2 s−1 irradiation and fluence dependency of D retention.

  12. The effect of retentive groove, sandblasting and cement type on the retentive strength of stainless steel crowns in primary second molars--an in vitro comparative study.

    Science.gov (United States)

    Veerabadhran, M M; Reddy, V; Nayak, U A; Rao, A P; Sundaram, M A

    2012-01-01

    This in vitro study was conducted to find out the effect of retentive groove, sand blasting and cement type on the retentive strength of stainless steel crowns in primary second molars. Thirty-two extracted intact human maxillary and mandibular primary second molars were embedded in aluminum blocks utilizing autopolymerising acrylic resin. After tooth preparation, the 3M stainless steel crown was adjusted to the prepared tooth. Then weldable buccal tubes were welded on the buccal and lingual surfaces of each crown as an attachment for the testing machine. A full factorial design matrix for four factors (retentive groove placement on the tooth, cement type, sandblasting and primary second molar) at two levels each was developed and the study was conducted as dictated by the matrix. The lower and upper limits for each factor were without and with retentive groove placement on the tooth, GIC and RMGIC, without and with sandblasting of crown, maxillary and mandibular second primary molar. For those teeth for which the design matrix dictated groove placement, the retentive groove was placed on the middle third of the buccal surface of the tooth horizontally and for those crowns for which sandblasting of the crowns are to be done, sandblasting was done with aluminium oxide with a particle size of 250 mm. The crowns were luted with either GIC or RMGIC, as dictated by the design matrix. Then the retentive strength of each sample was evaluated by means of an universal testing machine. The obtained data was analyzed using ANOVA for statistical analysis of the data and 't'- tests for pairwise comparison. The mean retentive strength in kg/cm 2 stainless steel crowns luted with RMGIC was 19.361 and the mean retentive strength of stainless steel crowns luted with GIC was 15.964 kg/cm 2 with a mean difference of 3.397 kg/cm 2 and was statistically significant. The mean retentive strength in kg/cm 2 of stainless steel crowns, which was not sandblasted, was 18.880 and which was

  13. Retention and effective diffusion of model metabolites on porous graphitic carbon.

    Science.gov (United States)

    Lunn, Daniel B; Yun, Young J; Jorgenson, James W

    2017-12-29

    The study of metabolites in biological samples is of high interest for a wide range of biological and pharmaceutical applications. Reversed phase liquid chromatography is a common technique used for the separation of metabolites, but it provides little retention for polar metabolites. An alternative to C18 bonded phases, porous graphitic carbon has the ability to provide significant retention for both non-polar and polar analytes. The goal of this work is to study the retention and effective diffusion properties of porous graphitic carbon, to see if it is suitable for the wide injection bands and long run times associated with long, packed capillary-scale separations. The retention of a set of standard metabolites was studied for both stationary phases over a wide range of mobile phase conditions. This data showed that porous graphitic carbon benefits from significantly increased retention (often >100 fold) under initial gradient conditions for these metabolites, suggesting much improved ability to focus a wide injection band at the column inlet. The effective diffusion properties of these columns were studied using peak-parking experiments with the standard metabolites under a wide range of retention conditions. Under the high retention conditions, which can be associated with retention after injection loading for gradient separations, D eff /D m ∼0.1 for both the C18-bonded and porous graphitic carbon columns. As C18 bonded particles are widely, and successfully utilized for long gradient separations without issue of increasing peak width from longitudinal diffusion, this suggests that porous graphitic carbon should be amenable for long runtime gradient separations as well. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Oxidation effects during corium melt in-vessel retention

    Energy Technology Data Exchange (ETDEWEB)

    Almyashev, V.I.; Granovsky, V.S.; Khabensky, V.B.; Krushinov, E.V.; Sulatsky, A.A.; Vitol, S.A. [Alexandrov Scientific-Research Institute of Technology (NITI), Sosnovy Bor (Russian Federation); Gusarov, V.V. [Ioffe Institute, St. Petersburg (Russian Federation); Bechta, S. [Royal Institute of Technology (KHT), Stockholm (Sweden); Barrachin, M.; Fichot, F. [Institut de Radioprotection et de Sûreté Nucléaire (IRSN), St Paul lez Durance (France); Bottomley, P.D., E-mail: paul.bottomley@ec.europa.eu [Joint Research Centre, Institut für Transurane (ITU), Karlsruhe (Germany); Fischer, M. [AREVA GmbH, Erlangen (Germany); Piluso, P. [CEA Cadarache-DEN/DTN/STRI (France)

    2016-08-15

    Highlights: • Corium–steel interaction tests were re-examined particularly for transient processes. • Oxidation of corium melt was sensitive to oxidant supply and surface characteristics. • Consequences for vessel steel corrosion rates in severe accidents were discussed. - Abstract: In the in-vessel corium retention studies conducted on the Rasplav-3 test facility within the ISTC METCOR-P project and OECD MASCA program, experiments were made to investigate transient processes taking place during the oxidation of prototypic molten corium. Qualitative and quantitative data have been produced on the sensitivity of melt oxidation rate to the type of oxidant, melt composition, molten pool surface characteristics. The oxidation rate is a governing factor for additional heat generation and hydrogen release; also for the time of secondary inversion of oxidic and metallic layers of corium molten pool.

  15. Classification of complementary and alternative medical practices: Family physicians' ratings of effectiveness.

    Science.gov (United States)

    Fries, Christopher J

    2008-11-01

    ABSTRACTOBJECTIVETo develop a classification of complementary and alternative medicine (CAM) practices widely available in Canada based on physicians' effectiveness ratings of the therapies.DESIGNA self-administered postal questionnaire asking family physicians to rate their "belief in the degree of therapeutic effectiveness" of 15 CAM therapies.SETTINGProvince of Alberta.PARTICIPANTSA total of 875 family physicians.MAIN OUTCOME MEASURESDescriptive statistics of physicians' awareness of and effectiveness ratings for each of the therapies; factor analysis was applied to the ratings of the 15 therapies in order to explore whether or not the data support the proposed classification of CAM practices into categories of accepted and rejected.RESULTSPhysicians believed that acupuncture, massage therapy, chiropractic care, relaxation therapy, biofeedback, and spiritual or religious healing were effective when used in conjunction with biomedicine to treat chronic or psychosomatic indications. Physicians attributed little effectiveness to homeopathy or naturopathy, Feldenkrais or Alexander technique, Rolfing, herbal medicine, traditional Chinese medicine, and reflexology. The factor analysis revealed an underlying dimensionality to physicians' effectiveness ratings of the CAM therapies that supports the classification of these practices as either accepted or rejected.CONCLUSIONThis study provides Canadian family physicians with information concerning which CAM therapies are generally accepted by their peers as effective and which are not.

  16. Effects of sodium polyacrylate on water retention and infiltration capacity of a sandy soil.

    Science.gov (United States)

    Zhuang, Wenhua; Li, Longguo; Liu, Chao

    2013-01-01

    Based on the laboratory study, the effects of sodium polyacrylate (SP) was investigated at 5 rates of 0, 0.08, 0.2, 0.5, and 1%, on water retention, saturated hydraulic conductivity(Ks), infiltration characteristic and water distribution profiles of a sandy soil. The results showed that water retention and available water capacity effectively increased with increasing SP rate. The Ks and the rate of wetting front advance and infiltration under certain pond infiltration was significantly reduced by increasing SP rate, which effectively reduced water in a sandy soil leaking to a deeper layer under the plough layer. The effect of SP on water distribution was obviously to the up layer and very little to the following deeper layers. Considering both the effects on water retention and infiltration capacity, it is suggested that SP be used to the sandy soil at concentrations ranging from 0.2 to 0.5%.

  17. Effect of Methylphenidate on Retention and Retrieval of Passive Avoidance Memory in Young and Aged Mice

    Directory of Open Access Journals (Sweden)

    Arzi

    2014-10-01

    Full Text Available Background Several studies showed that dopamine and norepinephrine improve retention and retrieval of memory. Methylphenidate is an enhancer of dopamine and norepinephrine in brain. Objectives In the present study, the effect of methylphenidate was evaluated on retention and retrieval of memory in young and aged mice using passive avoidance apparatus. Materials and Methods Animals were divided into groups (n = 8 as follows: test groups received electric shock plus methylphenidate (2.5, 5 and 10mg kg-1, i. P., control group received electric shock plus normal saline and blank group received only electric shock. In all groups, step-down latency for both retention and retrieval test of memory was measured. Methylphenidate was administered immediately after receiving electric shock in the retention test, but methylphenidate was administered 23.5 hours after receiving electric shock in the retrieval test. Results The mean of step-down latency on day 4 was significantly higher compared to day 2 (P < 0.05 in all young and aged groups of mice. The best response was attained with 5 mg/kg of methylphenidate. In memory retention test, the mean of step-down latency in young groups that received 2.5 and 5 mg/kg methylphenidate was significantly longer(P < 0.05 than aged groups. However, this difference was not significant in memory retrieval test. Conclusions Methylphenidate may improve memory retention and retrieval.

  18. Collaboration of Physician, Pharmacist and Director Model Toward the Improvement of Teamwork Effectiveness in Hospital

    Directory of Open Access Journals (Sweden)

    Widy S. Abdulkadir

    2017-09-01

    Full Text Available Collaboration of physicians and pharmacists is very important in providing treatment to patients. Collaboration includes an exchange of views or ideas that give perspective to all collaborators. In order to make collaborative relationship optimal, all members of the different professions should have a desire to cooperate. Pharmacists and physicians should plan and practice as colleagues, work interdependence within the limits of the scope of practice with a variety of values and knowledge. The role of director in cooperation between doctor and pharmacist takes decision-making which refers to treatment of patients to be decided together between health professionals (physician and pharmacist. The study was a quasi-experimental design with a pre-test-post-test control group design, using paired t-test analysis. The study was conducted from October 2012 until February 2013. The paired t-test results showed that the variable of teamwork effectiveness in M. M. Dunda Hospital increased significantly (p=0.038, which means that the three-party (physician-pharmacist-director collaboration model may increase teamwork effectiveness. Three-party collaboration model can improve physician-pharmacist relationship in the hospital. Leadership has a positive and significant effect on employees’ organizational commitment. Director can be an inspiration in the work and determine the direction and goals of the organization. Therefore, the three-party (physician-pharmacist-director collaboration model can improve the quality of the relationship between the two professions, physician and pharmacist.

  19. Beginning Teacher Induction: A Report on Beginning Teacher Effectiveness and Retention.

    Science.gov (United States)

    Serpell, Zewelanji; Bozeman, Leslie A.

    National statistics show a rise in the number of beginning teachers undergoing formal induction in their first year of teaching. This report discusses the effectiveness of induction programs and resulting outcomes for beginning teacher retention, beginning teacher effectiveness, and mentor participation. The various components of induction…

  20. Effect of noble gas ion pre-irradiation on deuterium retention in tungsten

    NARCIS (Netherlands)

    Cheng, L.; Zhao, Z. H.; De Temmerman, G.; Yuan, Y.; Morgan, T. W.; Guo, L. P.; Wang, B.; Zhang, Y.; Wang, B. Y.; Zhang, P.; Cao, X. Z.; Lu, G. H.

    2016-01-01

    Impurity seeding of noble gases is an effective way of decreasing the heat loads onto the divertor targets in fusion devices. To investigate the effect of noble gases on deuterium retention, tungsten targets have been implanted by different noble gas ions and subsequently exposed to deuterium

  1. A Study of the Effect of Color in Memory Retention When Used in Presentation Software.

    Science.gov (United States)

    McConnohie, Bruce Vernon

    A study of the effects of color as used in presentation software on short-range (immediately following treatment) and long-range (one hour following treatment) memory retention was conducted. Previous studies have concentrated on color as cueing or coding mechanisms primarily in print media and have not explored the effect of individual colors as…

  2. Recruitment and Retention of Effective Teachers in Multicultural Classrooms: A Qualitative Study

    Science.gov (United States)

    Phan, Michael N.

    2013-01-01

    The purpose of this qualitative exploratory case study was to explore how pre-service training and professional development affected recruitment and retention of effective teachers serving in multicultural classrooms. The research questions under investigation were: (1) what pre-service training did effective educators receive before entering…

  3. Effects of phytase supplementation on phosphorus retention in broilers and layers: A meta-analysis

    NARCIS (Netherlands)

    Bougouin, A.; Appuhamy, J.A.D.R.N.; Kebreab, E.; Dijkstra, J.; Kwakkel, R.P.; France, J.

    2014-01-01

    Phytase, a widely used feed additive in poultry diets, increases P availability and subsequently reduces inorganic-P supplementation and P-excretion. Phytase supplementation effect on P-retention in poultry has been investigated, but the effect sizes were highly variable. The present study’s

  4. The Effect of Acute Exercise on Consolidation and Retention of Motor Memory

    DEFF Research Database (Denmark)

    Skriver, Kasper Christen

    with the perspective of exploring the arguments for applying exercise systematically in the educational system. In addition, since a team sport could be more motivating to school children compared to e.g. running, we investigated the effects of both hockey and running on motor memory. Seventy-seven pre......There is substantial evidence that a single bout of exercise can improve cognitive functions and retention of certain types of declarative memory. However, it is unclear if a similar effect can be demonstrated when coupling physical activity with the acquisition and retention of a motor skill....... Hence, the overall aim of the present thesis was to investigate the relationship between acute exercise and motor memory, with special interest in investigating if exercise performed after motor skill learning could improve skill retention. Study I was designed to assess if a single bout of exercise...

  5. Student Mental Models of the Greenhouse Effect: Retention Months After Interventions

    Science.gov (United States)

    Harris, S. E.; Gold, A. U.

    2013-12-01

    Individual understanding of climate science, and the greenhouse effect in particular, is one factor important for societal decision-making. Ideally, learning opportunities about the greenhouse effect will not only move people toward expert-like ideas but will also have long-lasting effects for those individuals. We assessed university students' mental models of the greenhouse effect before and after specific learning experiences, on a final exam, then again a few months later. Our aim was to measure retention after students had not necessarily been thinking about, nor studying, the greenhouse effect recently. How sticky were the ideas learned? 164 students in an introductory science course participated in a sequence of two learning activities and assessments regarding the greenhouse effect. The first lesson involved the full class, then, for the second lesson, half the students completed a simulation-based activity and the other half completed a data-driven activity. We assessed student thinking through concept sketches, multiple choice and short answer questions. All students generated concept sketches four times, and completed a set of multiple choice (MCQs) and short answer questions twice. Later, 3-4 months after the course ended, 27 students ('retention students') completed an additional concept sketch and answered the questions again, as a retention assessment. These 27 students were nearly evenly split between the two contrasting second lessons in the sequence and included both high and low-achieving students. We then compared student sketches and scores to 'expert' answers. The general pattern over time showed a significant increase in student scores from before the lesson sequence to after, both on concept sketches and MCQs, then an additional increase in concept sketch score on the final exam (MCQs were not asked on the final exam). The scores for the retention students were not significantly different from the full class. Within the retention group

  6. EBM E-learning: Feasible and Effective for Occupational Physicians in Different Countries.

    Science.gov (United States)

    Hugenholtz, Nathalie Ir; Sluiter, Judith K; van Dijk, Frank Jh; Nieuwenhuijsen, Karen

    2012-09-01

    Although evidence-based medicine (EBM) is a useful method for integrating evidence into the decision-making process of occupational physicians, occupational physicians lack EBM knowledge and skills, and do not have the time to learn the EBM method. In order to enable them to educate themselves at the time and place they prefer, we designed an electronic EBM course. We studied the feasibility and utility of the course as well as its effectiveness in increasing EBM knowledge, skills, and behaviour. Occupational physicians from various countries were included in a within-subjects study. Measurements were conducted on participants' EBM knowledge, skills, behaviour, and determinants of behaviour at baseline, directly after finishing the course and 2 months later (n = 36). The feasibility and utility of the course were evaluated directly after the course (n = 42). The course is applicable as an introductory course on EBM for occupational physicians in various countries. The course is effective in enhancing EBM knowledge and self-efficacy in practising EBM. No significant effect was found on EBM skills, behaviour, and determinants of behaviour. After the course, more occupational physicians use the international journals to solve a case. An electronic introductory EBM course is suitable for occupational physicians. Although it is an effective method for increasing EBM knowledge, it does not seem effective in improving skills and behaviour. We recommend integrating e-learning courses with blended learning, where it can be used side by side with other educational methods that are effective in changing behaviour.

  7. The Effect Of Stem Degrees On The Performance And Retention Of Junior Officers In The U.S. Navy

    Science.gov (United States)

    2016-03-01

    satisfaction as well as increase their opportunities to pursue technical graduate education. This thesis compares job performance and retention outcomes...degrees. This thesis evaluates other factors that affect retention such as job fit. The high demand for STEM graduates in the civilian labor market is...examined to determine their effects on officer job performance and retention . Previous research has provided inconclusive results on the effects of

  8. The impact of the Department of Veterans Affairs Health Care Personnel Enhancement Act of 2004 on VA physicians' salaries and retention.

    Science.gov (United States)

    Weeks, William B; Wallace, Tanner A; Wallace, Amy E

    2009-01-01

    To determine whether the Department of Veterans Affairs Health Care Personnel Enhancement Act (the Act), which was designed to achieve VA physician salary parity with American Academy of Medical Colleges (AAMC) Associate Professors and enacted in 2006, had achieved its goal. Using VA human resources datasets and data from the AAMC, we calculated mean VA physician salaries, with 95 percent confidence intervals, for 15 different medical specialties. For each specialty, we compared VA salaries to the median, 25th, and 75th percentile of AAMC Associate Professors' incomes. The Act's passage resulted in a $20,000 annual increase in VA physicians' salaries. VA primary care physicians, medical subspecialists, and psychiatrists had salaries that were comparable to their AAMC counterparts prior to and after enactment of the Act. However, VA surgical specialists', anesthesiologists', and radiologists' salaries lagged their AAMC counterparts both before and after the Act's enactment. Income increases were negatively correlated with full-time workforce changes. VA does not appear to provide comparable salaries for physicians necessary for surgical care. In certain cases, VA should consider outsourcing surgical services.

  9. The Effects of Test Trial and Processing Level on Immediate and Delayed Retention

    Science.gov (United States)

    Chang, Sau Hou

    2017-01-01

    The purpose of the present study was to investigate the effects of test trial and processing level on immediate and delayed retention. A 2 × 2 × 2 mixed ANOVAs was used with two between-subject factors of test trial (single test, repeated test) and processing level (shallow, deep), and one within-subject factor of final recall (immediate, delayed). Seventy-six college students were randomly assigned first to the single test (studied the stimulus words three times and took one free-recall test) and the repeated test trials (studied the stimulus words once and took three consecutive free-recall tests), and then to the shallow processing level (asked whether each stimulus word was presented in capital letter or in small letter) and the deep processing level (whether each stimulus word belonged to a particular category) to study forty stimulus words. The immediate test was administered five minutes after the trials, whereas the delayed test was administered one week later. Results showed that single test trial recalled more words than repeated test trial in immediate final free-recall test, participants in deep processing performed better than those in shallow processing in both immediate and delayed retention. However, the dominance of single test trial and deep processing did not happen in delayed retention. Additional study trials did not further enhance the delayed retention of words encoded in deep processing, but did enhance the delayed retention of words encoded in shallow processing. PMID:28344679

  10. The Effects of Test Trial and Processing Level on Immediate and Delayed Retention

    Directory of Open Access Journals (Sweden)

    Sau Hou Chang

    2017-03-01

    Full Text Available The purpose of the present study was to investigate the effects of test trial and processing level on immediate and delayed retention. A 2 × 2 × 2 mixed ANOVAs was used with two between-subject factors of test trial (single test, repeated test and processing level (shallow, deep, and one within-subject factor of final recall (immediate, delayed. Seventy-six college students were randomly assigned first to the single test (studied the stimulus words three times and took one free-recall test and the repeated test trials (studied the stimulus words once and took three consecutive free-recall tests, and then to the shallow processing level (asked whether each stimulus word was presented in capital letter or in small letter and the deep processing level (whether each stimulus word belonged to a particular category to study forty stimulus words. The immediate test was administered five minutes after the trials, whereas the delayed test was administered one week later. Results showed that single test trial recalled more words than repeated test trial in immediate final free-recall test, participants in deep processing performed better than those in shallow processing in both immediate and delayed retention. However, the dominance of single test trial and deep processing did not happen in delayed retention. Additional study trials did not further enhance the delayed retention of words encoded in deep processing, but did enhance the delayed retention of words encoded in shallow processing.

  11. The Effects of Test Trial and Processing Level on Immediate and Delayed Retention.

    Science.gov (United States)

    Chang, Sau Hou

    2017-03-01

    The purpose of the present study was to investigate the effects of test trial and processing level on immediate and delayed retention. A 2 × 2 × 2 mixed ANOVAs was used with two between-subject factors of test trial (single test, repeated test) and processing level (shallow, deep), and one within-subject factor of final recall (immediate, delayed). Seventy-six college students were randomly assigned first to the single test (studied the stimulus words three times and took one free-recall test) and the repeated test trials (studied the stimulus words once and took three consecutive free-recall tests), and then to the shallow processing level (asked whether each stimulus word was presented in capital letter or in small letter) and the deep processing level (whether each stimulus word belonged to a particular category) to study forty stimulus words. The immediate test was administered five minutes after the trials, whereas the delayed test was administered one week later. Results showed that single test trial recalled more words than repeated test trial in immediate final free-recall test, participants in deep processing performed better than those in shallow processing in both immediate and delayed retention. However, the dominance of single test trial and deep processing did not happen in delayed retention. Additional study trials did not further enhance the delayed retention of words encoded in deep processing, but did enhance the delayed retention of words encoded in shallow processing.

  12. Green roof stormwater retention: effects of roof surface, slope, and media depth.

    Science.gov (United States)

    VanWoert, Nicholaus D; Rowe, D Bradley; Andresen, Jeffrey A; Rugh, Clayton L; Fernandez, R Thomas; Xiao, Lan

    2005-01-01

    Urban areas generate considerably more stormwater runoff than natural areas of the same size due to a greater percentage of impervious surfaces that impede water infiltration. Roof surfaces account for a large portion of this impervious cover. Establishing vegetation on rooftops, known as green roofs, is one method of recovering lost green space that can aid in mitigating stormwater runoff. Two studies were performed using several roof platforms to quantify the effects of various treatments on stormwater retention. The first study used three different roof surface treatments to quantify differences in stormwater retention of a standard commercial roof with gravel ballast, an extensive green roof system without vegetation, and a typical extensive green roof with vegetation. Overall, mean percent rainfall retention ranged from 48.7% (gravel) to 82.8% (vegetated). The second study tested the influence of roof slope (2 and 6.5%) and green roof media depth (2.5, 4.0, and 6.0 cm) on stormwater retention. For all combined rain events, platforms at 2% slope with a 4-cm media depth had the greatest mean retention, 87%, although the difference from the other treatments was minimal. The combination of reduced slope and deeper media clearly reduced the total quantity of runoff. For both studies, vegetated green roof systems not only reduced the amount of stormwater runoff, they also extended its duration over a period of time beyond the actual rain event.

  13. Effects of compensation methods and physician group structure on physicians' perceived incentives to alter services to patients.

    Science.gov (United States)

    Reschovsky, James D; Hadley, Jack; Landon, Bruce E

    2006-08-01

    To examine how health plan payment, group ownership, compensation methods, and other practice management tools affect physician perceptions of whether their overall financial incentives tilt toward increasing or decreasing services to patients. Nationally representative data on physicians are from the 2000-2001 Community Tracking Study Physician Survey (N=12,406). Ordered and multinomial logistic regression were used to explore how physician, group, and market characteristics are associated with physician reports of whether overall financial incentives are to increase services, decrease services, or neither. Seven percent of physicians report financial incentives are to reduce services to patients, whereas 23 percent report incentives to increase services. Reported incentives to reduce services were associated with reports of lower ability to provide quality care. Group revenue in the form of capitation was associated with incentives to reduce services whereas practice ownership and variable compensation and bonuses for employee physicians were mostly associated with incentives to increase services to patients. Full ownership of groups, productivity incentives, and perceived competitive markets for patients were associated with incentives to both increase and reduce services. Practice ownership and the ways physicians are compensated affect their perceived incentives to increase or decrease services to patients. In the latter case, this adversely affects perceived quality of care and satisfaction, although incentives to increase services may also have adverse implications for quality, cost, and insurance coverage.

  14. Effects of starvation and protein depletion on mercury retention in two strains of chickens

    Energy Technology Data Exchange (ETDEWEB)

    Larkin, D V; Miller, V L; Bearse, G E; Hamilton, C M

    1965-11-13

    Experiments were performed in an attempt to show the effects of deprivation of feed and water on the liver and kidney mercury retention in two strains of chickens. The chickens to be depleted were fasted for 24 h and offered granulated sugar and drinking water containing vitamins. When the protein-depleted chickens has lost 30% of their body weight, they were injected intramuscularly with 3 mg phenylmercuric acetate (PMA) or mercuric chloride. A chemical analysis of the livers and kidneys of the chickens revealed that more mercury was retained in the organs from the protein-depleted chickens than from the control chickens. A difference was also found in the mercury retention in the kidneys in the two strains of chickens. Thus, alteration of the mercury retention patterns of these two strains of chickens may be accomplished by limiting their protein intake.

  15. Effects of mineral additives on biochar formation: carbon retention, stability, and properties.

    Science.gov (United States)

    Li, Feiyue; Cao, Xinde; Zhao, Ling; Wang, Jianfei; Ding, Zhenliang

    2014-10-07

    Biochar is being recognized as a promising tool for long-term carbon sequestration, and biochar with high carbon retention and strong stability is supposed to be explored for that purpose. In this study, three minerals, including kaolin, calcite (CaCO3), and calcium dihydrogen phosphate [Ca(H2PO4)2], were added to rice straw feedstock at the ratio of 20% (w/w) for biochar formation through pyrolysis treatment, aiming to improve carbon retention and stabilization in biochar. Kaolin and CaCO3 had little effect on the carbon retention, whereas Ca(H2PO4)2 increased the carbon retention by up to 29% compared to untreated biochar. Although the carbon loss from the kaolin-modified biochar with hydrogen peroxide oxidation was enhanced, CaCO3 and Ca(H2PO4)2 modification reduced the carbon loss by 18.6 and 58.5%, respectively. Moreover, all three minerals reduced carbon loss of biochar with potassium dichromate oxidation from 0.3 to 38.8%. The microbial mineralization as CO2 emission in all three modified biochars was reduced by 22.2-88.7% under aerobic incubation and 5-61% under anaerobic incubation. Enhanced carbon retention and stability of biochar with mineral treatment might be caused by the enhanced formation of aromatic C, which was evidenced by cross-polarization magic angle spinning (13)C nuclear magnetic resonance spectra and Fourier transform infrared spectroscopy analysis. Our results indicated that the three minerals, especially Ca(H2PO4)2, were effective in increasing carbon retention and strengthening biochar stabilization, which provided a novel idea that people could explore and produce the designated biochar with high carbon sequestration capacity and stability.

  16. The Effects of Test Trial and Processing Level on Immediate and Delayed Retention

    Science.gov (United States)

    Chang, Sau Hou

    2017-01-01

    The purpose of the present study was to investigate the effects of test trial and processing level on immediate and delayed retention. A 2 × 2 × 2 mixed ANOVAs was used with two between-subject factors of test trial (single test, repeated test) and processing level (shallow, deep), and one within-subject factor of final recall (immediate,…

  17. Instructional strategy effects on the retention and transfer of procedures of different difficulty level

    NARCIS (Netherlands)

    Jelsma, Otto; Pieters, Julius Marie

    1989-01-01

    In the present study, the effects of two instructional strategies on the retention and transfer of procedures of different difficulty level were investigated. Difficulty level was manipulated by providing a different number of cues during training. The instructional strategies differed with respect

  18. Effects of Digital Story on Academic Achievement, Learning Motivation and Retention among University Students

    Science.gov (United States)

    Aktas, Elif; Yurt, Serap Uzuner

    2017-01-01

    The aim of this study was to determine the effect of the learning environment where digital stories are used as a learning material on the motivation, academic success, retention, and students' opinions. The study was carried out with mixed method which is a combination of quantitative and qualitative research approach. The study was implemented…

  19. Bridging effective stress and soil water retention equations in deforming unsaturated porous media : A Thermodynamic Approach

    NARCIS (Netherlands)

    Huyghe, J. M.; Nikooee, E.; Hassanizadeh, S. M.

    The finite deformation of an unsaturated porous medium is analysed from first principles of mixture theory. An expression for Bishop’s effective stress is derived from (1) the deformation-dependent Brooks and Corey’s water retention curve and (2) the restrictions on the constitutive relationships of

  20. The Effects of 3D Computer Simulation on Biology Students' Achievement and Memory Retention

    Science.gov (United States)

    Elangovan, Tavasuria; Ismail, Zurida

    2014-01-01

    A quasi experimental study was conducted for six weeks to determine the effectiveness of two different 3D computer simulation based teaching methods, that is, realistic simulation and non-realistic simulation on Form Four Biology students' achievement and memory retention in Perak, Malaysia. A sample of 136 Form Four Biology students in Perak,…

  1. Effect of Learning Cycle Approach-Based Science Teaching on Academic Achievement, Attitude, Motivation and Retention

    Science.gov (United States)

    Uyanik, Gökhan

    2016-01-01

    The purpose of this study was to examine the effect of learning cycle approach-based teaching on academic achievement, attitude, motivation and retention at primary school 4th grade science lesson. It was conducted pretest-posttest quasi-experimental design in this study. The study was conducted on a total of 65 students studying in two different…

  2. The Effects of Cooperative Learning on the Academic Achievement and Knowledge Retention

    Science.gov (United States)

    Tran, Van Dat

    2014-01-01

    This experimental study investigated the effects of cooperative learning on the achievement and knowledge retention of 110 first-year primary education students toward the psychology subject over the eight weeks of instruction at An Giang University. These tertiary students were divided into two matched groups of 55 to be taught by the same…

  3. Effects of eye contact and iconic gestures on message retention in human-robot interaction

    NARCIS (Netherlands)

    Dijk, van E.T.; Torta, E.; Cuijpers, R.H.

    2013-01-01

    The effects of iconic gestures and eye contact on message retention in human-robot interaction were investigated in a series of experiments. A humanoid robot gave short verbal messages to participants, accompanied either by iconic gestures or no gestures while making eye contact with the participant

  4. The effects of generative testing on text retention and text comprehension

    NARCIS (Netherlands)

    Dirkx, Kim; Kester, Liesbeth; Kirschner, Paul A.

    2011-01-01

    Dirkx, K. J. H., Kester, L., & Kirschner, P. A. (2011, 30 August). The effects of generative testing methods on text retention and text comprehension. Paper presented at the annual meeting of the European Association for Research on Learning and Instruction, Exeter, United Kingdom.

  5. Quality Induction: The Effects of Comprehensive Induction on New Teacher Retention and Job Satisfaction

    Science.gov (United States)

    Hendricks-Harris, Mary Therese

    2012-01-01

    This investigation examined the effect of a comprehensive new teacher induction program on teacher retention and job satisfaction in one suburban school district. New teachers are retained at low rates, and districts are spending resources in an attempt to decrease this number. New teacher induction includes supports for new teachers in their…

  6. The Effect of Case Teaching on Meaningful and Retentive Learning When Studying Genetic Engineering

    Science.gov (United States)

    Güccük, Ahmet; Köksal, Mustafa Serdar

    2017-01-01

    The purpose of this study is to investigate the effects of case teaching on how students learn about genetic engineering, in terms of meaningful learning and retention of learning. The study was designed as quasi-experimental research including 63 8th graders (28 boys and 35 girls). To collect data, genetic engineering achievement tests were…

  7. Effects of green-tree retention on abundance and guild composition of corticolous arthropods

    Science.gov (United States)

    Juraj Halaj; Charles B. Halpern; Hoonbok Yi

    2009-01-01

    We studied the effects of varying levels and patterns of green-tree retention on the community composition of bark-dwelling arthropods. Arthropods were sampled with crawl traps installed on 280 live trees and 260 snags (all Douglas-fir) at three locations (experimental blocks) in the western Cascade Range of Oregon and Washington. Sampling coincided with the breeding...

  8. Effects of Rote Versus Note Presentations on Rhythm Learning and Retention.

    Science.gov (United States)

    Shehan, Patricia K.

    1987-01-01

    Reports a study which examined the effects of audio and visual approaches to rhythm reading and short-term retention in second and sixth grade students. Sixth graders learned the patterns twice as fast as younger children. Simultaneous use of both auditory and visual channels facilitates learning. (Author/AEM)

  9. Effect of temperature and hydraulic retention time on hydrogen producing granules: Homoacetogenesis and morphological characteristics

    International Nuclear Information System (INIS)

    Abreu, A. A.; Danko, A. S.; Alves, M. M.

    2009-01-01

    The effect of temperature and hydraulic retention time (HRT) on the homoacetogenesisi and on the morphological characteristics of hydrogen producing granules was investigated. Hydrogen was produced using an expanded granular sludge blanket (EGSB) reactor, fed with glucose and L-arabinose, under mesophilic (37 degree centigrade), thermophilic (55 degree centigrade), and hyper thermophilic (70 degree centigrade) conditions. (Author)

  10. Chromatographic retention and structure roofing tile effect of isomers and its fine structure

    NARCIS (Netherlands)

    Walraven, J.J.; Ladon, A.W.; Keulemans, A.I.M.

    1968-01-01

    Logarithmic plots of gas chromatographic retention data for different classes of compds. on different pairs of stationary phases were constructed. A remarkable effect was found. Isomers are spread along parallel lines in a repeated pattern, forming a \\"roofing-tile\\" series. The scattering of points

  11. Acquisition system environmental effects study. [for capillary-screen propellant retention devices

    Science.gov (United States)

    1975-01-01

    The effects of vibration, warm gas exposure, and feed system startup/shutdown fluid dynamics on capillary-screen propellant retention capabilities are quantified. The existing technology is extended to the point where quantitative conlusions in terms of design criteria may be drawn.

  12. The Effect of Keyword Method on Vocabulary Retention of Senior High School EFL Learners in Iran

    Science.gov (United States)

    Davoudi, Mohammad; Yousefi, Dina

    2016-01-01

    This study aimed at investigating the effect of keyword method, as one of the mnemonic strategies, on vocabulary retention of Iranian senior high school EFL learners. Following a quasi-experimental design, the study used thirty eight (n = 38) female senior high school students in grade four from two intact classes at a public high school. The…

  13. Effects of Computer-Assisted Jigsaw II Cooperative Learning Strategy on Physics Achievement and Retention

    Science.gov (United States)

    Gambari, Isiaka Amosa; Yusuf, Mudasiru Olalere

    2016-01-01

    This study investigated the effects of computer-assisted Jigsaw II cooperative strategy on physics achievement and retention. The study also determined how moderating variables of achievement levels as it affects students' performance in physics when Jigsaw II cooperative learning is used as an instructional strategy. Purposive sampling technique…

  14. Investigating the Effectiveness of Audio Input Enhancement on EFL Learners' Retention of Intensifiers

    Science.gov (United States)

    Negari, Giti Mousapour; Azizi, Aliye; Arani, Davood Khedmatkar

    2018-01-01

    The present study attempted to investigate the effects of audio input enhancement on EFL learners' retention of intensifiers. To this end, two research questions were formulated. In order to address these research questions, this study attempted to reject two null hypotheses. Pretest-posttest control group quasi-experimental design was employed to…

  15. Effects of Mentoring Programs on New Teacher Retention: A Literature Review

    Science.gov (United States)

    Waterman, Sheryn; He, Ye

    2011-01-01

    Building upon previous literature reviews, this article highlights research and evaluation efforts regarding the effectiveness of mentoring programs for new teacher retention in the USA since 2005. Through the analysis of various mentoring program components, different research methods used, and major findings from these studies, we discuss the…

  16. Recruitment Combined with Retention Strategies Results in Institutional Effectiveness and Student Satisfaction.

    Science.gov (United States)

    Youngman, Curtis

    In Winter 1994, the Marketing Department at Salt Lake Community College (SLCC) in Utah implemented an educational marketing plan that incorporated a focus on customer service to improve institutional effectiveness and student satisfaction. The plan includes a retention and recruitment program to strengthen the college's relationship with current…

  17. Effect of a retention groove on the shear bond strength of dentin-bonded restorations

    NARCIS (Netherlands)

    de Kok, P.; de Jager, N.; Veerman, I.A.M.; Hafeez, N.; Kleverlaan, C.J.; Roeters, J.F.M.

    2016-01-01

    Statement of problem. With the increasing use of minimally invasive restorations, effective adhesion becomes more important. Applying mechanical retention to a flat dentin surface might improve the adhesion of ceramic and composite resin restorations. Purpose. The purpose of this in vitro study was

  18. Colour in Learning: Its Effect on the Retention Rate of Graduate Students

    Science.gov (United States)

    Olurinola, Oluwakemi; Tayo, Omoniyi

    2015-01-01

    Cognitive psychologists have discovered different design principles to enhance memory performance. It has been said that retrieving process depends on many variables and one of them is colour. This paper provides an overview of research on colour and learning. It includes the effect of colour on attention, retention and memory performance, and…

  19. Private sector contributions and their effect on physician emigration in the developing world.

    Science.gov (United States)

    Loh, Lawrence C; Ugarte-Gil, Cesar; Darko, Kwame

    2013-03-01

    The contribution made by the private sector to health care in a low- or middle-income country may affect levels of physician emigration from that country. The increasing importance of the private sector in health care in the developing world has resulted in newfound academic interest in that sector's influences on many aspects of national health systems. The growth in physician emigration from the developing world has led to several attempts to identify both the factors that cause physicians to emigrate and the effects of physician emigration on primary care and population health in the countries that the physicians leave. When the relevant data on the emerging economies of Ghana, India and Peru were investigated, it appeared that the proportion of physicians participating in private health-care delivery, the percentage of health-care costs financed publicly and the amount of private health-care financing per capita were each inversely related to the level of physician expatriation. It therefore appears that private health-care delivery and financing may decrease physician emigration. There is clearly a need for similar research in other low- and middle-income countries, and for studies to see if, at the country level, temporal trends in the contribution made to health care by the private sector can be related to the corresponding trends in physician emigration. The ways in which private health care may be associated with access problems for the poor and therefore reduced equity also merit further investigation. The results should be of interest to policy-makers who aim to improve health systems worldwide.

  20. Effects of Physician-directed Pharmaceutical Promotion on Prescription Behaviors: Longitudinal Evidence.

    Science.gov (United States)

    Datta, Anusua; Dave, Dhaval

    2017-04-01

    Spending on prescription drugs (Rx) represents one of the fastest growing components of US healthcare spending and has coincided with an expansion of pharmaceutical promotional spending. Most (83%) of Rx promotion is directed at physicians in the form of visits by pharmaceutical representatives (known as detailing) and drug samples provided to physicians' offices. Such promotion has come under increased public scrutiny, with critics contending that physician-directed promotion may play a role in raising healthcare costs and may unduly affect physicians' prescribing habits towards more expensive, and possibly less cost-effective, drugs. In this study, we bring longitudinal evidence to bear upon the question of how detailing impacts physicians' prescribing behaviors. Specifically, we examine prescriptions and promotion for a particular drug class based on a nationally representative sample of 150,000 physicians spanning 24 months. The use of longitudinal physician-level data allows us to tackle some of the empirical concerns in the extant literature, virtually all of which have relied on aggregate national data. We estimate fixed-effects specifications that bypass stable unobserved physician-specific heterogeneity and address potential targeting bias. In addition, we also assess differential effects at both the extensive and intensive margins of prescribing behaviors and differential effects across physician-level and market-level characteristics, questions that have not been explored in prior work. The estimates suggest that detailing has a significant and positive effect on the number of new scripts written for the detailed drug, with an elasticity magnitude of 0.06. This effect is substantially smaller than those in the literature based on aggregate information, suggesting that most of the observed relationship between physician-directed promotion and drug sales is driven by selection bias. We find that detailing impacts selective brand-specific demand but does

  1. {sup 3}He retention and structural evolution in erbium tritides: Phase and aging effects

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, X.S., E-mail: zlxs77@163.com [Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900 (China); Thin Film Centre, Scottish Universities Physics Alliance (SUPA), University of West of Scotland, Paisley PA1 2BE, Scotland (United Kingdom); Zhang, L.; Wang, W.D.; Liu, Q. [Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900 (China); Peng, S.M., E-mail: pengshuming@caep.cn [Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900 (China); Ding, W.; Long, X.G.; Cheng, G.J.; Liang, J.H. [Institute of Nuclear Physics and Chemistry, China Academy of Engineering Physics, Mianyang 621900 (China); Fu, Y.Q. [Thin Film Centre, Scottish Universities Physics Alliance (SUPA), University of West of Scotland, Paisley PA1 2BE, Scotland (United Kingdom)

    2015-06-15

    Highlights: • Effects of phase changes on {sup 3}He retention of Er tritide films were investigated. • The α phase in Er tritide films had no apparent effect on {sup 3}He release/retention. • Tritium content in the β phase showed significant effects on {sup 3}He retention. • Evolution of {sup 3}He in the β phase was apparently influenced by the γ phase. • Effects of phase changes on structure evolution of Er tritides were investigated. - Abstract: Effects of phase changes on {sup 3}He release/retention and crystal lattice evolution during aging of erbium (Er) tritide films were investigated using X-ray diffraction. The contents of α phase and γ phase in the Er tritide films showed significant different effects on {sup 3}He release/retention. The initial tritium stoichiometry or excess tritium atoms accommodated in the octahedral sites and the microstructure (i.e., the texture and Er{sub 2}O{sub 3} oxide inclusions) played an important role for the {sup 3}He release and the evolution of {sup 3}He bubbles in the β phase Er tritide films. In the β + γ region, evolution of {sup 3}He in the β phase was apparently influenced by the γ phase, which could result in a strongly anisotropic lattice dilation and an earlier inflection point of the expansion rate of (1 1 1) lattice parameter. A preferred occupation of {sup 3}He in basal plane of the hexagonal γ phase and the lattice expansion along the hexagonal direction were identified.

  2. Learning from Feedback: Spacing and the Delay-Retention Effect

    Science.gov (United States)

    Smith, Troy A.; Kimball, Daniel R.

    2010-01-01

    Most modern research on the effects of feedback during learning has assumed that feedback is an error correction mechanism. Recent studies of feedback-timing effects have suggested that feedback might also strengthen initially correct responses. In an experiment involving cued recall of trivia facts, we directly tested several theories of…

  3. The Moderating Effect of Job Satisfaction on Physicians' Motivation to Adhere to Financially Incentivized Clinical Practice Guidelines.

    Science.gov (United States)

    Waddimba, Anthony C; Beckman, Howard B; Mahoney, Thomas L; Burgess, James F

    2017-04-01

    We examined moderating effects of professional satisfaction on physicians' motivation to adhere to diabetes guidelines associated with pay-for-performance incentives. We merged cross-sectional survey data on attitudes, from 156 primary physicians, with prospective medical record-sourced data on guideline adherence and census data on ambulatory-care population characteristics. We examined moderating effects by testing theory-driven models for satisfied versus discontented physicians, using partial least squares structural equation modeling. Results show that attitudes motivated, while norms suppressed, adherence to guidelines among discontented physicians. Separate models for satisfied versus discontented physicians revealed motivational differences. Satisfied physicians disregarded intrinsic and extrinsic influences and biases. Discontented physicians, alienated by social pressure, favored personal inclinations. To improve adherence to guidelines among discontented physicians, incentives should align with personal attitudes and incorporate promotional campaigns countering resentment of peer and organizational pressure.

  4. The Hawthorne effect in direct observation research with physicians and patients.

    Science.gov (United States)

    Goodwin, Meredith A; Stange, Kurt C; Zyzanski, Stephen J; Crabtree, Benjamin F; Borawski, Elaine A; Flocke, Susan A

    2017-12-01

    This study examines the degree to which a "Hawthorne effect" alters outpatient-visit content. Trained research nurses directly observed 4454 visits to 138 family physicians. Multiple data sources were used to examine the Hawthorne effect including differences in medical record documentation for observed visits and the prior visit by the same patient, time use during visits on the first versus the second observation day of each physician, and report by the patient, physician, and observer of the effect of observation. Visits on the first versus the second observation day were longer by an average of 1 minute (P effect of the observer on the interaction was reported by 74% of patients and 55% of physicians. Most of those that reported an affect indicated it was slight. Patients with non-White race, lower-educational level, and poorer health were more likely to report being affected by the observer. In a study that was designed to minimize the Hawthorne effect, the presence of an observer had little effect on most patient-physician visits but appeared to at least slightly effect a subgroup of vulnerable patients. © 2017 John Wiley & Sons, Ltd.

  5. Physician gender effects in medical communication: a meta-analytic review.

    Science.gov (United States)

    Roter, Debra L; Hall, Judith A; Aoki, Yutaka

    2002-08-14

    Physician gender has been viewed as a possible source of variation in the interpersonal aspects of medical practice, with speculation that female physicians facilitate more open and equal exchange and a different therapeutic milieu from that of male physicians. However, studies in this area are generally based on small samples, with conflicting results. To systematically review and quantify the effect of physician gender on communication during medical visits. Online database searches of English-language abstracts for the years 1967 to 2001 (MEDLINE, AIDSLINE, PsycINFO, and Bioethics); a hand search was conducted of reprint files and the reference sections of review articles and other publications. Studies using a communication data source, such as audiotape, videotape, or direct observation, and large national or regional studies in which physician report was used to establish length of visit, were identified through bibliographic and computerized searches. Twenty-three observational studies and 3 large physician-report studies reported in 29 publications met inclusion criteria and were rated. The Cohen d was computed based on 2 reviewers' (J.A.H. and Y.A.) independent extraction of quantitative information from the publications. Study heterogeneity was tested using Q statistics and pooled effect sizes were computed using the appropriate effects model. The characteristics of the study populations were also extracted. Female physicians engage in significantly more active partnership behaviors, positive talk, psychosocial counseling, psychosocial question asking, and emotionally focused talk. There were no gender differences evident in the amount, quality, or manner of biomedical information giving or social conversation. Medical visits with female physicians are, on average, 2 minutes (10%) longer than those with male physicians. Obstetrics and gynecology may present a different pattern than that of primary care, with male physicians demonstrating higher levels of

  6. [Effect of psychosocial work environment and job satisfaction on burnout syndrome among specialist physicians].

    Science.gov (United States)

    Escribà-Agüir, Vicenta; Artazcoz, Lucía; Pérez-Hoyos, Santiago

    2008-01-01

    To describe the prevalence of burnout syndrome according to medical specialty and to examine the impact of work psychosocial risk factors, job satisfaction and professional characteristics on burnout syndrome among specialist physicians throughout Spain. A cross-sectional survey was carried out among 1,021 Spanish physicians. The outcome variables were the 3 dimensions of burnout syndrome: emotional exhaustion, depersonalization, and personal accomplishment. The explanatory variables were work psychosocial risk factors and job satisfaction evaluated by a stress scale specifically designed for physicians. Adjusted odds ratios and their 95% confidence intervals were calculated by logistic regression. The probability of high emotional exhaustion and depersonalization were greater in physicians exposed to a high level of contact with suffering and death and to a negative impact of work on home life. The probability of high emotional exhaustion was greater among physicians with a high work overload. The risk of low personal accomplishment was higher among physicians with low professional satisfaction and those without training activities. Dissatisfaction with relationships with patients and relatives had a negative effect on the 3 dimensions of burnout. Psychosocial work environment and job satisfaction have a negative effect on burnout syndrome, especially on emotional exhaustion and depersonalization.

  7. Studying the effect of clinical uncertainty on physicians' decision-making using ILIAD.

    Science.gov (United States)

    Anderson, J D; Jay, S J; Weng, H C; Anderson, M M

    1995-01-01

    The influence of uncertainty on physicians' practice behavior is not well understood. In this research, ILIAD, a diagnostic expert system, has been used to study physicians' responses to uncertainty and how their responses affected clinical performance. The simulation mode of ILIAD was used to standardize the presentation and scoring of two cases to 46 residents in emergency medicine, internal medicine, family practice and transitional medicine at Methodist Hospital of Indiana. A questionnaire was used to collect additional data on how physicians respond to clinical uncertainty. A structural equation model was developed, estimated, and tested. The results indicate that stress that physicians experience in dealing with clinical uncertainty has a negative effect on their clinical performance. Moreover, the way that physicians respond to uncertainty has positive and negative effects on their performance. Open discussions with patients about clinical decisions and the use of practice guidelines improves performance. However, when the physician's clinical decisions are influenced by patient demands or their peers, their performance scores decline.

  8. The effect of earthworm coprolites on the soil water retention curve

    Science.gov (United States)

    Smagin, A. V.; Prusak, A. V.

    2008-06-01

    The effect of earthworm coprolites on the water retention curves in soils of different geneses and textures was investigated by the method of equilibrium centrifuging. Coprolites sampled in the field were compared with the surrounding soil. The effect of earthworms on a soddy-podzolic light loamy soil (from Moscow oblast) was comprehensively analyzed in the course of a special model experiment in a laboratory. This experiment was necessary because it was difficult to separate the coprolites from the soil, in which additional coprolites could appear under natural conditions. In all the variants of the experiment, the differences between the water retention curves of the coprolites and the surrounding soil (or control substrates unaffected by earthworms) were statistically significant. The development of coprolites favored a considerable increase (up to 20 wt.% and more) of the soil water retention capacity upon equivalent water potentials within the range from 0 to -1000 kPa. In most cases, the soil water retention capacity increased within the entire range of the soil moisture contents. This could be explained by the fact that strongly swelling hygroscopic plant remains (detritus) were included into the coprolites and by the formation of a specific highly porous aggregate structure.

  9. Communicating clinical trial outcomes: Effects of presentation method on physicians' evaluations of new treatments

    Directory of Open Access Journals (Sweden)

    Francesco Marcatto

    2013-01-01

    Full Text Available Physicians expect a treatment to be more effective when its clinical outcomes are described as relative rather than as absolute risk reductions. We examined whether effects of presentation method (relative vs. absolute risk reduction remain when physicians are provided the baseline risk information, a vital piece of statistical information omitted in previous studies. Using a between-subjects design, ninety five physicians were presented the risk reduction associated with a fictitious treatment for hypertension either as an absolute risk reduction or as a relative risk reduction, with or without including baseline risk information. Physicians reported that the treatment would be more effective and that they would be more willing to prescribe it when its risk reduction was presented to them in relative rather than in absolute terms. The relative risk reduction was perceived as more effective than absolute risk reduction even when the baseline risk information was explicitly reported. We recommend that information about absolute risk reduction be made available to physicians in the reporting of clinical outcomes. Moreover, health professionals should be cognizant of the potential biasing effects of risk information presented in relative risk terms.

  10. Extended recency effect extended: blocking, presentation mode, and retention interval.

    Science.gov (United States)

    Glidden, L M; Pawelski, C; Mar, H; Zigman, W

    1979-07-01

    The effect of blocking of stimulus items on the free recall of EMR adolescents was examined. In Experiment 1 a multitrial free-recall list of 15 pictures was presented either simultaneously in groups of 3, or sequentially, one at a time. Consistent ordering was used in both conditions, so that on each trial, each item in each set of 3 pictures was presented contiguously with the other 2 items from that set. In addition, recall came immediately or after a filled or unfilled delay of 24.5 seconds. Results showed that simultaneous presentation led to higher recall, subjective organization, and clustering than did sequential presentation, but analysis of serial-position curves showed a much reduced extended recency effect in comparison with previous studies. Experiment 2 was designed to determine whether the cause of the reduced extended recency was the use of pictures rather than words as stimuli. Stimuli were presented either as pictures, as pictures with auditory labels, or as words with auditory labels, with both simultaneous and consistent ordering for all conditions. Results indicated a strong extended recency effect for all groups, eliminating presentation mode as a causal factor in the data of Experiment 1. We concluded that blocking leads to increased organization and recall over a variety of presentation modes, rates, and block sizes.

  11. The effects of health information technology adoption and hospital-physician integration on hospital efficiency.

    Science.gov (United States)

    Cho, Na-Eun; Chang, Jongwha; Atems, Bebonchu

    2014-11-01

    To determine the impact of health information technology (HIT) adoption and hospital-physician integration on hospital efficiency. Using 2010 data from the American Hospital Association's (AHA) annual survey, the AHA IT survey, supplemented by the CMS Case Mix Index, and the US Census Bureau's small area income and poverty estimates, we examined how the adoption of HIT and employment of physicians affected hospital efficiency and whether they were substitutes or complements. The sample included 2173 hospitals. We employed a 2-stage approach. In the first stage, data envelopment analysis was used to estimate technical efficiency of hospitals. In the second stage, we used instrumental variable approaches, notably 2-stage least squares and the generalized method of moments, to examine the effects of IT adoption and integration on hospital efficiency. We found that HIT adoption and hospital-physician integration, when considered separately, each have statistically significant positive impacts on hospital efficiency. Also, we found that hospitals that adopted HIT with employed physicians will achieve less efficiency compared with hospitals that adopted HIT without employed physicians. Although HIT adoption and hospital-physician integration both seem to be key parts of improving hospital efficiency when one or the other is utilized individually, they can hurt hospital efficiency when utilized together.

  12. Retention and effects of miniature transmitters in juvenile American eels

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Robert P.; Janak, Jill; Liss, Stephanie A.; Brown, Richard S.; Deng, Zhiqun; Harnish, Ryan A.

    2017-11-01

    This study was conducted to assess the effects of a non-functional acoustic micro transmitter (tag) on survival, tag loss, and swimming ability of juvenile American eels (Anguilla rostrata). The transmitter was designed for implantation through a < 3 mm opening into the body cavity of anguilliform fishes without the need for sutures. American eels used for the swimming performance study were 113–175 mm (N = 120). There were two treatment groups (tagged and non-tagged), each treatment was split into six size groups of 10 mm for testing. Potential transmitter effects on swimming performance were examined by comparing critical swimming speeds (Ucrit an index of prolonged swimming performance) for tagged and non-tagged eels. There was no significant difference in Ucrit between tagged and non-tagged eels for all of the size groups tested. Median Ucrits for tagged eels ranged from 50.2 cm/s for the smallest group tested (113–119 mm) to 63.9 cm/s for fish 141–150 mm in length. Non-tagged group median Ucrits ranged from 47.2 cm/s for the smallest group to 66.9 cm/s for the 141–150 mm group. An additional 26 eels (115–208 mm) were tagged and held for 38 d (without undergoing swimming performance tests) to determine the effects on survival and tag loss. There was no mortality during the holding period and the majority of the tag loss occurred after 20 days post-tagging, which is the current projected life of the tag. Our results indicate that micro acoustic tags can be successfully implanted in juvenile American eels with no apparent impacts to swimming ability, and would be a viable option for examining eel movement patterns in river systems and near hydroelectric facilities.

  13. Principles of effective communication with patients who have intellectual disability among primary care physicians.

    Science.gov (United States)

    Werner, S; Yalon-Chamovitz, S; Tenne Rinde, M; Heymann, A D

    2017-07-01

    Examine physicians' implementation of effective communication principles with patients with intellectual disabilities (ID) and its predictors. Focus groups helped construct a quantitative questionnaire. The questionnaire (completed by 440 physicians) examined utilization of effective communication principles, attitudes toward individuals with ID, subjective knowledge and number of patients with ID. Subjective knowledge of ID and more patients with ID increased utilization of effective communication principles. Provision of knowledge that allows patients to make their own medical decisions was predicted by more patients with ID, lower attitudes that treatment of this population group is not desirable, less negative affect and greater perception that treatment of this group is part of the physician's role. Effective preparation of patients with ID for treatment was predicted by higher perception of treatment of this group as part of the physician's role, lower perception of this field as undesirable and higher perception of these individuals as unable to make their own choice. Simplification of information was predicted by a greater perception of treatment of this group as part of the physician's role and more negative affect. Greater familiarity may enhance care for these patients. Increase exposure to patients with ID within training. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Do Pocket Electronic Dictionaries Influence Word Retention and Reading Comprehension? Their Effects and Mediating Factors

    OpenAIRE

    小林, 千穂

    2011-01-01

    This study explores the effectiveness of pocket electronic dictionaries (EDs) compared with printed dictionaries (PDs) on searching behavior, word retention, and reading comprehension. It also investigates how factors such as test formats, learners' proficiency level, and text difficulty are related to the effects of EDs. Thirty-six Japanese university students participated in the study. They read an English text and answered comprehension questions, while circling the words they looked up. T...

  15. Cost-effectiveness analysis of smoking-cessation counseling training for physicians and pharmacists.

    Science.gov (United States)

    Cantor, Scott B; Deshmukh, Ashish A; Luca, Nancy Stancic; Nogueras-González, Graciela M; Rajan, Tanya; Prokhorov, Alexander V

    2015-06-01

    Although smoking-cessation interventions typically focus directly on patients, this paper conducts an economic evaluation of a novel smoking-cessation intervention focused on training physicians and/or pharmacists to use counseling techniques that would decrease smoking rates at a reasonable cost. To evaluate the cost-effectiveness of interventions that train physicians and/or pharmacists to counsel their patients on smoking-cessation techniques. Using decision-analytic modeling, we compared four strategies for smoking-cessation counseling education: training only physicians, training only pharmacists, training both physicians and pharmacists (synergy strategy), and training neither physicians nor pharmacists (i.e., no specialized training, which is the usual practice). Short-term outcomes were based on results from a clinical trial conducted in 16 communities across the Houston area; long-term outcomes were calculated from epidemiological data. Short-term outcomes were measured using the cost per quit, and long-term outcomes were measured using the cost per quality-adjusted life-year (QALY). Cost data were taken from institutional sources; both costs and QALYs were discounted at 3%. Training both physicians and pharmacists added 0.09 QALY for 45-year-old men. However, for 45-year-old women, the discounted quality-adjusted life expectancy only increased by 0.01 QALY when comparing the synergy strategy to no intervention. The incremental cost-effectiveness ratio (ICER) of the synergy strategy with respect to the non-intervention strategy was US$868/QALY for 45-year-old men and US$8953/QALY for 45-year-old women. The results were highly sensitive to the quit rates and community size. Synergistic educational training for physicians and pharmacists could be a cost-effective method for smoking cessation in the community. Published by Elsevier Ltd.

  16. Effects of glibenclamide on memory retention of passive avoidance learning in rats

    Directory of Open Access Journals (Sweden)

    MH. Esmaeili

    2017-08-01

    Full Text Available Background: Glucose increases memory in rats, and inhibit memory impairments produced by morphine. One mechanism by which glucose might act on memory via regulating the ATP-sensitive potassium channel. Objective: The aim of present study was to investigate the effects of glibenclamide on memory retention of passive avoidance learning in rats. Methods: This experimental study has been conducted in Qazvin University of Medical Sciences (2016. Forty male Wistar rats were divided into: Control, DMSO and glibenclamide groups (n=8. All rats were trained in a passive avoidance task (50 Hz, 1 mA, 3 s. DMSO (0.2 ml or glibenclamide (1, 2, 5 mg/kg, i.p. were injected for 10 days before training. Retention test was done 48 h later. Memory retention of each animal was measured as latency takes to enter the dark chamber. Findings: The time spent in the light chamber area before entering to the dark area and total time spent in the light chamber in the glibenclamide groups were less than control group. These times in the glibenclamide (5 mg/kg group was significantly lower than control group (P<0.05, conversely total time spent in the dark chamber in the glibenclamide groups were higher than control group. Conclusion: Glibenclamide, as an ATP-sensitive potassium channel blocker, may reduce memory retention by increasing insulin levels and, consequently, reducing blood glucose levels.

  17. Effect of preparation convergence on retention of multiple unit restorations - An in vitrostudy

    Directory of Open Access Journals (Sweden)

    Dileep Nag Vinnakota

    2015-01-01

    Full Text Available Background and Aim: Convergence angle (CA is one of the major determinant factors in the retention of single as well as multiple units. Hence, the aim of the present study was to determine the effect of preparation convergence on the retention of multiple unit restorations. Materials and Methods: Nickel-chromium alloy single crowns as well as three, six and nine multiple unit fixed partial dentures (FPDs were casted for standardized milled dies that simulate canine, premolar and molar teeth machined with two different degrees of convergence, 12 (n = 55 and 20 (n = 55. The dies were threaded on rectangular metal platforms with the help of retainer shaft in the proper position to model either single or multiple preparations. The casted crowns and FPDs were cemented and retention tested by securing the units in an Instron universal testing machine. The tabulated values were analyzed statistically using Mann-Whitney test. Results: Single and multiple units with 12° CA needed greater force to dislodge compared to 20°, but this difference was not statistically significant for single units of premolar (P > 0.05. Irrespective of the angle, there was a simultaneous statistically significant increase in retention as the number of units increased in FPDs, except for the difference between 3 and 6 units in 20° group (P > 0.05. Conclusion: This study highlights the importance of emphasizing on CA, during canine and molar preparation for single units as well as preparation of canines for 6 units FPDs.

  18. Impurity effects of hydrogen isotope retention on boronized wall in LHD

    International Nuclear Information System (INIS)

    Oya, Yasuhisa; Okuno, Kenji; Ashikawa, Naoko; Nishimura, Kiyohiko; Sagara, Akio

    2010-11-01

    The impurity effect on hydrogen isotopes retention in the boron film deposited in LHD was evaluated by means of XPS and TDS. It was found that the impurity concentrations in boron film were increased after H-H main plasma exposure in LHD. The ratio of hydrogen retention trapped by impurity to total hydrogen retention during H-H main plasma exposure was reached to 70%, although that of deuterium retention by impurity in D 2 + implanted LHD-boron film was about 35%. In addition, the dynamic chemical sputtering of hydrogen isotopes with impurity as the form of water and / or hydrocarbons was occurred by energetic hydrogen isotopes irradiation. It was expected that the enhancement of impurity concentration during plasma exposure in LHD would induce the dynamic formation of volatile molecules and their re-emission to plasma. These facts would prevent stable plasma operation in LHD, concluding that the dynamic impurity behavior in boron film during plasma exposure is one of key issues for the steady-state plasma operation in LHD. (author)

  19. Effects of Different Types of True-False Questions on Memory Awareness and Long-Term Retention

    Science.gov (United States)

    Schaap, Lydia; Verkoeijen, Peter; Schmidt, Henk

    2014-01-01

    This study investigated the effects of two different true-false questions on memory awareness and long-term retention of knowledge. Participants took four subsequent knowledge tests on curriculum learning material that they studied at different retention intervals prior to the start of this study (i.e. prior to the first test). At the first and…

  20. Effect of the physicochemical parameters of benzimidazole molecules on their retention by a nonpolar sorbent from an aqueous acetonitrile solution

    Science.gov (United States)

    Shafigulin, R. V.; Safonova, I. A.; Bulanova, A. V.

    2015-09-01

    The effect of the structure of benzimidazoles on their chromatographic retention on octadecyl silica gel from an aqueous acetonitrile eluent was studied. One- and many-parameter correlation equations were obtained by linear regression analysis, and their prognostic potential in determining the retention factors of benzimidazoles under study was analyzed.

  1. Effects of supplementary private health insurance on physician visits in Korea.

    Science.gov (United States)

    Kang, Sungwook; You, Chang Hoon; Kwon, Young Dae; Oh, Eun-Hwan

    2009-12-01

    The coverage of social health insurance has remained limited, despite it being compulsory in Korea. Accordingly, Koreans have come to rely upon supplementary private health insurance (PHI) to cover their medical costs. We examined the effects of supplementary PHI on physician visits in Korea. This study used individual data from 11,043 respondents who participated in the Korean Labor and Income Panel Survey in 2001. We conducted a single probit model to identify the relationship between PHI and physician visits, with adjustment for the following covariates: demographic characteristics, socioeconomic status, health status, and health-related behavior. Finally, we performed a bivariate probit model to examine the true effect of PHI on physician visits, with adjustment for the above covariates plus unobservable covariates that might affect not only physician visit, but also the purchase of PHI. We found that about 38% of all respondents had one or more private health plans. Forty-five percent of all respondents visited one or more physicians, and 49% of those who were privately insured had physician visits compared with 42% of the uninsured. The single probit model showed that those with PHI were about 14 percentage points more likely to visit physicians than those who do not have PHI. However, this distinction disappears in the bivariate probit model. This result might have been a consequence of the nature of private health plans in Korea. Private insurance companies pay a fixed amount directly to their enrollees in case of illness/injury, and the individuals are responsible subsequently for purchasing their own healthcare services. This study demonstrated the potential of Korean PHI to address the problem of moral hazard. These results serve as a reference for policy makers when considering how to finance healthcare services, as well as to contain healthcare expenditure.

  2. The Effect of Different Water Temperatures on Retention Loss and Material Degradation of Locator Attachments.

    Science.gov (United States)

    Chiu, Lillian Pui Yuk; Vitale, Nicola Di; Petridis, Haralampos; McDonald, Ailbhe

    2017-08-01

    To examine the changes in Locator attachments after exposure to different water temperatures and cyclic loading. Four groups of pink Locator attachments (3.0 lb. light retention replacement patrix attachments; 10 per group) were soaked for the equivalent of 5 years of use in distilled water at the following temperatures: 20°C, 37°C, 60°C. One group was kept dry to test the effect of water. A universal testing machine was used to measure the retention force of each treated attachment during 5500 insertion and removal cycles, simulating approximately 5 years of use. The results were compared using Kruskal-Wallis one-way ANOVA by ranks. Surface changes of tested attachments were examined using scanning electron microscopy (SEM). The exposure to 60°C water significantly increased the percentage of retention loss in Locator attachments (p < 0.05) compared to the 20°C water group and significantly reduced the final retention force compared to the other groups (p < 0.05). SEM examinations revealed severe cracking and material degradation in Locator attachments after exposure to 60°C water and cyclic loading, which were not evident in other groups. Cracking was observed after exposure to 60˚C water before cyclic loading. Exposure to 60°C water, potentially similar to denture cleansing procedures, could cause cracking in Locator attachments. Cracking is associated with hydrolytic degradation of nylon at 60°C. The change in structure could result in a significant loss of retention. © 2016 by the American College of Prosthodontists.

  3. The effects of the macro-environment on treatment retention for problem cocaine users.

    Science.gov (United States)

    Lorenzoni, Valentina; Curzio, Olivia; Karakachoff, Matilde; Saponaro, Alessio; Sanza, Michele; Mariani, Fabio; Molinaro, Sabrina

    2013-01-01

    Client dropout is commonly used as an indicator of quality and effectiveness of drug treatment. Following increasing cocaine use in recent years, research has attempted to identify predictors of retention in treatment for cocaine users but there is no consensus about how individual characteristics and system variables (referral source, treatment setting), what we term here as the "macro-environment" - effect risk of dropout. This study sought to identify macro-environmental factors and examine the way these impact upon treatment retention. A retrospective longitudinal study of an admission cohort among drug services in Vasta Romagna in Emilia Romagna Region, Italy (up to 8 years of treatment or until discharge) was conducted to determine the effect of macro-environmental variables on retention among first time admitted cocaine-dependent clients in different treatment settings. The sample consisted of 1178 clients meeting DSM-IV-R criteria for cocaine dependence. The joint effect of individual and system factors had a significant impact on dropout rates. In particular, lower rates of dropout were observed for those treated in prison and those who had a stable home, HR: 0.09 (0.02-0.48), or lived in rehabilitation units, HR: 0.36 (0.15-0.88), and among clients referred by the local authority and those living with parents, HR: 0.60 (0.38-0.95). The combined effect of individual and system factors on retention in treatment sets a critical background necessary to assess any impact of organizational dynamics and delineate the trajectory for future interventions. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. The effect of teaching method on long-term knowledge retention.

    Science.gov (United States)

    Beers, Geri W; Bowden, Susan

    2005-11-01

    Choosing a teaching strategy that results in knowledge retention on the part of learners can be challenging for educators. Studies on problem-based learning (PBL) have supported its effectiveness, compared to other, more traditional strategies. The results of a previous study comparing the effect of lecture versus PBL on objective test scores indicated there was no significant difference in scores. To measure long-term knowledge retention, the same groups were evaluated 1 year after instruction. The posttest administered in the original study was repeated, and the scores from a comprehensive adult health examination and the endocrine subsection were analyzed. At an alpha level of 0.05, a statistically significant difference was found in the scores on two of the measures. The scores of the PBL group were significantly higher on the endocrine section of the examination and the repeat posttest.

  5. The effect of podcast lectures on nursing students' knowledge retention and application.

    Science.gov (United States)

    Abate, Karen S

    2013-01-01

    This pilot study sought to evaluate the effectiveness of academic podcasts in promoting knowledge retention and application in nursing students. Nursing education no longer simply occurs in a fixed location or time. Computer-enhanced mobile learning technologies, such as academic podcasts, must be grounded in pedagogically sound characteristics to ensure effective implementation and learning in nursing education. A convenience sample of 35 female undergraduate nursing students was randomized into three groups: a traditional face-to-face lecture group, an unsegmented (non-stop) podcast lecture group, and a segmented podcast lecture group. Retention and application of information were measured through a multiple-choice quiz and a case study based on lecture content. Students in the segmented podcast lecture group demonstrated higher scores on multiple-choice and case-study assessments than those in the other two groups. Nurse educators should be aware of this finding when seeking to employ podcast lectures in nursing education.

  6. Anion effect on the retention of recoil atom of coordination crystalline compounds

    International Nuclear Information System (INIS)

    Dimotakis, P.N.; Papadopoulos, B.P.

    1980-01-01

    The anion effect of various cobaltic crystalline compounds - having the same cation and differing in anion -on the retention of neutron activated central cobalt atom has been studied. The cation was trans-dichloro(bis)ethylenediamine cobalt(III) and the anions were simple spherical anions (Cl - , Br - , I - ), planar anions (NO 3 - ), trigonal pyramidal anions (ClO 3 - , BrO 3 - ), tetrahedral anions (SO 4 2- , CrO 4 2- , MnO 4 - ) and linear anions (SCN - ). The cobalt-60 activity after reactor irradiation either in simple Co 2+ cation or in cobaltic complex cation determined the retention values. In all irradiations at ordinary temperature and at liquid nitrogen temperature the results showed an effect of the different anions, depending on the geometry, volume and charge, on the recombination of the recoil cobalt with the ligands in the coordination sphere. (author)

  7. Memory Retention after Reading Alould and its Effects on the Internalization of New Items

    OpenAIRE

    佐藤, あずさ; Azusa, SATO; 安田女子大学大学院

    2014-01-01

    This paper reports the results of two studies focusing on internalization of newly learned items. In study 1, internalization was not confirmed, but reading and memory retention abilities of the reading-aloud subgroup (i.e., students with lower reading proficiency) improved significantly more than the reading-silently subgroup. In study 2 the same effects were confirmed in the reading-aloud subgroup, and internalization of newly learned items was finally confirmed in the reading-aloud group.

  8. The Effect of Internal Marketing on Employee retention in Pakistani Banks

    OpenAIRE

    Naveed Ahmad; Nadeem Iqbal; Muhammad Sheeraz

    2012-01-01

    This research investigates the effects of internal marketing on employee retention in banking sector of district D. G. Khan, Pakistan. Marketing is the process by which the external customers are satisfied through exact identification of their needs and wants. When we do the same thing- satisfaction- with our employees then this is named as internal marketing. This approach is used to motivate, align and integrate the employees towards the achievement of organizational goals. The motto of int...

  9. The Effect of Sleep on Children’s Word Retention and Generalization

    Directory of Open Access Journals (Sweden)

    Emma L. Axelsson

    2016-08-01

    Full Text Available In the first few years of life children spend a good proportion of time sleeping as well as acquiring the meanings of hundreds of words and their related associations. There is now ample evidence of the effects of sleep on memory in adults and the number of studies demonstrating the effects of napping and nocturnal sleep in children is also mounting. In particular, sleep appears to benefit children’s memory for recently-encountered novel words. The effect of sleep on children’s generalization of novel words across multiple items, however, is less clear. Given that sleep is polyphasic in the early years, made up of multiple episodes, and children’s word learning is gradual and strengthened slowly over time, it is highly plausible that sleep is a strong candidate in supporting children’s memory for novel words. Importantly, it appears that when children sleep shortly after exposure to novel word-object pairs retention is better than if sleep is delayed, suggesting that napping plays a vital role in long-term word retention for young children. Word learning is a complex, challenging and important part of development, thus the role that sleep plays in children’s retention of novel words is worthy of attention. As such, ensuring children get sufficient good quality sleep and regular opportunities to nap may be critical for strong language acquisition.

  10. Effective training strategies for teaching communication skills to physicians: an overview of systematic reviews.

    Science.gov (United States)

    Berkhof, Marianne; van Rijssen, H Jolanda; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

    2011-08-01

    Physicians need good communication skills to communicate effectively with patients. The objective of this review was to identify effective training strategies for teaching communication skills to qualified physicians. PubMED, PsycINFO, CINAHL, and COCHRANE were searched in October 2008 and in March 2009. Two authors independently selected relevant reviews and assessed their methodological quality with AMSTAR. Summary tables were constructed for data-synthesis, and results were linked to outcome measures. As a result, conclusions about the effectiveness of communication skills training strategies for physicians could be drawn. Twelve systematic reviews on communication skills training programmes for physicians were identified. Some focused on specific training strategies, whereas others emphasized a more general approach with mixed strategies. Training programmes were effective if they lasted for at least one day, were learner-centred, and focused on practising skills. The best training strategies within the programmes included role-play, feedback, and small group discussions. Training programmes should include active, practice-oriented strategies. Oral presentations on communication skills, modelling, and written information should only be used as supportive strategies. To be able to compare the effectiveness of training programmes more easily in the future, general agreement on outcome measures has to be established. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Managing Disruptive Physician Behavior: First Steps for Designing an Effective Online Resource

    Directory of Open Access Journals (Sweden)

    Derek Puddester

    2011-03-01

    Full Text Available Interviews with physician leaders from hospitals in a mid-sized Ontario City were conducted to determine their needs with regard to managing disruptive physician behaviour. These findings were used to inform the design of a two-day skill-development workshop for physician leaders on disruptive behaviour. The workshop was evaluated using a modified version of the Learner Experience Feedback Form, which was built to align with W(eLearn, http://www.ennovativesolution.com/WeLearn/ a framework developed to guide the design, delivery, development, and evaluation of online interprofessional courses and programs (MacDonald, Stodel, Thompson, & Casimiro, 2009. The surveys gathered information related to the content, media, service, structure, and outcomes of the workshop. The findings from the focus group interviews and workshop evaluation identify physician leaders’ needs with regard to disruptive behavior and were used to inform the design of the world’s first Online Physician Health and Wellness Resource http://www.ephysicianhealth.com/ an open access learning resources currently being used globally, in 91 countries. The resource was the recipient of the winner of the International Business/Professional 2010 International eLearning Award. The findings demonstrated the importance of conducting a needs analysis and using a framework to guide the design, delivery and evaluation of effective online healthcare education.

  12. Prosocial motivation and physicians' work attitudes. Effects of a triple synergy on prosocial orientation in a healthcare organization.

    Science.gov (United States)

    Kim, Young Shin

    2015-01-01

    Employees work attitudes are key determinants to organizational performance. This article proposes a model integrating servant leadership, prosocial motivation, and corporate social responsibility (CSR) in order to explain a mechanism through which prosocial motivation plays a central role in enhanding physicians' work attitudes. A cross sectional survey from a sample of physicians indicates that (1) prosocial motivation can be shaped from servant leadership when physicians perceive high value fit with their supervisors, (2) prosocial motivation improves physicians' job satisfaction. Its effects is strengthened when physicians perceive high CSR, and (3) job satisfaction improves organizational commitment. The results provide meaningful insights that a triple synergy of prosocial orientation among physicians, supervisors and organization enhances physicians' work attitudes.

  13. Effect of Technetium-99 sources on its retention in low activity waste glass

    Science.gov (United States)

    Luksic, Steven A.; Kim, Dong-Sang; Um, Wooyong; Wang, Guohui; Schweiger, Michael J.; Soderquist, Chuck Z.; Lukens, Wayne; Kruger, Albert A.

    2018-05-01

    Small-scale crucible melting tests on simulated waste glass were performed with technetium-99 (Tc-99) introduced as different species in a representative low activity waste simulant. The glass saw an increase in Tc-99 retention when TcO2•2H2O and various Tc-minerals containing reduced tetravalent Tc were used compared to tests in which pertechnetate with heptavalent Tc was used. We postulate that the increase of Tc retention is likely caused by different reaction paths for Tc incorporation into glass during early stages of melting, rather than the low volatility of reduced tetravalent Tc compounds, which has been a generally accepted idea. Additional studies are needed to clarify the exact mechanisms relevant to the effect of reduced Tc compounds on Tc incorporation into or volatilization from the glass melt.

  14. Biodestruction of strongly swelling polymer hydrogels and its effect on the water retention capacity of soils

    Science.gov (United States)

    Smagin, A. V.; Sadovnikova, N. B.; Smagina, M. V.

    2014-06-01

    The biodestruction of strongly swelling polymer hydrogels (water adsorbing soil conditioners of the new generation) has been studied at the quantitative level using original mathematical models. In laboratory experiments, a relationship between the hydrogel degradation rate and the temperature has been obtained, and the effect of the biodestruction on the water retention curve of soil compositions with hydrogels (used as an index of their water retention capacity) has been assessed. From the automatic monitoring data of the temperature regime of soils, the potential biodestruction of hydrogels has been predicted for different climatic conditions. The loss of hydrogels during three months of the vegetation period because of destruction can exceed 30% of their initial content in irrigated agriculture under arid climatic conditions and more than 10% under humid climatic conditions. Thus, the biodestruction of hydrogels is one of the most important factors decreasing their efficiency under actual soil conditions.

  15. Effect of Technetium-99 Sources on Its Retention in Low Activity Waste Glass

    Energy Technology Data Exchange (ETDEWEB)

    Luksic, Steven A.; Kim, Dong-Sang; Um, Wooyong; Wang, Guohui; Schweiger, Michael J.; Soderquist, Chuck Z.; Lukens, Wayne W.; Kruger, Albert A.

    2018-05-01

    Small-scale crucible melting tests on simulated waste glass were performed with technetium-99 (Tc-99) introduced as different species in a representative low activity waste simulant. The glass saw an increase in Tc-99 retention when TcO2∙2H2O and various Tc-minerals containing reduced tetravalent Tc were used compared to tests in which pertechnetate with hexavalent Tc was used. We postulate that the increase of Tc retention is likely caused by different reaction paths for Tc incorporation into glass during early stages of melting, rather than the low volatility of reduced tetravalent Tc compounds, which has been a generally accepted idea. Additional studies are needed to clarify the exact mechanisms relevant to the effect of reduced Tc compounds on Tc incorporation into or volatilization from glass melt.

  16. Radiation effect on 67Ga retention and distribution in mouse tissues

    International Nuclear Information System (INIS)

    Mainwaring, H.R.; Swartzendruber, D.C.; Lushbaugh, C.C.; Idoyaga-Vargas, N.L.; Watson, E.E.

    1976-01-01

    We have studied the effect of external x irradiation on the whole-body retention and tissue distribution of gallium-67 ( 67 Ga) in mice over a period of 20 days. Adult male C57BL/6 Cum mice were injected intraperitoneally with 5 μCi 67 Ga 24 hr before, immediately before, immediately after, or 24 hr after whole-body x-ray exposure to 450 R. Control mice received 67 Ga injections and sham irradiation. Increased excretion and reduced soft-tissue concentrations of 67 Ga occurred in irradiated mice. The greatest effect was observed when the radionuclide was injected 24 hr after irradiation and assayed 24 hr later. An analysis of variance of the retention data showed that the differences between the groups were significant at the 99 percent confidence level. Exponential least-squares analysis of whole-body counting results revealed three compartments in the biological retention data. The long-lived compartment possibly corresponds to 67 Ga bound relatively tightly in certain body tissues and lost slowly. The two remaining compartments have been tentatively identified as circulating unbound 67 Ga that is lost rapidly and circulating bound 67 Ga that is lost less rapidly

  17. Effect of biochar amendment on nitrate retention in a silty clay loam soil

    Directory of Open Access Journals (Sweden)

    Angela Libutti

    2016-08-01

    Full Text Available Biochar incorporation into agricultural soils has been proposed as a strategy to decrease nutrient leaching. The present study was designed to assess the effect of biochar on nitrate retention in a silty clay loam soil. Biochar obtained from the pyrogasification of fir wood chips was applied to soil and tested in a range of laboratory sorption experiments. Four soil treatments were considered: soil only (control, soil with 2, 4 and 8% of biochar by mass. The Freundlich sorption isotherm model was used to fit the adsorbed amount of nitrate in the soil-biochar mixtures. The model performed very well in interpreting the experimental data according to a general linear regression (analysis of co-variance statistical approach. Nitrate retention in the soilbiochar mixtures was always higher than control, regardless the NO3 – concentration in the range of 0-400 mg L–1. Different sorption capacities and intensities were detected depending on the biochar application rate. The highest adsorption capacity was observed in the soils added with 2 and 4% of biochar, respectively. From the results obtained is possible to infer that nitrate retention is higher at lower biochar addition rate to soil (2 and 4% and at lower nitrate concentration in the soil water solution. These preliminary laboratory results suggest that biochar addition to a typical Mediterranean agricultural soil could be an effective management option to mitigate nitrate leaching.

  18. Effectiveness of Resident Physicians as Triage Liaison Providers in an Academic Emergency Department.

    Science.gov (United States)

    Weston, Victoria; Jain, Sushil K; Gottlieb, Michael; Aldeen, Amer; Gravenor, Stephanie; Schmidt, Michael J; Malik, Sanjeev

    2017-06-01

    Emergency department (ED) crowding is associated with detrimental effects on ED quality of care. Triage liaison providers (TLP) have been used to mitigate the effects of crowding. Prior studies have evaluated attending physicians and advanced practice providers as TLPs, with limited data evaluating resident physicians as TLPs. This study compares operational performance outcomes between resident and attending physicians as TLPs. This retrospective cohort study compared aggregate operational performance at an urban, academic ED during pre- and post-TLP periods. The primary outcome was defined as cost-effectiveness based upon return on investment (ROI). Secondary outcomes were defined as differences in median ED length of stay (LOS), median door-to-provider (DTP) time, proportion of left without being seen (LWBS), and proportion of "very good" overall patient satisfaction scores. Annual profit generated for physician-based collections through LWBS capture (after deducting respective salary costs) equated to a gain (ROI: 54%) for resident TLPs and a loss (ROI: -31%) for attending TLPs. Accounting for hospital-based collections made both profitable, with gains for resident TLPs (ROI: 317%) and for attending TLPs (ROI: 86%). Median DTP time for resident TLPs was significantly lower (phistorical control. Proportion of "very good" patient satisfaction scores and LWBS was improved for both resident and attending TLPs over historical control. Overall median LOS was not significantly different. Resident and attending TLPs improved DTP time, patient satisfaction, and LWBS rates. Both resident and attending TLPs are cost effective, with residents having a more favorable financial profile.

  19. Effectiveness of e-learning in continuing medical education for occupational physicians

    NARCIS (Netherlands)

    Hugenholtz, Nathalie I. R.; de Croon, Einar M.; Smits, Paul B.; van Dijk, Frank J. H.; Nieuwenhuijsen, Karen

    2008-01-01

    Background Within a clinical context e-learning is comparable to traditional approaches of continuing medical education (CME). However, the occupational health context differs and until now the effect of postgraduate e-learning among occupational physicians (OPs) has not been evaluated. Aim To

  20. Effect of Physician Gender on Demand for Pap Tests

    OpenAIRE

    Lin, Tsui-Fang; Chen, Jennjou

    2014-01-01

    People’s demand for preventive medical care is one type of investment in health. The aim of this paper is to examine women’s demand for secondary prevention in Taiwan, focusing on the role a physician’s gender plays in women’s inclination to undergo Pap tests. Our estimation results show that regional ratio of female doctors has a positive and significant effect on utilization of Pap tests for the full sample and for women aged below 30. In addition, doctor’s gender matters only in utilizatio...

  1. Effect of Abutment Modification and Cement Type on Retention of Cement-Retained Implant Supported Crowns

    Science.gov (United States)

    Farzin, Mitra; Torabi, Kianoosh; Ahangari, Ahmad Hasan; Derafshi, Reza

    2014-01-01

    Objective: Provisional cements are commonly used to facilitate retrievability of cement-retained fixed implant restorations; but compromised abutment preparation may affect the retention of implant-retained crowns.The purpose of this study was to investigate the effect of abutment design and type of luting agent on the retentive strength of cement-retained implant restorations. Materials and Method: Two prefabricated abutments were attached to their corresponding analogs and embedded in an acrylic resin block. The first abutment (control group) was left intact without any modifications. The screw access channel for the first abutment was completely filled with composite resin. In the second abutment, (test group) the axial wall was partially removed to form an abutment with 3 walls. Wax models were made by CAD/CAM. Ten cast copings were fabricated for each abutment. The prepared copings were cemented on the abutments by Temp Bond luting agent under standardized conditions (n=20). The assemblies were stored in 100% humidity for one day at 37°C prior to testing. The cast crown was removed from the abutment using an Instron machine, and the peak removal force was recorded. Coping/abutment specimens were cleaned after testing, and the testing procedure was repeated for Dycal luting agent (n=20). Data were analyzed with two- way ANOVA (α=0.05). Results: There was no significant difference in the mean transformed retention (Ln-R) between intact abutments (4.90±0.37) and the abutments with 3 walls (4.83±0.25) using Dycal luting agent. However, in TempBond group, the mean transformed retention (Ln-R) was significantly lower in the intact abutment (3.9±0.23) compared to the abutment with 3 walls (4.13±0.33, P=0.027). Conclusion: The retention of cement-retained implant restoration can be improved by the type of temporary cement used. The retention of cast crowns cemented to implant abutments with TempBond is influenced by the wall removal. PMID:25628660

  2. Effect of abutment modification and cement type on retention of cement-retained implant supported crowns.

    Directory of Open Access Journals (Sweden)

    Mitra Farzin

    2014-06-01

    Full Text Available Provisional cements are commonly used to facilitate retrievability of cement-retained fixed implant restorations; but compromised abutment preparation may affect the retention of implant-retained crowns.The purpose of this study was to investigate the effect of abutment design and type of luting agent on the retentive strength of cement-retained implant restorations.Two prefabricated abutments were attached to their corresponding analogs and embedded in an acrylic resin block. The first abutment (control group was left intact without any modifications. The screw access channel for the first abutment was completely filled with composite resin. In the second abutment, (test group the axial wall was partially removed to form an abutment with 3 walls. Wax models were made by CAD/CAM. Ten cast copings were fabricated for each abutment. The prepared copings were cemented on the abutments by Temp Bond luting agent under standardized conditions (n=20. The assemblies were stored in 100% humidity for one day at 37°C prior to testing. The cast crown was removed from the abutment using an Instron machine, and the peak removal force was recorded. Coping/abutment specimens were cleaned after testing, and the testing procedure was repeated for Dycal luting agent (n=20. Data were analyzed with two- way ANOVA (α=0.05.There was no significant difference in the mean transformed retention (Ln-R between intact abutments (4.90±0.37 and the abutments with 3 walls (4.83±0.25 using Dycal luting agent. However, in TempBond group, the mean transformed retention (Ln-R was significantly lower in the intact abutment (3.9±0.23 compared to the abutment with 3 walls (4.13±0.33, P=0.027.The retention of cement-retained implant restoration can be improved by the type of temporary cement used. The retention of cast crowns cemented to implant abutments with TempBond is influenced by the wall removal.

  3. The Effect of Opioid Prescribing Guidelines on Prescriptions by Emergency Physicians in Ohio.

    Science.gov (United States)

    Weiner, Scott G; Baker, Olesya; Poon, Sabrina J; Rodgers, Ann F; Garner, Chad; Nelson, Lewis S; Schuur, Jeremiah D

    2017-12-01

    The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. We used Ohio's prescription drug monitoring program data from January 1, 2010, to December 31, 2014, and included the 5 most commonly prescribed opioids (hydrocodone, oxycodone, tramadol, codeine, and hydromorphone). The primary outcome was the monthly statewide prescription total of opioids written by emergency physicians in Ohio. We used an interrupted time series analysis to compare pre- and postguideline level and trend in number of opioid prescriptions dispensed by emergency physicians per month, number of prescriptions stratified by 5 commonly prescribed opioids, and number of prescriptions for greater than 3 days' supply of opioids. Beginning in January 2010, the number of prescriptions dispensed by all emergency physicians in Ohio decreased by 0.3% per month (95% confidence interval [CI] -0.49% to -0.15%). The implementation of the guidelines in April 2012 was associated with a 12% reduction (95% CI -17.7% to -6.3%) in the level of statewide total prescriptions per month and an additional decline of 0.9% (95% CI -1.1% to -0.7%) in trend relative to the preguideline trend. The estimated effect of the guidelines on total monthly prescriptions greater than a 3-day supply was an 11.2% reduction in level (95% CI -18.8% to -3.6%) and an additional 0.9% (95% CI -1.3% to -0.5%) decline in trend per month after the guidelines. Guidelines were also associated with a reduction in prescribing for each of the 5 individual opioids, with various effect. In Ohio, emergency physician opioid prescribing guidelines were associated with a decrease in the quantity of opioid prescriptions written by emergency physicians. Although introduction of the guidelines occurred in parallel with other opioid-related interventions, our

  4. The effect of using social pressure in cover letters to improve retention in a longitudinal health study: an embedded randomised controlled retention trial.

    Science.gov (United States)

    Cotterill, Sarah; Howells, Kelly; Rhodes, Sarah; Bower, Peter

    2017-07-20

    Retention of participants in cohort studies is important for validity. One way to promote retention is by sending a persuasive cover letter with surveys. The study aimed to compare the effectiveness of a covering letter containing social pressure with a standard covering letter on retention in a health cohort study. Social pressure involves persuading people to behave in a certain way by the promise that their actions will be made know to others. We implemented a mild form of social pressure, where the recipient was told that information about whether they responded to the current survey would be noted by the research team and printed on future correspondence from the research team to the recipient. The design was an embedded randomised controlled retention trial, conducted between July 2015 and April 2016 in Salford, UK. Participants in the host health cohort study were eligible. They received either: (1) a covering letter with two consecutive surveys (sent six and twelve months after recruitment), containing a social pressure intervention; or (2) a matching letter without the social pressure text. The primary outcome was retention in the host study, defined as return of both surveys. Randomisation was computer-generated, with stratification by household size. Participants were blinded to group assignment. Researchers were blinded for outcome ascertainment. Adults (n = 4447) aged over 65 years, with a long-term condition and enrolled in the host study, were randomly allocated to receive a social pressure covering letter (n = 2223) or control (n = 2224). All 4447 participants were included in the analysis. Both questionnaires were returned by 1577 participants (71%) sent the social pressure letters and 1511 (68%) sent control letters, a risk difference of 3 percentage points (adjusted odds ratio = 1.16 (95% confidence interval = 1.02-1.33)). A mild form of social pressure made a small but significant improvement in retention of older adults in

  5. Effectiveness of tamsulosin in prevention of post-operative urinary retention: a randomized double-blind placebo-controlled study.

    Science.gov (United States)

    Madani, Ali Hamidi; Aval, Hamidreza Baghani; Mokhtari, Gholamreza; Nasseh, Hamidreza; Esmaeili, Samaneh; Shakiba, Maryam; Shakiba, Reza Shahrokhi; Seyed Damavand, Seyed Mohamad

    2014-01-01

    Urinary retention is one of the most common complications contributing to surgical procedures. Recent studies have shown the benefits of alpha-adrenergic blockers in preventing post-operative urinary retention (POUR). The aim of this prospective study was to compare the prophylactic effect of tamsulosin with placebo on postoperative urinary retention. In this randomized placebo controlled, clinical trial, 232 male patients aged 18 to 50 years old admitted to Razi University Hospital for varicocelectomy, inguinal herniorrhaphy, and scrotal surgery were randomly assigned to receive either three doses of 0.4mg tamsulosin (n = 118) or placebo (n = 114), 14 and 2 hours before, and 10 hours after surgery. Patients were closely monitored for the development of urinary retention 24 hours after surgical intervention. The primary endpoint was to investigate the effect of tamsulosin in prevention of post-operative urinary retention during the first 24 hours after surgical intervention. Collected data were analyzed using SPSS software version 18 and the P tamsulosin arm and 114 in placebo arm. POUR in patients who received tamsulosin was significantly lower than placebo, as 5.9% of the patients treated with tamsulosin and 21.1% placebo group, reported urinary retention following surgery (P = 0.001). No serious adverse effects were seen in both groups. This study suggests that short perioperative treatment with tamsulosin can reduce the incidence of urinary retention and the need for catheterization after varicocelectomy, inguinal herniorrhaphy, and scrotal surgery.

  6. The impact of economic and noneconomic exchange on physicians' organizational attitudes: The moderating effects of the Chief Medical Officer.

    Science.gov (United States)

    Trybou, Jeroen; Gemmel, Paul; Annemans, Lieven

    2016-01-01

    Hospital-physician relationships are critical to hospitals' organizational success. A distinction can be drawn between economic and noneconomic physician-hospital exchange. Physician senior leadership could be an important component of managerial strategies aimed at optimizing hospital-physician relationships. The purpose of this study was to investigate the moderating role of the quality of exchange with the Chief Medical Officer (CMO) in the relationship between economic and noneconomic exchange and physicians' key organizational attitudes. Self-employed physicians practicing at six Belgian hospitals were surveyed. Economic exchange was conceptualized by the concepts of distributive and procedural justice, whereas noneconomic exchange was conceptualized by the concepts of administrative and professional psychological contract. Our outcomes comprise three key organizational attitudes identified in the literature (job satisfaction, affective organizational commitment, and intention to leave). The moderating role of leader-member exchange with the CMO in these relationships was assessed. Our results showed a relationship between both psychological contract breach and organizational justice and physicians' organizational attitudes. The quality of exchange with the CMO buffered the negative effect of psychological contract breach and reinforced the positive effects of organizational justice with respect to physicians' organizational attitudes. Our results demonstrate that both economic and noneconomic aspects are important when considering physicians' key organizational attitudes. The reciprocity dynamic between physician and hospital can be enhanced by high-quality exchange with the CMO.

  7. Effect of polymers on the retention and aging of enzyme on bioactive papers.

    Science.gov (United States)

    Khan, Mohidus Samad; Haniffa, Sharon B M; Slater, Alison; Garnier, Gil

    2010-08-01

    The effect of polymer on the retention and the thermal stability of bioactive enzymatic papers was measured using a colorimetric technique quantifying the intensity of the enzyme-substrate product complex. Alkaline phosphatase (ALP) was used as model enzyme. Three water soluble polymers: a cationic polyacrylamide (CPAM), an anionic polyacrylic acid (PAA) and a neutral polyethylene oxide (PEO) were selected as retention aids. The model polymers increased the enzyme adsorption on paper by around 50% and prevented enzyme desorption upon rewetting of the papers. The thermal deactivation of ALP retained on paper with polymers follows two sequential first order reactions. This was also observed for ALP simply physisorbed on paper. The retention aid polymers instigated a rapid initial deactivation which significantly decreased the longevity of the enzymatic papers. This suggests some enzyme-polymer interaction probably affecting the enzyme tertiary structure. A deactivation mathematical model predicting the enzymatic paper half-life was developed. Crown Copyright 2010. Published by Elsevier B.V. All rights reserved.

  8. Encoding vs. retention: differential effects of cue manipulation on working memory performance in schizophrenia.

    Science.gov (United States)

    Javitt, Daniel C; Rabinowicz, Esther; Silipo, Gail; Dias, Elisa C

    2007-03-01

    Deficits in working memory performance are among the most widely replicated findings in schizophrenia. Roles of encoding vs. memory retention in working memory remain unresolved. The present study evaluated working memory performance in schizophrenia using an AX-type continuous performance test (AX-CPT) paradigm. Participants included 48 subjects with schizophrenia and 27 comparison subjects. Behavior was obtained in 3 versions of the task, which differed based upon ease of cue interoperability. In a simple cue version of the task, cue letters were replaced with red or green circles. In the complex cue version, letter/color conjunctions served as cues. In the base version of the task, patients showed increased rates of false alarms to invalidly cued targets, similar to prior reports. However, when the cue stimuli were replaced with green or red circles to ease interpretation, patients showed similar false alarm rates to controls. When feature conjunction cues were used, patients were also disproportionately affected relative to controls. No significant group by interstimulus interval interaction effects were observed in either the simple or complex cue conditions, suggesting normal retention of information even in the presence of overall performance decrements. These findings suggest first, that cue manipulation disproportionately affects AX-CPT performance in schizophrenia and, second, that substantial behavioral deficits may be observed on working memory tasks even in the absence of disturbances in mnemonic retention.

  9. Effects of calcium carbonate and hydroxyapatite on zinc and iron retention in postmenopausal women

    International Nuclear Information System (INIS)

    Dawson-Hughes, B.; Seligson, F.H.; Hughes, V.A.

    1986-01-01

    We measured the effect of calcium carbonate and hydroxyapatite on whole-body retention of zinc-65 in 11 and iron-59 in 13 healthy, postmenopausal women. In a single-blind, controlled, crossover study, each subject, on three occasions, ingested a standard test meal supplemented with iron-59 or zinc-65 and capsules containing placebo or 500 mg elemental calcium as calcium carbonate or hydroxyapatite. Whole-body countings were performed prior to, 30 min after, and 2 wk after each meal. Mean (SEM) zinc retention was 18.1 +/- 1.0% with placebo (control) and did not vary significantly with calcium carbonate (110.0 +/- 8.6% of control) or hydroxyapatite (106.0 +/- 7.9% of control). Iron retention, 6.3 +/- 2.0% with placebo, was significantly reduced with both calcium carbonate (43.3 +/- 8.8% of control, p = 0.002) and hydroxyapatite (45.9 +/- 10.0% of control, p = 0.003). Iron absorption may be significantly reduced when calcium supplements are taken with meals

  10. The effect of 2,3-dimercaptopropane sodium sulfonate on mercury retention in rats in relation to age

    International Nuclear Information System (INIS)

    Kostial, K.; Kargacin, B.; Blanusa, M.; Landeka, M.

    1984-01-01

    The effectiveness of DMPS (sodium 2,3-dimercaptopropane-l-sulfonate) in reducing inorganic mercury retention was studied in 2-, 6-, and 28-week-old albino rats. 203 Hg was administered IP. The chelating agent DMPS was administered by injection at a dose of 250 μmol/kg body weight three times, 1 day after 203 Hg administration and at 24 h intervals thereafter. The whole body retention determined 1, 2, 3, and 6 days after 203 Hg administration showed that DMPS decreased the body retention of mercury in all age groups, being about twice as effective in adult compared to suckling rats. The reduced effectiveness was due to the reduced efficacy of DMPS in reducing kidney retention in young animals. In other organs the effectiveness of DMPS was not age dependent. These and previous results obtained with different chelating agents and other metals indicate that age might be an important factor in chelation therapy in general. (orig.)

  11. Retention based bio accessibility of carotenoids in green leafy vegetables: effect of different Indian culinary practices

    Directory of Open Access Journals (Sweden)

    Sreeenivasa J Rao

    2014-12-01

    Full Text Available Back ground: Green Leafy Vegetables (GLV is pigment-rich and nutritionally relevant functional food sources with unique phytochemical constituents that include carotenoids which are precursors for vitamin A and protect cells from oxidation and cellular damage. Cooking processes and other factors such as temperature, light and alteration in moisture content generally promote either isomerization (trans to cis form or oxidative degradation of carotenoids to epoxides. Rationale: Studies pertaining to the effect of cooking methods on dietary carotenoids bio accessibility and their retention percent are scarce, particularly in an Indian Diasporas. Objective: Present study was to determine the carotenoids retention based bio accessibility in GLV such as amaranth (Amaranthus gangeticus, spinach (Spinacia oleracea and curry leaves (Murraya koenigii, when subjected to domestic cooking methods of microwave cooking, sautéing, pressure cooking, steaming and deep frying in oil, for a time duration of 8 and 12 minutes, either with lid closed or open. Method: The retention based bio accessibility of carotenoids were quantified by rapid separation liquid chromatography (RSLC using RP-C-18 column (150mm×4.6µ with 70% acetonitrile, 20% dichlomethane and 10% methanol for 20 minutes at flow rate of 0.5 ml/min. Results: The maximum retention based bio accessibility of total carotenoids and β-carotene were observed with micro wave cooking, steaming and sautéing methods. (Spinach: 57.88% and 55.92%, Amaranth: 56.15% and 57.49%, Curry leaves: 50.55% and 52.66% respectively. Conclusion: The reduction in the contents of carotenes in GLVs in correlation to various cooking methods are discussed which would be valuable for food researchers, nutritionists as well as health practitioners and dietitians, in developing and promoting nutritionally balanced diets and minimize vitamin A deficiency in Indian context.

  12. Retention based bio accessibility of carotenoids in green leafy vegetables: effect of different Indian culinary practices

    Directory of Open Access Journals (Sweden)

    Sreeenivasa J Rao

    2014-12-01

    Full Text Available Back ground: Green Leafy Vegetables (GLV is pigment-rich and nutritionally relevant functional food sources with unique phytochemical constituents that include carotenoids which are precursors for vitamin A and protect cells from oxidation and cellular damage. Cooking processes and other factors such as temperature, light and alteration in moisture content generally promote either isomerization (trans to cis form or oxidative degradation of carotenoids to epoxides. Rationale: Studies pertaining to the effect of cooking methods on dietary carotenoids bio accessibility and their retention percent are scarce, particularly in an Indian Diasporas. Objective: Present study was to determine the carotenoids retention based bio accessibility in GLV such as amaranth (Amaranthus gangeticus, spinach (Spinacia oleracea and curry leaves (Murraya koenigii, when subjected to domestic cooking methods of microwave cooking, sautéing, pressure cooking, steaming and deep frying in oil, for a time duration of 8 and 12 minutes, either with lid closed or open. Method: The retention based bio accessibility of carotenoids were quantified by rapid separation liquid chromatography (RSLC using RP-C-18 column (150mm×4.6µ with 70% acetonitrile, 20% dichlomethane and 10% methanol for 20 minutes at flow rate of 0.5 ml/min. Results: The maximum retention based bio accessibility of total carotenoids and β-carotene were observed with micro wave cooking, steaming and sautéing methods. (Spinach: 57.88% and 55.92%, Amaranth: 56.15% and 57.49%, Curry leaves: 50.55% and 52.66% respectively. Conclusion: The reduction in the contents of carotenes in GLVs in correlation to various cooking methods are discussed which would be valuable for food researchers, nutritionists as well as health practitioners and dietitians, in developing and promoting nutritionally balanced diets and minimize vitamin A deficiency in Indian context.

  13. Super enhanced permeability and retention (SUPR) effects in tumors following near infrared photoimmunotherapy

    Science.gov (United States)

    Kobayashi, Hisataka; Choyke, Peter L.

    2016-06-01

    To date, the delivery of nano-sized therapeutic agents to cancers largely relies on enhanced permeability and retention (EPR) effects that are caused by the leaky nature of cancer vasculature. However, nano-sized agents delivered in this way have demonstrated limited success in oncology due to the relatively small magnitude of the EPR effect. For achieving superior delivery of nano-sized agents, super-enhanced permeability and retention (SUPR) effects are needed. Near infrared photo-immunotherapy (NIR-PIT) is a recently reported therapy that treats tumors with light therapy and subsequently causes an increase in nano-drug delivery up to 24-fold compared with untreated tumors in which only the EPR effect is present. SUPR effects could enhance delivery into tumor beds of a wide variety of nano-sized agents including particles, antibodies, and protein binding small molecular agents. Therefore, taking advantage of the SUPR effects after NIR-PIT may be a promising avenue to utilize a wide variety of nano-drugs in a highly effective manner.

  14. Direct-to-consumer advertising: physicians' views of its effects on quality of care and the doctor-patient relationship.

    Science.gov (United States)

    Murray, Elizabeth; Lo, Bernard; Pollack, Lance; Donelan, Karen; Lee, Ken

    2003-01-01

    The objective of the study was to determine physicians' views of the effects of Direct-to-Consumer Advertising (DTCA) on health service utilization, quality of care, and the doctor-patient relationship. Cross-sectional survey of a nationally representative sample of US physicians to determine their perceptions of the effects of patients discussing information from DTCA on time efficiency; requests for specific interventions; health outcomes; and the doctor-patient relationship. Physicians reported that more than half (56%) of patients who discussed information from DTCA in a visit did so because they wanted a specific intervention, such as a test, change in medication, or specialist referral. The physician deemed 49% of these requests clinically inappropriate. Physicians filled 69% of requests they deemed clinically inappropriate; 39% of physicians perceived DTCA as damaging to the time efficiency of the visit, and 13% saw it as helpful. Thirty-three percent of physicians thought discussing DTCA had improved the doctor-patient relationship; 8% felt it had worsened it. The effect on the relationship was strongly associated with doing what the patient wanted. DTCA can have good and bad effects on quality of care, the doctor-patient relationship, and health service utilization. The benefits might be maximized, and the harms minimized, by increasing the accuracy of information in advertisements; enhancing physicians' communication and negotiation skills; and encouraging patients to respect physicians' clinical expertise.

  15. Perceptions of effective and ineffective nurse-physician communication in hospitals.

    Science.gov (United States)

    Robinson, F Patrick; Gorman, Geraldine; Slimmer, Lynda W; Yudkowsky, Rachel

    2010-01-01

    Nurse-physician communication affects patient safety. Such communication has been well studied using a variety of survey and observational methods; however, missing from the literature is an investigation of what constitutes effective and ineffective interprofessional communication from the perspective of the professionals involved. The purpose of this study was to explore nurse and physician perceptions of effective and ineffective communication between the two professions. Using focus group methodology, we asked nurses and physicians with at least 5 years' acute care hospital experience to reflect on effective and ineffective interprofessional communication and to provide examples. Three focus groups were held with 6 participants each (total sample 18). Sessions were audio recorded and transcribed verbatim. Transcripts were coded into categories of effective and ineffective communication. The following themes were found. For effective communication: clarity and precision of message that relies on verification, collaborative problem solving, calm and supportive demeanor under stress, maintenance of mutual respect, and authentic understanding of the unique role. For ineffective communication: making someone less than, dependence on electronic systems, and linguistic and cultural barriers. These themes may be useful in designing learning activities to promote effective interprofessional communication.

  16. A new analytical formulation of retention effects on particle diffusion processes

    Directory of Open Access Journals (Sweden)

    Luiz Bevilacqua

    2011-12-01

    Full Text Available The ultimate purpose of this paper is to present a new analytical formulation to simulate diffusion with retention in a reactive medium under stable thermodynamic conditions. The analysis of diffusion with retention in a continuum medium is developed after the solution of an equivalent problem using a discrete approach. The new law may be interpreted as the reduction of all diffusion processes with retention to a unifying phenomenon that can adequately simulate the retention effect namely a circulatory motion. It is remarkable that the governing equation requires a fourth order differential term as suggested by the discrete approach. The relative fraction of diffusion particles β is introduced as a control parameter in the diffusion-retention law as suggested by the discrete approach. This control parameter is essential to avoid retention isolated from the diffusion process. Two matrices referring to material properties are introduced and related to the real phenomenon through the circulation hypothesis. The governing equation may be highly non-linear even if the material properties are constant, but the retention effect is a function of the concentration level, that is, β is a function of the concentration.O objetivo último desse trabalho é apresentar uma nova formulação analítica para simular difusão com retenção em um meio reativo sob condições termodinamicamente estáveis. A análise da difusão com retenção em um meio contínuo é desenvolvida a partir da solução de um problema equivalente usando uma abordagem discreta. A nova lei pode ser interpretada como a redução de todos os processos de difusão com retenção a um fenômeno unificador que pode simular adequadamente a retenção. O propósito principal desse trabalho é apresentar uma nova formulação analítica para simular difusão com retenção em meio reativo termodinamicamente estável. A análise da difusão com retenção em um meio contínuo é desenvolvido

  17. Acute effects of the electromagnetic waves emitted by mobile phones on attention in emergency physicians.

    Science.gov (United States)

    Altuntas, Gurkan; Sadoglu, Davut; Ardic, Senol; Yilmaz, Hakan; Imamoglu, Melih; Turedi, Suleyman

    2018-03-01

    The purpose of this study was to investigate the acute effects of the electromagnetic waves (EMW) emitted by mobile phones on attention in emergency physicians. This single-center, prospective, randomized, double-blinded clinical study was performed among emergency physicians in a tertiary hospital. Thirty emergency physicians were enrolled in the study. Initial d2 test was applied in the evaluation of attention and concentration of all the physicians, who were randomly assigned into one of two groups. The control group members hold mobile phones in 'off' mode to their left ears for 15min. The members of the intervention group hold mobile phones in 'on' mode to their left ears for 15min, thus exposing them to 900-1800MHz EMW. The d2 test was re-applied to both groups after this procedure. Differences in attention and concentration levels between the groups were compared. Difference between initial and final d2 test in total performance (TN-E, p=0.319), in total number of figures marked (TN, p=0.177), in test performance percentile (PR, p=0.619) and in attention fluctuation (FR, p=0.083) were similar between the groups. However, difference in the number of figures missed (E1 selective attention, p=0.025), difference between numbers of incorrectly marked figures (E2, p=0,018) and difference in focus levels (E, p=0.016) were significantly in favor of the intervention group. According to our study findings, the EMW emitted by mobile phones has no deleterious effect on the attention and concentration levels of emergency physicians, and even has a positive impact on selective attention levels. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians

    Directory of Open Access Journals (Sweden)

    Agra Yolanda

    2011-05-01

    Full Text Available Abstract Background The Spanish Palliative Care Strategy recommends an intermediate level of training for primary care physicians in order to provide them with knowledge and skills. Most of the training involves face-to-face courses but increasing pressures on physicians have resulted in fewer opportunities for provision of and attendance to this type of training. The effectiveness of on-line continuing medical education in terms of its impact on clinical practice has been scarcely studied. Its effect in relation to palliative care for primary care physicians is currently unknown, in terms of improvement in patient's quality of life and main caregiver's satisfaction. There is uncertainty too in terms of any potential benefits of asynchronous communication and interaction among on-line education participants, as well as of the effect of the learning process. The authors have developed an on-line educational model for palliative care which has been applied to primary care physicians in order to measure its effectiveness regarding knowledge, attitude towards palliative care, and physician's satisfaction in comparison with a control group. The effectiveness evaluation at 18 months and the impact on the quality of life of patients managed by the physicians, and the main caregiver's satisfaction will be addressed in a different paper. Methods Randomized controlled educational trial to compared, on a first stage, the knowledge and attitude of primary care physicians regarding palliative care for advanced cancer patients, as well as satisfaction in those who followed an on-line palliative care training program with tutorship, using a Moodle Platform vs. traditional education. Results 169 physicians were included, 85 in the intervention group and 84 in the control group, of which five were excluded. Finally 82 participants per group were analyzed. There were significant differences in favor of the intervention group, in terms of knowledge (mean 4.6; CI

  19. Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians.

    Science.gov (United States)

    Pelayo, Marta; Cebrián, Diego; Areosa, Almudena; Agra, Yolanda; Izquierdo, Juan Vicente; Buendía, Félix

    2011-05-23

    The Spanish Palliative Care Strategy recommends an intermediate level of training for primary care physicians in order to provide them with knowledge and skills. Most of the training involves face-to-face courses but increasing pressures on physicians have resulted in fewer opportunities for provision of and attendance to this type of training. The effectiveness of on-line continuing medical education in terms of its impact on clinical practice has been scarcely studied. Its effect in relation to palliative care for primary care physicians is currently unknown, in terms of improvement in patient's quality of life and main caregiver's satisfaction. There is uncertainty too in terms of any potential benefits of asynchronous communication and interaction among on-line education participants, as well as of the effect of the learning process.The authors have developed an on-line educational model for palliative care which has been applied to primary care physicians in order to measure its effectiveness regarding knowledge, attitude towards palliative care, and physician's satisfaction in comparison with a control group.The effectiveness evaluation at 18 months and the impact on the quality of life of patients managed by the physicians, and the main caregiver's satisfaction will be addressed in a different paper. Randomized controlled educational trial to compared, on a first stage, the knowledge and attitude of primary care physicians regarding palliative care for advanced cancer patients, as well as satisfaction in those who followed an on-line palliative care training program with tutorship, using a Moodle Platform vs. traditional education. 169 physicians were included, 85 in the intervention group and 84 in the control group, of which five were excluded. Finally 82 participants per group were analyzed. There were significant differences in favor of the intervention group, in terms of knowledge (mean 4.6; CI 95%: 2.8 to 6.5 (p = 0.0001), scale range 0-33), confidence

  20. Effects of Hydrocarbon-Based Grease on Rapid Prototype Material Used for Grease Retention Shrouds

    Science.gov (United States)

    Zakrajsek, Andrew J.; Valco, Daniel J.; Street, Kenneth W., Jr.

    2010-01-01

    Effects of hydrocarbon-based greases on specific rapid prototype (RP) materials used to fabricate grease retention shrouds (GRS) were explored in this study. Grease retention shrouds are being considered as a way to maintain adequate grease lubrication at the gear mesh in a prototype research transmission system. Due to their design and manufacturing flexibility, rapid prototype materials were chosen for the grease retention shrouds. In order to gain a better understanding of the short and long term effects grease pose on RP materials, research was conducted on the interaction of hydrocarbon-based grease with RP materials. The materials used in this study were durable polyamide (nylon), acrylonitrile butadiene styrene (ABS), and WaterClear 10120. Testing was conducted using Mobilgrease 28 and Syn-Tech 3913G grease (gear coupling grease). These greases were selected due to their regular use with mechanical components. To investigate the effect that grease has on RP materials, the following methods were used to obtain qualitative and quantitative data: Fourier transform infrared spectroscopy (FT-IR), interference profilometer measurements, digital camera imaging, physical shape measurement, and visual observations. To record the changes in the RP materials due to contact with the grease, data was taken before and after the grease application. Results showed that the WaterClear 10120 RP material provided the best resistance to grease penetration as compared to nylon and ABS RP materials. The manufacturing process, and thus resulting surface conditions of the RP material, played a key role in the grease penetration properties and resilience of these materials.

  1. Biochar effects on wet and dry regions of the soil water retention curve of a sandy loam

    DEFF Research Database (Denmark)

    Arthur, Emmanuel; Moldrup, Per; Sun, Zhencai

    2014-01-01

    Reported beneficial effects of biochar on soil physical properties and processes include decreased soil density, and increased soil water transport, water holding capacity and retention (mainly for the wet region). Research is limited on biochar effects on the full soil water retention curve (wet...... and dry regions) for a given soil and biochar amendment scenarios. This study evaluates how biochar applied to a sandy loam field at rates from 0 to 50 Mg ha−1 yr–1 in 2011, 2012, or both years (2011+2012) influences the full water retention curve. Inorganic fertilizer and pig slurry were added to all...... treatments. Six months after the last biochar application, intact and disturbed soil samples were collected for analyses. Soil water retention was measured from −1 kPa to −100 kPa using tension tables and ceramic plates and from −10 MPa to −480 MPa using a Vapor Sorption Analyzer. Soil specific area...

  2. Effects of Sexual Harassment on Job Satisfaction, Retention, Cohesion, Commitment and Unit Effectiveness: The Case of the Air Force

    Science.gov (United States)

    2010-07-01

    quid pro quo ). Examples of questions that were used in previous studies to measure crude/offensive behavior, as well as, other forms of sexual ...includes, but is not limited to, harassment in which submission is made a condition of employment (or quid pro quo ). Global or organizational...Effects of Sexual Harassment on Job Satisfaction, Retention, Cohesion, Commitment and Unit Effectiveness: The Case of the Air Force Dr. Brenda

  3. Continuing medical education effect on physician knowledge: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines.

    Science.gov (United States)

    Bordage, Georges; Carlin, Brian; Mazmanian, Paul E

    2009-03-01

    Physicians are continuously engaging in continuing medical education (CME) activities. Whether CME activities actually improve their knowledge and whether multiple media, instructional techniques, and exposures are better than single experiences are questions that are still under discussion. The Johns Hopkins Evidence-based Practice Center for Healthcare Research and Quality conducted a systematic review of the effectiveness of CME (Agency for Healthcare Research and Quality Evidence Report) from which the guideline panel used 28 (+/- 2) studies to answer these questions about improvements in knowledge. The studies were selected based on the presence of an adequate control group from an initial pool of 136 studies on CME. Despite the heterogeneity of the studies reviewed and the low quality of the evidence, the results from the majority of the studies (79%) showed that CME activities were associated with improvements in physician knowledge. The evidence gathered about the use of media and instructional techniques and the frequency of exposure suggests that multimedia, multiple instructional techniques, and multiple exposures be used whenever possible in CME. Future studies of CME should include assessment of applied knowledge, and should incorporate programmatic and collaborative studies of CME.

  4. The Effects of Test Trial and Processing Level on Immediate and Delayed Retention

    OpenAIRE

    Chang, Sau Hou

    2017-01-01

    The purpose of the present study was to investigate the effects of test trial and processing level on immediate and delayed retention. A 2 × 2 × 2 mixed ANOVAs was used with two between-subject factors of test trial (single test, repeated test) and processing level (shallow, deep), and one within-subject factor of final recall (immediate, delayed). Seventy-six college students were randomly assigned first to the single test (studied the stimulus words three times and took one free-recall test...

  5. Assessment of the nutrient removal effectiveness of floating treatment wetlands applied to urban retention ponds.

    Science.gov (United States)

    Wang, Chih-Yu; Sample, David J

    2014-05-01

    The application of floating treatment wetlands (FTWs) in point and non-point source pollution control has received much attention recently. Although the potential of this emerging technology is supported by various studies, quantifying FTW performance in urban retention ponds remains elusive due to significant research gaps. Actual urban retention pond water was utilized in this mesocosm study to evaluate phosphorus and nitrogen removal efficiency of FTWs. Multiple treatments were used to investigate the contribution of each component in the FTW system with a seven-day retention time. The four treatments included a control, floating mat, pickerelweed (Pontederia cordata L.), and softstem bulrush (Schoenoplectus tabernaemontani). The water samples collected on Day 0 (initial) and 7 were analyzed for total phosphorus (TP), total particulate phosphorus, orthophosphate, total nitrogen (TN), organic nitrogen, ammonia nitrogen, nitrate-nitrite nitrogen, and chlorophyll-a. Statistical tests were used to evaluate the differences between the four treatments. The effects of temperature on TP and TN removal rates of the FTWs were described by the modified Arrhenius equation. Our results indicated that all three FTW designs, planted and unplanted floating mats, could significantly improve phosphorus and nitrogen removal efficiency (%, E-TP and E-TN) compared to the control treatment during the growing season, i.e., May through August. The E-TP and E-TN was enhanced by 8.2% and 18.2% in the FTW treatments planted with the pickerelweed and softstem bulrush, respectively. Organic matter decomposition was likely to be the primary contributor of nutrient removal by FTWs in urban retention ponds. Such a mechanism is fostered by microbes within the attached biofilms on the floating mats and plant root surfaces. Among the results of the four treatments, the FTWs planted with pickerelweed had the highest E-TP, and behaved similarly with the other two FTW treatments for nitrogen removal

  6. Enhanced Tumor Retention Effect by Click Chemistry for Improved Cancer Immunochemotherapy.

    Science.gov (United States)

    Mei, Ling; Liu, Yayuan; Rao, Jingdong; Tang, Xian; Li, Man; Zhang, Zhirong; He, Qin

    2018-05-30

    Because of the limited drug concentration in tumor tissues and inappropriate treatment strategies, tumor recurrence and metastasis are critical challenges for effectively treating malignancies. A key challenge for effective delivery of nanoparticles is to reduce uptake by reticuloendothelial system and to enhance the permeability and retention effect. Herein, we demonstrated Cu(I)-catalyzed click chemistry triggered the aggregation of azide/alkyne-modified micelles, enhancing micelles accumulation in tumor tissues. In addition, combined doxorubicin with the adjuvant monophosphoryl lipid A, an agonist of toll-like receptor4, generated immunogenic cell death, which further promoted maturity of dendritic cells, antigen presentation and induced strong effector T cells in vivo. Following combined with anti-PD-L1 therapy, substantial antitumor and metastasis inhibitory effects were achieved because of the reduced PD-L1 expression and regulatory T cells. In addition, effective long-term immunity from memory T cell responses protected mice from tumor recurrence.

  7. Quantitative assessment of surface functionality effects on microglial uptake and retention of PAMAM dendrimers

    Science.gov (United States)

    Liaw, Kevin; Gök, Ozgul; DeRidder, Louis B.; Kannan, Sujatha; Kannan, Rangaramanujam M.

    2018-04-01

    Dendrimers are a promising class of polymeric nanoparticles for delivery of therapeutics and diagnostics. Polyamidoamine (PAMAM) dendrimers have shown significant efficacy in many animal models, with performance dependent on surface functionalities. Understanding the effects of end groups on biological interactions is critical for rational design of dendrimer-mediated therapies. In this study, we quantify the cellular trafficking kinetics (endocytosis and exocytosis) of generation 4 neutral (D4-OH), cationic (D4-NH2), anionic (D3.5-COOH), and generation 6 neutral (D6-OH) PAMAM dendrimers to investigate the nanoscale effects of surface functionality and size on cellular interactions. Resting and LPS-activated microglia were studied due to their central roles in dendrimer therapies for central nervous system disorders. D4-OH exhibits greater cellular uptake and lower retention than the larger D6-OH. D4-OH and D3.5-COOH exhibit similar trafficking kinetics, while D4-NH2 exhibits significant membrane interactions, resulting in faster cell association but lower internalization. Cationic charge may also enhance vesicular escape for greater cellular retention and preferential partitioning to nuclei. LPS activation further improves uptake of dendrimers, with smaller and cationic dendrimers experiencing the greatest increases in uptake compared to resting microglia. These studies have implications for the dependence of trafficking pathway on dendrimer properties and inform the design of dendrimer constructs tailored to specific therapeutic needs. Cationic dendrimers are ideal for delivering genetic materials to nuclei, but toxicity may be a limiting factor. Smaller, neutral dendrimers are best suited for delivering high levels of therapeutics in acute neuroinflammation, while larger or cationic dendrimers provide robust retention for sustained release of therapeutics in longer-term diseases.

  8. MANIPULATING L2 LEARNERS' ONLINE DICTIONARY USE AND ITS EFFECT ON L2 WORD RETENTION

    Directory of Open Access Journals (Sweden)

    Elke Peters

    2007-02-01

    Full Text Available This study explored the effect of two enhancement techniques on L2 learners' look-up behaviour during a reading task and word retention afterwards amongst Flemish learners of German: a Vocabulary Test Announcement and Task-induced Word Relevance. Eighty-four participants were recruited for this study. They were randomly assigned to one of two groups: 1 not forewarned of an upcoming vocabulary test (incidental condition or 2 forewarned of a vocabulary test (intentional condition. Task-induced Word Relevance was operationalized by a reading comprehension task. The relevance factor comprised two levels: plus-relevant and minus-relevant target words. Plus-relevant words needed to be looked up and used receptively in order to answer the comprehension questions. In other words, the reading comprehension task could not be accomplished without knowing the meaning of the plus-relevant words. The minus-relevant target words, on the other hand, were not linked to the reading comprehension questions. Our findings show a significant effect of Test Announcement and Word Relevance on whether a target word is looked up. In addition, Word Relevance also affects the frequency of clicks on target words. Word retention is only influenced by Task-induced Word Relevance. The effect of Word Relevance is durable.

  9. Effect of γ-exposure on retention of recoil 56Mn in permanganates

    International Nuclear Information System (INIS)

    Mishra, S.P.; Vijaya

    2002-01-01

    Full text: γ-exposure effect on recombination of recoil 56 Mn atom in La, Sr and Ba permanganates were studied with a special emphasis to pre-and post-activation γ-ray irradiation treatment using 60 Co source. Permanganates were inactivated by ionizing radiation as a function of γ-dose without neutron irradiation, however, pronounced effects were seen after neutron activation. Pre-irradiation increase the initial retention and promotes the annealing phenomenon as the introduction of defect into the lattice though on the other hand radiolytic phenomenon may also appear. Pre-activated sample gave higher retention value for lanthanum and barium permanganates in comparison to strontium permanganate at different γ-doses for desired period of gamma annealing than those obtained at corresponding γ-doses for similar length of time in case of post-activated targets. Kinetics of annealing by γ-radiolytic effects follow first order rate law. The observed results are discussed in the light of existing ideas for understanding the recoil stabilization phenomenon of parent reformation and the nature of precursors in permanganates

  10. Transmutation effects on long-term Cs retention in phyllosilicate minerals from first principles.

    Science.gov (United States)

    Sassi, Michel; Okumura, Masahiko; Machida, Masahiko; Rosso, Kevin M

    2017-10-11

    The accidental release and incorporation of radiocesium into soil minerals represents a massive environmental, technical and social challenge. Accurately forecasting the evolving distribution and fate of long- and medium-lived isotopes such as 137 Cs and 134 Cs over decadal time scales is essential. The cesium cation has long been modeled as a strongly and selectively sorbed species into clay mineral interlayers; however, because of the time scales involved by the radioisotopes half-lives, the effects of radioactive decay on Cs retention have been unknown. We report density functional theory (DFT) simulations of transmutation effects of radiocesium on long-term Cs retention in phlogopite. The calculations show that the progressive appearance of daughter product Ba 2+ is accompanied by a proportional increase in thermodynamic driving force to preferentially discharge remaining Cs, both radioactive and stable, back into aqueous solution. Based on thermodynamic analysis, the findings indicate that radiocesium transmutation provides a mean to weaken the binding of Cs in phyllosilicate minerals, therefore potentially involving a premature re-release of Cs back into the environment. In the case where radiogenic Ba 2+ ions accumulate in the mineral, collateral effects would ultimately be an increase in the overall interlayer binding energy and a lower resorption capacity.

  11. Effectiveness of Resident Physicians as Triage Liaison Providers in an Academic Emergency Department

    Directory of Open Access Journals (Sweden)

    Victoria Weston

    2017-04-01

    Full Text Available Introduction: Emergency department (ED crowding is associated with detrimental effects on ED quality of care. Triage liaison providers (TLP have been used to mitigate the effects of crowding. Prior studies have evaluated attending physicians and advanced practice providers as TLPs, with limited data evaluating resident physicians as TLPs. This study compares operational performance outcomes between resident and attending physicians as TLPs. Methods: This retrospective cohort study compared aggregate operational performance at an urban, academic ED during pre- and post-TLP periods. The primary outcome was defined as cost-effectiveness based upon return on investment (ROI. Secondary outcomes were defined as differences in median ED length of stay (LOS, median door-to-provider (DTP time, proportion of left without being seen (LWBS, and proportion of “very good” overall patient satisfaction scores. Results: Annual profit generated for physician-based collections through LWBS capture (after deducting respective salary costs equated to a gain (ROI: 54% for resident TLPs and a loss (ROI: −31% for attending TLPs. Accounting for hospital-based collections made both profitable, with gains for resident TLPs (ROI: 317% and for attending TLPs (ROI: 86%. Median DTP time for resident TLPs was significantly lower (p<0.0001 than attending or historical control. Proportion of “very good” patient satisfaction scores and LWBS was improved for both resident and attending TLPs over historical control. Overall median LOS was not significantly different. Conclusion: Resident and attending TLPs improved DTP time, patient satisfaction, and LWBS rates. Both resident and attending TLPs are cost effective, with residents having a more favorable financial profile.

  12. Effects of Physician Payment Methods : A Descriptive Study of the Situation in Norway, UK. Ghana.

    OpenAIRE

    Opoku, Michael Agyemang

    2010-01-01

    BACKGROUND: In view of the fact that payment systems for physicians may affect the efficiency and effectiveness of health care service provision, the design of compensation schemes is a major policy concern. According to standard labour economics and agency theory, fee-for-service and debatably pay for performance contracts are likely to provoke higher service production than salary contracts and capitation contracts. Compensation systems may also power service quality and the overall cost co...

  13. Specifying the effects of physician's communication on patients' outcomes: A randomised controlled trial.

    Science.gov (United States)

    van Osch, Mara; van Dulmen, Sandra; van Vliet, Liesbeth; Bensing, Jozien

    2017-08-01

    To experimentally test the effects of physician's affect-oriented communication and inducing expectations on outcomes in patients with menstrual pain. Using a 2×2 RCT design, four videotaped simulated medical consultations were used, depicting a physician and a patient with menstrual pain. In the videos, two elements of physician's communication were manipulated: (1) affect-oriented communication (positive: warm, emphatic; versus negative: cold, formal), and (2) outcome expectation induction (positive versus uncertain). Participants (293 women with menstrual pain), acting as analogue patients, viewed one of the four videos. Pre- and post video participants' outcomes (anxiety, mood, self-efficacy, outcome expectations, and satisfaction) were assessed. Positive affect-oriented communication reduced anxiety (pcommunication. Positive expectations increased feelings of self-efficacy (pcommunication and a positive expectation reduced anxiety (p=0.02), increased outcome expectancies (p=0.01) and satisfaction (p=0.001). Being empathic and inducing positive expectations have distinct and combined effects, demonstrating that both are needed to influence patients' outcomes for the best. Continued medical training is needed to harness placebo-effects of medical communication into practice. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Analysis of the temperature effect on the water retention capacity of soil using a thermodynamic approach

    International Nuclear Information System (INIS)

    Jacinto, A.C.; Ledesma, A.; Villar, M.V.

    2012-01-01

    between the amount adsorbed and the pressure is called the adsorption isotherm. In Geotechnical Engineering, the adsorption isotherm for a given soil is called the soil water retention curve (SWRC). SWRC defines the constitutive relationship between the amount of water in the soil and the suction. The amount of water in the soil can be given in terms of gravimetric water content , volumetric water content , or degree of saturation . To be useful in modeling processes, a continuous representation of the SWRC is required and needs to be incorporated in predictive models. Several mathematical equations have been proposed to describe the soil water retention curve. Many expressions proposed for the SWRC are mainly based on pore size distribution functions in combination with the concept of bundle of capillaries, in which the pores are represented by cylindrical capillary tubes obeying the Young and Laplace equation. The capillary model, although very intuitive, gives only a first approximation to interpret the effect of variables like temperature on the suction, as capillarity only represents one of the mechanisms by which soil is able to hold water in its voids. A more powerful tool is obtained when thermodynamic concepts of interfacial phenomena are considered to analyse the physical adsorption of water by soils. Surface thermodynamics is able to explain the physical adsorption of thin films on solid surface but its application to porous materials is of very limited utility because of the complex geometry of the interfaces in the case of soils. On the other hand, the thermodynamics of adsorption can be treated as a special case of solution thermodynamics for which the adsorbates are the solutes and the adsorbent is the solvent. Experimental results show that the water retention capacity of soil tends to reduce with increasing temperature. Traditionally, the temperature effect was analysed following the idea proposed by Philip and de Vries (1957) which suggested that changes

  15. Effect of collaborative testing on learning and retention of course content in nursing students.

    Science.gov (United States)

    Rivaz, Mozhgan; Momennasab, Marzieh; Shokrollahi, Paymaneh

    2015-10-01

    Collaborative testing is a learning strategy that provides students with the opportunity to learn and practice collaboration. This study aimed to determine the effect of collaborative testing on test performance and retention of course content in nursing students of Shiraz University of Medical Sciences, Shiraz, Iran. This quasi-experimental study was carried out on 84 students enrolled in the course of Medical-Surgical 2 in Spring 2013 and Fall 2013 semesters. The control group consisting of 39 students participated in the first mid-term exam in an individual format. The intervention group, on the other hand, consisted of 45 students who took the test in a two-stage process. The first stage included an individual testing, while the second stage was a collaborative one given in groups of five individuals chosen randomly. Four weeks later, in order to investigate retention of the course content, both groups took part in the second mid-term exam held individually. The study findings showed significant difference between the mean scores in the intervention group in the Fall 2013 semester (p=0.001). Besides, a statistically significant difference was found between the two groups regarding the tests mean scores (p=0.001). Moreover, retention of course content improved in the collaborative group (p=0.001). The results indicated an increase in test performance and a long-term learning enhancement in collaborative testing compared with the traditional method. Collaborative testing, as an active learning technique and a valuable assessment method, can help nursing instructors provide the alumni with strong problem-solving and critical thinking abilities at healthcare environments.

  16. Effects of Embodied Learning and Digital Platform on the Retention of Physics Content: Centripetal Force

    Science.gov (United States)

    Johnson-Glenberg, Mina C.; Megowan-Romanowicz, Colleen; Birchfield, David A.; Savio-Ramos, Caroline

    2016-01-01

    Embodiment theory proposes that knowledge is grounded in sensorimotor systems, and that learning can be facilitated to the extent that lessons can be mapped to these systems. This study with 109 college-age participants addresses two overarching questions: (a) how are immediate and delayed learning gains affected by the degree to which a lesson is embodied, and (b) how do the affordances of three different educational platforms affect immediate and delayed learning? Six 50 min-long lessons on centripetal force were created. The first factor was the degree of embodiment with two levels: (1) low and (2) high. The second factor was platform with three levels: (1) a large scale “mixed reality” immersive environment containing both digital and hands-on components called SMALLab, (2) an interactive whiteboard system, and (3) a mouse-driven desktop computer. Pre-tests, post-tests, and 1-week follow-up (retention or delayed learning gains) tests were administered resulting in a 2 × 3 × 3 design. Two knowledge subtests were analyzed, one that relied on more declarative knowledge and one that relied on more generative knowledge, e.g., hand-drawing vectors. Regardless of condition, participants made significant immediate learning gains from pre-test to post-test. There were no significant main effects or interactions due to platform or embodiment on immediate learning. However, from post-test to follow-up the level of embodiment interacted significantly with time, such that participants in the high embodiment conditions performed better on the subtest devoted to generative knowledge questions. We posit that better retention of certain types of knowledge can be seen over time when more embodiment is present during the encoding phase. This sort of retention may not appear on more traditional factual/declarative tests. Educational technology designers should consider using more sensorimotor feedback and gestural congruency when designing and opportunities for instructor

  17. Effects of Embodied Learning and Digital Platform on the Retention of Physics Content: Centripetal Force.

    Science.gov (United States)

    Johnson-Glenberg, Mina C; Megowan-Romanowicz, Colleen; Birchfield, David A; Savio-Ramos, Caroline

    2016-01-01

    Embodiment theory proposes that knowledge is grounded in sensorimotor systems, and that learning can be facilitated to the extent that lessons can be mapped to these systems. This study with 109 college-age participants addresses two overarching questions: (a) how are immediate and delayed learning gains affected by the degree to which a lesson is embodied, and (b) how do the affordances of three different educational platforms affect immediate and delayed learning? Six 50 min-long lessons on centripetal force were created. The first factor was the degree of embodiment with two levels: (1) low and (2) high. The second factor was platform with three levels: (1) a large scale "mixed reality" immersive environment containing both digital and hands-on components called SMALLab , (2) an interactive whiteboard system, and (3) a mouse-driven desktop computer. Pre-tests, post-tests, and 1-week follow-up (retention or delayed learning gains) tests were administered resulting in a 2 × 3 × 3 design. Two knowledge subtests were analyzed, one that relied on more declarative knowledge and one that relied on more generative knowledge, e.g., hand-drawing vectors. Regardless of condition, participants made significant immediate learning gains from pre-test to post-test. There were no significant main effects or interactions due to platform or embodiment on immediate learning. However, from post-test to follow-up the level of embodiment interacted significantly with time, such that participants in the high embodiment conditions performed better on the subtest devoted to generative knowledge questions. We posit that better retention of certain types of knowledge can be seen over time when more embodiment is present during the encoding phase. This sort of retention may not appear on more traditional factual/declarative tests. Educational technology designers should consider using more sensorimotor feedback and gestural congruency when designing and opportunities for instructor

  18. The effect of an enriched learning community on success and retention in chemistry courses

    Science.gov (United States)

    Willoughby, Lois Jane

    Since the mid-1990s, the United States has experienced a shortage of scientists and engineers, declining numbers of students choosing these fields as majors, and low student success and retention rates in these disciplines. Learning theorists, educational researchers, and practitioners believe that learning environments can be created so that an improvement in the numbers of students who complete courses successfully could be attained (Astin, 1993; Magolda & Terenzini, n.d.; O'Banion, 1997). Learning communities do this by providing high expectations, academic and social support, feedback during the entire educational process, and involvement with faculty, other students, and the institution (Ketcheson & Levine, 1999). A program evaluation of an existing learning community of science, mathematics, and engineering majors was conducted to determine the extent to which the program met its goals and was effective from faculty and student perspectives. The program provided laptop computers, peer tutors, supplemental instruction with and without computer software, small class size, opportunities for contact with specialists in selected career fields, a resource library, and Peer-Led Team Learning. During the two years the project has existed, success, retention, and next-course continuation rates were higher than in traditional courses. Faculty and student interviews indicated there were many affective accomplishments as well. Success and retention rates for one learning community class ( n = 27) and one traditional class (n = 61) in chemistry were collected and compared using Pearson chi square procedures ( p = .05). No statistically significant difference was found between the two groups. Data from an open-ended student survey about how specific elements of their course experiences contributed to success and persistence were analyzed by coding the responses and comparing the learning community and traditional classes. Substantial differences were found in their

  19. Effect of exercise on deposition and subsequent retention of inhaled particles

    International Nuclear Information System (INIS)

    Bennett, W.D.; Messina, M.S.; Smaldone, G.C.

    1985-01-01

    To investigate the effect of exercise and its associated increase in ventilation on the deposition and subsequent retention of inhaled particles, we measured the fractional and regional lung deposition of a radioactively tagged (/sup 99m/Tc) monodisperse aerosol (2.6 microns mass median aerodynamic diam) in normal human subjects at rest and while exercising on a bicycle ergometer. Breath-by-breath deposition fraction (DF) was measured throughout the aerosol exposures by Tyndallometry. Following each exposure gamma camera analysis was used to 1) determine the regional distribution of deposited particles and 2) monitor lung retention for 2.5 h and again at 24 h. We found that DF was unchanged between ventilation at rest (6-10 l/min) and exercise (32-46 l/min). Even though mouth deposition was enhanced with exercise, it was not large enough to produce a significant difference in the deposition fraction of the lung (DFL) between resting and exercise exposures. The central-to-peripheral distribution of deposited aerosol was larger for the exercise vs. resting exposure, reflecting a shift of particle deposition to more central bronchial airways. Apical-to-basal distribution was not different for the two exposures. Retention at 2.5 h and 24 h (R24) was reduced following the exercise vs. the resting exposure, consistent with greater bronchial deposition during exercise. The product of DFL and R24 gave a measure of fractional burden at 24 h (B24), i.e., the fraction of inhaled aerosol residing in the lungs 24 h after exposure. B24 was not significantly different between rest and exercise exposures

  20. Gas expulsion vs gas retention in young stellar clusters II: effects of cooling and mass segregation

    Science.gov (United States)

    Silich, Sergiy; Tenorio-Tagle, Guillermo

    2018-05-01

    Gas expulsion or gas retention is a central issue in most of the models for multiple stellar populations and light element anti-correlations in globular clusters. The success of the residual matter expulsion or its retention within young stellar clusters has also a fundamental importance in order to understand how star formation proceeds in present-day and ancient star-forming galaxies and if proto-globular clusters with multiple stellar populations are formed in the present epoch. It is usually suggested that either the residual gas is rapidly ejected from star-forming clouds by stellar winds and supernova explosions, or that the enrichment of the residual gas and the formation of the second stellar generation occur so rapidly, that the negative stellar feedback is not significant. Here we continue our study of the early development of star clusters in the extreme environments and discuss the restrictions that strong radiative cooling and stellar mass segregation provide on the gas expulsion from dense star-forming clouds. A large range of physical initial conditions in star-forming clouds which include the star-forming cloud mass, compactness, gas metallicity, star formation efficiency and effects of massive stars segregation are discussed. It is shown that in sufficiently massive and compact clusters hot shocked winds around individual massive stars may cool before merging with their neighbors. This dramatically reduces the negative stellar feedback, prevents the development of the global star cluster wind and expulsion of the residual and the processed matter into the ambient interstellar medium. The critical lines which separate the gas expulsion and the gas retention regimes are obtained.

  1. In Vitro Retentive Effect of Groove, Sandblasting, and Cement Type on Stainless Steel Crowns in Primary Molars.

    Science.gov (United States)

    Pathak, Sidhant; Shashibhushan, K K; Bharath, K P; Poornima, P; Reddy, V V Subba

    2015-01-01

    The purpose of this study was to evaluate and compare the effect of placing vertical grooves, sandblasting, and luting cements on the retention of stainless steel crowns (SSCs). Eighty extracted primary molars were mounted in acrylic blocks. Specimens were divided into Group 1 (RelyX U200) and Group 2 (Smart Cem2). Teeth in each group were further subdivided into Subgroup A (no vertical grooves and no sandblasting), Subgroup B (vertical grooves), Subgroup C (sandblasting of crowns), and Subgroup D (vertical grooves and sandblasting of crowns). After cementation, SSCs were pulled off using a universal testing machine. One-way analysis of variance was used for statistical analyses. In Groups 1 and 2, the highest retentive strengths were found in Subgroup D (1,124 and 783 kPa, respectively), followed by Subgroup C (1,066 and 748 kPa, respectively), Subgroup A (762 and 356 kPa, respectively), and Subgroup B (743 and 314 kPa, respectively). Retentive strength in Group one was significantly higher than in Group two; Subgroups A and B were significantly lower than C and D. RelyX U200 showed higher retentive strength than Smart Cem2. Sandblasting increased the retention strength, whereas a vertical groove had no significant effect on retention.

  2. The Effects of Different Doses of Curcuma longa Aqueous Extract on Memory Retention and Retrieval in Male Mice

    Directory of Open Access Journals (Sweden)

    2016-12-01

    Full Text Available Background and Objectives: Curcumin belongs to ginger family, which is used as food and drug from ancient times. Different studies have shown beneficial effects of curcumin on peptic ulcer, rheumatoid arthritis, asthma, and various types of cancer. In this study, the effect of different doses of Curcuma longa aqueous extract on memory retention and retrieval of mice, was investigated using passive avoidance apparatus. Methods: Mice were divided into 6 groups of 8 each for memory retention test and 6 groups of 8 each for memory retrieval test {experimental groups receiving the extract intraperitoneally at doses of 100, 200, 400, 800mg/kg, blank group, and control group}. In memory retention test, the curcumin extract was administered immediately after electric shock, while in the memory retrieval test, it was administered 24 h after receiving electric shock. To compare the complete stepping in the experiment days, One-way ANOVA and post-test LSD were used. The level of significance was considered p<0.05. Results: In this study, curcuma longa aqueous extract significantly increased memory retention and retrieval on the 4th day compared to blank and control groups. The best response for memory retention was obtained at the dose of 100mg/kg and for memory retrieval at the dose of 200mg/kg. Conclusion: According to the results of this study, it seems that Curcuma longa aqueous extract improves memory retention and retrieval in healthy mice.  

  3. Effect of Retention in Elementary Grades on Grade 9 Motivation for Educational Attainment

    Science.gov (United States)

    Cham, Heining; Hughes, Jan N.; West, Stephen G.; Im, Myung Hee

    2014-01-01

    This study investigated the effect of grade retention in elementary school on students’ motivation for educational attainment in grade 9. We equated retained and promoted students on 67 covariates assessed in grade 1 through propensity score weighting. Retained students (31.55%, nretained = 177) and continuously promoted students (68.45%, npromoted = 384) were compared on the bifactor model of motivation for educational attainment (Cham, Hughes, West, & Im, 2014). This model consists of a General factor (student’s overall motivation for educational attainment), and three specific factors: student perceived Teacher Educational Expectations, Peer Educational Aspirations, and Value of Education. Measurement invariance between retained and promoted groups was established. Retained students scored significantly higher than promoted students on each specific factor but not on the General factor. Results showed that the retained and promoted students did not significantly differ on the General factor. The retained students had significantly higher scores on each specific factor than the promoted students. The results suggested that grade retention may not have the negative effects so widely assumed in the published literature; it is an expensive intervention with minimal evidence of benefits to the retained student. PMID:25636258

  4. Effect of retention in elementary grades on grade 9 motivation for educational attainment.

    Science.gov (United States)

    Cham, Heining; Hughes, Jan N; West, Stephen G; Im, Myung Hee

    2015-02-01

    This study investigated the effect of grade retention in elementary school on students' motivation for educational attainment in grade 9. We equated retained and promoted students on 67 covariates assessed in grade 1 through propensity score weighting. Retained students (31.55%, nretained=177) and continuously promoted students (68.45%, npromoted=384) were compared on the bifactor model of motivation for educational attainment (Cham, Hughes, West & Im, 2014). This model consists of a General factor (student's overall motivation for educational attainment), and three specific factors: student perceived Teacher Educational Expectations, Peer Educational Aspirations, and Value of Education. Measurement invariance between retained and promoted groups was established. Retained students scored significantly higher than promoted students on each specific factor but not on the General factor. Results showed that the retained and promoted students did not significantly differ on the General factor. The retained students had significantly higher scores on each specific factor than those of the promoted students. The results suggested that grade retention may not have the negative effects so widely assumed in the published literature; it is an expensive intervention with minimal evidence of benefits to the retained student. Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  5. The effect of A teacher questioning strategy training program on teaching behavior, student achievement, and retention

    Science.gov (United States)

    Otto, Paul B.; Schuck, Robert F.

    The use of questions in the classroom has been employed throughout the recorded history of teaching. One still hears the term Socratic method during discussions of questioning procedures. The use of teacher questions is presently viewed as a viable procedure for effective instruction. This study was conducted to investigate the feasibility of training teachers in the use of a questioning technique and the resultant effect upon student learning. The Post-Test Only Control Group Design was used in randomly assigning teachers and students to experimental and control groups. A group of teachers was trained in the use of a specific questioning technique. Follow-up periodic observations were made of questioning technique behavior while teaching science units to groups of students. Post-unit achievement tests were administered to the student groups to obtain evidence of a relationship between the implementation of specific types of teacher questions and student achievement and retention. Analysis of observation data indicated a higher use of managerial and rhetorical questions by the control group than the experimental group. The experimental group employed a greater number of recall and data gathering questions as well as higher order data processing and data verification type questions. The student posttest achievement scores for both units of instruction were greater for the experimental groups than for the control groups. The retention scores for both units were Beater for the experimental groups than for the control groups.

  6. Immediate And Retention Effects Of Teaching Games For Understanding Approach On Basketball Knowledge

    Directory of Open Access Journals (Sweden)

    Olosová Gabriela

    2015-05-01

    Full Text Available Teaching Games for Understanding (TGfU links tactics and skills by emphasizing the appropriate timing and application within the tactical context of the game. It has been linked to the development of enhanced tactical knowledge. The purpose of the study was to determine immediate and delayed effects of TGfU on procedural and declarative knowledge of basketball and to compare it with a technical approach. Experimental group (EG (11 fifth graders + 18 sixth graders was taught by TGfU and a control group (CG (16 fifth graders + 24 sixth graders was taught by a technical approach for 8 weeks in Physical Education (PE classes, both. A written test was constructed to evaluate pupils’ declarative and procedural knowledge of basketball. The test was applied after the intervention to determine immediate effects and 8 months after the intervention to determine retention effects of the experimental programme. Shapiro-Wilk test, Wilcoxon T-test, Man-Whitney U-test were used for statistical analysis of obtained data. Cohen’s d was used to calculate effect size. Generally basketball knowledge was better in EG than in CG after the intervention (p<0.05 what confirms moderate effect size. When declarative and procedural knowledge were analysed separately there was no significant difference between EG and CG. Nevertheless, moderate effect sizes indicate that the data are particularly meaningful in terms of school practice. Retention effects of both approaches were similar. Total knowledge and declarative knowledge were worse after 8 months than immediately after the intervention in both groups (p<0.01. In both groups, there was no significant difference in procedural knowledge between the test written immediately after the intervention and 8 months later. Differences of changes were not significant between the groups.

  7. The Effects of Long-Duration Spaceflight on Training Retention and Transfer

    Science.gov (United States)

    Barshi, Immanuel; Healy, Alice; Dempsey, Donna L.; McGuire, Kerry M.; Landon, Lauren B.

    2018-01-01

    Training our crew members for long duration, exploration-class missions will have to maximize long-term retention and transfer of the trained skills. The expected duration of the missions, our inability to predict all the possible tasks the crew will be called upon to perform, and the low training-to-mission time ratio require that the training be maximally effective such that the skills acquired during training will be retained and will be transferrable across a wide range of specific tasks that are different from the particular tasks used during training. However, to be able to design training that can achieve these ambitious goals, we must first understand the ways in which long-duration spaceflight affects training retention and transfer. Current theories of training retention and transfer are largely based on experimental studies conducted at university laboratories using undergraduate students as participants. Furthermore, all such studies have been conducted on Earth. We do not know how well the results of these studies predict the performance of crew members. More specifically, we do not know how well the results of these studies predict the performance of crew members in space and especially during long-duration missions. To address this gap in our knowledge, the current on-going study seeks to test the null hypothesis that performance of university undergraduate students on Earth on training retention and transfer tests do in fact predict accurately the performance of crew members during long-duration spaceflights. To test this hypothesis, the study employs a single 16-month long experimental protocol with 3 different participant groups: undergraduate university students, crew members on the ground, and crew members in space. Results from this study will be presented upon its completion. This poster presents results of study trials of the two tasks used in this study: a data entry task and a mapping task. By researching established training principles, by

  8. Effect of a Dengue Clinical Case Management Course on Physician Practices in Puerto Rico.

    Science.gov (United States)

    Han, George S; Gregory, Christopher J; Biggerstaff, Brad J; Horiuchi, Kalanthe; Perez-Guerra, Carmen; Soto-Gomez, Eunice; Matos, Desiree; Margolis, Harold S; Tomashek, Kay M

    2016-11-15

     Prior to 2010, the clinical management of dengue in Puerto Rico was inconsistent with World Health Organization guidelines. A 4-hour classroom-style course on dengue clinical management was developed in 2009 and mandated for Puerto Rico medical licensure in 2010. Fifty physicians were trained as "master trainers" and gave this course to 7638 physicians. This study evaluated the effect of the course on the clinical management of hospitalized dengue patients.  Pre- and post-course test responses were compared. Changes in physician practices were assessed by reviewing medical records of 430 adult and 1075 pediatric dengue patients at the 12 hospitals in Puerto Rico that reported the most cases during 2008-2009 (pre-intervention) and 2011 (post-intervention). Mixed-effects logistic regression was used to compare key indicators of dengue management.  Physician test scores increased from 48% to 72% correct. Chart reviews showed that the percentage of adult patients who did not receive corticosteroids increased from 30% to 68% (odds ratio [OR], 5.9; 95% confidence interval [CI], 3.7-9.5) and from 91% to 96% in pediatric patients (OR, 2.7; 95% CI, 1.5-4.9). Usage of isotonic intravenous saline during the critical period increased from 57% to 90% in adult patients (OR, 6.2; 95% CI, 1.9-20.4) and from 25% to 44% in pediatric patients (OR, 3.4; 95% CI, 2.2-5.3).  Management of dengue inpatients significantly improved following implementation of a classroom-style course taught by master trainers. An online version of the course was launched in 2014 to expand its reach and sustainability. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  9. Effects of audio-visual aids on foreign language test anxiety, reading and listening comprehension, and retention in EFL learners.

    Science.gov (United States)

    Lee, Shu-Ping; Lee, Shin-Da; Liao, Yuan-Lin; Wang, An-Chi

    2015-04-01

    This study examined the effects of audio-visual aids on anxiety, comprehension test scores, and retention in reading and listening to short stories in English as a Foreign Language (EFL) classrooms. Reading and listening tests, general and test anxiety, and retention were measured in English-major college students in an experimental group with audio-visual aids (n=83) and a control group without audio-visual aids (n=94) with similar general English proficiency. Lower reading test anxiety, unchanged reading comprehension scores, and better reading short-term and long-term retention after four weeks were evident in the audiovisual group relative to the control group. In addition, lower listening test anxiety, higher listening comprehension scores, and unchanged short-term and long-term retention were found in the audiovisual group relative to the control group after the intervention. Audio-visual aids may help to reduce EFL learners' listening test anxiety and enhance their listening comprehension scores without facilitating retention of such materials. Although audio-visual aids did not increase reading comprehension scores, they helped reduce EFL learners' reading test anxiety and facilitated retention of reading materials.

  10. Waste activated sludge fermentation: effect of solids retention time and biomass concentration.

    Science.gov (United States)

    Yuan, Q; Sparling, R; Oleszkiewicz, J A

    2009-12-01

    Laboratory scale, room temperature, semi-continuous reactors were set-up to investigate the effect of solids retention time (SRT, equal to HRT hydraulic retention time) and biomass concentration on generation of volatile fatty acids (VFA) from the non-methanogenic fermentation of waste activated sludge (WAS) originating from an enhanced biological phosphorus removal process. It was found that VFA yields increased with SRT. At the longest SRT (10d), improved biomass degradation resulted in the highest soluble to total COD ratio and the highest VFA yield from the influent COD (0.14g VFA-COD/g TCOD). It was also observed that under the same SRT, VFA yields increased when the biomass concentration decreased. At a 10d SRT the VFA yield increased by 46%, when the biomass concentration decreased from 13g/L to 4.8g/L. Relatively high nutrient release was observed during fermentation. The average phosphorus release was 17.3mg PO(4)-P/g TCOD and nitrogen release was 25.8mg NH(4)-N/g TCOD.

  11. Encapsulation of vitamin E: effect of physicochemical properties of wall material on retention and stability.

    Science.gov (United States)

    Hategekimana, Joseph; Masamba, Kingsley George; Ma, Jianguo; Zhong, Fang

    2015-06-25

    Spray drying technique was used to fabricate Vitamin E loaded nanocapsules using Octenyl Succinic Anhydride (OSA) modified starches as emulsifiers and wall materials. Several physicochemical properties of modified starches that are expected to influence emulsification capacity, retention and storage stability of Vitamin E in nanocapsules were investigated. High Degree of Substitution (DS), low Molecular Weight (Mw) and low interfacial tension improved emulsification properties while Oxygen Permeability (OP) and Water Vapor Permeability (WVP) affected the film forming properties. The degradation profile of Vitamin E fitted well with the Weibull model. Nanocapsules from OSA modified starches MS-A and MS-B retained around 50% of Vitamin E after a period of 60 days at 4-35°C. Reduced retention and short half-life (35 days) in nanocapsules fabricated using MS-C at 35°C were attributed to autoxidation reaction occurred due to poor film forming capacity. These results indicated that low molecular weights OSA modified starches were effective at forming stable Vitamin E nanocapsules that could be used in drug and beverage applications. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. The effect of teaching methods on cognitive achievement, retention, and attitude among in biology studying

    Directory of Open Access Journals (Sweden)

    Snezana Stavrova Veselinovskaa

    2011-12-01

    Full Text Available The purpose of this paper is to determine the effects of usage of sequential teaching method on the academic achievement and retention level of students. Three student groups of biology students in University “Goce Delcev”, Faculty of Natural and Technical Sciences, Institute of Biology, - Stip, R. Macedonia were offered a topic on general characteristics of Proteins: Their Biological Functions and Primary Structure with different sequences of 3 teaching methods. The teaching methods were Laboratory method (student experiment, slide demonstration and lecture method. The first group started to course with experiments in the laboratory, then the relevant theory of proteins was given lecture method, and then the slides was shown (Group I. The sequence of these three teaching methods used in the first group was changed in both second and third group as follow: The lecture methods, slide show and experiment in Group II, and slide show, experiment and lecture method in Group III, respectively. Laboratory method used in the study was focused on the topic of this diversity and abundance reflect the central role of proteins in virtually all aspects of cell structure and function. Achievement test contained 20 questions, testing the knowledge of facts as well as the ability to transfer the knowledge and problem solving ability. This test was used as pre-test before methods’ application, post-test after the methods’ application and retention test after 30 days from methods’ applied.

  13. Effects of physician counseling on the smoking behavior of asbestos-exposed workers

    International Nuclear Information System (INIS)

    Li, V.C.; Kim, Y.J.; Ewart, C.K.; Terry, P.B.; Cuthie, J.C.; Wood, J.; Emmett, E.A.; Permutt, S.

    1984-01-01

    Physician antismoking advice has been shown to increase smoking cessation, particularly among patients who have medical problems or perceive themselves to be at risk. The present study tested three hypotheses: (a) providing 3 to 5 min of behavioral counseling regarding a cessation strategy would be more effective than simply warning the smoker to quit smoking; (b) smokers with abnormal pulmonary function would be more likely to comply with medical advice than would smokers with normal pulmonary function; and (c) that smokers with abnormal pulmonary function who receive behavioral counseling would be the group most likely to achieve prolonged abstinence. Asbestos-exposed smoking men undergoing screening in a mandated program for naval shipyard workers were categorized as having normal or abnormal pulmonary status on the basis of chest X ray and pulmonary function tests (PFT). They were then randomly assigned within PFT categories to receive either a simple warning or 3 to 5 min of behavioral cessation counseling from the physician who gave them the results of their pulmonary tests. Subjects smoking status was evaluated at 3- and 11-month intervals following the physician intervention. Smokers who received behavioral counseling were more likely to quit and remain abstinent over the 11-month period (8.4% abstinent) than were smokers given a minimal warning (3.6% abstinent). Prolonged abstinence rates among abnormal PFT subjects (3.7%) did not differ from those of normals (5.9%). The group with normal PFT who received behavioral counseling achieved the highest level of abstinence (9.5%)

  14. Effectiveness of tamsulosin in prevention of post-operative urinary retention: a randomized double-blind placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Ali Hamidi Madani

    2014-01-01

    Full Text Available Purpose: Urinary retention is one of the most common complications contributing to surgical procedures. Recent studies have shown the benefits of alpha-adrenergic blockers in preventing post-operative urinary retention (POUR. The aim of this prospective study was to compare the prophylactic effect of tamsulosin with placebo on postoperative urinary retention. Materials and Methods: In this randomized placebo controlled, clinical trial, 232 male patients aged 18 to 50 years old admitted to Razi University Hospital for varicocelectomy, inguinal herniorrhaphy, and scrotal surgery were randomly assigned to receive either three doses of 0.4mg tamsulosin (n = 118 or placebo (n = 114, 14 and 2 hours before, and 10 hours after surgery. Patients were closely monitored for the development of urinary retention 24 hours after surgical intervention. The primary endpoint was to investigate the effect of tamsulosin in prevention of post-operative urinary retention during the first 24 hours after surgical intervention. Collected data were analyzed using SPSS software version 18 and the P < 0.05 was considered statistically significant. Results: One hundred and eighteen patients were included in tamsulosin arm and 114 in placebo arm. POUR in patients who received tamsulosin was significantly lower than placebo, as 5.9% of the patients treated with tamsulosin and 21.1% placebo group, reported urinary retention following surgery (P = 0.001. No serious adverse effects were seen in both groups. Conclusions: This study suggests that short perioperative treatment with tamsulosin can reduce the incidence of urinary retention and the need for catheterization after varicocelectomy, inguinal herniorrhaphy, and scrotal surgery.

  15. Assessing the Effects of Individual Augmentation (IA) on Active Component Navy Enlisted and Officer Retention

    National Research Council Canada - National Science Library

    Fricker, Jr., Ronald D; Buttrey, Samuel E

    2008-01-01

    .... Retention rates were compared in three different ways: aggregate comparisons, comparisons by individual demographic categories, and comparisons based on standard statistical modeling techniques (logistic regression...

  16. The effect of testing versus restudy on retention: a meta-analytic review of the testing effect.

    Science.gov (United States)

    Rowland, Christopher A

    2014-11-01

    Engaging in a test over previously studied information can serve as a potent learning event, a phenomenon referred to as the testing effect. Despite a surge of research in the past decade, existing theories have not yet provided a cohesive account of testing phenomena. The present study uses meta-analysis to examine the effects of testing versus restudy on retention. Key results indicate support for the role of effortful processing as a contributor to the testing effect, with initial recall tests yielding larger testing benefits than recognition tests. Limited support was found for existing theoretical accounts attributing the testing effect to enhanced semantic elaboration, indicating that consideration of alternative mechanisms is warranted in explaining testing effects. Future theoretical accounts of the testing effect may benefit from consideration of episodic and contextually derived contributions to retention resulting from memory retrieval. Additionally, the bifurcation model of the testing effect is considered as a viable framework from which to characterize the patterns of results present across the literature. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  17. The Effects of Knowledge Maps on Acquisition and Retention of Visual Arts Concepts in Teacher Education

    Directory of Open Access Journals (Sweden)

    Paige Vitulli

    2014-01-01

    Full Text Available This study examined the use of knowledge maps as a tool for teacher education students to increase knowledge acquisition and retention of concepts related to the visual arts design elements: line, color, and shape. Participants were randomly assigned to either the no map or knowledge map group. Three instruments—Student Autobiography, Elements of Design Tests (EDT, and Knowledge Map Questionnaire—were used to collect data. Results revealed significantly higher means on the immediately administered posttest for the elements line and color and the delayed posttest for line map group. Questionnaire responses indicated positive attitudes toward knowledge map use as a study strategy. Specifically, endorsement was reported toward maps’ clarity, effectiveness for learning concepts, and enjoyment of use.

  18. Effects of oxidation potential and retention time on electrochromic stability of poly (3-hexyl thiophene) films

    Science.gov (United States)

    Kim, Tae-Ho; Hyun Song, Seok; Kim, Hyo-Jae; Oh, Seong-Hyeon; Han, Song-Yi; Kim, Goung; Nah, Yoon-Chae

    2018-06-01

    Herein, we report the effects of applied voltage on the electrochromic (EC) stability of poly(3-hexylthiophene) (P3HT) films during EC reactions. The transmittance difference and cycling stability of these films were monitored to optimize the oxidation voltage, and their chemical compositions were analyzed by X-ray photoelectron spectroscopy after long-term electrochemical cycling. High oxidation voltages increased the color contrast of P3HT films but decreased their cycling stability due to facilitating chemical degradation. Furthermore, at an optimized oxidation voltage, the retention time during potential pulsing was adjusted utilizing the optical memory of P3HT, revealing that the decreased voltage application time reduced power consumption by 9.6% and enhanced EC stability without loss of color contrast.

  19. Effect of biochar on soil structural characteristics: water retention and gas transport

    DEFF Research Database (Denmark)

    Sun, Zhencai; Møldrup, Per; Vendelboe, Anders Lindblad

    Biochar addition to agricultural soil has been reported to reduce climate gas emission, as well as improve soil fertility and crop productivity. Little, however, is known about biochar effects on soil structural characteristics. This study investigates if biochar-application changes soil structural...... characteristics, as indicated from water retention and gas transport measurements on intact soil samples. Soil was sampled from a field experiment on a sandy loam with four control plots (C) without biochar and four plots (B) with incorporated biochar at a rate of 20 tons per hectare (plot size, 6 x 8 m). The C......-gas diffusivity on intact 100cm3 soil samples (5 replicates in each plot). We found that biochar application significantly decreased soil bulk density, hereby creating higher porosity. At the same soil-water matric potential, all the soil-gas phase parameters (air-filled porosity, air permeability and gas...

  20. The effect of dilution on the gas-retention behavior of Tank 241-SY-101 waste

    International Nuclear Information System (INIS)

    Bredt, P.R.; Tingey, S.M.; Shade, E.H.

    1995-09-01

    The effect of dilution on gas retention in waste from Tank 241-SY-101 was investigated. A composite sample was prepared from material collected during the Window ''C'' and Window ''E'' sampling events. The composite contained material from both the convective and nonconvective layer in the proportions existing in the tank. Operation of the mixer pump in Tank 241-SY-101 has homogenized the tank material, and dilution of the current waste would require additional mixing; therefore, no attempt was made to use unhomogenized tank waste to prepare the composite. The composite was diluted with 2 M NaOH at ratios of 0.5:1, 0.75: 1, 1:1, and 3:1 per volume (2 M NaOH:tank waste)

  1. The effect of visual and verbal modes of presentation on children's retention of images and words

    Science.gov (United States)

    Vasu, Ellen Storey; Howe, Ann C.

    This study tested the hypothesis that the use of two modes of presenting information to children has an additive memory effect for the retention of both images and words. Subjects were 22 first-grade and 22 fourth-grade children randomly assigned to visual and visual-verbal treatment groups. The visual-verbal group heard a description while observing an object; the visual group observed the same object but did not hear a description. Children were tested individually immediately after presentation of stimuli and two weeks later. They were asked to represent the information recalled through a drawing and an oral verbal description. In general, results supported the hypothesis and indicated, in addition, that children represent more information in iconic (pictorial) form than in symbolic (verbal) form. Strategies for using these results to enhance science learning at the elementary school level are discussed.

  2. Particle size, magnetic field, and blood velocity effects on particle retention in magnetic drug targeting.

    Science.gov (United States)

    Cherry, Erica M; Maxim, Peter G; Eaton, John K

    2010-01-01

    A physics-based model of a general magnetic drug targeting (MDT) system was developed with the goal of realizing the practical limitations of MDT when electromagnets are the source of the magnetic field. The simulation tracks magnetic particles subject to gravity, drag force, magnetic force, and hydrodynamic lift in specified flow fields and external magnetic field distributions. A model problem was analyzed to determine the effect of drug particle size, blood flow velocity, and magnetic field gradient strength on efficiency in holding particles stationary in a laminar Poiseuille flow modeling blood flow in a medium-sized artery. It was found that particle retention rate increased with increasing particle diameter and magnetic field gradient strength and decreased with increasing bulk flow velocity. The results suggest that MDT systems with electromagnets are unsuitable for use in small arteries because it is difficult to control particles smaller than about 20 microm in diameter.

  3. The effects of problem-based learning during medical school on physician competency: a systematic review.

    Science.gov (United States)

    Koh, Gerald Choon-Huat; Khoo, Hoon Eng; Wong, Mee Lian; Koh, David

    2008-01-01

    Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.

  4. Effect of drying techniques on the retention of antioxidant activities of Saskatoon berries

    Directory of Open Access Journals (Sweden)

    Pranabendu Mitra

    2013-10-01

    Full Text Available The main objective of this research was to compare the retention of antioxidant activity and total anthocyanin content of Saskatoon berries dried by freeze drying, microwave-vacuum drying, thin layer hot air drying and vacuum drying. Antioxidant activity of berry samples was determined by DPPH radical scavenging and ABTS radical scavenging, and the pH differential method was used to determine total anthocyanin content of the berry samples. The results showed that the freeze dried Saskatoon berries exhibited the highest retention of anthocyanin and antioxidant activity among the dried samples, followed by microwave-vacuum dried berries, thin layer hot air dried berries and vacuum dried berries. There were significant differences between the berry samples at P<0.05.  DPPH radical scavenging and ABTS radical scavenging were correlated linearly with an R2 value of 0.99 at P<0.05 showing their effectiveness for the determination of the antioxidant activity of the Saskatoon berries. However, the DPPH radical scavenging assay was more effective than the ABTS radical scavenging assay. The results also showed that antioxidant activity of the berries was highly correlated with the total anthocyanin content of the fruit. The reduction of anthocyanin in dried berry samples was linearly correlated with the reduction of DPPH radical scavenging with an R2 value of 0.97 at P<0.05 and, also, linearly correlated with the reduction of ABTS radical scavenging with an R2 value of 0.88 at P<0.05.

  5. Effect of soy protein isolate in the diet on retention by the rat of iron from radiolabeled test meals

    International Nuclear Information System (INIS)

    Thompson, D.B.; Erdman, J.W. Jr.

    1984-01-01

    The influence of soy protein isolate (SPI) in the diet on whole-body retention of extrinsically radiolabeled iron from test meals containing or not containing SPI was evaluated in marginally iron-deficient weanling rats. In experiment 1 SPI was compared with casein in a 2 X 2 factorial design: diets and test meals were either SPI-based or casein-based. Diets were fed for 13 days prior to the test meal and for 7 days subsequent to the test meal. Rats fed the SPI-based diet retained less iron from test meals than did rats fed the casein-based diet (66.1 vs. 74.8%, P less than 0.01). Experiment 2 showed that an SPI-based diet fed during the final 4 days of a 14-day pre-test meal period and subsequent to the test meal led to less iron retention compared to a casein-based diet. In addition to the observed diet effect, experiment 1 showed that iron retention was less from an SPI-based test meal than from a casein-based test meal, confirming previous reports of adverse effects of SPI on iron retention. The present experiments show that SPI can adversely affect from retention in two ways: by its presence in the diet before and after a test meal, and by its presence in a test meal

  6. Effects of Physician Volume on Readmission and Mortality in Elderly Patients with Heart Failure: Nationwide Cohort Study.

    Science.gov (United States)

    Lee, Joo Eun; Park, Eun Cheol; Jang, Suk Yong; Lee, Sang Ah; Choy, Yoon Soo; Kim, Tae Hyun

    2018-03-01

    Readmission and mortality rates of patients with heart failure are good indicators of care quality. To determine whether hospital resources are associated with care quality for cardiac patients, we analyzed the effect of number of physicians and the combined effects of number of physicians and beds on 30-day readmission and 1-year mortality. We used national cohort sample data of the National Health Insurance Service (NHIS) claims in 2002-2013. Subjects comprised 2345 inpatients (age: >65 years) admitted to acute-care hospitals for heart failure. A multivariate Cox regression was used. Of the 2345 patients hospitalized with heart failure, 812 inpatients (34.6%) were readmitted within 30 days and 190 (8.1%) had died within a year. Heart-failure patients treated at hospitals with low physician volumes had higher readmission and mortality rates than high physician volumes [30-day readmission: hazard ratio (HR)=1.291, 95% confidence interval (CI)=1.020-1.633; 1-year mortality: HR=2.168, 95% CI=1.415-3.321]. Patients admitted to hospitals with low or middle bed and physician volume had higher 30-day readmission and 1-year mortality rates than those admitted to hospitals with high volume (30-day readmission: HR=2.812, 95% CI=1.561-5.066 for middle-volume beds & low-volume physicians, 1-year mortality: HR=8.638, 95% CI=2.072-36.02 for middle-volume beds & low-volume physicians). Physician volume is related to lower readmission and mortality for heart failure. Of interest, 30-day readmission and 1-year mortality were significantly associated with the combined effects of physician and institution bed volume. © Copyright: Yonsei University College of Medicine 2018

  7. Effect of interactive group discussion among physicians to promote rational prescribing.

    Science.gov (United States)

    Garjani, A; Salimnejad, M; Shamsmohamadi, M; Baghchevan, V; Vahidi, R G; Maleki-Dijazi, N; Rezazadeh, H

    2009-01-01

    This study assessed the effect of an educational intervention (interactive group discussion) on the prescribing behaviour of 51 general physicians from the north-west of Tabriz. Prescriptions were analysed pre-intervention and post-intervention (control and intervention groups) using a proforma with 8 indicators of correct prescribing. The mean number of drugs per prescription pre-intervention was 3.82. The percentage of prescriptions with antibiotics, corticosteroids and injections were 40.8%, 25.9% and 58.0%, respectively. Following the intervention there were slight but not significant changes in the indicators in both intervention and control groups compared with pre-intervention results.

  8. The effectivity of bentonites in cesium retention of cemented waste products

    International Nuclear Information System (INIS)

    Tello, Cledola Cassia Oliveira de

    2001-01-01

    The nuclear energy has been used for the human development in different areas, as in the medicine, in the agriculture, in the industry and in the environmental protection, besides the electricity generation. As in other activities, in the use of nuclear energy, residues are also generated. They are considered radioactive wastes when the contaminant content can bring a potential negative impact in the human health and in the environment. In this case they should be properly managed and should not be released without treatment. In general the waste processing consists in a volume reduction followed by solidification and/or conditioning. A number of materials can be considered as immobilisation matrices for the wastes, with the objective of maintain the radioactive material physical and chemically stable. The cement is extensively used because it is easy to obtain, there is large. experience in its use and the processing is done at room temperature. Many materials have been studied to improve the fixation characteristics of the radionuclides in the cemented product. The aim of this study was to search, among Brazilian natural materials, those that could be effective in the contaminant retention without jeopardising the process and other characteristics of the waste product. Four types of bentonite were selected to the process and product evaluation tests. Many mixtures were prepared with simulated waste, cement and bentonite in different proportions. The viscosity, set time, compressive strength and leaching were evaluated. In addition it was verified if the products were monolithic and without free water. Inactive caesium was used as tracer. The leaching resistance is the most important parameter in the product evaluation, because it indicates the retention capacity of the matrix for radionuclides when the product is in contact with the water. In 1985 leaching tests were begun and they have been continued till now and from their results it was proved that the

  9. The practice of euthanasia and physician-assisted suicide in the United States: adherence to proposed safeguards and effects on physicians.

    Science.gov (United States)

    Emanuel, E J; Daniels, E R; Fairclough, D L; Clarridge, B R

    1998-08-12

    Despite intense debates about legalization, there are few data examining the details of actual euthanasia and physician-assisted suicide (PAS) cases in the United States. To determine whether the practices of euthanasia and PAS are consistent with proposed safeguards and the effect on physicians of having performed euthanasia or PAS. Structured in-depth telephone interviews. Randomly selected oncologists in the United States. Adherence to primary and secondary safeguards for the practice of euthanasia and PAS; regret, comfort, and fear of prosecution from performing euthanasia or PAS. A total of 355 oncologists (72.6% response rate) were interviewed on euthanasia and PAS. On 2 screening questions, 56 oncologists (15.8%) reported participating in euthanasia or PAS; 53 oncologists (94.6% response rate) participated in in-depth interviews. Thirty-eight of 53 oncologists described clearly defined cases of euthanasia or PAS. Twenty-three patients (60.5%) both initiated and repeated their request for euthanasia or PAS, but 6 patients (15.8%) did not participate in the decision for euthanasia or PAS. Thirty-seven patients (97.4%) were experiencing unremitting pain or such poor physical functioning they could not perform self-care. Physicians sought consultation in 15 cases (39.5%). Overall, oncologists adhered to all 3 main safeguards in 13 cases (34.2%): (1) having the patient initiate and repeat the request for euthanasia or PAS, (2) ensuring the patient was experiencing extreme physical pain or suffering, and (3) consulting with a colleague. Those who adhered to the safeguards had known their patients longer and tended to be more religious. In 28 cases (73.7%), the family supported the decision. In all cases of pain, patients were receiving narcotic analgesia. Fifteen patients (39.5%) were enrolled in a hospice. While 19 oncologists (52.6%) received comfort from having helped a patient with euthanasia or PAS, 9 (23.7%) regretted having performed euthanasia or PAS, and

  10. Physician Retention in the Army Medical Department

    Science.gov (United States)

    2009-03-16

    Fifteen years ago, these jobs were filled by General Medical Officers ( GMO ) -- graduates of internships who spent some time “muddying their boots” in the...field while waiting a year or two for the residency position of their choice. Today, the GMO is an endangered species. In an effort to provide the best

  11. The Retention of Female Unrestricted Line Officers

    National Research Council Canada - National Science Library

    Pecenco, Elena G

    2005-01-01

    This thesis analyzes the retention of female Naval officers, focusing on the relationship between officer selection metrics and retention beyond minimum service obligation and the effect of lateral...

  12. Shared Decision Making and Effective Physician-Patient Communication: The Quintessence of Patient-Centered Care

    Directory of Open Access Journals (Sweden)

    Huy Ming Lim

    2015-03-01

    Full Text Available The Institute of Medicine’s (IOM 2001 landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century, identified patient-centeredness as one of the fundamental attributes of quality health care, alongside safety, effectiveness, timeliness, efficiency, and equity. The IOM defined patient-centeredness as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.” This concept of patient-centered care represents a paradigm shift from the traditional disease-oriented and physician-centered care, grounding health care in the subjective experience of illness and the needs and preferences of individual patients rather than the evaluation and treatment of diseases which emphasizes on leveraging clinical expertise and evidence derived from population-based studies. Regrettably, despite the ubiquitous talk about patient-centered care in modern health care, shared decision-making and effective physician-patient communication—the two cruxes of patient-centered care—are yet to become the norms. Strategies to promote and enhance shared decision-making and effective communication between clinicians and patients should be rigorously implemented to establish a health care system that truly values patients as individuals and turn the rhetoric of patient-centered care into reality.

  13. The effects of nursing preceptorship on new nurses' competence, professional socialization, job satisfaction and retention: A systematic review.

    Science.gov (United States)

    Ke, Ya-Ting; Kuo, Chia-Chi; Hung, Chich-Hsiu

    2017-10-01

    The aim of this study was to determine the effects of nursing preceptorship on the competence, job satisfaction, professional socialization and retention of new nurses. Although studies have focused on the effects of nursing preceptorship on new nurses' competence and retention, a systematic review of the overall effects is lacking. A quantitative systematic review. Five English/Chinese databases were searched for original articles published before June 2015 and only six articles published between 2001-2014 were included in the final analysis. Joanna Briggs Methodology was used to process one randomization control trial, one quasi-experimental study and four observational studies. Two appraisers independently reviewed each study using the standardized critical appraisal tools from the Joanna Briggs Institute. The most adopted preceptorship was a fixed preceptor/preceptee model and one-on-one for 1-3-month duration. It showed that new nurses' overall competence increased significantly due to preceptorship. Only a few studies explored the effects of preceptorship on the job satisfaction and professional socialization of new nurses. Clear conclusions regarding the effect of preceptorship on nurses' retention rate could not be made because of inconsistent time points for calculation and a lack of control groups in the study design. Preceptorship can improve new nurses' nursing competence; however, more studies are needed to ascertain its effects on new nurses' retention rates, job satisfaction and professional socialization to promote nursing care quality and resolve nursing shortages. © 2017 John Wiley & Sons Ltd.

  14. Effective physician-nurse communication: a patient safety essential for labor and delivery.

    Science.gov (United States)

    Lyndon, Audrey; Zlatnik, Marya G; Wachter, Robert M

    2011-08-01

    Effective communication is a hallmark of safe patient care. Challenges to effective interprofessional communication in maternity care include differing professional perspectives on clinical management, steep hierarchies, and lack of administrative support for change. We review principles of high reliability as they apply to communication in clinical care and discuss principles of effective communication and conflict management in maternity care. Effective clinical communication is respectful, clear, direct, and explicit. We use a clinical scenario to illustrate an historic style of nurse-physician communication and demonstrate how communication can be improved to promote trust and patient safety. Consistent execution of successful communication requires excellent listening skills, superb administrative support, and collective commitment to move past traditional hierarchy and professional stereotyping. Copyright © 2011 Mosby, Inc. All rights reserved.

  15. The effect of anchovy substrate application to fluor retention rate on Sprague Dawley rat tooth email (in vivo)

    Science.gov (United States)

    Zabrina, S.; Puspitawati, R.; Gunawan, H. A.

    2017-08-01

    Usage of anchovies (Stolephorus insularis), which contain a high fluoride concentration in a CaF2 compound, needs to be examined as a topical fluoridative agent. Aim: To study the effects of an anchovy substrate application, either by chewing or smearing, in increasing fluoride retention of enamel. Fourteen Sprague Dawley rats were divided into five groups: baseline, experimental (feeding and smearing), and negative controls. After 15 days, lower incisor teeth were extracted and fluoride retention on the enamel surface was measured using EDX. Data were analyzed by the independent samples t-test, the Mann-Whitney U test, and the Kruskal-Wallis test. There was a significant increase in fluoride retention on enamel from the experimental groups compared to the negative control group (p < 0.05). Fluoride retention levels of the experimental feeding group (6.823%) were slightly higher than those of the experimental smearing group (6.783%), though the difference was not statistically significant (p < 0.05). Anchovy substrate application, either by chewing or smearing, increases fluoride retention on tooth enamel.

  16. Effects of systematic asymmetric discounting on physician-patient interactions: a theoretical framework to explain poor compliance with lifestyle counseling

    Directory of Open Access Journals (Sweden)

    Fleischer Alan B

    2002-11-01

    Full Text Available Abstract Background This study advances the use of a utility model to model physician-patient interactions from the perspectives of physicians and patients. Presentation of the hypothesis In cases involving acute care, patient counseling involves a relatively straightforward transfer of information from the physician to a patient. The patient has less information than the physician on the impact the condition and its treatment have on utility. In decisions involving lifestyle changes, the patient may have more information than the physician on his/her utility of consumption; moreover, differences in discounting future health may contribute significantly to differences between patients' preferences and physicians' recommendations. Testing the hypothesis The expectation of differences in internal discount rate between patients and their physicians is discussed. Implications of the hypothesis This utility model provides a conceptual basis for the finding that educational approaches alone may not effect changes in patient behavior and suggests other economic variables that could be targeted in the attempt to produce healthier behavior.

  17. The Effect of Context (Humorous vs. Non-humorous on Vocabulary Acquisition and Retention of Iranian EFL Learners

    Directory of Open Access Journals (Sweden)

    Mohsen Ghaffari

    2012-11-01

    Full Text Available For almost four decades, ESL/EFL scholars have been trying to find which learning type, contextualized vs. decontextualized, leads to better vocabulary acquisition and retention. In an attempt to solve this problem, this study tried to examine the possible effectiveness of using humorous context on vocabulary acquisition and retention. Another issue that was undertaken in the present study was comparing the efficiency of contextualized and decontextualized vocabulary learning and retention. For this purpose, 58 Iranian EFL learners were categorized into 3 groups: a humorous, b non-humorous, and c decontextualized. The findings were analyzed using one-way ANOVA and Tukey post hoc test. As the results revealed, the participants in decontextualized group outperformed the participants in both humorous and non-humorous groups. However, it should be noted that the performance of humorous group was significantly better than the performance of non-humorous group.

  18. Effect of gamma rays on grafting parameters and liquid retention property of cassava starch-g-PAN

    International Nuclear Information System (INIS)

    Kiatkamjornwong, S.; Chvajarernpun, J.; Nakason, C.

    1992-01-01

    Radiation modification on liquid retention properties of native cassava starch, gelatinized at 85 0 C, by graft copolymerization with acrylonitrile was carried out by mutual irradiation to γ-rays. A thin aluminium foil was used to cover the inner wall of the reaction vessel so that the extent of homo polymer could be reduced to be less than 1.6% with a distilled water retention value of 665 g/g of the dry weight of the saponified grafted product. Confirmations of graft copolymerization and saponification reactions were made by the infrared spectrophotometric technique. The combined effect of radiation parameters in terms of an irradiation time and a dose rate to the same total dose on the extent of grafting reaction expressed in terms of grafting parameters which directly influenced liquid retention values was evaluated in conjunction with statistical analysis

  19. The Effects of Hospital-Level Factors on Patients' Ratings of Physician Communication.

    Science.gov (United States)

    Al-Amin, Mona; Makarem, Suzanne C

    2016-01-01

    The quality of physician-patient communication influences patient health outcomes and satisfaction with healthcare delivery. Yet, little is known about contextual factors that influence physicians' communication with their patients. The main purpose of this article is to examine organizational-level factors that influence patient perceptions of physician communication in inpatient settings. We used the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and American Hospital Association data to determine patients' ratings of physician communication at the hospital level, and to collect information about hospital-level factors that can potentially influence physician communication. Our sample consisted of 2,756 hospitals. We ran a regression analysis to determine the predictors of poor physician communication, measured as the percentage of patients in a hospital who reported that physicians sometimes or never communicated well. In our sample of hospitals, this percentage ranged between 0% and 21%, with 25% of hospitals receiving poor ratings from more than 6% of patients. Three organizational factors had statistically significant negative associations with physician communication: for-profit ownership, hospital size, and hospitalists providing care in the hospital, On the other hand, the number of full-time-equivalent physicians and dentists per 10,000 inpatient days, physician ownership of the hospital, Medicare share of inpatient days, and public ownership were positively associated with patients' ratings of physician communication. Physician staffing levels are an understudied area in healthcare research. Our findings indicate that physician staffing levels affect the quality of physician communication with patients. Moreover, for-profit and larger hospitals should invest more in physician communication given the role that HCAHPS plays in value-based purchasing.

  20. Are Australasian academic physicians an endangered species?

    Science.gov (United States)

    Wilson, A

    2007-11-01

    It has been stated that academic medicine is in a worldwide crisis. Is this decline in hospital academic practice a predictable consequence of modern clinical practice with its emphasis on community and outpatient-based services as well as a corporate health-care ethos or does it relate to innate problems in the training process and career structure for academic clinicians? A better understanding of the barriers to involvement in academic practice, including the effect of gender, the role and effect of overseas training, expectation of further research degrees and issues pertaining to the Australian academic workplace will facilitate recruitment and retention of the next generation of academic clinicians. Physician-scientists remain highly relevant as medical practice and education evolves in the 21st century. Hospital-based academics carry out a critical role in the ongoing mentoring of trainees and junior colleagues, whose training is still largely hospital based in most specialty programmes. Academic clinicians are uniquely placed to translate the rapid advances in medical biology into the clinical sphere, by guiding and carrying out translational research as well as leading clinical studies. Academic physicians also play key leadership in relations with government and industry, in professional groups and medical colleges. Thus, there is a strong case to assess the problems facing recruitment and retention of physician-scientists in academic practice and to develop workable solutions.

  1. Effectiveness of e-learning in continuing medical education for occupational physicians.

    Science.gov (United States)

    Hugenholtz, Nathalie I R; de Croon, Einar M; Smits, Paul B; van Dijk, Frank J H; Nieuwenhuijsen, Karen

    2008-08-01

    Within a clinical context e-learning is comparable to traditional approaches of continuing medical education (CME). However, the occupational health context differs and until now the effect of postgraduate e-learning among occupational physicians (OPs) has not been evaluated. To evaluate the effect of e-learning on knowledge on mental health issues as compared to lecture-based learning in a CME programme for OPs. Within the context of a postgraduate meeting for 74 OPs, a randomized controlled trial was conducted. Test assessments of knowledge were made before and immediately after an educational session with either e-learning or lecture-based learning. In both groups, a significant gain in knowledge on mental health care was found (P effect of e-learning on OPs' mental health care knowledge is comparable to a lecture-based approach. Therefore, e-learning can be beneficial for the CME of OPs.

  2. Transport, retention, and size perturbation of graphene oxide in saturated porous media: Effects of input concentration and grain size

    Science.gov (United States)

    Accurately predicting the fate and transport of graphene oxide (GO) in porous media is critical to assess its environmental impact. In this work, sand column experiments were conducted to determine the effect of input concentration and grain size on transport, retention, and size perturbation of GO ...

  3. Effects of Printed, Pocket Electronic, and Online Dictionaries on High School Students' English Vocabulary Retention

    Science.gov (United States)

    Chiu, Li-Ling; Liu, Gi-Zen

    2013-01-01

    This study obtained empirical evidence regarding the effects of using printed dictionaries (PD), pocket electronic dictionaries (PED), and online type-in dictionaries (OTID) on English vocabulary retention at a junior high school. A mixed-methods research methodology was adopted in this study. Thirty-three seventh graders were asked to use all…

  4. Effects of Information and Communication Technology (ICT) on Students' Academic Achievement and Retention in Chemistry at Secondary Level

    Science.gov (United States)

    Hussain, Ishtiaq; Suleman, Qaiser; ud Din, M. Naseer; Shafique, Farhan

    2017-01-01

    The current paper investigated the effects of information and communication technology on the students' academic achievement and retention in chemistry. Fifty students of 9th grade were selected randomly from Kohsar Public School and College Latamber Karak. The students were grouped into equivalent groups based on pretest score. In order to…

  5. Effects of Creative Drama Method on Students' Attitude towards Social Studies, Academic Achievement and Retention in Turkey

    Science.gov (United States)

    Kaf, Ozlem; Yilmaz, Ozge Uygungul

    2017-01-01

    The purpose of this study was to investigate the effect of creative drama as a teaching method on academic achievement and retention in social studies, students' attitude towards social studies of 4th grade. The research is designed according to quasiexperimental model. The research was conducted with 4th year students in a public school in Adana…

  6. A Thematic-Based Meta Analytic Study Regarding the Effect of Creativity on Academic Success and Learning Retention

    Science.gov (United States)

    Özdas, Faysal; Batdi, Veli

    2017-01-01

    This thematic-based meta-analytic study aims to examine the effect of creativity on the academic success and learning retention scores of students. In the context of this aim, 18 out of 225 studies regarding creativity that were carried out between 2001 and 2011 have been obtained from certain national and international databases. The studies…

  7. The Effect of Concept Mapping-Guided Discovery Integrated Teaching Approach on Chemistry Students' Achievement and Retention

    Science.gov (United States)

    Fatokun, K. V. F.; Eniayeju, P. A.

    2014-01-01

    This study investigates the effects of Concept Mapping-Guided Discovery Integrated Teaching Approach on the achievement and retention of chemistry students. The sample comprised 162 Senior Secondary two (SS 2) students drawn from two Science Schools in Nasarawa State, Central Nigeria with equivalent mean scores of 9.68 and 9.49 in their pre-test.…

  8. The Effect of Input Enhancement of Collocations in Reading on Collocation Learning and Retention of EFL Learners

    Science.gov (United States)

    Goudarzi, Zahra; Moini, M. Raouf

    2012-01-01

    Collocation is one of the most problematic areas in second language learning and it seems that if one wants to improve his or her communication in another language should improve his or her collocation competence. This study attempts to determine the effect of applying three different kinds of collocation on collocation learning and retention of…

  9. The Effects of Guided Discussion on Math Anxiety Levels, Course Performance, and Retention in a College Algebra Internet Class

    Science.gov (United States)

    Emig, Christa

    2009-01-01

    The study sought to test the hypotheses that effective, guided discussions that facilitate meaningful dialogue about math anxiety would reduce levels of math anxiety in college algebra students, and would enhance course performance and course retention at a large community college in South Texas. The study was quantitative with a qualitative…

  10. Phosphorus in the feeding of pigs : effect of diet on the absorption and retention of phosphorus by growing pigs

    NARCIS (Netherlands)

    Jongbloed, A.W.

    1987-01-01

    An extensive review is given of the literature concerning phosphorus feeding of pigs. Subjects dealt with are: 1. physiological background, regulation and effect of diet composition and nutrient supply on phosphorus absorption and retention; 2. estimation of the amount of P present in the

  11. Relative Effect of Lecture Method Supplemented with Music and Computer Animation on Senior Secondary School Students' Retention in Electrochemistry

    Science.gov (United States)

    Akpoghol, T. V.; Ezeudu, F. O.; Adzape, J. N.; Otor, E. E.

    2016-01-01

    The study investigated the effects of Lecture Method Supplemented with Music (LMM) and Computer Animation (LMC) on senior secondary school students' retention in electrochemistry in Makurdi metropolis. Three research questions and three hypotheses guided the study. The design of the study was quasi experimental, specifically the pre-test,…

  12. Effect of communication style and physician-family relationships on satisfaction with pediatric chronic disease care.

    Science.gov (United States)

    Swedlund, Matthew P; Schumacher, Jayna B; Young, Henry N; Cox, Elizabeth D

    2012-01-01

    Over 8% of children have a chronic disease and many are unable to adhere to treatment. Satisfaction with chronic disease care can impact adherence. We examine how visit satisfaction is associated with physician communication style and ongoing physician-family relationships. We collected surveys and visit videos for 75 children ages 9-16 years visiting for asthma, diabetes, or sickle cell disease management. Raters assessed physician communication style (friendliness, interest, responsiveness, and dominance) from visit videos. Quality of the ongoing relationship was measured with four survey items (parent-physician relationship, child-physician relationship, comfort asking questions, and trust in the physician), while a single item assessed satisfaction. Correlations and chi square were used to assess association of satisfaction with communication style or quality of the ongoing relationship. Satisfaction was positively associated with physician to parent (p relationships (p communication style and the quality of the ongoing relationship contribute to pediatric chronic disease visit satisfaction.

  13. Effects of variable attachment shapes and aligner material on aligner retention.

    Science.gov (United States)

    Dasy, Hiltrud; Dasy, Andreas; Asatrian, Greg; Rózsa, Noémi; Lee, Hao-Fu; Kwak, Jin Hee

    2015-11-01

    To evaluate the retention of four types of aligners on a dental arch with various attachments. For this study, three casts were manufactured, two of which contained attachments (ellipsoid and beveled), and one without any attachments to serve as a control. Four types of aligners were thermoformed: Clear-Aligner (CA)-soft, CA-medium, and CA-hard, with various thicknesses, and Essix ACE. Measurements of vertical displacement force during aligner removal were performed with the Gabo Qualimeter Eplexor. Means and standard deviations were next compared between different aligner thicknesses and attachment shapes. CA-soft, CA-medium, and CA-hard did not present a significant increase in retention, except when used in the presence of attachments. Additionally, CA-medium and CA-hard required significantly more force for removal. Essix ACE demonstrated a significant decrease in retention when used with ellipsoid attachments. The force value for Essix ACE removal from the cast with beveled attachments was comparable to that of CA-medium. Forces for aligner removal from the model without attachments showed a linear trend. Essix ACE did not show a continuous increase in retention for each model. Overall, ellipsoid attachments did not present a significant change in retention. In contrast, beveled attachments improved retention. Ellipsoid attachments had no significant influence on the force required for aligner removal and hence on aligner retention. Essix ACE showed significantly less retention than CA-hard on the models with attachments. Furthermore, beveled attachments were observed to increase retention significantly, compared with ellipsoid attachments and when using no attachments.

  14. Physician Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Physician Compare, which meets Affordable Care Act of 2010 requirements, helps you search for and select physicians and other healthcare professionals enrolled in...

  15. An effective utilization management strategy by dual approach of influencing physician ordering and gate keeping.

    Science.gov (United States)

    Elnenaei, Manal O; Campbell, Samuel G; Thoni, Andrea J; Lou, Amy; Crocker, Bryan D; Nassar, Bassam A

    2016-02-01

    There is increasing recognition of the importance of appropriate laboratory test utilization. We investigate the effect of a multifaceted educational approach that includes physician feedback on individual test ordering, in conjunction with targeted restriction, on the utilization of selected laboratory tests. Scientific evidence was compiled on the usefulness and limitations of tests suspected of being over utilized in our laboratories. A variety of approaches were used to deliver education on each of the targeted tests, with greater focus on primary care physicians (PCPs). Feedback on requesting behavior of these tests was also communicated to the latter group which included an educational component. Laboratory based restriction of testing was also exercised, including the unbundling of our electrolyte panel. PCP requesting patterns for the selected tests were found to be markedly skewed. The interventions implemented over the study period resulted in a substantial 51% reduction in overall ordering of five of the targeted tests equating to an annual marginal cost saving of $60,124. Unbundling of the electrolyte panel resulted in marginal cost savings that equated annually to $42,500 on chloride and $48,000 on total CO2. A multifaceted educational approach combined with feedback on utilization and laboratory driven gate-keeping significantly reduced the number of laboratory tests suspected of being redundant or unjustifiably requested. Laboratory professionals are well positioned to manage demand on laboratory tests by utilizing evidence base in developing specific test ordering directives and gate-keeping rules. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  16. Rise of Health Consumerism in China and Its Effects on Physicians' Professional Identity and the Physician-Patient Relationship and Communication.

    Science.gov (United States)

    Tang, Lu; Guan, Mengfei

    2018-05-01

    The physician-patient relationship in China is highly strained. This study examined the professional identity of physicians and their perceptions of the physician-patient relationship against the backdrop of the rise of health consumerism in China. Structured interviews with 29 physicians found that the marketization of medical care and the rise of health consumerism caused physicians to have a conflicted professional identity. The traditional bureaucratic relationship between physicians and patients based on implicit trust was gradually replaced by an arm's length relationship characterized by self-interest, opportunism, and mistrust. In addition, the transition from physician-centered communication to patient-centered communication in China was tenacious. Theoretical and practical implications of the current study are discussed.

  17. The Effect of Sandblasting on the Retention of Orthodontic Bands: An in vitro Study

    Directory of Open Access Journals (Sweden)

    Vishal A Nalawade

    2013-01-01

    Interpretation and conclusion: GIC requires the highest force to deband when compared with polycarboxylate and zinc phosphate cements when used on nonsandblasted bands. In-office sandblasting appears to be an efficient method to increase the retention of orthodontic bands.

  18. Kinetic modeling of the effect of solids retention time on methanethiol dynamics in anaerobic digestion.

    Science.gov (United States)

    Zhang, Dian; Strawn, Mary; Novak, John T; Wang, Zhi-Wu

    2018-07-01

    The highly volatile methanethiol (MT) with an extremely low odor threshold and distinctive putrid smell is often identified as a major odorous compound generated under anaerobic conditions. As an intermediate compound in the course of anaerobic digestion, the extent of MT emission is closely related to the time of anaerobic reaction. In this study, lab-scale anaerobic digesters were operated at solids retention time (SRTs) of 15, 20, 25, 30, 40 and 50 days to investigate the effect of SRT on MT emission. The experimental results demonstrated a bell-shaped curve of MT emission versus SRT with a peak around 20 days SRT. In order to understand this SRT effect, a kinetic model was developed to describe MT production and utilization dynamics in the course of anaerobic digestion and calibrated with the experimental results collected from this study. The model outcome revealed that the high protein content in the feed sludge together with the large maintenance coefficient of MT fermenters are responsible for the peak MT emission emergence in the range of typical SRT used for anaerobic digestion. A further analysis of the kinetic model shows that it can be extensively simplified with reasonable approximation to a form that anaerobic digestion practitioners could easily use to predict the MT and SRT relationship. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Effect of Rehearsal Modality on Knowledge Retention in Surgical Trainees: A Pilot Study.

    Science.gov (United States)

    Finnesgard, Eric J; Aho, Johnathon M; Pandian, T K; Farley, David R

    2016-01-01

    The operating room is an exciting learning environment. With growing curriculum limitations and increasing complexity of care, existing education opportunities need to be optimized. Rehearsal has benefits for surgeon performance in the operating room, but its role for enhancing operative learning remains unclear. This pilot study aimed to differentiate the effects of physical rehearsal (PR) and cognitive rehearsal (CR) modalities on surgical trainee technical knowledge retention. Participants took part in a 2-day (sequential Fridays), instructed operative workshop performing midline laparotomy, splenectomy, left nephrectomy, and hand-sewn, side-to-side small bowel anastomosis (SBA). Participants were randomized to 10 minutes of either a (PR; n = 5) or (CR; n = 5) activity each day before operating. PR consisted of practicing SBA on a felt bowel model. CR entailed viewing narrated operative footage detailing the steps of SBA. Participants' technical knowledge of all procedures was assessed at 1 and 12 weeks postworkshop using a 31-question test. Animal operative suites at an academic medical center. A total of 10 general surgery postgraduate year 1 interns participated in the workshop; all completed the study. Participants had similar levels of operative exposure at the time of study participation. At 1-week postworkshop, mean assessment scores for CR were higher than PR (Mean ± Standard Deviation) (CR = 24.7 ± 1.6 vs. PR = 21.8 ± 1.7, p = 0.02). After 12 weeks, there was no difference in mean scores (CR = 23.3 ± 2 vs. PR = 21.7 ± 1.8, p = 0.22). Knowledge decay for the 12-week period was similar between groups (CR = -1.4 ± 1.6 vs. PR = -0.1 ± 2.4, p = 0.36). Study participants performed better on SBA-related questions than unrelated questions (laparotomy, splenectomy, and nephrectomy) at 1-week (related = 81.5% ± 11.3 vs. unrelated = 71.9% ± 6.6, p = 0.03) and 12 weeks (related = 81% ± 13.1 vs. unrelated = 68.6% ± 8.8, p = 0.02). This pilot data suggests

  20. Effect of Solvent Type and Drying Method on Protein Retention in ...

    African Journals Online (AJOL)

    There appears to be a link between the pKa of the acids and the degree of chitosan–solvent interaction on the one hand, and protein retention on the other hand. Increase in elution pH from 1.2 to 5.0 did not significantly (P>0.05) affect protein retention. Furthermore, there was no significant difference (p>0.05) between the ...

  1. The grit effect: predicting retention in the military, the workplace, school and marriage

    OpenAIRE

    Eskreis-Winkler, Lauren; Shulman, Elizabeth P.; Beal, Scott A.; Duckworth, Angela L.

    2014-01-01

    Remaining committed to goals is necessary (albeit not sufficient) to attaining them, but very little is known about domain-general individual differences that contribute to sustained goal commitment. The current investigation examines the association between grit, defined as passion and perseverance for long-term goals, other individual difference variables, and retention in four different contexts: the military, workplace sales, high school, and marriage. Grit predicted retention over and ...

  2. Silica fume effect on retention characteristics of portland cement for uranium (VI)

    International Nuclear Information System (INIS)

    Tan Hongbin; Ma Xiaoling; Li Yuxiang

    2005-01-01

    With simulated groundwater as leachant, the retention capabilities of the portland cement, which contains different amount of silica fume, are investigated under 25 degree C and 42 days. The results indicate that silica fume can improve the retention capabilities of portland cement for uranium. When the cement contains 15% silica fume, the diffusion coefficient is 7 x 10 -3 cm 3 · -1 . It is only 5.5% of the cement without containing fume. (authors)

  3. Effect of blended materials on U(VI) retention characteristics for portland cement solidification product

    International Nuclear Information System (INIS)

    Tan Hongbin; Ma Xiaoling; Li Yuxiang

    2006-01-01

    Using the simulated groundwater as leaching liquid, the retention capability of U(VI) in solidification products with Portland cement, the Portland cement containing silica fume, the Portland cement containing metakaolin and the Portland cement containing fly ash was researched by leaching experiments at 25 degree C for 42 d. The results indicate silica fume and metakaolin as blended materials can improve the U(VI) retention capability of Portland cement solidification product, but fly ash can not. (authors)

  4. Effects of receptor-mediated endocytosis and tubular protein composition on volume retention in experimental glomerulonephritis

    DEFF Research Database (Denmark)

    Kastner, Christian; Pohl, Marcus; Sendeski, Mauricio

    2009-01-01

    Human glomerulonephritis (GN) is characterized by sustained proteinuria, sodium retention, hypertension, and edema formation. Increasing quantities of filtered protein enter the renal tubule, where they may alter epithelial transport functions. Exaggerated endocytosis and consequent protein...... overload may affect proximal tubules, but intrinsic malfunction of distal epithelia has also been reported. A straightforward assignment to a particular tubule segment causing salt retention in GN is still controversial. We hypothesized that 1) trafficking and surface expression of major transporters...

  5. Effect of gavaged chemical form of 241Am on its retention in mice

    International Nuclear Information System (INIS)

    Hisamatsu, S.; Takizawa, Y.

    1987-01-01

    The retention of 241 Am in mice 48 h after administration by gavage is reported here. The 241 Am was given to mice in the form of either 241 Am nitrate or 241 Am citrate. The 241 Am was also injected into rats in the same form. The homogenized livers of those rats were subsequently administered by gavage to another group of mice. The retention of 241 Am citrate was 1.5 X 10(-2)% of the original dose and was the highest among the compounds examined. The retention of biologically incorporated 241 Am into the liver as 241 Am nitrate and as 241 Am citrate was 2.4 X 10(-3) and 2.6 X 10(-3)%, respectively, and was similar to the retention of 241 Am nitrate, which was 2.8 X 10(-3)%. The ratio of the retention in the carcass to that in the liver for the 241 Am citrate was lower than that of the 241 Am nitrate and the biologically incorporated 241 Am. This difference indicates that the distribution of 241 Am in the animal body depends on the chemical form administered. The retention of liver-incorporated 241 Am as citrate after autolysis of the liver is similar to that of fresh liver-incorporated 241 Am citrate

  6. Effect of molecular interactions on retention and selectivity in reversed-phase liquid chromatography.

    Science.gov (United States)

    Szepesy, László

    2002-06-25

    The linear solvation energy relationships (LSERs) have been applied in the last years for description and prediction of retention and selectivity in reversed-phase liquid chromatography with good results. Widely different stationary phases have been compared and characterized by LSERs. In recent publications the influence of the type of the organic moderator and the composition of the mobile phase have also been described. However, the influence of the molecular properties of the solutes to be separated has never been discussed. According to the LSER model variation in retention factors (log k) with solute structure can be related to their potential for various intermolecular interactions. The retention factor is given as the sum of the terms of the LSER equation representing various types of molecular interactions. For this reason the influence of the structure and molecular properties of the solutes to be separated can also be investigated using the LSER equation. In this study we shall demonstrate how the specific molecular interactions influence chromatographic retention and selectivity. We intend to show that retention and selectivity depend on all participants of the system. In addition to the structure and properties of the stationary phase and the type and composition of the mobile phase the molecular properties of the solutes, characterized by the solvation parameters, will also influence the type and extent of the various molecular interactions governing retention and selectivity.

  7. The confidence-accuracy relationship for eyewitness identification decisions: Effects of exposure duration, retention interval, and divided attention.

    Science.gov (United States)

    Palmer, Matthew A; Brewer, Neil; Weber, Nathan; Nagesh, Ambika

    2013-03-01

    Prior research points to a meaningful confidence-accuracy (CA) relationship for positive identification decisions. However, there are theoretical grounds for expecting that different aspects of the CA relationship (calibration, resolution, and over/underconfidence) might be undermined in some circumstances. This research investigated whether the CA relationship for eyewitness identification decisions is affected by three, forensically relevant variables: exposure duration, retention interval, and divided attention at encoding. In Study 1 (N = 986), a field experiment, we examined the effects of exposure duration (5 s vs. 90 s) and retention interval (immediate testing vs. a 1-week delay) on the CA relationship. In Study 2 (N = 502), we examined the effects of attention during encoding on the CA relationship by reanalyzing data from a laboratory experiment in which participants viewed a stimulus video under full or divided attention conditions and then attempted to identify two targets from separate lineups. Across both studies, all three manipulations affected identification accuracy. The central analyses concerned the CA relation for positive identification decisions. For the manipulations of exposure duration and retention interval, overconfidence was greater in the more difficult conditions (shorter exposure; delayed testing) than the easier conditions. Only the exposure duration manipulation influenced resolution (which was better for 5 s than 90 s), and only the retention interval manipulation affected calibration (which was better for immediate testing than delayed testing). In all experimental conditions, accuracy and diagnosticity increased with confidence, particularly at the upper end of the confidence scale. Implications for theory and forensic settings are discussed.

  8. [General principles of effective communication between physician and patient with selected mental disorders].

    Science.gov (United States)

    Błaszczyk, Justyna; Bobińska, Kinga; Filip, Maria; Gałecki, Piotr

    2015-04-01

    Faced with the growing frequency of mental disorders occurrence and considering the necessity of improving the patient care, it is particularly important that physicians of different specialties knew the general principles of effective communication with patients who are mentally ill. Equally important is to spread the knowledge of the symptomatology of various mental illnesses. Studies published by the Institute of Psychiatry and Neurology involving persons between 18 and 64 years old, show that 8 millions Poles suffers or suffered from mental disorders. This represents almost 25% of Polish society. The above data confirm, that basic knowledge of criteria for diagnosing mental disorders and their treatment by primary care physicians, determines the success of the entire health care system. It must be taken into consideration that frequently patients seeing general practitioner (GP) are suffering from more than one mental illness or it is accompanied by somatic disease. Adequate communication determines effective treatment. Simple yet exact message, ability to adapt it to patient and problems reported by him, is a valuable means in daily medical practice. It reduces the risk of iatrogenic disorder, encourages the efficiency of the entire therapeutic process. Good cooperation with the patient is also determined by patience, empathy, understanding, and competence. The aim of this study is to present the principles of effective communication between doctor and patient suffering from selected mental disorders. The article defines the concept of communication. It shows symptomatology of primary psychiatric disorders. Moreover, the most common difficulties in relationship between the doctor and the patient had been pointed. © 2015 MEDPRESS.

  9. Determining the level of awareness of the physicians in using the variety of electronic information resources and the effecting factors.

    Science.gov (United States)

    Papi, Ahmad; Ghazavi, Roghayeh; Moradi, Salimeh

    2015-01-01

    Understanding of the medical society's from the types of information resources for quick and easy access to information is an imperative task in medical researches and management of the treatment. The present study was aimed to determine the level of awareness of the physicians in using various electronic information resources and the factors affecting it. This study was a descriptive survey. The data collection tool was a researcher-made questionnaire. The study population included all the physicians and specialty physicians of the teaching hospitals affiliated to Isfahan University of Medical Sciences and numbered 350. The sample size based on Morgan's formula was set at 180. The content validity of the tool was confirmed by the library and information professionals and the reliability was 95%. Descriptive statistics were used including the SPSS software version 19. On reviewing the need of the physicians to obtain the information on several occasions, the need for information in conducting the researches was reported by the maximum number of physicians (91.9%) and the usage of information resources, especially the electronic resources, formed 65.4% as the highest rate with regard to meeting the information needs of the physicians. Among the electronic information databases, the maximum awareness was related to Medline with 86.5%. Among the various electronic information resources, the highest awareness (43.3%) was related to the E-journals. The highest usage (36%) was also from the same source. The studied physicians considered the most effective deterrent in the use of electronic information resources as being too busy and lack of time. Despite the importance of electronic information resources for the physician's community, there was no comprehensive knowledge of these resources. This can lead to less usage of these resources. Therefore, careful planning is necessary in the hospital libraries in order to introduce the facilities and full capabilities of the

  10. The effect of generation on retention of women engineers in aerospace and industry

    Science.gov (United States)

    Kiernan, Kristine Maria

    The purpose of this dissertation was to determine the nature and extent of differences between generational cohorts regarding the effect of family factors on retention of women in engineering, with an emphasis on women in the aerospace industry. While 6% of the aerospace workforce is made up of aeronautical engineers, an additional 11.2% of the aerospace workforce is drawn from other engineering disciplines. Therefore, the analysis included all engineering sub-disciplines. In order to include women who had left the workforce, women in all industries were used as a proxy for women in aerospace. Exits to other fields were modeled separately from exits out of the workforce. The source of data was the National Survey of College Graduates. Women engineers were divided into the Baby Boom cohort (born 1945-1964), the Generation X cohort (born 1965-1980), and the Millennial cohort (born 1981-1997). A time-lag design was used to compare generational cohorts when they were the same age. The results of this study showed that generational cohort did not affect retention of women in engineering. However, generational cohort affected family formation decisions, with Millennial women marrying and having children later than their counterparts in the Generation X and Baby Boom cohorts. Generational cohort also affected the influence of motherhood on retention in the workforce, with Generation X and Millennial mothers more likely to stay in the workforce than their counterparts in the Baby Boom cohort. There was no significant difference between Generation X and Millennial women in the proportion of mothers who stayed in the workforce. Generational cohort influenced the reasons women left the workforce. Women in the Millennial cohort were more likely to cite not needing or wanting to work, while women in the Generation X cohort were more likely to cite family responsibilities. Among mothers in the Millennial cohort who were out of the workforce, the proportion who cited not needing

  11. The Effects of Cultural Differences on the Physician-Patient Relationship

    OpenAIRE

    Manassis, Katharina

    1986-01-01

    Differences between patients' and physicians' perceptions of illness can result in poor communication and unsatisfactory treatment results. These differences are more likely when the patient's cultural background is different from the physician's. This article provides a case history of a cultural conflict between a patient, the patient's family, and the medical care system. The beliefs and practices of people unfamiliar with the North American health care system are discussed, and physicians...

  12. Brightening up: the effect of the Physician Payment Sunshine Act on existing regulation of pharmaceutical marketing.

    Science.gov (United States)

    Gorlach, Igor; Pham-Kanter, Genevieve

    2013-01-01

    With the passage of the Physician Payment Sunshine Act as part of the federal health care reform law, pharmaceutical manufacturers are now required to disclose a wide range of payments made by manufacturers to physicians. We review current state regulation of pharmaceutical marketing and consider how the federal sunshine provision will affect existing marketing regulation. We analyze the legal and practical implications of the Physician Payment Sunshine Act. © 2013 American Society of Law, Medicine & Ethics, Inc.

  13. Effect of hydraulic retention time on metal precipitation in sulfate reducing inverse fluidized bed reactors

    KAUST Repository

    Villa-Gómez, Denys Kristalia

    2014-02-13

    BACKGROUND: Metal sulfide recovery in sulfate reducing bioreactors is a challenge due to the formation of small precipitates with poor settling properties. The size of the metal sulfide precipitates with the change in operational parameters such as pH, sulfide concentration and reactor configuration has been previously studied. The effect of the hydraulic retention time (HRT) on the metal precipitate characteristics such as particle size for settling has not yet been addressed. RESULTS: The change in size of the metal (Cu, Zn, Pb and Cd) sulfide precipitates as a function of the HRT was studied in two sulfate reducing inversed fluidized bed (IFB) reactors operating at different chemical oxygen demand concentrations to produce high and low sulfide concentrations. The decrease of the HRT from 24 to 9h in both IFB reactors affected the contact time of the precipitates formed, thus making differences in aggregation and particle growth regardless of the differences in sulfide concentration. Further HRT decrease to 4.5h affected the sulfate reducing activity for sulfide production and hence, the supersaturation level and solid phase speciation. Metal sulfide precipitates affected the sulfate reducing activity and community in the biofilm, probably because of the stronger local supersaturation causing metal sulfides accumulation in the biofilm. CONCLUSIONS: This study shows that the HRT is an important factor determining the size and thus the settling rate of the metal sulfides formed in bioreactors.

  14. Effect of solids retention time on the bioavailability of organic carbon in anaerobically digested swine waste.

    Science.gov (United States)

    Kinyua, Maureen N; Cunningham, Jeffrey; Ergas, Sarina J

    2014-06-01

    Anaerobic digestion (AD) can be used to stabilize and produce energy from livestock waste; however, digester effluents may require further treatment to remove nitrogen. This paper quantifies the effects of varying solids retention time (SRT) methane yield, volatile solids (VS) reduction and organic carbon bioavailability for denitrification during swine waste AD. Four bench-scale anaerobic digesters, with SRTs of 14, 21, 28 and 42 days, operated with swine waste feed. Effluent organic carbon bioavailability was measured using anoxic microcosms and respirometry. Excellent performance was observed for all four digesters, with >60% VS removal and CH4 yields between 0.1 and 0.3(m(3)CH4)/(kg VS added). Organic carbon in the centrate as an internal organic carbon source for denitrification supported maximum specific denitrification rates between 47 and 56(mg NO3(-)-N)/(g VSS h). The digester with the 21-day SRT had the highest CH4 yield and maximum specific denitrification rates. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Effects of stormwater infiltration on quality of groundwater beneath retention and detention basins

    Science.gov (United States)

    Fischer, D.; Charles, E.G.; Baehr, A.L.

    2003-01-01

    Infiltration of storm water through detention and retention basins may increase the risk of groundwater contamination, especially in areas where the soil is sandy and the water table shallow, and contaminants may not have a chance to degrade or sorb onto soil particles before reaching the saturated zone. Groundwater from 16 monitoring wells installed in basins in southern New Jersey was compared to the quality of shallow groundwater from 30 wells in areas of new-urban land use. Basin groundwater contained much lower levels of dissolved oxygen, which affected concentrations of major ions. Patterns of volatile organic compound and pesticide occurrence in basin groundwater reflected the land use in the drainage areas served by the basins, and differed from patterns in background samples, exhibiting a greater occurrence of petroleum hydrocarbons and certain pesticides. Dilution effects and volatilization likely decrease the concentration and detection frequency of certain compounds commonly found in background groundwater. High recharge rates in storm water basins may cause loading factors to be substantial even when constituent concentrations in infiltrating storm water are relatively low.

  16. The effect of a total rewards strategy on school teachers’ retention

    Directory of Open Access Journals (Sweden)

    Boitomelo Makhuzeni

    2015-11-01

    Full Text Available Orientation: South African schools are facing significant challenges to retain a talented pool of school teachers. A total rewards strategy could assist schools to reduce teacher turnover. Research purpose: The aim of this study was to determine the effect of a total rewards strategy on the turnover intentions of school teachers in the North-West province. Motivation: The under supply of quality teachers has negative consequences for both school pupils and the larger community. Research approach, design and method: A qualitative research approach was followed using semi-structured interviews to gather data from teachers in the North-West province (N = 6. Main findings: The findings showed that performance management, career development and compensations of teachers were poorly applied in schools. Teachers strongly considered leaving the teaching profession as a result of poor rewards. The participants were fairly satisfied with their work benefits and work-life balance. Practical/managerial implications: School management should implement reward practices and policies that will attract and enhance retention of school teachers. Contribution: This research highlighted the problematic areas in the reward systems for school teachers and the subsequent impact thereof on their turnover intentions.

  17. Effect of saffron petal extract on retention quality of fresh-cut watermelon cubes

    Directory of Open Access Journals (Sweden)

    hamed kaveh

    2017-01-01

    Full Text Available Saffron is considered as a valuable produce by producers and traders. Unfortunately, the use of its floral by products like petal which have proven to be antioxidant, antimicrobial and nutritional value is limited. In order to investigate the application of saffron petal extracts as an ameliorative on postharvest and processing quality of fresh-cut ‘Crimson Sweet’ watermelon, a completely randomized designed investigation was done on watermelon cubes with 1cm diameter (1±0.5 gram mean weight. Prepared watermelon cubes were divided into four groups and treated with saffron petal extract (10 % V/V for 10 minutes, UV irradiation (maximum wavelength 253.4 nm and 15W for 5 minutes, 10 minutes of saffron petal extract then UV irradiation for 5 minutes and control. After the application of treatments, fresh-cut watermelon cubes were stored at 5±0.5 ºC for 14 days. Sampling and observation of the studied characteristics (physiological loss in weight, soluble solid content, lycopene, microbial load and color quality (Chroma Hue was done every two days to find the trend of changes during the retention period. The results of experiment showed that petal extract of saffron could not decrease weight loss but it was significantly effective in lowering microbial load and increasing color quality, and prevention of lycopene degradation (P≤5%. Although treatment of UV+SPE had better efficiency to suppress microbial load significantly (P≤5%.

  18. Effect of Cardiac Arrhythmia Simulation on Nursing Students' Knowledge Acquisition and Retention.

    Science.gov (United States)

    Tubaishat, Ahmad; Tawalbeh, Loai I

    2015-09-01

    The realistic and practical environment that simulation provides is an extremely useful part of the teaching process. Simulation is widely used in health and nursing education today. This study aims to evaluate the effect of simulation-based teaching on the acquisition and retention of arrhythmia-related knowledge among nursing students. A randomized controlled design involving a pretest-posttest was used. Nursing students were allocated randomly either to the experimental group (n = 47), who attended simulation scenarios on cardiac arrhythmia, or to the control group (n = 44) who received a traditional lecture on the same topic. A paired t test showed that the mean knowledge score at the posttest was significantly higher than at the pretest for both groups. However, participants in the experimental group demonstrated significantly increased knowledge of cardiac arrhythmia in the first and the second posttest compared with those in the control group. Thus, simulation is superior and significantly improves students' arrhythmia knowledge. © The Author(s) 2014.

  19. Effect of temperature and cultivar on polyphenol retention and mass transfer during osmotic dehydration of apples.

    Science.gov (United States)

    Devic, Emilie; Guyot, Sylvain; Daudin, Jean-Dominique; Bonazzi, Catherine

    2010-01-13

    Several cultivars of apples (Malus domestica) were chosen for their variable concentrations and compositions in phenolic compounds. Cubed samples (1 cm3) were subjected to osmotic dehydration, and the effect of temperature was studied at 45 and 60 degrees C. Water loss, sucrose impregnation, and the evolution of some natural components of the product were followed to quantify mass transfer. Ascorbic acid and polyphenols were quantified by HPLC for several osmotic dehydration times and regardless of the quantity of impregnated sugar. Changes in antioxidant components differed as a function of the nature of molecules. Their concentrations decreased in line with temperature, and few differences were observed between cultivars. Processing at a lower temperature (45 degrees C) caused a total loss in ascorbic acid but allowed the retention of between 74 and 85% of initial polyphenols, depending on the cultivar. Cultivars containing highly polymerized procyanidins (such as Guillevic) experienced less loss. Hydroxycinnamic acids and monomeric catechins displayed the most marked changes. Leaching with water into the soaking solution was the principal mechanism retained to explain these losses.

  20. Suburban watershed nitrogen retention: Estimating the effectiveness of stormwater management structures

    Science.gov (United States)

    Koch, Benjamin J.; Febria, Catherine M.; Cooke, Roger M.; Hosen, Jacob D.; Baker, Matthew E.; Colson, Abigail R.; Filoso, Solange; Hayhoe, Katharine; Loperfido, J. V.; Stoner, Anne M.K.; Palmer, Margaret A.

    2015-01-01

    Excess nitrogen (N) is a primary driver of freshwater and coastal eutrophication globally, and urban stormwater is a rapidly growing source of N pollution. Stormwater best management practices (BMPs) are used widely to remove excess N from runoff in urban and suburban areas, and are expected to perform under a wide variety of environmental conditions. Yet the capacity of BMPs to retain excess N varies; and both the variation and the drivers thereof are largely unknown, hindering the ability of water resource managers to meet water quality targets in a cost-effective way. Here, we use structured expert judgment (SEJ), a performance-weighted method of expert elicitation, to quantify the uncertainty in BMP performance under a range of site-specific environmental conditions and to estimate the extent to which key environmental factors influence variation in BMP performance. We hypothesized that rain event frequency and magnitude, BMP type and size, and physiographic province would significantly influence the experts’ estimates of N retention by BMPs common to suburban Piedmont and Coastal Plain watersheds of the Chesapeake Bay region.

  1. Promoting healthy lifestyles and decreasing childhood obesity: increasing physician effectiveness through advocacy.

    Science.gov (United States)

    Saxe, Jessica Schorr

    2011-01-01

    Childhood obesity is a well-documented public health crisis. Even many children who are not overweight have inadequate physical activity, poor nutrition, excessive television and other screen time, or some combination thereof. The solution lies in the community. Environmental interventions are among the most effective for improving public health. In addition to addressing lifestyle issues in the office, physicians should advocate for environmental approaches. We can advocate at institutional, local, state, and federal levels through speaking, writing, and collaborating with others. In the United States, the timing is right to synergize with efforts such as the White House Task Force on Childhood Obesity and the Surgeon General's emphasis on changing the national conversation "from a negative one about obesity and illness" to a positive one about health and fitness.

  2. The effect of medical malpractice liability on rate of referrals received by specialist physicians.

    Science.gov (United States)

    Xu, Xiao; Spurr, Stephen J; Nan, Bin; Fendrick, A Mark

    2013-10-01

    Using nationally representative data from the United States, this paper analyzed the effect of a state’s medical malpractice environment on referral visits received by specialist physicians. The analytic sample included 12,839 ambulatory visits to specialist care doctors in office-based settings in the United States during 2003–2007. Whether the patient was referred for the visit was examined for its association with the state’s malpractice environment, assessed by the frequency and severity of paid medical malpractice claims, medical malpractice insurance premiums and an indicator for whether the state had a cap on non-economic damages. After accounting for potential confounders such as economic or professional incentives within practices, the analysis showed that statutory caps on non-economic damages of $250,000 were significantly associated with lower likelihood of a specialist receiving referrals, suggesting a potential impact of a state’s medical malpractice environment on physicians’ referral behavior.

  3. Physician and Patient and Caregiver Health Attitudes and Their Effect on Medicare Resource Allocation for Patients With Advanced Cancer.

    Science.gov (United States)

    Rocke, Daniel J; Beumer, Halton W; Taylor, Donald H; Thomas, Steven; Puscas, Liana; Lee, Walter T

    2014-06-01

    Physicians must participate in end-of-life discussions, but they understand poorly their patients' end-of-life values and preferences. A better understanding of these preferences and the effect of baseline attitudes will improve end-of-life discussions. To determine how baseline attitudes toward quality vs quantity of life affect end-of-life resource allocation. Otolaryngology-head and neck surgery (OHNS) physicians were recruited to use a validated online tool to create a Medicare health plan for advanced cancer patients. During the exercise, participants allocated a limited pool of resources among 15 benefit categories. These data were compared with preliminary data from patients with cancer and their caregivers obtained from a separate study using the same tool. Attitudes toward quality vs quantity of life were assessed for both physicians and patients and caregivers. Participation in online assessment exercise. Medicare resource allocation. Of 9120 OHNS physicians e-mailed, 767 participated. Data collected from this group were compared with data collected from 146 patients and 114 caregivers. Compared with patients and caregivers, OHNS physician allocations differed significantly in all 15 benefit categories except home care. When stratified by answers to 3 questions about baseline attitudes toward quality vs quantity of life, there were 3 categories in which allocations of patients and caregivers differed significantly from the group with the opposite attitude for at least 2 questions: other medical care (question 1, P attitude question: cash (question 1, P = .02), drugs (question 2, P = .03), and home care (question 3, P = .048). Patients with cancer and their caregivers have different preferences from physicians. These preferences are, for these patients and their caregivers, affected by their baseline health attitudes, but physician preferences are not. Understanding the effect of baseline attitudes is important for effective end

  4. Effect of Physician Delegation to Other Healthcare Providers on the Quality of Care for Geriatric Conditions.

    Science.gov (United States)

    Lichtenstein, Brian J; Reuben, David B; Karlamangla, Arun S; Han, Weijuan; Roth, Carol P; Wenger, Neil S

    2015-10-01

    The quality of care of older adults in the United States has been consistently shown to be inadequate. This gap between recommended and actual care provides an opportunity to improve the value of health care for older adults. Prior work from the Assessing Care of Vulnerable Elders (ACOVE) investigators first defined, and then sought to improve, clinical practice for common geriatric conditions. A critical component of the ACOVE intervention for practice improvement was an emphasis on the delegation of specific care processes, but the independent effect of delegation on the quality of care has not been evaluated. This study analyzed the pooled results of prior ACOVE projects from 1998 to 2010. Totaled, these studies included 4,776 individuals aged 65 and older of mixed demographic backgrounds and 16,204 ACOVE quality indicators (QIs) for three geriatric conditions: falls, urinary incontinence, and dementia. In unadjusted analyses, QI pass probabilities were 0.36 for physician-performed tasks, 0.55 for nurse practitioner (NP)-, physician assistant (PA)-, and registered nurse (RN)-performed tasks; and 0.61 for medical assistant- and licensed vocational nurse-performed tasks. In multiply adjusted models, the independent pass-probability effect of delegation to NPs, PAs, and RNs was 1.37 (P = .05). These findings suggest that delegation of selected tasks to nonphysician healthcare providers is associated with higher quality of care for these geriatric conditions in community practices and supports the value of interdisciplinary team management for common outpatient conditions in older adults. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  5. Physician-based activity counseling: intervention effects on mediators of motivational readiness for physical activity.

    Science.gov (United States)

    Pinto, B M; Lynn, H; Marcus, B H; DePue, J; Goldstein, M G

    2001-01-01

    In theory-based interventions for behavior change, there is a need to examine the effects of interventions on the underlying theoretical constructs and the mediating role of such constructs. These two questions are addressed in the Physically Active for Life study, a randomized trial of physician-based exercise counseling for older adults. Three hundred fifty-five patients participated (intervention n = 181, control n = 174; mean age = 65.6 years). The underlying theories used were the Transtheoretical Model, Social Cognitive Theory and the constructs of decisional balance (benefits and barriers), self-efficacy, and behavioral and cognitive processes of change. Motivational readiness for physical activity and related constructs were assessed at baseline, 6 weeks, and 8 months. Linear or logistic mixed effects models were used to examine intervention effects on the constructs, and logistic mixed effects models were used for mediator analyses. At 6 weeks, the intervention had significant effects on decisional balance, self-efficacy, and behavioral processes, but these effects were not maintained at 8 months. At 6 weeks, only decisional balance and behavioral processes were identified as mediators of motivational readiness outcomes. Results suggest that interventions of greater intensity and duration may be needed for sustained changes in mediators and motivational readiness for physical activity among older adults.

  6. Avoiding a Pilot Retention Death Spiral: The Pilot Shortage and DOD’s Challenge to Maintain an Effective Fighting Force

    Science.gov (United States)

    2018-04-09

    public oversight.”79 His comments apply equally well to the Air Force or the Navy. Anecdotal evidence provided by an anonymous survey on social media ...Master’s Thesis 31 July 2017- 09 APRIL 2018 Avoiding a Pilot Retention Death Spiral: The Pilot Shortage and DOD’s Challenge to Maintain an Effective ...DOD’S CHALLENGE TO MAINTAIN AN EFFECTIVE FIGHTING FORCE by Nathan Thompson Lieutenant Colonel, United States Air Force

  7. Effect of damage on water retention and gas transport properties geo-materials: Application to geological storage of radioactive waste

    International Nuclear Information System (INIS)

    M'Jahad, S.

    2012-01-01

    In the context of geological disposal of radioactive waste, this work contributes to the characterization of the effect of diffuse damage on the water retention and gas transfer properties of concrete (CEM I and CEM V) selected by Andra, Callovo-Oxfordian argillite (host rock) and argillite / concrete interfaces. This study provides information on the concrete microstructure from Mercury porosimetry intrusion and water retention curves: each concrete has a distinct microstructure, CEM I concrete is characterized by a significant proportion of capillary pores while CEM V concrete has a large proportion of C-S-H pores. Several protocols have been developed in order to damage concrete. The damage reduces water retention capacity of CEM I concrete and increases its gas permeability. Indeed, gas breakthrough pressure decreases significantly for damaged concrete, and this regardless of the type of concrete. For argillite, the sample mass increases gradually at RH = 100%, which creates and increases damage in the material. This reduces its ability to retain water. Otherwise, water retention and gas transport properties of argillite are highly dependent of its initial water saturation, which is linked to its damage. Finally, we observed a clogging phenomenon at the argillite/concrete interfaces, which is first mechanical and then hydraulic (and probably chemical) after water injection. This reduces the gas breakthrough pressure interfaces. (author)

  8. Impact of oxy-fuel combustion gases on mercury retention in activated carbons from a macroalgae waste: effect of water.

    Science.gov (United States)

    Lopez-Anton, M A; Ferrera-Lorenzo, N; Fuente, E; Díaz-Somoano, M; Suarez-Ruíz, I; Martínez-Tarazona, M R; Ruiz, B

    2015-04-01

    The aim of this study is to understand the different sorption behaviors of mercury species on activated carbons in the oxy-fuel combustion of coal and the effect of high quantities of water vapor on the retention process. The work evaluates the interactions between the mercury species and a series of activated carbons prepared from a macroalgae waste (algae meal) from the agar-agar industry in oxy-combustion atmospheres, focussing on the role that the high concentration of water in the flue gases plays in mercury retention. Two novel aspects are considered in this work (i) the impact of oxy-combustion gases on the retention of mercury by activated carbons and (ii) the performance of activated carbons prepared from biomass algae wastes for this application. The results obtained at laboratory scale indicate that the effect of the chemical and textural characteristics of the activated carbons on mercury capture is not as important as that of reactive gases, such as the SOx and water vapor present in the flue gas. Mercury retention was found to be much lower in the oxy-combustion atmosphere than in the O2+N2 (12.6% O2) atmosphere. However, the oxidation of elemental mercury (Hg0) to form oxidized mercury (Hg2+) amounted to 60%, resulting in an enhancement of mercury retention in the flue gas desulfurization units and a reduction in the amalgamation of Hg0 in the CO2 compression unit. This result is of considerable importance for the development of technologies based on activated carbon sorbents for mercury control in oxy-combustion processes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Career satisfaction and retention risk among Wisconsin internists.

    Science.gov (United States)

    Giriyappa, Pradeep; Sullivan, Kandis K

    2009-09-01

    Physician career satisfaction has been studied extensively, but career satisfaction as it relates to retention is less well studied. The objective was to assess the relationship between career satisfaction and retention in primary care internal medicine physicians in Wisconsin. In this descriptive quantitative study, survey data was assessed for correlations between career satisfaction, risk to retention, and demographics. The survey included 1231 primary care internal medicine physicians in the Wisconsin Medical Directory (2007). Responses were measured by career satisfaction variables, and demographics and retention variables for the purpose of correlations and regression analysis. Survey responses included 573 physicians. An additional 85 physicians were disqualified. The final survey group included 1146 physicians for a response rate of 50%. A total of 116 physicians (20.2%) reported anticipating leaving their current position, 84 (14.7%) physicians reported anticipating leaving the career of medicine. Identified at risk for retention were 144 (25.1%) physicians. The lowest career satisfaction scores were reported in the areas of compensation (3.19) and practice (3.42) on a scale of 1 (very dissatisfied) to 5 (very satisfied). The highest correlations to retention were associated with practice, followed by compensation satisfaction. The level of significance for this study was identified as 0.05, and the P-value was 0.000. The study findings reveal a significant risk to the stability of continuity of care for patients, and may cost Wisconsin health care organizations more than $35 million in recruitment costs to replace departing physicians.

  10. Shade and flow effects on ammonia retention in macrophyte-rich streams: implications for water quality

    International Nuclear Information System (INIS)

    Wilcock, Robert J.; Scarsbrook, Mike R.; Cooke, James G.; Costley, Kerry J.; Nagels, John W.

    2004-01-01

    Controlled releases of NH 4 -N and conservative tracers (Br - and Cl - ) to five reaches of four streams with contrasting macrophyte communities have shown differing retentions, largely as a result of the way plants interact with stream flow and velocity. First-order constants (k) were 1.0-4.8 d -1 and retention of NH 4 -N was 6-71% of amounts added to each reach. Distance travelled before a 50% reduction in concentration was achieved were 40-450 m in three streams under low-flow conditions, and 2400-3800 m at higher flows. Retention (%) of NH 4 -N can be approximated by a simple function of travel time and k, highlighting the importance of the relationship between macrophytes and stream velocity on nutrient processing. This finding has significant management implications, particularly with respect to restoration of riparian shade. Small streams with predominantly marginal emergent plants are likely to have improved retention of NH 4 -N as a result of shading or other means of reducing plant biomass. Streams dominated by submerged macrophytes will have impaired NH 4 -N retention if plant biomass is reduced because of reduced contact times between NH 4 -N molecules and reactive sites. In these conditions water resource managers should utilise riparian shading in concert with unshaded vegetated reaches to achieve a balance between enhanced in-stream habitat and nutrient processing capacity

  11. Risk as feelings in the effect of patient outcomes on physicians' future treatment decisions: a randomized trial and manipulation validation.

    Science.gov (United States)

    Hemmerich, Joshua A; Elstein, Arthur S; Schwarze, Margaret L; Moliski, Elizabeth Ghini; Dale, William

    2012-07-01

    The present study tested predictions derived from the Risk as Feelings hypothesis about the effects of prior patients' negative treatment outcomes on physicians' subsequent treatment decisions. Two experiments at The University of Chicago, U.S.A., utilized a computer simulation of an abdominal aortic aneurysm (AAA) patient with enhanced realism to present participants with one of three experimental conditions: AAA rupture causing a watchful waiting death (WWD), perioperative death (PD), or a successful operation (SO), as well as the statistical treatment guidelines for AAA. Experiment 1 tested effects of these simulated outcomes on (n = 76) laboratory participants' (university student sample) self-reported emotions, and their ratings of valence and arousal of the AAA rupture simulation and other emotion-inducing picture stimuli. Experiment 2 tested two hypotheses: 1) that experiencing a patient WWD in the practice trial's experimental condition would lead physicians to choose surgery earlier, and 2) experiencing a patient PD would lead physicians to choose surgery later with the next patient. Experiment 2 presented (n = 132) physicians (surgeons and geriatricians) with the same experimental manipulation and a second simulated AAA patient. Physicians then chose to either go to surgery or continue watchful waiting. The results of Experiment 1 demonstrated that the WWD experimental condition significantly increased anxiety, and was rated similarly to other negative and arousing pictures. The results of Experiment 2 demonstrated that, after controlling for demographics, baseline anxiety, intolerance for uncertainty, risk attitudes, and the influence of simulation characteristics, the WWD experimental condition significantly expedited decisions to choose surgery for the next patient. The results support the Risk as Feelings hypothesis on physicians' treatment decisions in a realistic AAA patient computer simulation. Bad outcomes affected emotions and decisions, even

  12. Correlates of Physician Visits Among Children and Adolescents in West Texas: Effects Of Hyperglycemia Symptoms

    Science.gov (United States)

    Arif, Ahmed A.; Venati, Girikumar; Borders, Tyrone F.; Rohrer, James E.

    2004-01-01

    Health care services use by children varies tremendously. Because of the increasing prevalence of diabetes in children and adolescents, one of the major concerns is access to physician care among children with diabetes and diabetes symptoms. This population-based cross-sectional study examines correlates of physician visit among children and…

  13. Odor-context effects in free recall after a short retention interval: a new methodology for controlling adaptation.

    Science.gov (United States)

    Isarida, Takeo; Sakai, Tetsuya; Kubota, Takayuki; Koga, Miho; Katayama, Yu; Isarida, Toshiko K

    2014-04-01

    The present study investigated context effects of incidental odors in free recall after a short retention interval (5 min). With a short retention interval, the results are not confounded by extraneous odors or encounters with the experimental odor and possible rehearsal during a long retention interval. A short study time condition (4 s per item), predicted not to be affected by adaptation to the odor, and a long study time condition (8 s per item) were used. Additionally, we introduced a new method for recovery from adaptation, where a dissimilar odor was briefly presented at the beginning of the retention interval, and we demonstrated the effectiveness of this technique. An incidental learning paradigm was used to prevent overshadowing from confounding the results. In three experiments, undergraduates (N = 200) incidentally studied words presented one-by-one and received a free recall test. Two pairs of odors and a third odor having different semantic-differential characteristics were selected from 14 familiar odors. One of the odors was presented during encoding, and during the test, the same odor (same-context condition) or the other odor within the pair (different-context condition) was presented. Without using a recovery-from-adaptation method, a significant odor-context effect appeared in the 4-s/item condition, but not in the 8-s/item condition. Using the recovery-from-adaptation method, context effects were found for both the 8- and the 4-s/item conditions. The size of the recovered odor-context effect did not change with study time. There were no serial position effects. Implications of the present findings are discussed.

  14. Impact of regression methods on improved effects of soil structure on soil water retention estimates

    Science.gov (United States)

    Nguyen, Phuong Minh; De Pue, Jan; Le, Khoa Van; Cornelis, Wim

    2015-06-01

    Increasing the accuracy of pedotransfer functions (PTFs), an indirect method for predicting non-readily available soil features such as soil water retention characteristics (SWRC), is of crucial importance for large scale agro-hydrological modeling. Adding significant predictors (i.e., soil structure), and implementing more flexible regression algorithms are among the main strategies of PTFs improvement. The aim of this study was to investigate whether the improved effect of categorical soil structure information on estimating soil-water content at various matric potentials, which has been reported in literature, could be enduringly captured by regression techniques other than the usually applied linear regression. Two data mining techniques, i.e., Support Vector Machines (SVM), and k-Nearest Neighbors (kNN), which have been recently introduced as promising tools for PTF development, were utilized to test if the incorporation of soil structure will improve PTF's accuracy under a context of rather limited training data. The results show that incorporating descriptive soil structure information, i.e., massive, structured and structureless, as grouping criterion can improve the accuracy of PTFs derived by SVM approach in the range of matric potential of -6 to -33 kPa (average RMSE decreased up to 0.005 m3 m-3 after grouping, depending on matric potentials). The improvement was primarily attributed to the outperformance of SVM-PTFs calibrated on structureless soils. No improvement was obtained with kNN technique, at least not in our study in which the data set became limited in size after grouping. Since there is an impact of regression techniques on the improved effect of incorporating qualitative soil structure information, selecting a proper technique will help to maximize the combined influence of flexible regression algorithms and soil structure information on PTF accuracy.

  15. Adverse reactions, psychological factors, and their effect on donor retention in men and women.

    Science.gov (United States)

    Veldhuizen, Ingrid; Atsma, Femke; van Dongen, Anne; de Kort, Wim

    2012-09-01

    This study investigates the effect of a vasovagal reaction (VVR) or needle reaction (NR) on the risk of stopping as a blood donor, taking into account variables from the Theory of Planned Behavior (TPB). Is stopping risk solely related to the adverse reaction itself, or do the TPB variables play a role as well? Emphasis is placed on possible sex differences. TPB variables were assessed within 12,051 whole blood donors. Also, donors reported the occurrence of adverse reactions during or after their last donation. Blood bank records were used to determine whether donors stopped donating within the next 2 years. Logistic regression analyses were performed to estimate the effect of self-reported adverse reactions on stopping risk, adjusting for the TPB variables. Analyses were performed separately for both sexes. Men have a lower odds of reporting a NR or a VVR than women (odds ratio [OR] 0.34, 95% confidence interval [CI], 0.28-0.43; and OR 0.26, 95% CI 0.19-0.36, for NR and VVR, respectively). For both sexes, only a VVR was associated with stopping risk, which is higher in men (men, OR 3.95, 95% CI 2.19-7.11; women, OR 1.78, 95% CI 1.35-2.35). After adjusting for the TPB variables both ORs declined (men, OR 3.38, 95% CI 1.86-6.15; women, OR 1.58, 95% CI 1.17-2.14). Also, self-efficacy and affective attitude are negatively associated with adverse reactions. Female donors report more VVRs than male donors, but male donors have a higher stopping risk after a VVR than female donors. Coping differences and possible reporting tendencies might play a role. For donor retention purposes, prevention and coping techniques should take sex differences into account. © 2012 American Association of Blood Banks.

  16. Effect of prolonging radiation delivery time on retention of gammaH2AX

    International Nuclear Information System (INIS)

    Moiseenko, Vitali; Banáth, Judit P; Duzenli, Cheryl; Olive, Peggy L

    2008-01-01

    Compared to conventional external beam radiotherapy, IMRT requires significantly more time to deliver the dose. Prolonging dose delivery potentially increases DNA repair which would reduce the biological effect. We questioned whether retention of γH2AX, a measure of lack of repair of DNA damage, would decrease when dose delivery was protracted. Exponentially growing SiHa cervical carinoma cells were irradiated with 6 MV photons in a water tank using a VarianEX linear accelerator. Cells held at 37°C received 2 Gy in 0.5 min and 4 Gy in 1 min. To evaluate effect of dose delivery prolongation, 2 and 4 Gy were delivered in 30 and 60 min. After 24 h recovery, cells were analyzed for clonogenic survival and for residual γH2AX as measured using flow cytometry. Increasing the dose delivery time from 0.5 or 1 min to 30 or 60 min produced a signficant increase in cell survival from 0.45 to 0.48 after 2 Gy, and from 0.17 to 0.20 after 4 Gy. Expression of residual γH2AX decreased from 1.27 to 1.22 relative to background after 2 Gy and 1.46 to 1.39 relative to background after 4 Gy, but differences were not statistically significant. The relative differences in the slopes of residual γH2AX versus dose for acute versus prolonged irradiation bordered on significant (p = 0.055), and the magnitude of the change was consistent with the observed increase in surviving fraction. These results support the concept that DNA repair underlies the increase in survival observed when dose delivery is prolonged. They also help to establish the limits of sensitivity of residual γH2AX, as measured using flow cytometry, for detecting differences in response to irradiation

  17. Postgraduate training at the ends of the earth - a way to retain physicians?

    Science.gov (United States)

    Straume, Karin; Søndenå, Mona S; Prydz, Peter

    2010-01-01

    The recruitment and retention of health workers, crucial to health service delivery, is a major challenge in many rural and remote areas. Finnmark, the most remote and northern county in Norway, has faced recurrent shortages during the last 5 decades, especially of primary care physicians. This article describes a postgraduate training model for family physicians and public health/community medicine physicians, based on group tutorial and in-service training in rural areas. The effect of the training programs on physician retention in Finnmark is evaluated by a longitudinal cohort study. In total, 65-67% of the physicians from the programs are still working in the county 5 years after completion of the group tutorial. Rural practice provides good learning conditions when accompanied by appropriate tutelage, and in-service training allows the trainees and their families to 'grow roots' in the remote area while in training. The group tutorial develops peer support and professional networks to alleviate professional isolation. On the basis of these findings, traditional centralistic training models are challenged. Postgraduate (vocational) training (residency) for primary care physicians can be successfully carried out in-service in remote areas, in a manner that enhances retention without compromising the quality of the training.

  18. Effect of Cimetidine and Gastric Acidity on the Gastric Mucosal Retention of 99mTc-Pertechnetate in Rate

    International Nuclear Information System (INIS)

    Kim, Sung Hoon; Kim, Jong Woo; Baik, Yong Whee

    1989-01-01

    99m Tc-Pertechnetate (TcO 4 - ) is concentrated by the stomach after intravenous injection, allowing the detection of ectopic gastric mucosa. It has been used to develop a noninvasive test of gastric secretion. However the cellular site of concentration is still controversial, that is whether mucin-secreting epithelial cell or acid-secreting parietal cell. This study is planned to investigate the effects of cimetidine and gastric acidity on the retention of TcO 4 - in the gastric wall of the rat. Also we further attempted to clarify the uptake and secreting cell of TcO 4 - in the gastric mucosa. One hundred rats were divided into two groups, preliminary (40 rats) and main examination group (60 rats). Preliminary examination group was composed of fasting group (20 rats) for the detection of the time for reaching stable TcO 4 - retention ratio in gastric wall and post-prandial group (20 rats) for the detection of the time for reaching the maximal gastric acidity. Main examination group was composed of fasting group (30 rats), which was subdivided into control group (10 rats), cimetidine group (10 rats), Mylanta group (10 rats) and post-prandial group (30 rats), which was subdivided into 90 min group (10 rats), 90 min cimetidine group (10 rats), and 120 min group (10 rats). Retention ratio (%) of TcO 4 - in the gastric wall and the pH of the gastric contents were measured in the extracted stomach of the six groups. Gastric wail retention ratio of TcO 4 - was calculated by the gastric wall radioactivity (cpm) divided by total gastric radioactivity (cpm) at 30 mins after intravenous injection of 0.4 mCi of TcO 4 - . The results were as follows: 1) The time required for reaching stable TcO 4 - retention ratio and the lowest gastric pH were 30 min and 90 min, respectively. 2) In the fasting group, the gastric wall retention ratio of TcO 4 - was significantly increased in the cimetidine group, compared with the control group (P 4 - retention ratio and gastric pH were well

  19. The effectiveness of adhesives on the retention of mandibular free end saddle partial dentures: An in vitro study.

    Science.gov (United States)

    Quiney, Daniel; Nishio Ayre, Wayne; Milward, Paul

    2017-07-01

    Existing in vitro methods for testing denture adhesives do not fully replicate the complex oral geometries and environment; and in vivo methods are qualitative, prone to bias and not easily reproducible. The purpose of this study was to develop a novel, quantitative and more accurate model to test the effect of adhesives on the retentive force of mandibular free end saddle partial dentures. An in vitro model was developed based on an anatomically accurate cast of a clinical case. Experimentally, the amount of adhesive was varied (0.2g-1g) and the tensile force required for displacement was measured. Different commercially available adhesives were then tested at the optimum volume using the in vitro model. A 3D finite element model of the denture was used to assess how the forces to induce denture displacement varied according to the position of the force along the saddle length. The mass of adhesive was found to significantly alter retention forces, with 0.4-0.7g being the optimum range for this particular scenario. Use of adhesives significantly improved mandibular free end saddle partial denture retention with the worst performing adhesive increasing retention nine-fold whilst the best performing adhesive increased retention twenty three-fold. The finite element model revealed that 77% more force was required to displace the denture by positioning forces towards the mesial end of the saddle compared to the distal end. An in vitro denture adhesive model was developed, which demonstrated that mass of adhesive plays a significant role in enhancing denture retention and supported the design principle of placing as few teeth as clinically necessary on the distal end of the free end saddles. Limiting the position of teeth on free end saddles to the mesial and mid portion of the saddle will reduce displacements caused by mastication. The movement of mandibular free end saddle partial dentures can be restricted with the use of denture adhesives. Altering the mass of

  20. [Gender as a key effect modifier of the relationship between physician work stressors and the acquired cardiovascular disorders].

    Science.gov (United States)

    Nedić, Olesja; Belkić, Karen; Filipović, Danka; Jocić, Neda

    2008-01-01

    To assess gender as an effect-modifier vis-â-vis exposure to work stressors and the acquired cardiovascular disorders (ACVDC). The Occupational Stress Index for physicians was used in a case-control study (>90% participation rate) among physicians in Novi Sad (Cases: 50 males and 51 females with ACVD, Referents: 46 males and 6l females without ACVD). Patterns of disease manifestation, sociodemography, risk factors, Minnesota Multiphasic Personality Inventory (MMPI) tendency and exposure to work stressors differed in male compared to female physicians with ACVD. Accounting for these covariates, the males with ACVD had significantly higher general-level threat avoidance vigilance scores (more witnessed accidents at work and expert-witnessing in court (p accounting for covariates. Females in the surgical care specialties with ACVD were exposed to significantly higher demands, speed-up, and need for constant high attention than their female colleagues without ACVD, after accounting for covariates. Gender is a key effect-modifier of the relationship between exposure to work stressors and ACVD among physicians. Intervention studies should consider gender-specific work stressors, as well as those specific to physicians.

  1. Giving patients responsibility or fostering mutual response-ability: family physicians' constructions of effective chronic illness management.

    Science.gov (United States)

    Thille, Patricia H; Russell, Grant M

    2010-10-01

    Current visions of family medicine and models of chronic illness management integrate evidence-based medicine with collaborative, patient-centered care, despite critiques that these constructs conflict with each other. With this potential conflict in mind, we applied a critical discursive psychology methodology to present discursive patterns articulated by 13 family physicians in Ontario, Canada, regarding care of patients living with multiple chronic illnesses. Physicians constructed competing versions of the terms "effective chronic illness management" and "patient involvement." One construction integrated individual responsibility for health with primacy of "evidence," resulting in a conceptualization consistent with paternalistic care. The second constructed effective care as involving active partnership of physician and patient, implying a need to foster the ability of both practitioners and patients to respond to complex challenges as they arose. The former pattern is inconsistent with visions of family medicine and chronic illness management, whereas the latter embodies it.

  2. Death by request in The Netherlands: facts, the legal context and effects on physicians, patients and families.

    Science.gov (United States)

    Kimsma, G K

    2010-11-01

    In this article I intend to describe an issue of the Dutch euthanasia practice that is not common knowledge. After some general introductory descriptions, by way of formulating a frame of reference, I shall describe the effects of this practice on patients, physicians and families, followed by a more philosophical reflection on the significance of these effects for the assessment of the authenticity of a request and the nature of unbearable suffering, two key concepts in the procedure towards euthanasia or physician-assisted suicide. This article does not focus on the arguments for or against euthanasia and the ethical justification of physician-assisted dying. These arguments have been described extensively in Kimsma and Van Leeuwen (Asking to die. Inside the Dutch debate about euthanasia, Kluwer Academic Publishers, Dordrecht, 1998).

  3. The effect of tissue decalcification on mRNA retention within bone for in-situ hybridization studies.

    Science.gov (United States)

    Walsh, L; Freemont, A J; Hoyland, J A

    1993-06-01

    Tissue decalcification is a routine part of the preparation of bone tissue for histological studies. Although in-situ hybridization has been employed to localize mRNA of collagenous and non-collagenous bone related proteins in skeletal tissue, little is known regarding the effects of decalcifying agents on mRNA retention within tissue. In this study in-situ hybridization using an oligonucleotide probe (i.e. a poly d(T) probe) to detect total messenger RNA has been employed to investigate the effects of the decalcifying agents nitric acid, formic acid and EDTA on mRNA retention compared to undeacalcified tissue. The results show that formalin fixation and EDTA decalcification preserve substantial amounts of mRNA within the tissue. In particular, this study illustrates that it is possible to perform in-situ hybridization on formalin fixed decalcified paraffin embedded tissue.

  4. The Effects of Visual Feedback on CPR Skill Retention in Graduate Student Athletic Trainers

    Directory of Open Access Journals (Sweden)

    Michael G. Miller

    2015-09-01

    Full Text Available Context: Studies examining the effectiveness of cardiopulmonary resuscitation (CPR chest compressions have found compression depth and rate to be less than optimal and recoil to full release to be incomplete. Objective: To determine if visual feedback affects the rate and depth of chest compressions and chest recoil values during CPR training of athletic trainers and to determine retention of proficiency over time. Design: Pre-test, post-test. Setting: Medical simulation laboratory. Participants: Eleven females and one male (23.08+.51 years old, from an Athletic Training Graduate Program. All participants were Certified Athletic Trainers (1.12+.46 years of experience and certified in CPR for the Professional Rescuer. Interventions: Participants completed a pre-test, practice sessions, and a post-test on a SimMan® (Laerdal Medical manikin with visual feedback of skills in real time. After the pre-test, participants received feedback by the investigators. Participants completed practice sessions as needed (range=1-4 sessions, until they reached 100% skill proficiency. After achieving proficiency, participants returned 8 weeks later to perform the CPR skills. Main Outcome Measures: The average of all compression outcome measures (rate, depth, recoil was captured every 10 seconds (6x per min. All participants performed 5 cycles of 30 compressions. A two-tailed paired samples t-test (pre to post was used to compare rate of chest compressions, depth of chest compressions, and recoil of the chest. Significance was set a priori at pResults: There was a significant difference between pre and post-test compression depth average, p=.002. The pre-depth average was 41mm + 9.83mm compared to the post-depth average of 52.26mm + 5mm. There were no significant differences between pre and post-test chest compression rates and recoil. Conclusions: The use of a simulated manikin with visual feedback facilitated participants to reach the recommended compression

  5. Chaotic....!! Active and Engaged. Effects of an active learning classroom on student retention and engagement.

    Science.gov (United States)

    Palsole, S.; Serpa, L. F.

    2014-12-01

    Scientific literacy has been defined as the foremost challenge of this decade (AAAS, 2012). The Geological Society of American in its position statement postis that due to the systemic nature of the discipline of earth science, it is the most effective way to engage students in STEM disciplines. Given that the most common place for exposure to earth sciences is at the freshman level for non majors, we decided to transform a freshman introductory geology course to an active, student centered course, using an inquiry based approach. Our focus was to ensure the students saw the earth sciences as broadly applicative field, and not an esoteric science. To achieve this goal, we developed a series of problems that required the students to apply the concepts acquired through their self guided learning into the different topics of the course. This self guided learning took the form of didactic content uploaded into the learning management system (the various elements used to deliver the content were designed video clips, short text based lectures, short formative assessments, discussion boards and other web based discovery exercises) with the class time devoted to problem solving. A comparison of student performance in the active learning classroom vs. a traditional classroom as measured on a geoscience concept inventory (the questions were chosen by a third party who was not teaching either courses) showed that the the students in the active learning classroom scored 10% higher on the average in comparison to the traditional class. In addition to this heightened performance, the students in the active classroom also showed a higher degree of content retention 8 weeks after the semester had ended. This session will share the design process, some exercises and efficacy data collected.

  6. Preventive effect of tamsulosin on postoperative urinary retention in neurosurgical patients.

    Science.gov (United States)

    Basheer, Azam; Alsaidi, Mohammed; Schultz, Lonni; Chedid, Mokbel; Abdulhak, Muwaffak; Seyfried, Donald

    2017-01-01

    Postoperative urinary retention (POUR) is common in neurosurgical patients. The use of alpha-blockade therapy, such as tamsulosin, has benefited many patients with a history of obstructive uropathy by decreasing lower urinary tract symptoms such as distension, infections, and stricture formation, as well as the incidence of POUR. For this study, we targeted patients who had undergone spinal surgery to examine the prophylactic effects of tamsulosin. Increased understanding of this therapy will assist in minimizing the morbidity of spinal surgery. We enrolled 95 male patients undergoing spine surgery in a double-blind, randomized, placebo-controlled trial. Patients were randomly assigned to receive either preoperative tamsulosin (N = 49) or a placebo (N = 46) and then followed-up prospectively for the development of POUR after removal of an indwelling urinary catheter (IUC). They were also followed-up for the incidence of IUC reinsertions. The rate of developing POUR was similar in both the groups. Of the 49 patients given tamsulosin, 16 (36%) developed POUR compared to 13 (28%) from the control group ( P = 0.455). In the control group, 5 (11%) patients had IUC re-inserted postoperatively, whereas 7 (14%) patients in the tamsulosin group had IUC re-inserted postoperatively ( P = 0.616). In patients suffering from axial-type symptoms (i.e., mechanical back pain), 63% who received tamsulosin and 18% from the control group ( P = 0.048) developed POUR. Overall, there was no statistically significant difference in the rates of developing POUR among patients in either group. POUR is caused by a variety of factors, and further studies are needed to shed light on its etiology.

  7. Effect of artificial sunlight on the retention of external calcein marks on lake trout

    Science.gov (United States)

    Honeyfield, D.C.; Kehler, T.; Fletcher, J.W.; Mohler, J.W.

    2008-01-01

    When choosing a fish marking technique to address fishery related questions, it is important to consider factors that affect mark retention. Calcein, a chemical marking agent, is under investigation for potential use on fish. Two laboratory trials were conducted with calcein-marked lake trout Salvelinus namaycush to determine the effect of artificial sunlight on calcein mark intensity. In trial 1, fish exposed to 18,000 lx for 7 d lost 90% or more of the calcein mark intensity (relative to the colorimetric key, mg/L) on the head, body, ventral region, and pectoral fins relative to mark intensity in fish that were maintained in darkness. In trial 2, light intensity was reduced 2.5-3.0-fold. After 7 d of light exposure, calcein mark intensity on the head was reduced by 40-45% relative to mark intensity in fish that were held in darkness; by day 14, calcein mark intensity on the head was reduced by 55-60% relative to that of dark-treated fish. No further decline was observed in light-exposed fish, and head mark intensity values did not differ among days 14, 21, and 28 for this treatment group. Of the four areas evaluated, the head and pectoral fin were more easily read using a colorimetric key than the lateral or ventral regions of the fish. The concentration of calcein spotted on filter paper to devise the colorimetric key ranged from 1 to 100 mg/L. A difference of approximately 7 mg/L in apparent calcein mark intensity means for the head region could be detected using the colorimetric key. These trials showed that calcein mark intensity on lake trout declined when fish were exposed to artificial sunlight, and the use of a colorimetric key improved the objectivity of calcein mark intensity assessment.

  8. True Grit: Trait-level Perseverance and Passion for Long-term Goals Predicts Effectiveness and Retention among Novice Teachers.

    Science.gov (United States)

    Robertson-Kraft, Claire; Duckworth, Angela Lee

    2014-01-01

    Surprisingly little progress has been made in linking teacher effectiveness and retention to factors observable at the time of hire. The rigors of teaching, particularly in low-income school districts, suggest the importance of personal qualities that have so far been difficult to measure objectively. In this study, we examine the predictive validity of personal qualities not typically collected by school districts during the hiring process. Specifically, we use a psychological framework to explore how biographical data on grit, a disposition toward perseverance and passion for long-term goals, explains variance in novice teachers' effectiveness and retention. In two prospective, longitudinal samples of novice teachers assigned to schools in low-income districts (N = 154 and N = 307, respectively), raters blind to outcomes followed a 7-point rubric to rate grit from information on college activities and work experience extracted from teachers' résumés. We used independent-samples t-tests and binary logistic regression models to predict teacher effectiveness and retention from these grit ratings as well as from other information (e.g., SAT scores, college GPA, interview ratings of leadership potential) available at the time of hire. Grittier teachers outperformed their less gritty colleagues and were less likely to leave their classrooms mid-year. Notably, no other variables in our analysis predicted either effectiveness or retention. These findings contribute to a better understanding of what leads some novice teachers to outperform others and remain committed to the profession. In addition to informing policy decisions surrounding teacher recruitment and development, this investigation highlights the potential of a psychological framework to explain why some individuals are more successful than others in meeting the rigorous demands of teaching.

  9. The effect of dentifrice quantity and toothbrushing behaviour on oral delivery and retention of fluoride in vivo.

    Science.gov (United States)

    Creeth, Jonathan; Zero, Domenick; Mau, Melissa; Bosma, Mary Lynn; Butler, Andrew

    2013-12-01

    While toothpaste F(-) concentration and rinsing regimen have well-characterised impacts on fluoride's effectiveness, other aspects of brushing regimen have much less well-established effects, in particular, dentifrice quantity and brushing duration. An in vivo study (n = 42) of oral fluoride delivery (i.e. oral disposition post-brushing), and retention (i.e. concentration of F(-) in saliva post-brushing, a known efficacy predictor), was performed to compare effects observed with those of dentifrice F(-) concentration and rinsing regimen. Subjects brushed with a NaF-silica dentifrice (Aquafresh Advanced, 1,150 ppm F(-) ) or a control dentifrice (250 ppm F(-) , same base), for 45, 60, 120 or 180 seconds with 0.5 or 1.5 g dentifrice, and rinsed with 15 ml water once or three times in a cross-over design. The F(-) concentration was measured in post-brushing expectorate, rinse and toothbrush washing samples, and in saliva between 5-120 minutes after brushing. Using 1.5 g versus 0.5 g dentifrice increased F(-) in all samples: oral retention of F(-) was almost doubled by this increase. Increasing duration of brushing had more complex effects. The amount of F(-) in the expectorate increased but decreased in both rinse and toothbrush washing samples. Oral F(-) retention increased, but only in the period 30-120 minutes after brushing. Over the ranges investigated, the order of importance on oral F(-) retention was: dentifrice F(-) concentration > quantity > rinsing regimen > brushing duration. Hence, increasing dentifrice quantity and, to a lesser extent, the duration of brushing, can elevate oral fluoride post-brushing. Evidence is accumulating that the importance of these variables to fluoride efficacy may have been underestimated. © 2013 FDI World Dental Federation.

  10. "Bird in the hand" cash was more effective than prize draws in increasing physician questionnaire response.

    Science.gov (United States)

    Drummond, Frances J; O'Leary, Eamonn; O'Neill, Ciaran; Burns, Richeal; Sharp, Linda

    2014-02-01

    To investigate the effects of two monetary incentives on response rates to postal questionnaires from primary care physicians (PCPs). The PCPs were randomized into three arms (n=550 per arm), namely (1) €5 sent with the questionnaire (cash); (2) entry into a draw on return of completed questionnaire (prize); or (3) no incentive. Effects of incentives on response rates and item nonresponse were examined, as was cost-effectiveness. Response rates were significantly higher in the cash (66.1%; 95% confidence interval [CI]: 61.9, 70.4%) and prize arms (44.8%; 95% CI: 40.1, 49.3%) compared with the no-incentive arm (39.9%; 95% CI: 35.4, 44.3%). Adjusted relative risk of response was 1.17 (95% CI: 1.02, 1.35) and 1.68 (95% CI: 1.48, 1.91) in the prize and cash arms, respectively, compared with the no-incentive group. Costs per completed questionnaire were €9.85, €11.15, and €6.31 for the cash, prize, and no-incentive arms, respectively. Compared with the no-incentive arm, costs per additional questionnaire returned in the cash and prize arms were €14.72 and €37.20, respectively. Both a modest cash incentive and entry into a prize draw were effective in increasing response rates. The cash incentive was most effective and the most cost-effective. Where it is important to maximize response, a modest cash incentive may be cost-effective. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. The effect of hospital-physician integration on health information technology adoption.

    Science.gov (United States)

    Lammers, Eric

    2013-10-01

    The US federal government has recently made a substantial investment to enhance the US health information technology (IT) infrastructure. Previous literature on the impact of IT on firm performance across multiple industries has emphasized the importance of a process of co-invention whereby organizations develop complementary practices to achieve greater benefit from their IT investments. In health care, employment of physicians by hospitals can confer greater administrative control to hospitals over physicians' actions and resources and thus enable the implementation of new technology and initiatives aimed at maximizing benefit from use of the technology. In this study, I tested for the relationship between hospital employment of physicians and hospitals' propensity to use health IT. I used state laws that prohibit hospital employment of physicians as an instrument to account for the endogenous relationship with hospital IT use. Hospital employment of physicians is associated with significant increases in the probability of hospital health IT use. Therefore, subsidization of health IT among hospitals not employing physicians may be less efficient. Furthermore, state laws prohibiting hospitals from employing physicians may inhibit adoption of health IT, thus working against policy initiatives aimed at promoting use of the technology. Copyright © 2012 John Wiley & Sons, Ltd.

  12. Retention of radioactive particles and associated effects in the filter-feeding marine mollusc Mytilus edulis

    Energy Technology Data Exchange (ETDEWEB)

    Jaeschke, B.C., E-mail: Ben.Jaeschke@gmail.com [Department of Ecology Environment and Plant Sciences, Stockholm University, SE-106 91 Stockholm (Sweden); CERAD CoE, Department of Environmental Sciences, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, N-1432 Ås (Norway); Lind, O.C. [CERAD CoE, Department of Environmental Sciences, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, N-1432 Ås (Norway); Bradshaw, C. [Department of Ecology Environment and Plant Sciences, Stockholm University, SE-106 91 Stockholm (Sweden); Salbu, B. [CERAD CoE, Department of Environmental Sciences, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, N-1432 Ås (Norway)

    2015-01-01

    Radioactive particles are aggregates of radioactive atoms that may contain significant activity concentrations. They have been released into the environment from nuclear weapons tests, and from accidents and effluents associated with the nuclear fuel cycle. Aquatic filter-feeders can capture and potentially retain radioactive particles, which could then provide concentrated doses to nearby tissues. This study experimentally investigated the retention and effects of radioactive particles in the blue mussel, Mytilus edulis. Spent fuel particles originating from the Dounreay nuclear establishment, and collected in the field, comprised a U and Al alloy containing fission products such as {sup 137}Cs and {sup 90}Sr/{sup 90}Y. Particles were introduced into mussels in suspension with plankton-food or through implantation in the extrapallial cavity. Of the particles introduced with food, 37% were retained for 70 h, and were found on the siphon or gills, with the notable exception of one particle that was ingested and found in the stomach. Particles not retained seemed to have been actively rejected and expelled by the mussels. The largest and most radioactive particle (estimated dose rate 3.18 ± 0.06 Gy h{sup −1}) induced a significant increase in Comet tail-DNA %. In one case this particle caused a large white mark (suggesting necrosis) in the mantle tissue with a simultaneous increase in micronucleus frequency observed in the haemolymph collected from the muscle, implying that non-targeted effects of radiation were induced by radiation from the retained particle. White marks found in the tissue were attributed to ionising radiation and physical irritation. The results indicate that current methods used for risk assessment, based upon the absorbed dose equivalent limit and estimating the “no-effect dose” are inadequate for radioactive particle exposures. Knowledge is lacking about the ecological implications of radioactive particles released into the environment

  13. Retention of radioactive particles and associated effects in the filter-feeding marine mollusc Mytilus edulis

    International Nuclear Information System (INIS)

    Jaeschke, B.C.; Lind, O.C.; Bradshaw, C.; Salbu, B.

    2015-01-01

    Radioactive particles are aggregates of radioactive atoms that may contain significant activity concentrations. They have been released into the environment from nuclear weapons tests, and from accidents and effluents associated with the nuclear fuel cycle. Aquatic filter-feeders can capture and potentially retain radioactive particles, which could then provide concentrated doses to nearby tissues. This study experimentally investigated the retention and effects of radioactive particles in the blue mussel, Mytilus edulis. Spent fuel particles originating from the Dounreay nuclear establishment, and collected in the field, comprised a U and Al alloy containing fission products such as 137 Cs and 90 Sr/ 90 Y. Particles were introduced into mussels in suspension with plankton-food or through implantation in the extrapallial cavity. Of the particles introduced with food, 37% were retained for 70 h, and were found on the siphon or gills, with the notable exception of one particle that was ingested and found in the stomach. Particles not retained seemed to have been actively rejected and expelled by the mussels. The largest and most radioactive particle (estimated dose rate 3.18 ± 0.06 Gy h −1 ) induced a significant increase in Comet tail-DNA %. In one case this particle caused a large white mark (suggesting necrosis) in the mantle tissue with a simultaneous increase in micronucleus frequency observed in the haemolymph collected from the muscle, implying that non-targeted effects of radiation were induced by radiation from the retained particle. White marks found in the tissue were attributed to ionising radiation and physical irritation. The results indicate that current methods used for risk assessment, based upon the absorbed dose equivalent limit and estimating the “no-effect dose” are inadequate for radioactive particle exposures. Knowledge is lacking about the ecological implications of radioactive particles released into the environment, for example

  14. Effect of In-Vessel Retention Strategies under Postulated SGTR Accidents of OPR1000

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Wonjun; Lee, Yongjae; Kim, Sung Joong [Hanyang University, Seoul (Korea, Republic of); Kim, Hwan-Yeol; Park, Rae-Joon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    In this study, MELCOR code was used to simulate the severe accident of the OPR1000. MELCOR code is computer code which enables to simulate the progression of the severe accident for light water reactors. It has been developed by Sandia National Laboratories for plant risk assessment and source term analysis since 1982. According to the probabilistic safety analysis (PSA) Level 1 of OPR1000, typical severe accident scenarios of high probability of a transition to severe accident for OPR1000 were identified as Small Break Loss of Coolant Accident (SBLOCA), Station Black out (SBO), Total Loss of Feed Water (TLOFW), and Steam Generator Tube Rupture. While the first three accidents are expected to result in the generation and transportation of the radioactive nuclides within the containment building as consequence of the core damage and subsequent reactor pressure vessel (RPV) failure, the latter accident scenario may be progressed with possible direct release of the radioactive nuclides to the environment by bypassing the containment building. Thus it is of significance to investigate the SGTR accident with a sophisticated severe accident code. This code can simulate the whole phenomena of a severe accident such as thermal-hydraulic response, core heat-up, oxidation and relocation, and fission product release and transport. Thus many researchers have used MELCOR in severe accident studies. In this study, in-vessel retention strategies were applied for postulated SGTR accidents. Mitigation effect and adverse effect of in-vessel strategies was studied in aspect of RPV failure, fission product release and containment thermal-hydraulic and hydrogen behavior. Base case of SGTR accident and three mitigation cases were simulated using MELCOR code 1.8.6. For each mitigation cases, mitigation effect and adverse effect were investigated. Conclusions can be summarized as follows: (1) RPV failure of SGTR base case occurred at 5.62 hours and fission product of RCS released to

  15. Kentucky physicians and politics.

    Science.gov (United States)

    VonderHaar, W P; Monnig, W B

    1998-09-01

    Approximately 19% of Kentucky Physicians are KEMPAC members or contribute to state legislative and Gubernatorial candidates. This limited study of political activity indicates that a small percentage of physicians participate in the political process. Despite the small number of contributors to state legislative candidates, KMA's legislative and lobbying effort is highly effective and members receive high quality service and representation in the political arena.

  16. The effects of fatigue and dissatisfaction on how physicians perceive their social responsibilities.

    Science.gov (United States)

    O'Donnell, Erin P; Humeniuk, Katherine M; West, Colin P; Tilburt, Jon C

    2015-02-01

    To examine how fatigue and dissatisfaction with practicing medicine relate to US physicians' perceptions of their professional responsibilities in a time of upheaval in health care. From May 30, 2012, through September 1, 2012, we mailed an 8-page paper survey, including measures of perceived social responsibility, fatigue, and satisfaction, to a random sample of 3897 physicians selected from the American Medical Association Physician Masterfile. We performed bivariate tests and multivariable logistic regression to examine associations between key predictors (fatigue and satisfaction) and 3 dependent variables: obligations to care for the uninsured and underinsured, obligations to address policy issues, and agreement with cost-containment. A total of 2556 physicians (65.6%) responded to the survey. Nearly half of physicians (1160 [45.4%]) reported high levels of fatigue, whereas most (1810 [70.8%]) expressed satisfaction with practicing medicine. Dissatisfaction in practicing medicine proved to be a significant predictor in how physicians perceive their professional responsibilities and in medical decision-making. Overall, physicians who rated themselves as very dissatisfied had a significantly reduced likelihood of favoring limiting reimbursement to expand basic coverage (odds ratio, 0.5; 95% CI, 0.3-0.7), recognizing an obligation to care for the uninsured (odds ratio, 0.5; 95% CI, 0.3-0.7), and addressing societal health policy issues (OR, 0.7; 95% CI, 0.5-0.9). Although fatigue and satisfaction are strongly associated, only satisfaction appears to correlate with physicians' perceived social responsibilities. Physicians who are dissatisfied with their profession may be less inclined to address health policy issues, embrace charity care, or practice cost containment. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  17. Effects of scanning and eliminating paper-based medical records on hospital physicians' clinical work practice.

    Science.gov (United States)

    Laerum, Hallvard; Karlsen, Tom H; Faxvaag, Arild

    2003-01-01

    It is not automatically given that the paper-based medical record can be eliminated after the introduction of an electronic medical record (EMR) in a hospital. Many keep and update the paper-based counterpart, and this limits the use of the EMR system. The authors have evaluated the physicians' clinical work practices and attitudes toward a system in a hospital that has eliminated the paper-based counterpart using scanning technology. Combined open-ended interviews (8 physicians) and cross-sectional survey (70 physicians) were conducted and compared with reference data from a previous national survey (69 physicians from six hospitals). The hospitals in the reference group were using the same EMR system without the scanning module. The questionnaire (English translation available as an online data supplement at ) covered frequency of use of the EMR system for 19 defined tasks, ease of performing them, and user satisfaction. The interviews were open-ended. The physicians routinely used the system for nine of 11 tasks regarding retrieval of patient data, which the majority of the physicians found more easily performed than before. However, 22% to 25% of the physicians found retrieval of patient data more difficult, particularly among internists (33%). Overall, the physicians were equally satisfied with the part of the system handling the regular electronic data as that of the physicians in the reference group. They were, however, much less satisfied with the use of scanned document images than that of regular electronic data, using the former less frequently than the latter. Scanning and elimination of the paper-based medical record is feasible, but the scanned document images should be considered an intermediate stage toward fully electronic medical records. To our knowledge, this is the first assessment from a hospital in the process of completing such a scanning project.

  18. Effects of Quizzing Methodology on Student Outcomes: Reading Compliance, Retention, and Perceptions

    Science.gov (United States)

    Dowling, Carey Bernini

    2017-01-01

    This study set out to replicate and extend research on students' reading compliance and examine the impact of daily quizzing methodology on students' reading compliance and retention. 98 students in two sections of Abnormal Psychology participated (mean age = 21.5, SD = 3.35; 72.4% Caucasian). Using a multiple baseline quasi-experimental design…

  19. Postpartum urinary retention: a systematic review of adverse effects and management

    NARCIS (Netherlands)

    Mulder, F. E. M.; Hakvoort, R. A.; Schoffelmeer, M. A.; Limpens, J.; van der Post, J. A. M.; Roovers, J. P. W. R.

    2014-01-01

    Postpartum urinary retention (PUR) is a well-known condition after childbirth. Often clinicians assume that this condition is transient, either through belief or by not being aware that its occurrence as measurement of post-void residual volume (PVRV) is often not routine. However, long lasting

  20. Effects of variable retention harvesting on natural tree regeneration in Pinus resinosa (red pine) forests

    Science.gov (United States)

    Margaret W. Roberts; Anthony W. D' Amato; Christel C. Kern; Brian J. Palik

    2017-01-01

    Concerns over loss of ecosystem function and biodiversity in managed forests have led to the development of silvicultural approaches that meet ecological goals as well as sustain timber production. Variable Retention Harvest (VRH) practices, which maintain mature overstory trees across harvested areas, have been suggested as an approach to balance these objectives;...

  1. Learning Motivation and Retention Effects of Pair Programming in Data Structures Courses

    Science.gov (United States)

    Yang, Ya-Fei; Lee, Chien-I; Chang, Chih-Kai

    2016-01-01

    Collaborative learning is an activity in which two or more students learn something together. Many studies have found that collaborative learning improve students' memory retention and motivation to learn. Peer Instruction (PI) is one of the most successful evidence-based collaborative learning methods. This article investigates issues of student…

  2. Everyday Attention and Lecture Retention: The Effects of Time, Fidgeting, and Mind Wandering

    Directory of Open Access Journals (Sweden)

    James eFarley

    2013-09-01

    Full Text Available We have all had our thoughts wander from the immediate task at hand. The emerging embodied cognition literature emphasizes the role that the body plays in human thought, and raises the possibility that changes in attentional focus may be associated with changes in body behaviour. Recent research has found that when individuals view a lecture, mind wandering increases as a function of time. In the present study we asked whether this decline in attention during lecture viewing was associated with fidgeting. Participants were filmed while they watched a 40-minute lecture video, and at regular 5 minute intervals provided ratings of their attentiveness. Following the lecture, participant's memory for the material was assessed. Fidgeting behaviour was coded from video recordings of each session. Results indicated that attention to, and retention of, lecture material declined as a function of time on task. Critically, and as predicted, fidgeting also increased with time on task. We also found that the relation between fidgeting and retention was significant even when the role of attention was factored into the equation, suggesting that fidgeting makes a unique contribution to retention of lecture material over and above that contributed by an individual’s attention. We propose a novel non-attentional stress-based account of fidgeting and how this impacts retention for lecture material over and above changes in levels in mind wandering vis-a-vis changes in attention.

  3. The grit effect: predicting retention in the military, the workplace, school and marriage.

    Science.gov (United States)

    Eskreis-Winkler, Lauren; Shulman, Elizabeth P; Beal, Scott A; Duckworth, Angela L

    2014-01-01

    Remaining committed to goals is necessary (albeit not sufficient) to attaining them, but very little is known about domain-general individual differences that contribute to sustained goal commitment. The current investigation examines the association between grit, defined as passion and perseverance for long-term goals, other individual difference variables, and retention in four different contexts: the military, workplace sales, high school, and marriage. Grit predicted retention over and beyond established context-specific predictors of retention (e.g., intelligence, physical aptitude, Big Five personality traits, job tenure) and demographic variables in each setting. Grittier soldiers were more likely to complete an Army Special Operations Forces (ARSOF) selection course, grittier sales employees were more likely to keep their jobs, grittier students were more likely to graduate from high school, and grittier men were more likely to stay married. The relative predictive validity of grit compared to other traditional predictors of retention is examined in each of the four studies. These findings suggest that in addition to domain-specific influences, there may be domain-general individual differences which influence commitment to diverse life goals over time.

  4. Effects of Academic Mindsets on College Students' Achievement and Retention

    Science.gov (United States)

    Han, Cheon-woo; Farruggia, Susan P.; Moss, Thomas P.

    2017-01-01

    Noncognitive factors, such as academic self-efficacy, motivation, and sense of belonging, predict college students' academic performance and retention. It is unclear if varying profiles of academic mindset are differentially associated with student success. We examined first-year college students' academic mindsets (perceived academic…

  5. The grit effect: predicting retention in the military, the workplace, school and marriage

    Directory of Open Access Journals (Sweden)

    Lauren eEskreis-Winkler

    2014-02-01

    Full Text Available Remaining committed to goals is necessary (albeit not sufficient to attaining them, but very little is known about domain-general individual differences that contribute to sustained goal commitment. The current investigation examines the association between grit, defined as passion and perseverance for long-term goals, other individual difference variables, and retention in four different contexts: the military, workplace sales, high school, and marriage. Grit predicted retention over and beyond established context-specific predictors of retention (e.g. intelligence, physical aptitude, Big Five personality traits, job tenure and demographic variables in each setting. Grittier soldiers were more likely to complete an Army Special Operations Forces (ARSOF selection course, grittier sales employees were more likely to keep their jobs, grittier students were more likely to graduate from high school, and grittier men were more likely to stay married. The relative predictive validity of grit compared to other traditional predictors of retention is examined in each of the four studies. These findings suggest that in addition to domain-specific influences, there may be domain-general individual differences which influence commitment to diverse life goals over time.

  6. Effect of lowering dietary calcium intake on fractional whole body calcium retention

    International Nuclear Information System (INIS)

    Dawson-Hughes, B.; Stern, D.T.; Shipp, C.C.; Rasmussen, H.M.

    1988-01-01

    Although fractional calcium absorption is known to vary inversely with calcium intake, the extent and timing of individual hormonal and calcium absorption responses to altered calcium intake have not been defined. We measured fractional whole body retention of orally ingested 47 Ca, an index of calcium absorption, in nine normal women after they had eaten a 2000-mg calcium diet for 8 weeks and a 300-mg calcium diet for 1, 2, 4, and 8 weeks. After the diet change, serum intact PTH (32.2% increase; P = 0.005), serum 1,25-dihydroxyvitamin D [1,25-(OH)2D; 43.8% increase; P = 0.003], and fractional whole body calcium retention (42.8% increase; P = 0.004) increased within 1 week. Although the PTH and calcium retention responses remained fairly constant throughout the low calcium intake period, serum 1,25-(OH)2D concentrations declined toward baseline after week 1. Thus, the late increase in calcium retention may have resulted from calcium absorption that was independent of 1,25-(OH)2D stimulation

  7. Key Issue: Increasing Teacher Retention to Facilitate the Equitable Distribution of Effective Teachers

    Science.gov (United States)

    Lasagna, Molly

    2009-01-01

    The term "teacher retention" refers to the ability to keep teachers on the job. In other words, it is the ability to reduce or eliminate teacher turnover. "Turnover" refers to the migration of teachers between schools or districts "and" the attrition of teachers from the profession (Ingersoll & Perda, 2009). From the perspective of a principal,…

  8. Sample dimensions effect on prediction of soil water retention curve and saturated hydraulic conductivity

    Science.gov (United States)

    Soil water retention curve (SWRC) and saturated hydraulic conductivity (SHC) are key hydraulic properties for unsaturated zone hydrology and groundwater. Not only are the SWRC and SHC measurements time-consuming, their results are scale dependent. Although prediction of the SWRC and SHC from availab...

  9. The Effects of Hypertext Gloss on Comprehension and Vocabulary Retention under Incidental and Intentional Learning Conditions

    Science.gov (United States)

    Zandieh, Zeinab; Jafarigohar, Manoochehr

    2012-01-01

    The present study investigated comprehension, immediate and delayed vocabulary retention under incidental and intentional learning conditions via computer mediated hypertext gloss. One hundred and eighty four (N = 184) intermediate students of English as a foreign language at an English school participated in the study. They were randomly assigned…

  10. The effect of financial incentives on the quality of health care provided by primary care physicians.

    Science.gov (United States)

    Scott, Anthony; Sivey, Peter; Ait Ouakrim, Driss; Willenberg, Lisa; Naccarella, Lucio; Furler, John; Young, Doris

    2011-09-07

    The use of blended payment schemes in primary care, including the use of financial incentives to directly reward 'performance' and 'quality' is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify:i) the different types of financial incentives that have improved quality;ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; andiii) the characteristics of PCPs who have responded to financial incentives. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library), MEDLINE, HealthSTAR, EMBASE, CINAHL, PsychLIT, and ECONLIT. Searches of Internet-based economics and health economics working paper collections were also conducted. Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field. Articles were included if they were published from 2000 to August 2009. Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs). Quality of care was defined as patient reported outcome

  11. Utility and Cost-Effectiveness of Motivational Messaging to Increase Survey Response in Physicians: A Randomized Controlled Trial

    Science.gov (United States)

    Chan, Randolph C. H.; Mak, Winnie W. S.; Pang, Ingrid H. Y.; Wong, Samuel Y. S.; Tang, Wai Kwong; Lau, Joseph T. F.; Woo, Jean; Lee, Diana T. F.; Cheung, Fanny M.

    2018-01-01

    The present study examined whether, when, and how motivational messaging can boost the response rate of postal surveys for physicians based on Higgin's regulatory focus theory, accounting for its cost-effectiveness. A three-arm, blinded, randomized controlled design was used. A total of 3,270 doctors were randomly selected from the registration…

  12. Death by request in The Netherlands: facts, the legal context and effects on physicians, patients and families.

    NARCIS (Netherlands)

    Kimsma, G.K.

    2010-01-01

    In this article I intend to describe an issue of the Dutch euthanasia practice that is not common knowledge. After some general introductory descriptions, by way of formulating a frame of reference, I shall describe the effects of this practice on patients, physicians and families, followed by a

  13. Effects of sludge retention time (SRT) and biosurfactant on the removal of polyaromatic compounds and toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Sponza, Delia Teresa, E-mail: delya.sponza@deu.edu.tr [Dokuz Eylul University, Engineering Faculty, Environmental Engineering Department, Buca Kaynaklar Campus, 35160 Izmir (Turkey); Gok, Oguzhan [Dokuz Eylul University, Engineering Faculty, Environmental Engineering Department, Buca Kaynaklar Campus, 35160 Izmir (Turkey)

    2011-12-15

    Graphical abstract: Acute toxicities in (a) influent wastewater (EC{sub 50} = 45.02 ng ml{sup -1}) and (b) effluent wastewater in aerobic activated sludge reactor at SRT = 25 days (EC{sub 6} = 5.30 ng ml{sup -1}). Highlights: Black-Right-Pointing-Pointer Over 90% of the total PAHs was removed at Rhamnolipid and sludge retention time of 15 mg l{sup -1} and 25 days. Black-Right-Pointing-Pointer 93% of the COD originating from the inert organics was removed in the aerobic reactor. 96-97% of the Rhamnolipid was biodegraded. Black-Right-Pointing-Pointer The EC50 value was reduced from EC{sub 50} = 45.02 ng ml{sup -1} to C{sub 6} = 5.30 ng ml{sup -1} with Daphnia magna. Toxicity removals originating from the PAHs were 96%. - Abstract: A laboratory-scale aerobic activated sludge reactor (AASR) system was employed to investigate the effects of SRT on the removal of three less hydrophobic and six more hydrophobic PAHs in the presence of rhamnolipid (RD), emulsan (EM) and surfactine (SR) biosurfactants. Among the biosurfactants it was found that RD exhibits a better performance than the others in the removal of PAHs. At a RD of 15 mg l{sup -1} aerobic treatment for 25 days SRT was enough to remove over 90% of the total PAHs, 88% of the COD originating from the inert organics (COD{sub inert}) and 93% of the COD originating from the inert soluble microbial products (COD{sub imp}). At this SRT and RD concentration, about 96-98% of the RD was biodegraded by the AASR system, 1.2-1.4% was accumulated in the system, 1.1-1.3% was released in the effluent, and 1.2-1.4% remained in the waste sludge. The addition of electron acceptors (NO{sub 3}{sup -1}, SO{sub 4}{sup -2}) and increasing of temperature up to 45 Degree-Sign C enhanced the PAH yields. The most effective PAH degradation occurred in high-oxygenated and neutral pH conditions. The PAH concentration affecting half of the Daphnia magna organism (EC{sub 50} value) was reduced from EC{sub 50} = 45.02 ng ml{sup -1} to the PAH

  14. Effects of sludge retention time (SRT) and biosurfactant on the removal of polyaromatic compounds and toxicity

    International Nuclear Information System (INIS)

    Sponza, Delia Teresa; Gok, Oguzhan

    2011-01-01

    Graphical abstract: Acute toxicities in (a) influent wastewater (EC 50 = 45.02 ng ml −1 ) and (b) effluent wastewater in aerobic activated sludge reactor at SRT = 25 days (EC 6 = 5.30 ng ml −1 ). Highlights: ► Over 90% of the total PAHs was removed at Rhamnolipid and sludge retention time of 15 mg l −1 and 25 days. ► 93% of the COD originating from the inert organics was removed in the aerobic reactor. 96–97% of the Rhamnolipid was biodegraded. ► The EC50 value was reduced from EC 50 = 45.02 ng ml −1 to C 6 = 5.30 ng ml −1 with Daphnia magna. Toxicity removals originating from the PAHs were 96%. - Abstract: A laboratory-scale aerobic activated sludge reactor (AASR) system was employed to investigate the effects of SRT on the removal of three less hydrophobic and six more hydrophobic PAHs in the presence of rhamnolipid (RD), emulsan (EM) and surfactine (SR) biosurfactants. Among the biosurfactants it was found that RD exhibits a better performance than the others in the removal of PAHs. At a RD of 15 mg l −1 aerobic treatment for 25 days SRT was enough to remove over 90% of the total PAHs, 88% of the COD originating from the inert organics (COD inert ) and 93% of the COD originating from the inert soluble microbial products (COD imp ). At this SRT and RD concentration, about 96–98% of the RD was biodegraded by the AASR system, 1.2–1.4% was accumulated in the system, 1.1–1.3% was released in the effluent, and 1.2–1.4% remained in the waste sludge. The addition of electron acceptors (NO 3 −1 , SO 4 −2 ) and increasing of temperature up to 45 °C enhanced the PAH yields. The most effective PAH degradation occurred in high-oxygenated and neutral pH conditions. The PAH concentration affecting half of the Daphnia magna organism (EC 50 value) was reduced from EC 50 = 45.02 ng ml −1 to the PAH concentration affecting only 6% of the live Daphnia magna (EC 6 = 5.30 ng ml −1 ) at the end of the aerobic treatment at a SRT of 25 days. Toxicity

  15. A comparative evaluation of the effect of dentin desensitizers on the retention of complete cast metal crowns

    Directory of Open Access Journals (Sweden)

    Saili M Chandavarkar

    2015-01-01

    Full Text Available Context: Desensitizers are used to reduce dentin hypersensitivity. They affect the surface texture of prepared dentin and may alter the retention of fixed restorations. Aims: The aim was to evaluate the effect of dentin desensitizers on the retention of complete cast metal crowns luted with glass ionomer cement. Subjects and Methods: Fifty freshly extracted human premolars were subjected to standardized tooth preparation (20° total convergence, 4 mm axial height with a computer numerically controlled machine. Individual cast metal crowns were fabricated from a base metal alloy. Dentin desensitizers included none (control, a glutaraldehyde (GLU based primer (Gluma desensitizer, casein phosphopeptide (CPP-amorphous calcium phosphate (ACP (GC Mousse, erbium, chromium: YSGG laser (Waterlase MD Turbo, Biolase and Pro-Argin (Colgate Sensitive Pro-Relief desensitizing polishing paste. After desensitization, crowns were luted with glass ionomer cement and kept for 48 h at 37°C in 100% relative humidity. The samples were tested using a universal testing machine by applying a load at a crosshead speed of 0.5 mm/min. Statistical Analysis Used: Statistical analysis included One-way ANOVA, followed by the Scheffe post-hoc test with P < 0.05. Results: All dentin desensitizers showed significantly different values: Pro-Argin (4.10 Megapascals [Mpa] < CPP-ACP (4.01 mpa < GLU based primer (3.87 Mpa < Virgin dentin (3.65 Mpa < LASER (3.37 Mpa. Conclusions : On comparing the effect of prepared virgin dentin, GLU based primer, CPP-ACP, LASER and Pro-Argin on the retention of complete cast metal crowns luted with glass ionomer cement on prepared teeth, it can be concluded that Pro-Argin and CPP-ACP showed the best retention in this in vitro study.

  16. Prospective-pricing strategies for hospital and departmental effectiveness: the physician's response.

    Science.gov (United States)

    Shapleigh, C

    1985-10-01

    Physician-practice patterns are discussed, and programs of decentralization designed to reduce ancillary use are described. The New England Medical Center (NEMC) conducted a study with two other major hospitals in Boston comparing physician-practice patterns for patients who had had carotid endarterectomies. The indications for surgery for these patients did not appear to be different among the hospitals; however, average charges and length of stay varied considerably. Operating-room time and postoperative management also varied substantially. Strategies to change physician-practice patterns must address the issues of incentives to physicians and hospitals. At NEMC, a program of decentralization is being implemented that involves physician participation in budgeting hospital resources. A program of product pricing has been developed, whereby the NEMC offers an HMO a fixed price for certain kinds of cases upon admission. A daily use report was started to report resource use for specific cases compared with annual medians for that type of case. Case types from many different surgical specialties are involved. The reports show physicians the difference between the actual and expected costs in terms of variances. The NEMC has reoriented its budgeting process to include clinical divisions. Clinical services are planning to budget the use of intermediate products across different cost centers. The clinical budgeting program makes the planning process more objective, lowers the use of ancillary services, and reduces costs.

  17. On-call work and physicians' turnover intention: the moderating effect of job strain.

    Science.gov (United States)

    Heponiemi, Tarja; Presseau, Justin; Elovainio, Marko

    2016-01-01

    Physician shortage and turnover are major problems worldwide. On-call duties may be among the risk factors of high turnover rates among physicians. We investigated whether having on-call duties is associated with physicians' turnover intention and whether job strain variables moderate this association. The present study was a cross-sectional questionnaire study among 3324 (61.6% women) Finnish physicians. The analyses were conducted using analyses of covariance adjusted for age, gender, response format, specialization status and employment sector. The results showed that job strain moderated the association between being on-call and turnover intention. The highest levels of turnover intention were among those who had on-call duties and high level of job strain characterized by high demands and low control opportunities. The lowest levels of turnover intention were among those who were not on-call and who had low strain involving low demands and high control. Also, job demands moderated the association between being on-call and turnover intention; turnover intention levels were higher among those with on-call duties and high demands than those being on-call and low demands. To conclude, working on-call was related to physicians' turnover intention particularly in those with high job strain. Health care organizations should focus more attention on working arrangements and scheduling of on-call work, provide a suitable working pace and implement means to increase physicians' participation and control over their job.

  18. Urinary Retention

    Science.gov (United States)

    ... 2011. [4] Mevcha A, Drake MJ. Etiology and management of urinary retention in women. Indian Journal of Urology. 2010;26(2):230–235. August ... 30 a.m. to 5 p.m. eastern time, M-F Follow Us NIH… Turning Discovery Into ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

  19. Effect of response format for clinical vignettes on reporting quality of physician practice

    Directory of Open Access Journals (Sweden)

    Durieux Pierre

    2009-07-01

    Full Text Available Abstract Background Clinical vignettes have been used widely to compare quality of clinical care and to assess variation in practice, but the effect of different response formats has not been extensively evaluated. Our objective was to compare three clinical vignette-based survey response formats – open-ended questionnaire (A, closed-ended (multiple-choice questionnaire with deceptive response items mixed with correct items (B, and closed-ended questionnaire with only correct items (C – in rheumatologists' pre-treatment assessment for tumor-necrosis-factor (TNF blocker therapy. Methods Study design: Prospective randomized study. Setting: Rheumatologists attending the 2004 French Society of Rheumatology meeting. Physicians were given a vignette describing the history of a fictitious woman with active rheumatoid arthritis, who was a candidate for therapy with TNF blocking agents, and then were randomized to receive questionnaire A, B, or C, each containing the same four questions but with different response formats, that asked about their pretreatment assessment. Measurements: Long (recommended items and short (mandatory items checklists were developed for pretreatment assessment for TNF-blocker therapy, and scores were expressed on the basis of responses to questionnaires A, B, and C as the percentage of respondents correctly choosing explicit items on these checklists. Statistical analysis: Comparison of the selected items using pairwise Chi-square tests with Bonferonni correction for variables with statistically significant differences. Results Data for all surveys distributed (114 As, 118 Bs, and 118 Cs were complete and available for analysis. The percentage of questionnaire A, B, and C respondents for whom data was correctly complete for the short checklist was 50.4%, 84.0% and 95.0%, respectively, and was 0%, 5.0% and 5.9%, respectively, for the long version. As an example, 65.8%, 85.7% and 95.8% of the respondents of A, B, and C

  20. Doctor knows best: physician endorsements, public opinion, and the politics of comparative effectiveness research.

    Science.gov (United States)

    Gerber, Alan S; Patashnik, Eric M; Doherty, David; Dowling, Conor M

    2014-02-01

    The Obama administration has made a major investment in comparative effectiveness research (CER) to learn what treatments work best for which patients. CER has the potential to reduce wasteful medical spending and improve patient outcomes, but the political sustainability of this initiative remains unclear because of concerns that it will threaten the doctor-patient relationship. An unresolved question is whether it is possible to boost public support for the use of CER as a cost-control strategy. We investigate one potential source of public support: Americans' trust in physicians as faithful agents of patient interests. We conducted two national surveys to explore the public's confidence in doctors compared to other groups. We find that doctors are viewed as harder workers, more trustworthy, and more caring than other professionals. Through survey experiments, we demonstrate that the support of doctors' groups for proposals to control costs and use CER have a greater influence on aggregate public opinion than do cues from political actors including congressional Democrats, Republicans, and a bipartisan commission. Our survey results suggest that the medical profession's stance will be an important factor in shaping the political viability of efforts to use CER as a tool for health care cost control.

  1. Exploring the Effects of Hope on GPA and Retention among College Undergraduate Students on Academic Probation

    Directory of Open Access Journals (Sweden)

    Holly Seirup

    2011-01-01

    Full Text Available This study analyzed the impact of hope on the academic achievement and retention of 235 students on academic probation at a private Northeastern university. Probationary students were enrolled in a mandatory online course designed to facilitate academic and nonacademic skills, to improve student GPAs and overall retention. The Hope Scale (Snyder et al. (1991 was administered to identify whether students with greater levels of hope would experience an increase in academic success upon completion of the course. Students were broken down into groups of high, medium, and low hope based on their scores on the instrument. Results showed students who completed the course were more likely to be retained than those who did not complete the course, had a slight increase in GPA by the end of the semester, and high-hope students showed the greatest overall gain in GPAs.

  2. Effects of work burden, job strain and support on depressive symptoms and burnout among Japanese physicians

    Directory of Open Access Journals (Sweden)

    Yasuaki Saijo

    2014-12-01

    Full Text Available Objectives: Days off, on call, night duty, working hours and job stress can affect physicians’ mental health, and support from supervisors and co-workers may have a buffering effect. This study elucidates whether job strain and job factors affect physicians’ mental health, and whether support from supervisors and co-workers has a protective effect on their mental health. Material and Methods: The subjects included 494 physicians. The Brief Job Stress Questionnaire (BJSQ was used to evaluate job demand, job control and support. High job strain was defined as a combination of high job demand and low job control. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory- General Survey was used to evaluate burnout. Possible confounder adjusted logistic regression analyses were performed to obtain odds ratios for depressive symptoms and burnout. Results: As per the analysis, high job strain had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for depressive symptoms. High job strain and having only 2–4 days off per month (compared to > 8 days off per month had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for burnout. Conclusions: High job strain was related to depressive symptoms and burnout, and support from co-workers had a buffering effect on depressive symptoms and burnout. An inadequate number of days off was related to burnout. Assessment of job strain may be a good tool to measure physicians’ mental health, and a sufficient number of days off may be needed to prevent burnout.

  3. Life-Work Balance and the Effects on Retention in the Navy Nurse Corps

    Science.gov (United States)

    2017-03-01

    simply not enough people who have the clinical know how and experience to see these issues through or to even recognize them. This puts tremendous... how identification of work-life/life-work balance1 issues , specifically within the Navy Nurse Corps (NC), may assist the DON and the NC with... issues regarding retention and quality of life affecting both sexes. The reason for the removal of the specific gender focus is the unique makeup of

  4. Effects of an additional small group discussion to cognitive achievement and retention in basic principles of bioethics teaching methods

    Directory of Open Access Journals (Sweden)

    Dedi Afandi

    2009-03-01

    Full Text Available Aim The place of ethics in undergraduate medical curricula is essential but the methods of teaching medical ethics did not show substantial changes. “Basic principles of bioethics” is the best knowledge to develop student’s reasoning analysis in medical ethics In this study, we investigate the effects of an additional small group discussion in basic principles of bioethics conventional lecture methods to cognitive achievement and retention. This study was a randomized controlled trial with parallel design. Cognitive scores of the basic principles of bioethics as a parameter was measured using basic principles of bioethics (Kaidah Dasar Bioetika, KDB test. Both groups were attending conventional lectures, then the intervention group got an additional small group discussion.Result Conventional lectures with or without small group discussion significantly increased cognitive achievement of basic principles of bioethics (P= 0.001 and P= 0.000, respectively, and there were significant differences in cognitive achievement and retention between the 2 groups (P= 0.000 and P= 0.000, respectively.Conclusion Additional small group discussion method improved cognitive achievement and retention of basic principles of bioethics. (Med J Indones 2009; 18: 48-52Keywords: lecture, specification checklist, multiple choice questions

  5. Echoic memory in the rat: effects of inspection time, retention interval, and the spectral composition of masking noise.

    Science.gov (United States)

    O'Connor, K; Ison, J R

    1991-10-01

    Memory for tones (1100 vs. 2330 Hz) was studied in 4 rats (Rattus norvegicus), as affected by the durations of both target tones (30 to 620 ms) and noise-filled retention intervals (0 to 480 ms). With a 0-ms delay, performance was near asymptotic with the 30-ms tone, but the memory of this brief tone suffered a massive decrement at retention intervals as brief as 60 ms; in contrast, memory for the 340-ms tone was stable for at least 240 ms. If the retention interval was filled by band-stop noise (with targets presented in the spectral gap), then the rat's memory for brief tones was superior to that obtained with the standard broad-band noise filler, and band-stop noise was better than a band-pass noise that had the tones embedded in the region of its spectral energy. These findings are consistent with the hypotheses that auditory memory in the rat consists of a transient sensorylike echoic store and a short-term store more resistant to the effects of retroactive interference.

  6. The effects of nutritional factors on absorption, retention and excretion of organic and inorganic mercury in mice and rats

    International Nuclear Information System (INIS)

    Gjedsted Hoejbjerg, S.

    1995-01-01

    The industrial use of mercury compounds is declining, but naturally occurring mercury always exists. Earlier experiments have demonstrated effects of dietary fibres, high protein diets and dry milk on whole-body retention and relative organ distribution of orally and intraperitoneally administered methylmercy chloride and mercuric chloride were determined in female NMRI/born mice fed semisynthetic diets in which the energy contribution from protein (soy protein, caseinate or fish protein), or from lipids (coconut oil, cod liver oil, or soy oil), was varied or to which different amounts and types of dietary fibres (cellulose, 60% fibre tablet, pectin K, oat, corn and soy fibre) were added. The whole-body retention of both organic and inorganic mercury depended on the diet composition. Thus, highly significant reductions in whole-body retention of mercury were observed in groups of mice orally administered methylmercury chloride and fed diets with cod liver oil as lipid energy source, or diets with high amounts of soy protein or fish protein as protein energy source, compared to groups fed diets with coconut oil, soy oil, caseinate and lower amounts of fish or soy protein. In most cases, the relative organ distribution was not significantly affected by the diet composition, except that the fractional mercury deposition in the brain was increased in the groups receiving high amounts of cod liver oil compared to the group fed high amounts of coconut oil. (au) 112 p

  7. The Effect of Typographical Features of Subtitles on Nonnative English Viewers’ Retention and Recall of Lyrics in English Music Videos

    Directory of Open Access Journals (Sweden)

    Farshid Tayari Ashtiani

    2017-10-01

    Full Text Available The goal of this study was to test the effect of typographical features of subtitles including size, color and position on nonnative English viewers’ retention and recall of lyrics in music videos. To do so, the researcher played a simple subtitled music video for the participants at the beginning of their classes, and administered a 31-blank cloze test from the lyrics at the end of the classes. In the second test, the control group went through the same procedure but experimental group watched the customized subtitled version of the music video. The results demonstrated no significant difference between the two groups in the first test but in the second, the scores remarkably increased in the experimental group and proved better retention and recall. This study has implications for English language teachers and material developers to benefit customized bimodal subtitles as a mnemonic tool for better comprehension, retention and recall of aural contents in videos via Computer Assisted Language Teaching approach.

  8. The Effect of Abutment Surface Roughness on the Retention of Implant-Supported Crowns Cemented with Provisional

    Directory of Open Access Journals (Sweden)

    Seyyed Mohammad Abrisham

    2012-09-01

    Full Text Available Introduction: Surface roughness can increase the retention of castings by ridges and grooves that are microretentive. This study compared the retention of implant-supported crowns when used with 3 different surface roughness abutments and one temporary cement. Methods: Thirty solid abutments (ITI, 4 mm high, were divided into three groups randomly. In the first group, 10 abutments were roughened with sandblast (50-µm aluminum oxide and in the second group, 10 abutments were roughened with diamond bur. The third group had no surface treatment. Then, thirty implant fixture analogs (ITI were placed in the center of acrylic cylinders. After that a solid abutment was tightened on the each fixture analog with 35 N/cm force. Thirty base metal crowns were made on the 4 mm ITI abutment analogs using plastic coping. The prepared copings were cemented on the abutments by TempBond temporary cement and finally, crowns were pulled from the abutment in a universal test machine at a cross speed of 0.5cm/min. Results: The mean tensile strength in sandblasted, bur treated, and control group were 64.38±8, 91.37±7.19, and 58.61±1.93, respectively. Bur treated group showed higher tensile strength in comparison with two other groups. Conclusion: Surface modification of implant abutment by diamond bur may be an effective method to increase retention of crown when TempBond is used.

  9. The Effect of Abutment Surface Roughness on the Retention of Implant-Supported Crowns Cemented with Provisional Luting Cement

    Directory of Open Access Journals (Sweden)

    Jalil Ganbarzadeh

    2013-01-01

    Full Text Available Introduction: Surface roughness can increase the retention of castings by ridges and grooves that are microretentive. This study compared the retention of implant-supported crowns when used with 3 different surface roughness abutments and one temporary cement. Methods: Thirty solid abutments (ITI, 4 mm high, were divided into three groups randomly. In the first group, 10 abutments were roughened with sandblast (50-µm aluminum oxide and in the second group, 10 abutments were roughened with diamond bur. The third group had no surface treatment. Then, thirty implant fixture analogs (ITI were placed in the center of acrylic cylinders. After that a solid abutment was tightened on the each fixture analog with 35 N/cm force. Thirty base metal crowns were made on the 4 mm ITI abutment analogs using plastic coping. The prepared copings were cemented on the abutments by TempBond temporary cement and finally, crowns were pulled from the abutment in a universal test machine at a cross speed of 0.5cm/min. Results: The mean tensile strength in sandblasted, bur treated, and control group were 64.38±8, 91.37±7.19, and 58.61±1.93, respectively. Bur treated group showed higher tensile strength in comparison with two other groups. Conclusion: Surface modification of implant abutment by diamond bur may be an effective method to increase retention of crown when TempBond is used.

  10. The effect of additives on release and in vitro skin retention of flavonoids from emulsion and gel semisolid formulations.

    Science.gov (United States)

    Dyja, R; Jankowski, A

    2017-08-01

    To assess the effect of two different additives (propylene glycol (PG) and polyethylene glycol 400 (PEG 400)) on release and in vitro skin retention of quercetin and chrysin from semisolid bases (amphiphilic creams and acidic carbomer gels). For obtaining semisolid formulations, flavonoids were pre-dissolved in the liquid (PG or PEG 400) or directly suspended in the semisolid base. Three chrysin formulations ('cream 0', 'PG-cream' and 'PEG 400-cream') and five quercetin formulations ('cream 0', 'PG cream', 'PEG 400 cream', 'gel 0' and 'PG gel') were prepared. The release studies were carried out in Franz diffusion cells by means of a cellulose membrane. The porcine ear skin was used in in vitro skin retention studies. The dissolution was a prerequisite to increase the release rates of tested flavonoids from obtained semisolid formulations. The cumulative amount of chrysin released after 6 h from 'PEG 400 cream' containing partly dissolved form of that flavonoid was higher than that from 'cream 0' or 'PG cream' containing its suspended form. The formulations containing quercetin dissolved in PG ('PG cream', 'PG gel') or PEG 400 ('PEG 400 cream') exhibited higher release rates of that flavonoid than corresponding semisolid suspensions ('cream 0' or 'gel 0'). The effects of both liquid additives (PG and PEG 400) on the cumulative amount of quercetin released after 6 h were comparable. However, there was no correlation between the release rate and the skin retention. The amounts of the flavonoids found in the skin were strongly affected by the type of the used solvent. While PG increased the skin retention of both flavonoids, PEG 400 had no effect on chrysin skin retention and delayed quercetin skin absorption. The proper choice of the solvent added to the semisolid base is crucial for enhanced skin delivery of the tested flavonoids. PG is more efficient absorption promoter than PEG 400 of both chrysin and quercetin. © 2017 Society of Cosmetic Scientists and the Soci

  11. The effect of physician feedback and an action checklist on diabetes care measures.

    Science.gov (United States)

    Schectman, Joel M; Schorling, John B; Nadkarni, Mohan M; Lyman, Jason A; Siadaty, Mir S; Voss, John D

    2004-01-01

    The objective was to evaluate whether physician feedback accompanied by an action checklist improved diabetes care process measures. Eighty-three physicians in an academic general medicine clinic were provided a single feedback report on the most recent date and result of diabetes care measures (glycosylated hemoglobin [A1c], urine microalbumin, serum creatinine, lipid levels, retinal examination) as well as recent diabetes medication refills with calculated dosing and adherence on 789 patients. An educational session regarding the feedback and adherence information was provided. The physicians were asked to complete a checklist accompanying the feedback on each of their patients, indicating requested actions with respect to follow-up, testing, and counseling. The physicians completed 82% of patient checklists, requesting actions consistent with patient needs on the basis of the feedback. Of the physicians, 93% felt the patient information and intervention format to be useful. The odds of urine microalbumin testing, serum creatinine, lipid profile, A1c, and retinal examination increased in the 6 months after the feedback. The increase was sustained at 1 year only for microalbumin and retinal exams. There was no significant change in refill adherence for the group overall after the feedback, although adherence did improve among patients of physicians attending the educational session. No significant change was noted in lipid or A1c levels during the study period. In conclusion, a simple physician feedback tool with action checklist can be both helpful and popular for improving rates of diabetes care guideline adherence. More complex interventions are likely required to improve diabetes outcomes.

  12. Effects of temperature and surface contamination on D retention in ultrathin Li films on TZM

    Energy Technology Data Exchange (ETDEWEB)

    Capece, A.M., E-mail: acapece@pppl.gov [Princeton Plasma Physics Laboratory, Princeton, NJ (United States); Roszell, J.P. [Princeton University, Department of Chemical and Biological Engineering, Princeton, NJ (United States); Skinner, C.H. [Princeton Plasma Physics Laboratory, Princeton, NJ (United States); Koel, B.E. [Princeton University, Department of Chemical and Biological Engineering, Princeton, NJ (United States)

    2015-08-15

    In this work, we investigate deuterium retention at the Mo–Li interface by studying thin Li films three monolayers thick on a TZM Mo alloy. Li films at temperatures between 315 and 460 K were exposed to a deuterium ion beam and D retention was measured using temperature programmed desorption. In the absence of oxygen, D is retained as LiD, and the relative amount of retained D decreases with increasing substrate temperature. In three-monolayer thick lithium oxide films, the amount of D retained was 2.5 times higher than the amount retained as LiD in the metallic Li film. However, oxygen reduces the thermal stability of D in the film, causing D{sub 2}O and D{sub 2} to be released from the surface at temperatures 150–200 K below the LiD decomposition temperature. These results highlight the importance of maintaining a metallic Li layer for high D retention in Li films on TZM at elevated temperatures.

  13. EFFECTS OF ANISOMYCIN ON RETENTION OF THE PASSIVE-AVOIDANCE HABIT AS A FUNCTION OF AGE

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Hasker P.; Rosenzweig, Mark R.; Kinkade, Patrick T.; Bennett, Edward L.

    1980-09-01

    Three age groups of male Swiss albino CD-1 mice (2-3 mo, 6-7 mo, and 14-15 mo) were treated with a 120 mg/kg dose of the protein synthesis inhibitor anisomycin or with an equal volume of saline at various times before and after training (20 min pretraining, 0, 10, 30, and 180 min posttraining) in a shock motivated passive-avoidance task. Young (2-3 mo) and intermediate-aged (6-7 mo) mice treated with anisomycin before or immediately after training demonstrated impaired retention at a 7 day test, but retention was normal for mice injected 10, 30, or 180 min posttraining. The older mice (14-15 mo) showed similar results, with one exception: Those older mice injected with anisomycin 10 min posttraining were significantly impared in retention as compared to older saline controls and to identically treated young or intermediate-aged mice. The prolonged gradient of retrograde amnesia demonstrated by older mice could not be accounted for by impaired acquisition, impaired short-term memory, altered spontaneous locomotor activity, or differential inhibition of brain protein synthesis.

  14. Effect of alkali metal content of carbon on retention of iodine at high temperatures

    International Nuclear Information System (INIS)

    Evans, A.G.

    1975-01-01

    Activated carbon for filters in reactor confinement systems is intentionally impregnated with iodine salts to enhance the removal of radioiodine from air streams containing organic iodides. When a variety of commercial impregnated carbons were evaluated for iodine retention at elevated temperatures (4 hours at 180 0 C), wide variations in iodine penetration were observed. The alkali metal and iodine content of carbon samples was determined by neutron activation analysis, and a strong correlation was shown between the atom ratio of iodine to alkali metals in the carbons and the high-temperature retention performance. Carbons containing excess alkali (especially potassium) have iodine penetration values 10 to 100 times lower than carbons containing excess iodine. Both low I/K ratios and high pH values were shown essential to high efficiency iodine retention; therefore, conversion of elemental iodine to ionic iodine is the basic reaction mechanism. The natural high K + content and high pH coconut carbons make coconut the preferred natural base material for nuclear air cleaning applications. Studies show, however, that treatment of low potassium carbons with a mixture of KOH and I 2 may produce a product equal to or better than I 2 -impregnated coconut carbons at a lower cost. (U.S.)

  15. Effect of dose on lead retention and distribution in suckling and adult female mice

    International Nuclear Information System (INIS)

    Keller, C.A.; Doherty, R.A.

    1980-01-01

    Single doses of lead (trace to 445 mg/kg) were administered per os to suckling and adult mice. Both groups exhibited dose-independent lead retention when doses of 4 to 445 mg/kg were administered. However, developmental differences in the fraction of initial dose (FID) retained were evident for all doses administered. A much larger FID was retained in both age groups following administration of carrier-free 203 Pb. The results are consistent with a mechanism of gastrointestinal lead absorption comprising two or more processes. Developmental differences were also observed in organ lead concentration relative to whole body concentration for kidneys, skull and brain 6 days following lead administration. Lead retentions (relative to whole body retention) in brain and in bone were linearly related to dose of lead administered in both suckling and adult age groups. Though uptake of lead into brain and into femur was observed to be directly related to dose over a wide range, relative blood lead concentrations were not linearly correlated with dose administered. The relationships between lead concentrations of blood and organ(s) were also shown to be nonlinear relative to dose. However, blood lead concentration was found to be a reliable indicator of kidney and liver lead concentrations following an acute lead exposure

  16. Effectiveness of a multifaceted implementation strategy on physicians? referral behavior to an evidence-based psychosocial intervention in dementia: a cluster randomized controlled trial

    OpenAIRE

    D?pp, Carola ME; Graff, Maud JL; Teerenstra, Steven; Nijhuis-van der Sanden, Maria WG; Olde Rikkert, Marcel GM; Vernooij-Dassen, Myrra JFJ

    2013-01-01

    BACKGROUND: To evaluate the effectiveness of a multifaceted implementation strategy on physicians' referral rate to and knowledge on the community occupational therapy in dementia program (COTiD program). METHODS: A cluster randomized controlled trial with 28 experimental and 17 control clusters was conducted. Cluster included a minimum of one physician, one manager, and two occupational therapists. In the control group physicians and managers received no interventions and occupational therap...

  17. Effects of a physician-led home care team on terminal care.

    Science.gov (United States)

    Zimmer, J G; Groth-Juncker, A; McCusker, J

    1984-04-01

    Inconsistent results in studies of cost-effectiveness of home health care have led to the need for identification of target populations for whom cost-savings can be anticipated if expanded home care programs are introduced. This analysis of results of a randomized controlled study of efficacy of a physician/geriatric nurse practitioner/social worker home care team identifies such a potential target population. The team provides round-the-clock on-call medical services in the home when needed, in addition to usual nursing and other home care services, to home-bound chronically or terminally ill elderly patients. Overall health services utilization and estimated costs were not substantially different for the patients who did not die while in the study; however, for those who did die, team patients had considerably lower rates of hospitalization and overall cost than controls, and more frequently died at home. Of 21 team and 12 control patients who died but had at least two weeks of utilization experience in the study, team patients had about half the number of hospital days compared with controls during the terminal two weeks, and although they had more home care services, had only 69 per cent of the estimated total health care costs of the controls. Satisfaction with care received was significantly greater among the total group of team patients, and especially among their family caretakers, than among controls. This model is effective in providing appropriate medical care for seriously ill and terminal patients, and in enabling them to die at home if they so wish, while at the same time reducing costs of care during the terminal period.

  18. Death by request in The Netherlands: facts, the legal context and effects on physicians, patients and families

    OpenAIRE

    Kimsma, G.K.

    2010-01-01

    In this article I intend to describe an issue of the Dutch euthanasia practice that is not common knowledge. After some general introductory descriptions, by way of formulating a frame of reference, I shall describe the effects of this practice on patients, physicians and families, followed by a more philosophical reflection on the significance of these effects for the assessment of the authenticity of a request and the nature of unbearable suffering, two key concepts in the procedure towards...

  19. The effects of flow-path modification on water-quality constituent retention in an urban stormwater detention pond and wetland system, Orlando, Florida

    Science.gov (United States)

    Gain, W.S.

    1996-01-01

    Changes in constituent retention in a wet stormwater-detention pond and wetland system in Orlando, Florida, were evaluated following the 1988 installation of a flow barrier which approximately doubled the flow path and increased detention time in the pond. The pond and wetland were arranged in series so that stormwater first enters the pond and overflows into the wetland before spilling over to the regional stream system. Several principal factors that contribute to constituent retention were examined, including changes in pond-water quality between storms, stormwater quality, and pond-water flushing during storms. A simple, analytical pond-water mixing model was used as the basis for interpreting changes in retention efficiencies caused by pond modification. Retention efficiencies were calculated by a modified event-mean concentration efficiency method using a minimum variance unbiased estimator approach. The results of this study generally support the hypothesis that changes in the geometry of stormwater treatment systems can significantly affect the constituent retention efficiency of the pond and wetland system. However, the results also indicate that these changes in efficiency are caused not only by changes in residence time, but also by changes in stormwater mixing and pond water flushing during storms. Additionally, the use of average efficiencies as indications of treatment effectiveness may fail to account for biases associated with sample distribution and independent physical properties of the system, such as the range and concentrations of constituents in stormwater inflows and stormwater volume. Changes in retention efficiencies varied among chemical constituents and were significantly different in the pond and wetland. Retention efficiency was related to inflow concentration for most constituents. Increased flushing of the pond after modification caused decreases in retention efficiencies for constituents that concentrate in the pond between storms

  20. The gendered realities and talent management imperatives of women physicians.

    Science.gov (United States)

    Hoff, Timothy; Scott, Sarah

    2016-01-01

    U.S. medicine is increasingly a gender-balanced profession with half of all medical school graduates now female. Despite this reality and the potentially transformative nature of a large female physician cohort in U.S. health care, there is less examination of their workplace realities and the key talent management strategies for health care organizations employing women physicians. First, we identify current knowledge about U.S. women physician satisfaction, role challenges, and work tradeoffs. Gender theory is used to help interpret these workplace realities. Second, we use this information to identify talent management strategies health care organizations might consider to mitigate the realities and provide greater support for women physicians. To facilitate our analysis, we conducted a narrative review of published research that includes analysis focused on U.S. women physicians for the time period 2006-2014. Applying ideas from gender theory, we extrapolated key findings from that research related to three issues: satisfaction, role challenges, and tradeoffs. Then we synthesized the findings to identify general talent management strategies that could address these dynamics proactively while enhancing recruitment and retention with respect to women physicians. U.S. women physicians express strong levels of satisfaction, particularly with their careers, at the same time they continue to experience gender-based inequities, role challenges, and lack of work-life balance in their chosen specialty fields. Lack of suitable role models and appropriate mentoring for women physicians, in addition to barriers to career advancement, are also prevalent across different medical specialties. Similar to other occupations and industries, gender-based inequities and role strains are very real issues for women physicians. Health care organizations must acknowledge these issues and employ effective talent management strategies aimed at women doctors if they are to be viewed as an

  1. The effect of hydraulic retention time in onsite wastewater treatment and removal of pharmaceuticals, hormones and phenolic utility substances.

    Science.gov (United States)

    Ejhed, H; Fång, J; Hansen, K; Graae, L; Rahmberg, M; Magnér, J; Dorgeloh, E; Plaza, G

    2018-03-15

    Micropollutants such as pharmaceuticals, hormones and phenolic utility chemicals in sewage water are considered to be an emerging problem because of increased use and observed adverse effects in the environment. The study provides knowledge on the removal efficiency of micropollutants with a range of physical and chemical properties in three commercially available onsite wastewater treatment facilities (OWTFs), tested on influent wastewater collected from 2500 person equivalents in Bildchen, Germany. A longer hydraulic retention time would in theory be expected to have a positive effect, and this study presents results for three different OWTFs in full-scale comparable tests under natural conditions. A range of 24 different pharmaceuticals, five phenols and three hormones were analyzed. Flow-proportional consecutive sampling was performed in order to determine the removal efficiency. Twenty-eight substances were detected in the effluent wastewater out of 32 substances included. Average effluent concentrations of Simvastatin, Estrone, Estradiol and Ethinylestradiol were above the indicative critical-effect concentration of pharmacological effect on fish in all facilities. Average effluent concentrations of both Diclofenac and Estradiol were higher than the Environmental Quality Standards applied in Sweden (190-240 times and 9-35 times respectively). The removal efficiency of micropollutants was high for substances with high logK ow , which enhance the adsorption and removal with sludge. Low removal was observed for substances with low logK ow and acidic characteristics, and for substances with stabilizing elements of the chemical structure. Facilities that use activated sludge processes removed hormones more efficiently than facilities using trickling filter treatment technique. Moreover, longer hydraulic retention time increased the removal of pharmaceuticals, hormones, turbidity and total nitrogen. Removal of Caffeine, Ibuprofen, Estrone, Naproxen and Estradiol

  2. Physician contact by older Asian Americans: the effects of perceived mental health need

    Directory of Open Access Journals (Sweden)

    Duy Nguyen

    2010-11-01

    Full Text Available Duy NguyenSilver School of Social Work, New York University, New York, NY, USAObjective: The use of physicians is more common than of behavioral specialists, especially in underserved Asian American communities. Despite a rapidly aging Asian American population, research has overlooked older people. This study examines the way mental health need affects the number of physician contacts by older Asian Americans.Method: This study uses data on self-identified Asian Americans aged over age 50 years derived from the 2001 California Health Interview Survey. A total of 1191 Asian Americans from Chinese, Filipino, Korean, and Vietnamese backgrounds were studied. Replicate weights were applied to account for the survey’s complex sampling methods. Linear regression was used to identify the number of physician contacts.Results: Overall, respondents had seen a doctor an average of five times in the previous 12 months; 7% perceived that they had a mental health need. Perceiving a mental health need was associated with a decreased number of physician contacts for Filipino and Korean Americans.Conclusion: This study revealed interethnic differences among older Asian Americans’ contact with physicians. As older Filipino and Korean Americans who perceive a mental health need have fewer contacts with their physician, correctly identifying mental health needs in the health care system for these groups is crucial. Health and mental health professionals can work toward reducing mental health disparities by accounting for older Asian Americans’ help-seeking patterns when designing evidence-based interventions.Keywords: minority groups, Asians, health service use

  3. Association between late effects assessed by physicians and quality of life reported by head-and-neck cancer survivors

    DEFF Research Database (Denmark)

    Daugaard, Rikke; Kjaer, Trille; Johansen, Christoffer

    2017-01-01

    BACKGROUND: Many survivors of head-and-neck cancer (HNC) suffer from late effects. Their overall quality of life deteriorates during treatment, followed by a slow recovery up to five years after treatment. We examined the association between the severity of physician-assessed late effects...... and the health-related quality of life (HRQoL) reported by survivors of HNC. MATERIAL AND METHODS: The analysis was based on data collected during follow-up for 136 survivors of cancer in the oral cavity, pharynx, larynx, or salivary glands. Physicians' assessments of dysphagia, xerostomia, fibrosis...... models were used to examine the association between the severity of each late effect and HRQoL. RESULTS: Quality of life was decreased among patients with moderate to severe dysphagia compared to patients without dysphagia (-16 points; 95% CI -21;-3). Also role functioning (-20 points; 95% CI -38...

  4. Effect of boundary conditions on measured water retention behavior within soils

    Science.gov (United States)

    Galindo-torres, S.; Scheuermann, A.; Pedroso, D.; Li, L.

    2013-12-01

    conducted to examine how the fluids are distributed inside the porous medium. This distribution is quantified by the measurement of the interfacial area which behaves also differently between the two configurations. Hassanizadeh proposed an unique relation among saturation, suction and interfacial area, which has been validated experimentally [4]. However we found that such relation is not 'unique' and instead depends on the flow and boundary conditions. While future experimental tests on these results need to be carried out, the simulated SWCC behaviors raise serious questions about the current experimental set-up for measuring the soil water retention characteristics. References. 1. Serrano, S.E., Modeling infiltration with approximate solutions to Richard's equation. Journal of Hydrologic Engineering, 2004. 9(5): p. 421-432. 2. Galindo-Torres, S.A., et al., A Lattice Boltzmann model for studying transient effects during imbibition-drainage cycles in unsaturated soils. Computer Physics Communications, 2013. 184(4): p. 1086-1093. 3. Drake, S.S., D.M. O'Carroll, and J.I. Gerhard, Wettability contrasts between fresh and weathered diesel fuels. Journal of contaminant hydrology, 2012. 4. Culligan, K.A., et al., Interfacial area measurements for unsaturated flow through a porous medium. Water Resources Research, 2004. 40(12).

  5. Effects of HMO market penetration on physicians' work effort and satisfaction.

    Science.gov (United States)

    Hadley, J; Mitchell, J M

    1997-01-01

    We investigate whether geographic variations in health maintenance organization (HMO) market penetration are associated with three aspects of physicians' practices: number of hours worked per year, number of patients seen per week, and satisfaction with the current practice. Based on multivariate regression analysis of data for 4,373 patient care physicians (under age forty-five) from a national random sample surveyed in 1991, we estimate that a doubling of the average level of HMO penetration is associated with statistically significant differences of 4 percent fewer annual hours, 13.7 percent fewer patients seen per week, and a 20 percent greater likelihood of not being very satisfied with one's current practice.

  6. Effect of Infrared Blanching on Enzyme Activity and Retention of β-Carotene and Vitamin C in Dried Mango.

    Science.gov (United States)

    Guiamba, Isabel R F; Svanberg, Ulf; Ahrné, Lilia

    2015-06-01

    The objectives of this work were to evaluate infrared (IR) dry blanching in comparison with conventional water blanching prior to hot air drying of mango to inactivate polyphenol oxidase (PPO) and ascorbic acid oxidase (AAO) enzymes, and to study its effect on color change and retention of vitamin C and β-carotene. Mango cylinders were blanched under similar temperature-time conditions either by IR heating or by immersion in a water bath during 2 min at 90 °C (high-temperature-short-time-HTST) or for 10 min at 65 °C (low-temperature-long-time-LTLT). After blanching mango was hot air dried at 70 °C. PPO was completely inactivated during the blanching treatments, but AAO had a moderate remaining activity after LTLT treatment (∼30%) and a low remaining activity after HTST treatment (9% to 15%). A higher retention of vitamin C was observed in mango subjected to IR dry blanching, 88.3 ± 1.0% (HTST) and 69.2 ± 2.9% (LTLT), compared with water blanching, 61.4 ± 5.3% (HTST) and 50.7 ± 9.6% (LTLT). All-trans-β-carotene retention was significantly higher in water blanched dried mango, 93.2 ± 5.2% (LTLT) and 91.4 ± 5.1% (HTST), compared with IR dry blanched, 73.6 ± 3.6% (LTLT) and 76.9 ± 2.9% (HTST). Increased levels of 13-cis-β-carotene isomer were detected only in IR dry blanched mango, and the corresponding dried mango also had a slightly darker color. IR blanching of mango prior to drying can improve the retention of vitamin C, but not the retention of carotenoids, which showed to be more dependent on the temperature than the blanching process. A reduction of drying time was observed in LTLT IR-blanching mango. © 2015 Institute of Food Technologists®

  7. Effect of Pharmacist Participation During Physician Rounds and Prescription Error in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Marlina A. Turnodihardjo

    2016-09-01

    Full Text Available Patient’s safety is now a prominent issue in pharmaceutical care because of adverse drug events that is common in hospitalized patients. Majority of error are likely occured during prescribing, which is the first stage of pharmacy process. Prescription errors mostly occured in an Intensive Care Unit (ICU, which is due to the severity of the illness of its patients as well as the large number of medications prescribed. Pharmacist participation actually could reduce prescribing error made by doctors. The main objective of this study was to determine the effect of pharmacist participation during physician rounds on prescription errors in the ICU. This study was a quasi-experimental design with one group pre-post test. A prospective study was conducted from April to May 2015 by screening 110 samples of orders. Screening was done to identify type of prescription errors. Prescription error was defined as error in the prescription writing process – incomplete information and not according to agreement. Mann-Whitney test was used to analyze the differences in prescribing errors. The results showed that there was the differences between prescription errors before and during the pharmacist participation (p<0.05. There was also a significant negative correlation between the frequency of pharmacist recommendation on drug ordering and prescription errors (r= –0.638; p<0.05. It means the pharmacist participation was one of the strategies that can be adopted to prevent in prescribing errors and implementation of collaboration between both doctors and pharmacists. In other words, the supporting hospital management system which would encourage interpersonal communication among health care proffesionals is needed.

  8. Mobility of US Rural Primary Care Physicians During 2000-2014.

    Science.gov (United States)

    McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Bazemore, Andrew W

    2017-07-01

    Despite considerable investment in increasing the number of primary care physicians in rural shortage areas, little is known about their movement rates and factors influencing their mobility. We aimed to characterize geographic mobility among rural primary care physicians, and to identify location and individual factors that influence such mobility. Using data from the American Medical Association Physician Masterfile for each clinically active US physician, we created seven 2-year (biennial) mobility periods during 2000-2014. These periods were merged with county-level "rurality," physician supply, economic characteristics, key demographic measures, and individual physician characteristics. We computed (1) mobility rates of physicians by rurality; (2) linear regression models of county-level rural nonretention (departure); and (3) logit models of physicians leaving rural practice. Biennial turnover was about 17% among physicians aged 45 and younger, compared with 9% among physicians aged 46 to 65, with little difference between rural and metropolitan groups. County-level physician mobility was higher for counties that lacked a hospital (absolute increase = 5.7%), had a smaller population size, and had lower primary care physician supply, but area-level economic and demographic factors had little impact. Female physicians (odds ratios = 1.24 and 1.46 for those aged 45 or younger and those aged 46 to 65, respectively) and physicians born in a metropolitan area (odds ratios = 1.75 and 1.56 for those aged 45 or younger and those aged 46 to 65, respectively) were more likely to leave rural practice. These flndings provide national-level evidence of rural physician mobility rates and factors associated with both county-level retention and individual-level departures. Outcomes were notably poorer in the most remote locations and those already having poorer physician supply and professional support. Rural health workforce planners and policymakers must be cognizant of

  9. Treatment of subclinical fluid retention in patients with symptomatic heart failure: effect on exercise performance.

    Science.gov (United States)

    Chomsky, D B; Lang, C C; Rayos, G; Wilson, J R

    1997-08-01

    Patients with heart failure frequently have elevated intracardiac diastolic pressures but no clinical evidence of excess fluid retention. We speculated that such pressure elevations may indicate subclinical fluid retention and that removal of this fluid could improve exercise intolerance. To test this hypothesis, we studied 10 patients with right atrial pressure > or = 8 mm Hg but without rales, edema, or apparent jugular venous distension. Right-sided heart catheterization was performed, after which patients underwent maximal treadmill cardiopulmonary testing. Patients were then hospitalized and underwent maximal diuresis, after which exercise was repeated. Before diuresis, right atrial pressure averaged 16 +/- 5 mm Hg (+/-standard deviation), pulmonary capillary wedge pressure 30 +/- 6 mm Hg, and peak exercise Vo2 11.2 +/- 2.3 ml/min/ kg. Patients underwent diuresis of 4.5 +/- 2.2 kg over 4 +/- 2 days to a resting right atrial pressure of 6 +/- 4 and wedge pressure of 19 +/- 7 mm Hg. After diuresis, all patients reported overall symptomatic improvement. Maximal exercise duration increased significantly from 9.2 +/- 4.2 to 12.5 +/- 4.7 minutes. At matched peak workloads, significant improvements were also seen in minute ventilation (45 +/- 12 to 35 +/- 9 L/min), lactate levels (42 +/- 16 to 29 +/- 9 mg/dl), and Borg dyspnea scores (15 +/- 3 to 12 +/- 4) (all p < 0.05). Invasive hemodynamic monitoring allows the identification of excess fluid retention in patients with heart failure when there are no clinical signs of fluid overload. Removal of this subclinical excess fluid improves exercise performance and exertional dyspnea.

  10. Oxidation effect on steel corrosion and thermal loads during corium melt in-vessel retention

    Energy Technology Data Exchange (ETDEWEB)

    Granovsky, V.S.; Khabensky, V.B.; Krushinov, E.V.; Vitol, S.A.; Sulatsky, A.A.; Almjashev, V.I. [Alexandrov Scientific-Research Technology Institute (NITI), Sosnovy Bor (Russian Federation); Bechta, S.V. [KTH, Stockholm (Sweden); Gusarov, V.V. [SPb State Technology University (SPbGTU), St. Petersburg (Russian Federation); Barrachin, M. [Institut de Radioprotection et de Sûreté Nucléaire (IRSN), St Paul lez Durance (France); Bottomley, P.D., E-mail: paul.bottomley@ec.europa.eu [EC-Joint Research Centre, Institute for Transuranium Elements (ITU), Karlsruhe (Germany); Fischer, M. [AREVA GmbH, Erlangen (Germany); Piluso, P. [Commissariat à l’Energie Atomique et aux Energies Alternatives (CEA), Cadarache, St Paul lez Durance (France)

    2014-10-15

    Highlights: • The METCOR facility simulates vessel steel corrosion in contact with corium. • Steel corrosion rates in UO{sub 2+x}–ZrO{sub 2}–FeO{sub y} coria accelerate above 1050 K. • However corrosion rates can also be limited by melt O{sub 2} supply. • The impact of this on in-vessel retention (IVR) strategy is discussed. - Abstract: During a severe accident with core meltdown, the in-vessel molten core retention is challenged by the vessel steel ablation due to thermal and physicochemical interaction of melt with steel. In accidents with oxidizing atmosphere above the melt surface, a low melting point UO{sub 2+x}–ZrO{sub 2}–FeO{sub y} corium pool can form. In this case ablation of the RPV steel interacting with the molten corium is a corrosion process. Experiments carried out within the International Scientific and Technology Center's (ISTC) METCOR Project have shown that the corrosion rate can vary and depends on both surface temperature of the RPV steel and oxygen potential of the melt. If the oxygen potential is low, the corrosion rate is controlled by the solid phase diffusion of Fe ions in the corrosion layer. At high oxygen potential and steel surface layer temperature of 1050 °C and higher, the corrosion rate intensifies because of corrosion layer liquefaction and liquid phase diffusion of Fe ions. The paper analyzes conditions under which corrosion intensification occurs and can impact on in-vessel melt retention (IVR)

  11. Effect of reference conditions on flow rate, modifier fraction and retention in supercritical fluid chromatography.

    Science.gov (United States)

    De Pauw, Ruben; Shoykhet Choikhet, Konstantin; Desmet, Gert; Broeckhoven, Ken

    2016-08-12

    When using compressible mobile phases such as fluidic CO2, the density, the volumetric flow rates and volumetric fractions are pressure dependent. The pressure and temperature definition of these volumetric parameters (referred to as the reference conditions) may alter between systems, manufacturers and operating conditions. A supercritical fluid chromatography system was modified to operate in two modes with different definition of the eluent delivery parameters, referred to as fixed and variable mode. For the variable mode, the volumetric parameters are defined with reference to the pump operating pressure and actual pump head temperature. These conditions may vary when, e.g. changing the column length, permeability, flow rate, etc. and are thus variable reference conditions. For the fixed mode, the reference conditions were set at 150bar and 30°C, resulting in a mass flow rate and mass fraction of modifier definition which is independent of the operation conditions. For the variable mode, the mass flow rate of carbon dioxide increases with system pump operating pressure, decreasing the fraction of modifier. Comparing the void times and retention factor shows that the deviation between the two modes is almost independent of modifier percentage, but depends on the operating pressure. Recalculating the set volumetric fraction of modifier to the mass fraction results in the same retention behaviour for both modes. This shows that retention in SFC can be best modelled using the mass fraction of modifier. The fixed mode also simplifies method scaling as it only requires matching average column pressure. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Modelling the effect of continuous infusion DTPA therapy on the retention and dosimetry of inhaled actinides

    International Nuclear Information System (INIS)

    Guilmette, R.A.; Muggenburg, B.A.

    1989-01-01

    A biokinetic model of the treatment of dogs that inhaled 241 AmO 2 aerosols with continuously infused DTPA has been adapted from a previously published model by Mewhinney and Griffith. This model was parameterised to simulate both the tissue retention and the excretion of 241 Am, and was used to estimate the cumulative radiation doses to tissues at risk from the α radiation of 241 Am. The results showed that at 64 days after exposure, the liver dose of the DTPA-treated animals was 3% that of the corresponding controls, the skeleton dose was 2%, the kidney dose was 4% and the lung dose was 67% of controls. (author)

  13. Mastery versus the standard proficiency target for basic laparoscopic skill training: effect on skill transfer and retention.

    Science.gov (United States)

    Kolozsvari, Nicoleta O; Kaneva, Pepa; Brace, Chantalle; Chartrand, Genevieve; Vaillancourt, Marilou; Cao, Jiguo; Banaszek, Daniel; Demyttenaere, Sebastian; Vassiliou, Melina C; Fried, Gerald M; Feldman, Liane S

    2011-07-01

    Little evidence exists to guide educators in the best way to implement simulation within surgical skills curricula. This study investigated whether practicing a basic Fundamentals of Laparoscopic Surgery (FLS) simulator task [peg transfer (PT)] facilitates learning a more complex skill [intracorporeal suturing (ICS)] and compared the effect of PT training to mastery with training to the passing level on PT retention and on learning ICS. For this study, 98 surgically naïve subjects were randomized to one of three PT training groups: control, standard training, and overtraining. All the participants then trained in ICS. The learning curves for ICS were analyzed by estimating the learning plateau and rate using nonlinear regression. Skill retention was assessed by retesting participants 1 month after training. The groups were compared using analysis of variance (ANOVA). Effectiveness of skill transfer was calculated using the transfer effectiveness ratio (TER). Data are presented as mean±standard deviation (pstandard, and 23 overtrained subjects). The ICS learning plateau rose with increasing PT training (452±10 vs. 459±10 vs. 467±10; p0.5). The PT training took 20±10 min for standard training and 39±20 min for overtraining (pstandard training group, suggesting that PT overtraining took longer than the time saved on ICS training. For surgically naïve subjects, part-task training with PT alone was associated with slight improvements in the learning curve for ICS. However, overtraining with PT did not improve skill retention, and peg training alone was not an efficient strategy for learning ICS.

  14. Effects of inactivating individual cerebellar nuclei on the performance and retention of an operantly conditioned forelimb movement.

    Science.gov (United States)

    Milak, M S; Shimansky, Y; Bracha, V; Bloedel, J R

    1997-08-01

    These experiments were designed to examine the effects of inactivating separately each of the major cerebellar nuclear regions in cats on the execution and retention of a previously learned, operantly conditioned volitional forelimb movement. The experiments test the postulates that the cerebellar nuclei, and particularly the interposed nuclei, contribute substantially to the spatial and temporal features of the interjoint coordination required to execute the task and that the engram necessary for the retention of this task is not located in any one of the cerebellar nuclei. All cats were trained to perform a task in which they were required to reach for and grasp a vertical bar at the sound of a tone and move the bar to a reward zone through a template consisting of two straight grooves in the shape of an inverted "L." After the task was learned, the effects of inactivating separately each nuclear region (the fastigial, interposed, and dentate nuclei) using muscimol microinjections were determined. Data were analyzed by quantifying several features of the movement's kinematics and by determining changes in the organization of the reaching component of the movement using an application of dimensionality analysis, an analysis that examines the correlation among the changes in joint angles and limb segment positions during the task. The retention of the previously learned task also was assessed after each injection. Injections of each nuclear region affected temporal and spatial features of the learned movement. However, the largest effects resulted from inactivating the interposed nuclei. These effects included an increased length of the reach trajectory, an accentuated deviation of the wrist trajectory from a straight line, cyclic movement of the distal extremity as the target was approached, a difficulty in grasping the bar, altered temporal features of the movement, and a highly characteristic change in the dimensionality measurements. The changes in

  15. Study on the retention of enriched UO2F2 in the mouse and its radiogenotoxicological effects

    International Nuclear Information System (INIS)

    Hu Qiyue; Zhu Shoupeng

    1991-06-01

    The study on toxicological effects of enriched UO 2 F 2 was undertaken in purebred BALB/c male mice to examine: (a) the retention in body; (b) the testicular clearance; (c) the effect of sperm abnormality; (d) the effect of chromosomal aberrations in spermatogonia and primary spermatocytes; and (e) the effect of DNA damage in germ cells in various spermiogenic stages. Results show that enriched UO 2 F 2 mainly deposited in the kidneys, then the skeleton and liver. The amount of enriched UO 2 F 2 depositing in other tissues was small. Enriched UO 2 F 2 was similar to the natural uranium in transference and retention in the body. The testis had efficient clearance of enriched UO 2 F 2 . Enriched UO 2 F 2 could result in sperm abnormality. Even with the same treating does but at different treating time the rates of sperm abnormality were different. Enriched UO 2 F 2 could result in chromosomal aberrations in spermatogonia and primary spermatocytes. The important type of aberrations in spermatogonia was break. For primary spermatocytes the most significant aberration was multivalents. Enriched UO 2 F 2 could also result in DNA breakage in germ cells. The sensitivity of mouse germ cells at various stages to enriched UO 2 F 2 was different. There was a linear relationship between the amount of sperm DNA eluted and enriched UO 2 F 2 dose

  16. Coupling hydrologic and hydraulic models to take into consideration retention effects on extreme peak discharges in Switzerland

    Science.gov (United States)

    Felder, Guido; Zischg, Andreas; Weingartner, Rolf

    2015-04-01

    Estimating peak discharges with very low probabilities is still accompanied by large uncertainties. Common estimation methods are usually based on extreme value statistics applied to observed time series or to hydrological model outputs. However, such methods assume the system to be stationary and do not specifically consider non-stationary effects. Observed time series may exclude events where peak discharge is damped by retention effects, as this process does not occur until specific thresholds, possibly beyond those of the highest measured event, are exceeded. Hydrological models can be complemented and parameterized with non-linear functions. However, in such cases calibration depends on observed data and non-stationary behaviour is not deterministically calculated. Our study discusses the option of considering retention effects on extreme peak discharges by coupling hydrological and hydraulic models. This possibility is tested by forcing the semi-distributed deterministic hydrological model PREVAH with randomly generated, physically plausible extreme precipitation patterns. The resulting hydrographs are then used to force the hydraulic model BASEMENT-ETH (riverbed in 1D, potential inundation areas in 2D). The procedure ensures that the estimated extreme peak discharge does not exceed the physical limit given by the riverbed capacity and that the dampening effect of inundation processes on peak discharge is considered.

  17. Results of Large-Scale Testing on Effects of Anti-Foam Agent on Gas Retention and Release

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, Charles W.; Guzman-Leong, Consuelo E.; Arm, Stuart T.; Butcher, Mark G.; Golovich, Elizabeth C.; Jagoda, Lynette K.; Park, Walter R.; Slaugh, Ryan W.; Su, Yin-Fong; Wend, Christopher F.; Mahoney, Lenna A.; Alzheimer, James M.; Bailey, Jeffrey A.; Cooley, Scott K.; Hurley, David E.; Johnson, Christian D.; Reid, Larry D.; Smith, Harry D.; Wells, Beric E.; Yokuda, Satoru T.

    2008-01-03

    The U.S. Department of Energy (DOE) Office of River Protection’s Waste Treatment Plant (WTP) will process and treat radioactive waste that is stored in tanks at the Hanford Site. The waste treatment process in the pretreatment facility will mix both Newtonian and non-Newtonian slurries in large process tanks. Process vessels mixing non-Newtonian slurries will use pulse jet mixers (PJMs), air sparging, and recirculation pumps. An anti-foam agent (AFA) will be added to the process streams to prevent surface foaming, but may also increase gas holdup and retention within the slurry. The work described in this report addresses gas retention and release in simulants with AFA through testing and analytical studies. Gas holdup and release tests were conducted in a 1/4-scale replica of the lag storage vessel operated in the Pacific Northwest National Laboratory (PNNL) Applied Process Engineering Laboratory using a kaolin/bentonite clay and AZ-101 HLW chemical simulant with non-Newtonian rheological properties representative of actual waste slurries. Additional tests were performed in a small-scale mixing vessel in the PNNL Physical Sciences Building using liquids and slurries representing major components of typical WTP waste streams. Analytical studies were directed at discovering how the effect of AFA might depend on gas composition and predicting the effect of AFA on gas retention and release in the full-scale plant, including the effects of mass transfer to the sparge air. The work at PNNL was part of a larger program that included tests conducted at Savannah River National Laboratory (SRNL) that is being reported separately. SRNL conducted gas holdup tests in a small-scale mixing vessel using the AZ-101 high-level waste (HLW) chemical simulant to investigate the effects of different AFAs, their components, and of adding noble metals. Full-scale, single-sparger mass transfer tests were also conducted at SRNL in water and AZ-101 HLW simulant to provide data for PNNL

  18. The effect of post-conditioning exposure to morphine on the retention of a morphine-induced conditioned taste aversion.

    Science.gov (United States)

    Jacobs, W J; Zellner, D A; LoLordo, V M; Riley, A L

    1981-06-01

    In the following experiment, multiple injections of morphine sulfate following the acquisition of a morphine-induced taste aversion had no effect on the retention of the previously acquired aversion. Post-conditioning injections of morphine resulted in the development of physical dependence to morphine and led to a decrement in the ability of morphine to induce a subsequent aversion to a second novel taste. This failure of post-conditioning exposures to morphine to affect a previously acquired morphine-induced taste aversion even though tolerance to morphine had occurred was discussed in the context of Rescorla's event-memory model of conditioning.

  19. Effect of a tailor-made continuous medical education program for primary care physicians on self-perception of physicians' roles and quality of care.

    Science.gov (United States)

    Twig, Gilad; Lahad, Amnon; Kochba, Ilan; Ezra, Vered; Mandel, Dror; Shina, Avi; Kreiss, Yitshak; Zimlichman, Eyal

    2010-09-01

    A survey conducted among Israel Defense Force primary care physicians in 2001 revealed that they consider patients' needs more than they do organizational needs and that the education PCPs currently receive is inadequate. In 2003 the medical corps initiated a multi-format continuous medical education program aimed at improving skills in primary care medicine. To measure and analyze the effect of the tailor-made CME program on PCPs' self-perception 3 years after its implementation and correlate it to clinical performance. In 2006 a questionnaire was delivered to a representative sample of PCPs in the IDF. The questionnaire included items on demographic and professional background, statements on self-perception issues, and ranking of roles. We compared the follow-up survey (2006) to the results of the original study (2001) and correlated the survey results with clinical performance as measured through objective indicators. In the 2006 follow-up survey PCPs scored higher on questions dealing with their perception of themselves as case managers (3.8 compared to 4.0 on the 2001 survey on a 5 point scale, P = 0.046), perceived quality of care and education (3.5 vs. 3.8, P = 0.06), and on questions dealing with organizational commitment (3.5 vs. 3.8, P = 0.01). PCPs received higher scores on clinical indicators in the later study (odds ratio 2.05, P < 0.001). PCPs in the IDF perceived themselves more as case managers as compared to the 2001 survey. A tailor-made CME program may have contributed to the improvement in skills and quality of care.

  20. Effects of temperature and body size on radiocaesium retention in brown trout, Salmo trutta

    International Nuclear Information System (INIS)

    Ugedal, O.; Jonsson, B.; Njastad, O.; Naeumann, R.

    1992-01-01

    The elimination rate of radiocaesium in brown trout Salmo trutta L. was determined in the laboratory at four water temperatures (range 4.4 -15.6 0 C). In the experiments three or four homogeneous size-groups of fish (mean weights 23-496g) were studied at each temperature. The brown trout received acute oral doses of 134 Cs and were killed at intervals for radioactivity counting. The retention versus time curves were composed of two distinct exponential components. The long-lived component was quantitatively the most important for retention of radiocaesium. Elimination rate increased with increasing water temperature and decreased with increasing body weight. The biological half-life of 134 Cs (T b , days) was related to fresh body weight (W, g) and water temperature (t, 0 C) by the equation: T b = 290 x W 0.176 x e -0.106 x t . The elimination rate of Cs could be predicted from weight-specific metabolic rate as given by Elliott's equations for brown trout. (author)

  1. MS PHD'S: Effective Strategies for the Retention and Advancement of URM Students in ESS

    Science.gov (United States)

    Escalera, J.; Burgess, A. K.; Pace, L.; Scott, O.; Strickland, J.; Johnson, A.; Williamson Whitney, V.; Ithier-Guzman, W.

    2012-12-01

    The Minorities Striving and Pursuing Higher Degrees of Success (MS PHD'S) Professional Development Program in Earth system science (ESS) is a model initiative for improving the retention of underrepresented minority (URM) students in STEM fields. Entering its ninth cohort, MS PHD'S remains committed to helping URM undergraduate and graduate students achieve outstanding careers in ESS. MS PHD'S facilitates URM student achievement through a three-phase program designed to increase student exposure to the ESS community. By engaging in a series of professional development and skill building exercises, peer-to-peer community building activities, participation in scientific society conferences and workshops, mentoring by URM and other scientists, and a virtual community, URM students gain the confidence and support necessary to achieve their academic goals and enter the ESS workforce. Since its inception, MS PHD'S continues to support 189 participants. Of these 189 participants, 35 have advanced from undergraduate and graduate academic pathways to completion of their PhD and another 60 are currently enrolled in doctoral programs. MS PHD'S maintains close ties with program alumni to further support retention, inclusivity, and broadening participation of URM students and graduates in STEM activities. Its model is built on reengaging alumni to become mentors and leaders for each new cohort as well as facilitating valuable opportunities for alumni to advance in their ESS related academic and professional career pathways.

  2. Effect of direct neuroradiologist participation in physician marketing on imaging volumes in outpatient radiology.

    Science.gov (United States)

    Grignon, L; Keiper, M; Vavricek, J; Horsley, W; Murphy, R; Grignon, A; Yu, F

    2014-08-01

    Over the past several years, decreased demand for and increased supply of imaging services has increased competition among outpatient imaging centers in the United States. This study hypothesizes that using a radiology sales representative and neuroradiologist as a team in marketing and sales will increase imaging referrals in outpatient imaging. From January to December 2009, baseline monthly physician referral data of CT and MR scans of 19 referring clinicians (neurologists, neurosurgeons, and anesthesiologists) to an outpatient radiology group were collected. During that time, a nonphysician radiology sales representative visited the referring clinicians' offices every 2 weeks. From January to June 2010, the same radiology sales representative visited the referring clinicians' offices every 2 weeks but was accompanied by a neuroradiologist once a month. From July 2010 to June 2011, the same radiology sales representative visited the referring clinicians' offices twice a month without a neuroradiologist. Cross-sectional imaging referral volumes were approximately 2.5 times greater during the 6-month period using the neuroradiologist for direct physician-to-physician marketing when compared with the volumes achieved with the sales representative alone, and continued neuroradiologist involvement in marketing and sales is required to maintain referral volumes over time. The impact on imaging referral volumes during the 6-month use of the neuroradiologist for direct physician-to-physician marketing in this study supports the assertion that neuroradiologist visits are an important element in establishing and maintaining a relationship with the referring clinician's office and thereby maximizing imaging referrals. © 2014 by American Journal of Neuroradiology.

  3. Limited Effects of Variable-Retention Harvesting on Fungal Communities Decomposing Fine Roots in Coastal Temperate Rainforests.

    Science.gov (United States)

    Philpott, Timothy J; Barker, Jason S; Prescott, Cindy E; Grayston, Sue J

    2018-02-01

    Fine root litter is the principal source of carbon stored in forest soils and a dominant source of carbon for fungal decomposers. Differences in decomposer capacity between fungal species may be important determinants of fine-root decomposition rates. Variable-retention harvesting (VRH) provides refuge for ectomycorrhizal fungi, but its influence on fine-root decomposers is unknown, as are the effects of functional shifts in these fungal communities on carbon cycling. We compared fungal communities decomposing fine roots (in litter bags) under VRH, clear-cut, and uncut stands at two sites (6 and 13 years postharvest) and two decay stages (43 days and 1 year after burial) in Douglas fir forests in coastal British Columbia, Canada. Fungal species and guilds were identified from decomposed fine roots using high-throughput sequencing. Variable retention had short-term effects on β-diversity; harvest treatment modified the fungal community composition at the 6-year-postharvest site, but not at the 13-year-postharvest site. Ericoid and ectomycorrhizal guilds were not more abundant under VRH, but stand age significantly structured species composition. Guild composition varied by decay stage, with ruderal species later replaced by saprotrophs and ectomycorrhizae. Ectomycorrhizal abundance on decomposing fine roots may partially explain why fine roots typically decompose more slowly than surface litter. Our results indicate that stand age structures fine-root decomposers but that decay stage is more important in structuring the fungal community than shifts caused by harvesting. The rapid postharvest recovery of fungal communities decomposing fine roots suggests resiliency within this community, at least in these young regenerating stands in coastal British Columbia. IMPORTANCE Globally, fine roots are a dominant source of carbon in forest soils, yet the fungi that decompose this material and that drive the sequestration or respiration of this carbon remain largely

  4. Effects of different N sources on riverine DIN export and retention in a subtropical high-standing island, Taiwan

    Science.gov (United States)

    Huang-Chuan, Jr.; Lee, Tsung-Yu; Lin, Teng-Chiu; Hein, Thomas; Lee, Li-Chin; Shih, Yu-Ting; Kao, Shuh-Ji; Shiah, Fuh-Kwo; Lin, Neng-Huei

    2016-03-01

    Increases in nitrogen (N) availability and mobility resulting from anthropogenic activities have substantially altered the N cycle, both locally and globally. Taiwan characterized by the subtropical montane landscape with abundant rainfall, downwind of the most rapidly industrializing eastern coast of China, can be a demonstration site for extremely high N input and riverine DIN (dissolved inorganic N) export. We used 49 watersheds with similar climatic and landscape settings but classified into low, moderate, and highly disturbed categories based on population density to illustrate their differences in nitrogen inputs (through atmospheric N deposition, synthetic fertilizers, and human emission) and DIN export ratios. Our results showed that the island-wide average riverine DIN export is ˜ 3800 kg N km-2 yr-1, approximately 18 times the global average. The average riverine DIN export ratios are 0.30-0.51, which are much higher than the averages of 0.20-0.25 of large rivers around the world, indicating excessive N input relative to ecosystem demand or retention capacity. The low disturbed watersheds have a high N retention capacity and DIN export ratios of 0.06-0.18 in spite of the high N input (˜ 4900 kg N km-2 yr-1). The high retention capacity is likely due to effective uptake by secondary forests in the watersheds. The moderately disturbed watersheds show a linear increase in DIN export with increases in total N inputs and mean DIN export ratios of 0.20 to 0.31. The main difference in land use between low and moderately disturbed watersheds is the greater proportion of agricultural land cover in the moderately disturbed watersheds. Thus, their greater DIN export could be attributed to N fertilizers used in the agricultural lands. The greater export ratios also imply that agricultural lands have a lower proportional N retention capacity and that reforestation could be an effective land management practice to reduce riverine DIN export. The export ratios of the

  5. Effects of training on short- and long-term skill retention in a complex multiple-task environment.

    Science.gov (United States)

    Sauer, J; Hockey, G R; Wastell, D G

    2000-12-01

    The paper reports the results of an experiment on the performance and retention of a complex task. This was a computer-based simulation of the essential elements of a spacecraft's life support system. It allowed the authors to take a range of measures, including primary and secondary task performance, system intervention and information sampling strategies, mental model structure, and subjective operator state. The study compared the effectiveness of two methods of training, based on low level (procedure-based) and high level (system-based) understanding. Twenty-five participants were trained extensively on the task, then given a 1-h testing session. A second testing session was carried out 8 months after the first (with no intervening practice) with 17 of the original participants. While training had little effect on control performance, there were considerable effects on system management strategies, as well as in structure of operator's mental model. In the second testing session, the anticipated general performance decrement did not occur, though for complex faults there was an increase in selectivity towards the primary control task. The relevance of the findings for training and skill retention in real work environments is discussed in the context of a model of compensatory control.

  6. Effects of the restriction of food and water intake on the distribution and retention of radioiodine in mice

    International Nuclear Information System (INIS)

    Takahashi, Sentaro; Sato, Hiroshi; Kubota, Yoshihisa; Sun, Xuezhi; Dao Thi Bich Thuy; Chandrasekharan, N.V.

    2000-01-01

    The effects of the restriction of food and water intakes on gastrointestinal absorption, distribution to organs and excretion of 131 I were investigated in C3H/He mice. The animals were divided into four groups and administered orally 37 kBq carrier-free Na 131 I in 0.25 ml normal saline. One group of animals was given food and water ad libitum throughout the experimental period. Food and water to the remaining groups were restricted before and/or after the administration of 131 I. The animals in each group were sacrificed 4 h and 24 h after administration, and the activity of 131 I in thyroid, blood, liver, kidney, gastrointestinal tract, urine, feces, and carcass was measured. There was a significant increase in the retention of 131 I in the thyroid and the concentration of 131 I in the blood due to the restriction of food and water after the administration of 131 I. In contrast, a significant decrease in the urinary excretion was observed in these animals. In those animals, which fasted before administration only, the retention of 131 I in the thyroid and other organs were decreased. Therefore, for an accurate diagnosis and effective therapy with radioiodine as well as effective radiation protection, the intake of food and water should be taken into account. (author)

  7. The effect of ochre applied to buffer zones on soluble phosphorus retention during combined surface and subsurface flow conditions

    Science.gov (United States)

    Habibiandehkordi, R.; Quinton, J.; Surridge, B.

    2012-12-01

    Despite invention of a wide range of mitigating measures, diffuse phosphorus (P) pollution from agricultural lands still remains a major threat to the water resources. Thus, reducing P inputs along with improving the effectiveness of current best management practices (BMPs) is necessary to avoid eutrophication. Buffer zones are considered to be among the BMPs to control diffuse P pollution. However, these features are less effective in controlling soluble P loss with a retention range of -71 to +95% which is generally governed by the process of infiltration. Moreover, the soil in buffer strip system can be saturated over a course of time thereby enriching surface and subsurface runoff with soluble P. The aim of this study is to evaluate effectiveness of ochre applied to buffer strips in reducing the loss of soluble P during coupled surface and subsurface flow conditions. Batch experiments showed a maximum P retention capacity of 17.2 g kg-1 for ochre collected from a mine water treatment plant in Capehouse, UK without any risk of P desorption or releasing trace elements to the environment. The preliminarily results of flume experiments confirms the suitability of ochre to be used as a soil amendment in conjunction with buffer strips for tackling soluble P loss.

  8. The cost-effectiveness of training US primary care physicians to conduct colorectal cancer screening in family medicine residency programs.

    Science.gov (United States)

    Edwardson, Nicholas; Bolin, Jane N; McClellan, David A; Nash, Philip P; Helduser, Janet W

    2016-04-01

    Demand for a wide array of colorectal cancer screening strategies continues to outpace supply. One strategy to reduce this deficit is to dramatically increase the number of primary care physicians who are trained and supportive of performing office-based colonoscopies or flexible sigmoidoscopies. This study evaluates the clinical and economic implications of training primary care physicians via family medicine residency programs to offer colorectal cancer screening services as an in-office procedure. Using previously established clinical and economic assumptions from existing literature and budget data from a local grant (2013), incremental cost-effectiveness ratios are calculated that incorporate the costs of a proposed national training program and subsequent improvements in patient compliance. Sensitivity analyses are also conducted. Baseline assumptions suggest that the intervention would produce 2394 newly trained residents who could perform 71,820 additional colonoscopies or 119,700 additional flexible sigmoidoscopies after ten years. Despite high costs associated with the national training program, incremental cost-effectiveness ratios remain well below standard willingness-to-pay thresholds under base case assumptions. Interestingly, the status quo hierarchy of preferred screening strategies is disrupted by the proposed intervention. A national overhaul of family medicine residency programs offering training for colorectal cancer screening yields satisfactory incremental cost-effectiveness ratios. However, the model places high expectations on primary care physicians to improve current compliance levels in the US. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Are online learning modules an effective way to deliver hand trauma management continuing medical education to emergency physicians?

    Science.gov (United States)

    Williams, Jason G

    2014-01-01

    The enormity of modern medical knowledge and the rapidity of change have created increased need for ongoing or continuing medical education (CME) for physicians. Online CME is attractive for its availability at any time and any place, low cost and potentially increased effectiveness compared with traditional face-to-face delivery. To determine whether online CME modules are an effective method for delivering plastic surgery CME to primary care physicians. A needs assessment survey was conducted among all emergency and family physicians in Nova Scotia. Results indicated that this type of program was appealing, and that hand trauma related topics were most desired for CME. 7 Lesson Builder (SoftChalk LLC, www.softchalk.com) was used to construct a multimedia e-learning module that was distributed along with a pretest, post-test and feedback questionnaire. Quantitative (pre- and post-test scores) and qualitative (feedback responses) data were analyzed. The 32 participants who completed the study indicated that it was a positive and enjoyable experience, and that there was a need for more resources like this. Compared with pretest scores, there was a significant gain in knowledge following completion of the module (P=0.001). The present study demonstrated that an e-learning format is attractive for this population and effective in increasing knowledge. This positive outcome will lead to development of additional modules.

  10. Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students.

    Science.gov (United States)

    McKenna, Mindi K; Gartland, Myles P; Pugno, Perry A

    2004-01-01

    Research regarding the development of healthcare leadership competencies is widely available. However, minimal research has been published regarding the development of physician leadership competencies, despite growing recognition in recent years of the important need for effective physician leadership. Usingdata from an electronically distributed, self-administered survey, the authors examined the perceptions held by 110 physician leaders, physician educators, and medical students regarding the extent to which nine competencies are important for effective physician leadership, ten activities are indicative of physician leadership, and seven methods are effective for the development of physician leadership competencies. Results indicated that "interpersonal and communication skills" and "professional ethics and social responsibility" are perceived as the most important competencies for effective physician leadership. Furthermore, respondents believe "influencing peers to adopt new approaches in medicine" and "administrative responsibility in a healthcare organization" are the activities most indicative of effective physician leadership. Finally, respondents perceive"coaching or mentoring from an experienced leader" and "on-job experience (e.g., a management position)" as the most effective methods for developing physician leadership competencies. The implications of these findings for the education and development of physician leaders are discussed.

  11. Physician suicide.

    Science.gov (United States)

    Preven, D W

    1981-01-01

    The topic of physician suicide has been viewed from several perspectives. The recent studies which suggest that the problem may be less dramatic statistically, do not lessen the emotional trauma that all experience when their lives are touched by the grim event. Keeping in mind that much remains to be learned about suicides in general, and physician suicide specifically, a few suggestions have been offered. As one approach to primary prevention, medical school curriculum should include programs that promote more self-awareness in doctors of their emotional needs. If the physician cannot heal himself, perhaps he can learn to recognize the need for assistance. Intervention (secondary prevention) requires that doctors have the capacity to believe that anyone, regardless of status, can be suicidal. Professional roles should not prevent colleague and friend from identifying prodromal clues. Finally, "postvention" (tertiary prevention) offers the survivors, be they family, colleagues or patients, the opportunity to deal with the searing loss in a therapeutic way.

  12. Effect of calcium and vitamin D deficiency in the diet on the capture and retention of 99mTc-methylenediphosphonate and of 85Sr in rat bones

    International Nuclear Information System (INIS)

    Kapitola, J.; Jahoda, I.; Kobos, L.; Knotova, S.; Stepankova, M.

    1990-01-01

    The effect was examined of vitamin D-free low-calcium diet on the 24 h retention of 99m Tc-methylenediphosphonate in the whole body and in the tibia, on the long-term whole-body 85 Sr retention and on the 2 h retention of 85 Sr in the epiphysis, the metaphysis and the diaphysis of the rat femur and tibia. The density and ash weight of the tibia were also determined in some experiments. The whole-body 99m Tc-MDP retention increased significantly as early as the 3rd day of administration of the diet. In two other experiments, the retention in the tibia as well as in the whole body was increased in 1, 2 and 4 weeks of the diet; the density decreased from the 1st or 2nd week. The whole-body 85 Sr retention was increased after significantly as early as after two days of administration of the diet; after discontinuation of the diet the high difference as against controls only slowly decreased. The 2 h 85 Sr retention in samples of the femur and the tibia on days 2, 5, 10 and 20 of the diet was examined in a separate experiment. The retention increased significantly in 20 days; the bone density and ash weight were significantly lower on days 10 and 20 days of the diet. Hence, the low-calcium diet brings about an increase in the retention of the two osteotropic substances in the bone. This response was expected in the case of 85 Sr; in the case of 99m Tc-MDP it indicates that the retention may be related to the mineral component of the bone tissue. The enhanced retention of the two substances is apparently not associated with local blood circulation, which in earlier experiments was found reduced under the conditions employed. The results confirm that 85 Sr and 99m Tc-MDP retention is a sensitive and early indicator of calcium metabolism imbalance. (author). 1 fig., 2 tabs., 10 refs

  13. Work hours and turnover intention among hospital physicians in Taiwan: does income matter?

    Science.gov (United States)

    Tsai, Yu-Hsuan; Huang, Nicole; Chien, Li-Yin; Chiang, Jen-Huai; Chiou, Shu-Ti

    2016-11-21

    Physician shortage has become an urgent and critical challenge to many countries. According to the workforce dynamic model, long work hours may be one major pressure point to the attrition of physicians. Financial incentive is a common tool to human power retention. Therefore, this large-scale physician study investigated how pay satisfaction may influence the relationship between work hours and hospital physician's turnover intention. Data were obtained from a nationwide survey of full-time hospital staff members working at 100 hospitals in Taiwan. The analysis sample comprised 2423 full-time physicians. Dependent variable was degree of the physicians' turnover intention to leave the current hospital. The pay satisfaction was assessed by physicians themselves. We employed ordinal logistic regression models to analyze the association between the number of work hours and turnover intention. To consider the cluster effect of hospitals, we used the "gllamm" command in the statistical software package Stata Version 12.1. The results show that 351 (14.5%) of surveyed physicians reported strong intention to leave current hospital. The average work hours per week among hospital physicians was 59.8 h. As expected, work hours exhibited an independent relationship with turnover intention. More importantly, pay satisfaction could not effectively moderate the positive relationship between work hours and intentions to leave current hospital. The findings show that overtime work is prevalent among hospital physicians in Taiwan. Both the Taiwanese government and hospitals must take action to address the emerging problem of physician high turnover rate. Furthermore, hospitals should not consider relying solely on financial incentives to solve the problem. This study encouraged tackling work hour problem, which would lead to the possibility of solving high turnover intention among hospital physicians in Taiwan.

  14. Positron Emission Tomography Based Elucidation of the Enhanced Permeability and Retention Effect in Dogs with Cancer Using Copper-64 Liposomes

    DEFF Research Database (Denmark)

    Hansen, Anders Elias; Petersen, Anncatrine Luisa; Henriksen, Jonas Rosager

    2015-01-01

    Since the first report of the enhanced permeability and retention (EPR) effect, the research in nanocarrier based antitumor drugs has been intense. The field has been devoted to treatment of cancer by exploiting EPR-based accumulation of nanocarriers in solid tumors, which for many years...... was considered to be a ubiquitous phenomenon. However, the understanding of differences in the EPR-effect between tumor types, heterogeneities within each patient group, and dependency on tumor development stage in humans is sparse. It is therefore important to enhance our understanding of the EPR......-effect in large animals and humans with spontaneously developed cancer. In the present paper, we describe a novel loading method of copper-64 into PEGylated liposomes and use these liposomes to evaluate the EPR-effect in 11 canine cancer patients with spontaneous solid tumors by PET/CT imaging. We thereby provide...

  15. Self- and rater-assessed effectiveness of "thinking-aloud" and "regular" morning report to intensify young physicians' clinical skills.

    Science.gov (United States)

    Hsu, Hui-Chi; Lee, Fa-Yauh; Yang, Ying-Ying; Tsao, Yen-Po; Lee, Wen-Shin; Chuang, Chiao-Lin; Chang, Ching-Chih; Huang, Chia-Chang; Huang, Chin-Chou; Ho, Shung-Tai

    2015-09-01

    This study compared the effects of the "thinking aloud" (TA) morning report (MR), which is characterized by sequential and interactive case discussion by all participants, with "regular" MR for clinical skill training of young physicians. Between February 2011 and February 2014, young physicians [including postgraduate year-1 (PGY1) residents, interns, and clerks) from our hospital were sequentially enrolled and followed for 3 months. The self- and rater-assessed educational values of two MR models for building up clinical skills of young physicians were compared. The junior (intern and clerk) attendees had higher self-assessed educational values scores and reported post-training application frequency of skills trained by TA MR compared with the senior (PGY1 resident) attendees. Higher average and percentage of increased overall rater-assessed OSCE scores were noted among the regular MR senior attendees and TA MR junior attendees than in their corresponding control groups (regular MR junior attendees and TA MR senior attendees). Interestingly, regular MRs provided additional beneficial effects for establishing the "professionalism, consulting skills and organization efficiency" aspects of clinical skills of senior/junior attendees. Moreover, senior and junior attendees benefited the most by participating in seven sessions of regular MR and TA MR each month, respectively. TA MR effectively trains junior attendees in basic clinical skills, whereas regular MR enhances senior attendees' "work reports, professionalism, organizational efficiency, skills in dealing with controversial and professional issues." Undoubtedly, all elements of the two MR models should be integrated together to ensure patient safety and good discipline among young physicians. Copyright © 2015. Published by Elsevier Taiwan.

  16. ASSOCIATIVE EFFECT OF MOLASSES-UREA BLOCK AND FORAGE QUALITY ON NUTRIENT DIGESTION AND NITROGEN RETENTION IN SHEEP

    Directory of Open Access Journals (Sweden)

    lqbal Saeed. M. M. Siddiqui and G. I. Habib

    2002-01-01

    Full Text Available A study was conducted in a 4x4 Latin square design involving four adult crossbred (Kaghani x Rambouillet weather kept in individual metabolic crates and four experimental diets viz: maize stovers (Diet A, maize stovers with 150 g/d molasses-urea block (Diet B, lucerne hay (Diet Cand lucerne hay with 150 g/d molasses-urea block (Diet D. The forage intake was restricted to 2% of body weight. Each experimental period consisted 10 days of adaptation followed by five days of data collection. Total dry matter intake on molasses-urea block (MUB supplemented diets was higher (p<0.05 than unsupplemented diets. The daily quantity of total dry matter and water consumed by weathers was higher (p < 0.001 on MUB supplemented diets. Water consumption was positively co-related to nitrogen intake (r2 0.66: p< 0.00 I and varied due to diets (p < 0.00 I. in vivo dry matter digestibility (DMD and organic matter digestibility (OMD of lucerne hay-based diets were greater (P< 005 than those containing maize stovers. Supplementation of MUB did not affect the DMD or OMD of the diets. The interaction of MUB and forage (P = 0.06 revealed that MUB was effective in increasing (P< 0.05 the nitrogen digestibility of maize stovers from 30,59% on diet A to 51.33% on diet B but did not affect the nitrogen digestibility in animals fed lucerne hay. The wethers receiving lucerne hay-based diets retained more nitrogen (p< 0.001 than those given maize stovers (8.50 's 3,12 g/d. Molasses-urea block supplementation on both forages increased (p < 0.05 the nitrogen retention. Mean nitrogen retention was I 82. 4.41, 7 .19 and 9.82 gld in wethers receiving diets A. B. C and D. respectively. Mean rumen ammonia concentration (mg N/lOO ml in wethers receiving maize stovers. was 10.52. which increased (p< 0,05 to 17.87 in response to MUB supplementation. On lucerne hay. the rumen ammonia concentrations did not change due to MUB and the mean values on diets C and D were 24,24 and 29.88 mg N/100

  17. Effects of different N sources on riverine DIN export and retention in subtropical high-standing island, Taiwan

    Science.gov (United States)

    Huang, J.-C.; Lee, T.-Y.; Lin, T.-C.; Hein, T.; Lee, L.-C.; Shih, Y.-T.; Kao, S.-J.; Shiah, F.-K.; Lin, N.-H.

    2015-10-01

    Increases in nitrogen (N) availability and mobility resulting from anthropogenic activities has substantially altered N cycle both locally and globally. Taiwan characterized by the subtropical montane landscape with abundant rainfall, downwind to the most rapidly industrializing east coast of China can be a demonstration site for extreme high N input and riverine DIN (dissolved inorganic N) export. We used 49 watersheds classified into low-, moderate-, and highly-disturbed categories based on population density to illustrate their differences in nitrogen inputs through atmospheric N deposition, synthetic fertilizers and human emission and DIN export ratios. Our results showed that the island-wide average riverine DIN export is ~ 3800 kg N km-2 yr-1, approximately 18-fold higher than the global average mostly due to the large input of synthetic fertilizers. The average riverine DIN export ratio is 0.30-0.51, which is much higher than the average of 0.20-0.25 of large rivers around the world indicating excessive N input relative to ecosystem demand or retention capacity. The low-disturbed watersheds, despite of high N input, only export 0.06-0.18 of the input so were well buffered to changes in input quantity suggesting high efficiency of nitrogen usage or high N retention capacity of the less disturbed watersheds. The high retention capacity probably is due to the effective uptake by secondary forests in the watersheds. The moderate-disturbed watersheds show a linear increase of output with increases in total N inputs and a mean DIN export ratio of 0.20 to 0.31. The main difference in land use between low and moderately disturbed watershed is the relative proportions of agricultural land and forests, not the built-up lands. Thus, their greater DIN export quantity could be attributed to N fertilizers used in the agricultural lands. The greater export ratios also imply that agricultural lands have lower proportional N retention capacity and that reforestation could be

  18. National survey addressing the information needs of primary care physicians: Side effect management of patients on androgen deprivation therapy.

    Science.gov (United States)

    Soeyonggo, Tony; Locke, Jennifer; Giudice, Maria Elizabeth Del; Alibhai, Shabbir; Fleshner, Neil Eric; Warde, Padraig

    2014-03-01

    Androgen deprivation therapy (ADT) is a common treatment for prostate cancer with numerous side effects. We assess primary care physicians' (PCPs) knowledge of ADT side effects and their interest in increasing their knowledge in this area. A list of active Canadian PCPs was obtained using the Canadian Medical Directory. A cross-sectional survey was distributed to 600 randomly selected physicians. We collected PCPs' demographic information, experience with ADT management, knowledge regarding ADT side effects and desired sources for obtaining knowledge on ADT management. In total, we received 103 completed questionnaires. Of these, 89% of PCPs had patients on ADT. One-third of respondents prescribed ADT and over half of them administered ADT annually. Thirty-eight percent felt their knowledge of ADT side effects was inadequate and 50% felt uncomfortable counselling patients on ADT. Many PCPs were less familiar with the incidence of functional side effects of ADT (i.e., hot flashes, fatigue and erectile dysfunction) compared to life-threatening side effects (i.e., cardiovascular events, metabolic syndrome, fractures). In terms of increasing their knowledge of ADT side effects, 82% of PCPs would use educational resources if they were available (52% and 32% preferred continued medical education [CME] events and educational pamphlets, respectively). PCPs play an important role in managing ADT side effects. There is poor awareness of the prevalence of ADT side effects, and many are uncomfortable in managing these side effects. These areas may be addressed through CME programs and educational pamphlets.

  19. Effects of e-learning, lectures, and role playing on nursing students' knowledge acquisition, retention and satisfaction.

    Science.gov (United States)

    Pourghaznein, Tayebeh; Sabeghi, Hakimeh; Shariatinejad, Keyvan

    2015-01-01

    Nursing education can maintain its dynamic quality when it moves toward innovation and modern methods of teaching and learning. Therefore, teachers are required to employ up to date methods in their teaching plans. This study evaluated the effects of e-learning, lectures, and role playing on nursing students' learning, retention, and satisfaction. Sixty nursing students were selected as an experiment and control groups during two consecutive semesters. The educational content was presented as e-learning and role playing during one semester (experiment group) and as lectures in the next semester (control group). A questionnaire containing three parts was used to assess demographics, learning and satisfaction statuses. The questionnaire also included a final openended question to evaluate the students' ideas about the whole course. The mean scores of posttest were 16.13 ± 1.37 using role playing, 15.50 ± 1.44 using e-learning and 16.45 ± 1.23 using lectures. The differences between the mean scores of posttest and pretest were 12.84 ± 1.43, 12.56 ± 1.57, and 13.73 ± 1.53 in the mentioned methods, respectively. Lectures resulted in significantly better learning compared to role playing and e-learning. In contrast, retention rates were significantly lower using lectures than using role playing and e-learning. Students' satisfaction from e-learning was significantly lower than lecturing and role playing. Due to the lower rates of retention following lectures, the teachers are recommended to use student- centered approaches in their lectures. Since students' satisfaction with e-learning was lower than the other methods, further studies are suggested to explore the problems of e-learning in Iran.

  20. Effect of Continuous Motion Parameter Feedback on Laparoscopic Simulation Training: A Prospective Randomized Controlled Trial on Skill Acquisition and Retention.

    Science.gov (United States)

    Buescher, Julian Frederik; Mehdorn, Anne-Sophie; Neumann, Philipp-Alexander; Becker, Felix; Eichelmann, Ann-Kathrin; Pankratius, Ulrich; Bahde, Ralf; Foell, Daniel; Senninger, Norbert; Rijcken, Emile

    To investigate the effect of motion parameter feedback on laparoscopic basic skill acquisition and retention during a standardized box training curriculum. A Lap-X Hybrid laparoscopic simulator was designed to provide individual and continuous motion parameter feedback in a dry box trainer setting. In a prospective controlled trial, surgical novices were randomized into 2 groups (regular box group, n = 18, and Hybrid group, n = 18) to undergo an identical 5-day training program. In each group, 7 standardized tasks on laparoscopic basic skills were completed twice a day on 4 consecutive days in fixed pairs. Additionally, each participant performed a simulated standard laparoscopic cholecystectomy before (day 1) and after training (day 5) on a LAP Mentor II virtual reality (VR) trainer, allowing an independent control of skill progress in both groups. A follow-up assessment of skill retention was performed after 6 weeks with repetition of both the box tasks and VR cholecystectomy. Muenster University Hospital Training Center, Muenster, Germany. Medical students without previous surgical experience. Laparoscopic skills in both groups improved significantly during the training period, measured by the overall task performance time. The 6 week follow-up showed comparable skill retention in both groups. Evaluation of the VR cholecystectomies demonstrated significant decrease of operation time (p Simulation training on both trainers enables reliable acquisition of laparoscopic basic skills. Furthermore, individual and continuous motion feedback improves laparoscopic skill enhancement significantly in several aspects. Thus, training systems with feedback of motion parameters should be considered to achieve long-term improvement of motion economy among surgical trainees. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. The radioimmunotoxicological and radiogenotoxicological effect induced by 134Cs retention in the whole body and skeleton and germ system

    International Nuclear Information System (INIS)

    Zhu Shoupeng; Xia Fen; Yang Weidong

    1993-05-01

    A fitted equation to describe the retention of 134 Cs in whole body is obtained by a whole body counter. The equation consists of two half-life components, the fast component is T 1/2 = 0.07 d and the slow component is T 1/2 = 16.14 d. Two fitted equations describing the retention of 134 Cs in skeleton and testes are also introduced. The T 1/2 in skeleton is 5.73 d and in testes is 5.21 d. The results of investigating radioimmunotoxicological effect induced by 134 Cs show that the inhibition of thymus cells is higher than bone marrow cells, the spleen T-lymphocytes is more sensitive to 134 Cs than B-lymphocytes and lymphocytes of peripheral immune organ are more sensitive to radiation than central immune cells and thymus cells. The study of radiogenotoxicological effect induced by 134 Cs shows that the chromosome aberration frequencies and PCE micronucleus formation in bone marrow cells are significantly high, it can induce chromosome aberrations of spermatogonia and increases the abnormality of sperm. The relations between injected dose and abnormalities can be expressed by power functions

  2. The Effect of CTL Approach Based on NHT Learning Model toward Students’ motivation, Science Achievement, and Retention

    Directory of Open Access Journals (Sweden)

    Muhammad Mifta Fausan

    2017-07-01

    Full Text Available The learning is an interaction process between students and their environment in order to improve good behavior. The results of observation which has been done in grade V SDN No. 4 Tanjung Batu showed that the students’ motivation and science achievement were low. This was becaused by the learning process which was still product oriented (based on material content, consequently, this lead to limit the learning is merely on memorizing concept activities. One of the learning approach that can be used to solve this problem is the Contextual Teaching and Learning (CTL based on Numbered Head Together (NHT. This research aims to determine the effect of CTL based on NHT toward student’s motivation, science achievement, and retention. Subjects in this research were the students of grade V SDN No. 4 Tanjung Batu. This research is a quasi-experimental using post-test only control design. The data obtained were analyzed by using descriptive and inferential statistical analysis. The research instruments were observation sheets and written test. The results showed that there was significant effect of CTL based on NHT toward students’ motivation, science achievement, and retention. It can be seen from the independent sample t-test results which showed significant value less than 0.05.

  3. Passive cooling effect of RC roof covered with the ceramics having high water retention and evaporation capacity

    International Nuclear Information System (INIS)

    Yamazaki, M; Kanaya, M; Shimazu, T; Ohashi, T; Kato, N; Horikoshi, T

    2011-01-01

    Hot days in metropolitan cities have increased remarkably by the heat island phenomenon these days. Thus the authors tried to develop the porous ceramics with high water retention and evaporation capacity as a maintenance-free material to improve thermal environment. The developed ceramic pellets have high water retention of more than 60% of water absorption and high water evaporation which is similar to water surface. In this study, three types of 5 meter squared large flat-roofed structural specimen simulated reinforced concrete (RC) slab were constructed on the outside. The variation of water content and temperature of the specimens and atmosphere temperature around the specimens were measured from summer in 2009. In the case of the ceramic pellets, the temperature under RC slab was around 15 deg. lower than that of the control. The results were probably contributed by passive cooling effect of evaporated rain water, and the effect was similar to in the case of the grasses. From the viewpoint of thermal environment improvement, substitution of a rooftop gardening by the porous ceramics could be a promising method.

  4. Effectiveness of In-Vessel Retention Strategies and Minimum Safety Injection Flow over Postulated Severe Accidents of OPR1000

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Joong; Seo, Seungwon; Lee, Seongnyeon [Hanyang Univ., Seoul (Korea, Republic of); KIm, Hwan Yeol; Ha, Kwang Soon; Park, Jonghwa; Park, Raejoon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-10-15

    The objective of this study is first to evaluate various serious severe accident scenarios of OPR1000 with and without in-vessel retention strategies using MELCOR code. Second is to develop a mechanistic model of minimum safety injection flow using the thermal-hydraulic parameters of CET and collapsed water level obtained from the MELCOR simulation results. Effectiveness of RCS depressurization of OPR1000 is investigated for postulated severe accidents of SBLOCA, SBO, and TLOF. It is seen that timely operator action is important to achieve the best mitigation. Also The MELCOR simulation results of SBLOCA, SBO, and TLOFW are utilized to develop a model for minimum safety injection flow. The model suggests that if HPSI is available with RCS pressure lower than 120 bars, the core coolability can be guaranteed. In this study, several MELCOR simulations are conducted in search for effective in-vessel retention strategies over postulated severe accidents of SBLOCA, SBO, and TLOFW of OPR1000. Detailed accident sequences are presented and indicative parameters diagnosing the reactor thermal-hydraulic state are interrogated to provide useful information to the operator actions. To properly assist operator's action during the severe accident, the thermal-hydraulic parameters should be virtual, intuitive, and reliable. In addition, the parameters should be collected through the instrumentations close to the reactor core. In this regard, Core Exit Temperature (CET) and collapsed core water level are deemed as the commensurate parameters.

  5. Effectiveness of In-Vessel Retention Strategies and Minimum Safety Injection Flow over Postulated Severe Accidents of OPR1000

    International Nuclear Information System (INIS)

    Kim, Sung Joong; Seo, Seungwon; Lee, Seongnyeon; KIm, Hwan Yeol; Ha, Kwang Soon; Park, Jonghwa; Park, Raejoon

    2013-01-01

    The objective of this study is first to evaluate various serious severe accident scenarios of OPR1000 with and without in-vessel retention strategies using MELCOR code. Second is to develop a mechanistic model of minimum safety injection flow using the thermal-hydraulic parameters of CET and collapsed water level obtained from the MELCOR simulation results. Effectiveness of RCS depressurization of OPR1000 is investigated for postulated severe accidents of SBLOCA, SBO, and TLOF. It is seen that timely operator action is important to achieve the best mitigation. Also The MELCOR simulation results of SBLOCA, SBO, and TLOFW are utilized to develop a model for minimum safety injection flow. The model suggests that if HPSI is available with RCS pressure lower than 120 bars, the core coolability can be guaranteed. In this study, several MELCOR simulations are conducted in search for effective in-vessel retention strategies over postulated severe accidents of SBLOCA, SBO, and TLOFW of OPR1000. Detailed accident sequences are presented and indicative parameters diagnosing the reactor thermal-hydraulic state are interrogated to provide useful information to the operator actions. To properly assist operator's action during the severe accident, the thermal-hydraulic parameters should be virtual, intuitive, and reliable. In addition, the parameters should be collected through the instrumentations close to the reactor core. In this regard, Core Exit Temperature (CET) and collapsed core water level are deemed as the commensurate parameters

  6. Passive cooling effect of RC roof covered with the ceramics having high water retention and evaporation capacity

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, M; Kanaya, M; Shimazu, T; Ohashi, T [INAX Corporation, 97-1, Yariba, Kume, Tokoname, Aichi, 479-0002 (Japan); Kato, N; Horikoshi, T, E-mail: m.yamazaki@i2.inax.co.jp [Department of Architecture, Nagoya Institute of technology, Gokiso-cho, Showa-ku, Nagoya, Aichi, 466-8555 (Japan)

    2011-10-29

    Hot days in metropolitan cities have increased remarkably by the heat island phenomenon these days. Thus the authors tried to develop the porous ceramics with high water retention and evaporation capacity as a maintenance-free material to improve thermal environment. The developed ceramic pellets have high water retention of more than 60% of water absorption and high water evaporation which is similar to water surface. In this study, three types of 5 meter squared large flat-roofed structural specimen simulated reinforced concrete (RC) slab were constructed on the outside. The variation of water content and temperature of the specimens and atmosphere temperature around the specimens were measured from summer in 2009. In the case of the ceramic pellets, the temperature under RC slab was around 15 deg. lower than that of the control. The results were probably contributed by passive cooling effect of evaporated rain water, and the effect was similar to in the case of the grasses. From the viewpoint of thermal environment improvement, substitution of a rooftop gardening by the porous ceramics could be a promising method.

  7. Effectiveness of non-monetary factors on staff retention within the South African banking sector

    Directory of Open Access Journals (Sweden)

    Sandiso Ngcobo

    2015-01-01

    Full Text Available The recent global recession resulted in many job losses across the world with the financial industry being most severely impacted. Today the focus for many banks is to do more with less employees and to reduce the cost to income ratio on their balance sheets. It is therefore pertinent that they devise strategies that will enable them to retain talented employees. This paper mainly employed a quantitative approach in which a questionnaire was utilised as the instrument for data collection with a focus on non-monetary incentives and turnover intentions. Small scale interviews were used to supplement the collected quantitative data. The findings revealed that non-financial rewards are an important factor in employee retention that cannot be ignored.

  8. Effect of Different Skin Penetration Promoters in Halobetasol Propionate Permeation and Retention in Human Skin

    Directory of Open Access Journals (Sweden)

    Paulina Carvajal-Vidal

    2017-11-01

    Full Text Available Halobetasol propionate (HB is a potent synthetic corticosteroid used against inflammatory skin diseases, such as dermatitis, eczema, and psoriasis, among others. The aim of this study is to define how the presence of different skin penetration enhancers (nonane, menthone, limonene, azone, carene, decanol, linoleic acid and cetiol affects the penetration and retention in skin of HB. To determine drug penetration through skin, 5% of each promoter was used in an ex vivo system with human skin on Franz cells. The results showed that the highest permeation occurs in the presence of menthone, followed by nonane. Permeation parameters were determined. The in vivo test was assessed, and the formulation containing HB-menthone presented better anti-inflammatory efficacy. These results are useful to generate a specific treatment according to each patient’s needs, and the inflammatory characteristics of the disease.

  9. Effect of calcium/silicon ratio on retention of uranium (VI) in portland cement materials

    International Nuclear Information System (INIS)

    Tan Hongbin; Li Yuxiang

    2005-01-01

    Calcium silicate hydrate (CSH) materials of varied calcium to silicon (Ca/Si) ratios were prepared by hydrothermal synthesis at 80 degree C, with calcium oxide and micro-silicon employed. These products were determined to be of gel phase by XRD. Leaching tests with 1% hydrochloric acid indicated that more Uranium (VI) was detained by CSH with lower Ca/Si ratios. Alkali-activated slag cement (with a lower Ca/Si ratio) was found to have a stronger retention capacity than Portland cement (with a higher Ca/Si ratio), at 25 degree C in 102-days leaching tests with simulated solidified forms containing Uranium (VI). The accumulative leaching fraction of Uranium (VI) for Alkali-activated slag cement solidified forms is 17.6% lower than that for Portland cement. The corresponding difference of diffusion coefficients is 40.6%. This could be correlated with the difference of Ca/Si ratios between cements of two kinds. (authors)

  10. Modeling gravity effects on water retention and gas transport characteristics in plant growth substrates

    DEFF Research Database (Denmark)

    Deepagoda Thuduwe Kankanamge Kelum, Chamindu; Jones, Scott B.; Tuller, Markus

    2014-01-01

    utilization to conserve energy and to limit transport costs, native materials mined on Moon or Mars are of primary interest for plant growth media in a future outpost, while terrestrial porous substrates with optimal growth media characteristics will be useful for onboard plant growth during space missions....... Due to limited experimental opportunities and prohibitive costs, liquid and gas behavior in porous substrates under reduced gravity conditions has been less studied and hence remains poorly understood. Based on ground-based measurements, this study examined water retention, oxygen diffusivity and air...... that estimates the gas percolation threshold based on the pore size distribution. The model successfully captured measured data for all investigated media and demonstrated the implications of the poorly-understood shift in gas percolation threshold with improved gas percolation in reduced gravity. Finally, using...

  11. Retention of katakana as foreign scripts: The effects of mnemonics and spatial ability

    Directory of Open Access Journals (Sweden)

    Sachiko Matsunaga

    2009-01-01

    Full Text Available This paper reports the results of an experiment, which showed that: (a regardless of their Ll script type (Roman or nonRoman, learners of Japanese as a foreign language did not benefit from the conventional mnemonics for the short-term or long-term retention of katakana (introduced after hiragana; (b only the spatial ability of the Roman group (whose L1 employed Roman scripts had significant correlations with their immediate recall performances. By comparing these results with those of Matsunaga's (2003, 2005 studies on hiragana, this paper discusses: (a changes in learning strategies, (b the role of the spatial ability, (c the possibility of L1 script recognition strategy transfer, (d the role of practice, and (e pedagogical implications and suggestions for future studies.

  12. The Effect of Physician Delegation to Other Health Care Providers on the Quality of Care for Geriatric Conditions

    Science.gov (United States)

    Lichtenstein, Brian J.; Reuben, David B.; Karlamangla, Arun S.; Han, Weijuan; Roth, Carol P.; Wenger, Neil S.

    2016-01-01

    OBJECTIVES to examine the effects of delegation on quality of care that patients receive for three common geriatric conditions: dementia, falls, and incontinence. DESIGN pooled analysis of 8 the Assessing Care of Vulnerable Elders (ACOVE) projects from 1998 to 2010. SETTING 15 ambulatory practice sites across the United States PARTICIPANTS 4,776 patients age ≥ 65 years, of mixed demographic backgrounds who participated in ACOVE studies. INTERVENTION multivariate analysis of prior ACOVE observation and intervention studies was conducted, with in addition to two retrospectively defined variables: “intent to delegate” and “maximum delegation” for each ACOVE quality indicator (QI). MEASUREMENTS The primary outcome for the study was QI pass probability, by level of delegation, for 47 ACOVE quality indicators. RESULTS A total of 4,776 patients were evaluated, with 16,204 QIs included for analysis. Across all studies, QI pass probabilities were 0.36 for physician-performed tasks; 0.55 for nurse practitioner (NP), physician assistant (PA), and registered nurse (RN)-performed tasks; and 0.61 for medical assistant (MA), or licensed vocational nurse (LVN)-performed tasks. In multiply adjusted models, the independent pass-probability effect of delegation to NPs, PAs, or RNs was 1.37 (p = 0.055) CONCLUSIONS Delegation to non-physician providers is associated with higher quality of care for geriatric conditions in community practices and supports the value of interdisciplinary team management for common outpatient conditions among older adults. PMID:26480977

  13. Patient-centered recruitment and retention for a randomized controlled study.

    Science.gov (United States)

    Chhatre, Sumedha; Jefferson, Ashlie; Cook, Ratna; Meeker, Caitlin R; Kim, Ji Hyun; Hartz, Kayla Marie; Wong, Yu-Ning; Caruso, Adele; Newman, Diane K; Morales, Knashawn H; Jayadevappa, Ravishankar

    2018-03-27

    Recruitment and retention strategies for patient-centered outcomes research are evolving and research on the subject is limited. In this work, we present a conceptual model of patient-centered recruitment and retention, and describe the recruitment and retention activities and related challenges in a patient-centered comparative effectiveness trial. This is a multicenter, longitudinal randomized controlled trial in localized prostate cancer patients. We recruited 743 participants from three sites over 15 months period (January 2014 to March 2015), and followed them for 24 months. At site 1, of the 773 eligible participants, 551 (72%) were enrolled. At site 2, 34 participants were eligible and 23 (68%) enrolled. Of the 434 eligible participants at site 3, 169 (39%) enrolled. We observed that strategies related to the concepts of trust (e.g., physician involvement, ensuring protection of information), communication (e.g., brochures and pamphlets in physicians' offices, continued contact during regular clinic visits and calling/emailing assessment), attitude (e.g., emphasizing the altruistic value of research, positive attitude of providers and research staff), and expectations (e.g., full disclosure of study requirements and time commitment, update letters) facilitated successful patient recruitment and retention. A stakeholders' advisory board provided important input for the recruitment and retention activities. Active engagement, reminders at the offices, and personalized update letters helped retention during follow-up. Usefulness of telephone recruitment was site specific and, at one site, the time requirement for telephone recruitment was a challenge. We have presented multilevel strategies for successful recruitment and retention in a clinical trial using a patient-centered approach. Our strategies were flexible to accommodate site-level requirements. These strategies as well as the challenges can aid recruitment and retention efforts of future large

  14. Does sildenafil enhance the effect of tamsulosin in relieving acute urinary retention?

    Directory of Open Access Journals (Sweden)

    Seyed Hossein Hosseini Sharifi

    2014-06-01

    Full Text Available Objective To compare the safety and efficacy of combined therapy using sildenafil and tamsulosin for management of acute urinary retention (AUR with tamsulosin alone in patients with benign prostate hyperplasia (BPH. Materials and Methods 101 patients were enrolled in a randomized placebo-controlled study from June 2009 to April 2012. Patients presenting with an initial episode of spontaneous AUR underwent urethral catheterization and then prospectively randomized to receive tamsulosin 0.4mg plus sildenafil 50mg in group A and tamsulosin 0.4mg plus placebo in group B for three days. Urethral catheter was removed three days after medical treatment and patient’s ability to void assessed at the day after catheter removal and seven days later. Patients who voided successfully were followed at least for three months. Results Mean age of patients was 59.64 ± 3.84 years in group A and 60.56 ± 4.12 years in group B (p value = 0.92. Mean prostate volume and mean residual urine were comparable between both groups (p value = 0.74 and 0.42, respectively. Fifteen patients in group A (success rate: 70% and nineteen patients in group B (success rate: 62.7% had failed trial without catheter (TWOC at 7th day following AUR (p value = 0.3. No significant difference was noted between both groups regarding the rate of repeated AUR at one month and three month follow-up period (p = 0.07 and p = 0.45, respectively. Conclusion It seems that combination therapy by using 5-phosphodiesterase inhibitor and tamsulosin has no significant advantages to improve urinary retention versus tamsulosin alone.

  15. Does sildenafil enhance the effect of tamsulosin in relieving acute urinary retention?

    Science.gov (United States)

    Sharifi, Seyed Hossein Hosseini; Mokarrar, Mohsen Heidari; Khaledi, Flora; Yamini-Sharif, Reyhaneh; Lashay, Alireza; Soltani, Mohammad Hossein

    2014-01-01

    To compare the safety and efficacy of combined therapy using sildenafil and tamsulosin for management of acute urinary retention (AUR) with tamsulosin alone in patients with benign prostate hyperplasia (BPH). 101 patients were enrolled in a randomized placebo-controlled study from June 2009 to April 2012. Patients presenting with an initial episode of spontaneous AUR underwent urethral catheterization and then prospectively randomized to receive tamsulosin 0.4 mg plus sildenafil 50mg in group A and tamsulosin 0.4 mg plus placebo in group B for three days. Urethral catheter was removed three days after medical treatment and patient's ability to void assessed at the day after catheter removal and seven days later. Patients who voided successfully were followed at least for three months. Mean age of patients was 59.64 ± 3.84 years in group A and 60.56 ± 4.12 years in group B (p value = 0.92). Mean prostate volume and mean residual urine were comparable between both groups (p value = 0.74 and 0.42, respectively). Fifteen patients in group A (success rate: 70%) and nineteen patients in group B (success rate: 62.7%) had failed trial without catheter (TWOC) at 7th day following AUR (p value = 0.3). No significant difference was noted between both groups regarding the rate of repeated AUR at one month and three month follow-up period (p = 0.07 and p = 0.45, respectively). It seems that combination therapy by using 5-phosphodiesterase inhibitor and tamsulosin has no significant advantages to improve urinary retention versus tamsulosin alone.

  16. Temperature effect on uranium retention onto Zr2O(PO4)2 surface

    International Nuclear Information System (INIS)

    Almazan Torres, M.G.

    2007-03-01

    Uranium sorption onto Zr 2 O(PO 4 ) 2 has been studied between 298 K and 363 K, in 0.1 M NaClO 4 medium. Potentiometric titrations were realized to determine temperature dependency of the acid-base properties (pH(pcn), acidity constants). Classical batch experiments were performed at different temperatures. The sorption experiments revealed that the uranium sorption onto Zr 2 O(PO 4 ) 2 is favoured with the temperature. Structural characterization of the surface complexes was performed by both Time-Resolved Laser-Induced Fluorescence (TRLIF) and EXAFS spectroscopy. The TRLIF measurements vs. temperature revealed two uranyl surface complexes. No influence of the temperature onto the nature surface complex was observed. The EXAFS analysis showed a splitting of the equatorial oxygen atoms in two shells, corresponding to uranyl bidentate, inner-sphere complexes. The obtained structural uranyl surface complex information was used to simulate (using a constant capacitance model) the sorption edges. The proposed complexes equilibrium model consists of the following surface complexes: (ZrOH) 2 UO 2 2+ and (PO) 2 UO 2 . Besides the stability constants for the surface complexes, the thermodynamic parameters ΔH 0 and ΔS 0 were determined using the van't Hoff equation. The enthalpy values associated to the U(VI) retention onto Zr 2 O(PO 4 ) 2 , determined by the temperature dependence of the stability constants, testify that the formation of the complex (PO) 2 UO 2 (55 kJ/mol) is endothermic, while no influence of the temperature was observed for the formation of the complex (ZrOH) 2 UO 2 2+ . The adsorption reaction of the last complex is then driven by entropy. In addition, calorimetric measurements of uranium sorption onto Zr 2 O(PO 4 ) 2 were carried out to directly quantify the enthalpy associated to the retention processes. (author)

  17. Assessment of the effectiveness of sustained release Bupropion and intensive physician advice in smoking cessation

    Directory of Open Access Journals (Sweden)

    Singh Pranav

    2010-01-01

    Full Text Available Background: Tobacco use is the cause of immense burden on our nation in terms of mortality and morbidity, being the single leading cause of preventable illnesses and death. Smoking cessation interventions in our country will be the most cost effective of all interventions considering that the cost incurred on the three main tobacco related illnesses (COPD, CAD, and Cancer being around Rs 27,761 crore in the year 1999. Materials and Methods: A double blind placebo controlled trial was conducted to see the efficacy of Bupropion in smoking cessation. Smokers with current depression were excluded. The subjects (n = 30 were randomly assigned to receive Bupropion SR 300 mg/day or placebo for seven weeks. Target quit date was preferentially 8 th day of starting the treatment. Intensive counseling was provided by the physician at the baseline and brief counseling at every visit weekly during the treatment phase and at weeks 12 and 16. Self reported abstinence was confirmed by a carbon monoxide concentration in expired air of less than 10 ppm. Results: The seven-day point prevalence abstinence rate at the end of week 2 and week 16 in the drug group was 46.67% and 53.33 % respectively and in the placebo group was 13.33% and 20% respectively with the ′P" value of 0.04 and 0.05 respectively. Rates of continuous abstinence at weeks 4, 7 and 16 were 46.67%, 40% and 33.33% in the drug group and 13.33%, 13.33% and 13.33% in the placebo group respectively. The rates were significantly higher in the drug group till week 4 starting from week 2 of the treatment phase. The mean weight gain in drug group was found to be significant less as compared to the placebo at week 16 (P = 0.025 The mean change of depression scores from the baseline was not significantly different between the two groups at any point of time. The withdrawal symptom score increase from the baseline was not significantly higher at any point of time in the drug group but in the placebo group the

  18. The effect of physician staffing model on patient outcomes in a medical progressive care unit.

    Science.gov (United States)

    Yoo, E J; Damaghi, N; Shakespeare, W G; Sherman, M S

    2016-04-01

    Although evidence supports the impact of intensivist physician staffing in improving intensive care unit (ICU) outcomes, the optimal coverage for progressive care units (PCU) is unknown. We sought to determine how physician staffing models influence outcomes for intermediate care patients. We conducted a retrospective observational comparison of patients admitted to the medical PCU of an academic hospital during 12-month periods of high-intensity and low-intensity staffing. A total of 318 PCU patients were eligible for inclusion (143 high-intensity and 175 low-intensity). We found that low-intensity patients were more often stepped up from the emergency department and floor, whereas high-intensity patients were ICU transfers (61% vs 42%, P = .001). However, Mortality Probability Model scoring was similar between the 2 groups. In adjusted analysis, there was no association between intensity of staffing and hospital mortality (odds ratio, 0.84; 95% confidence interval, 0.36-1.99; P = .69) or PCU mortality (odds ratio, 0.96; 95% confidence interval, 0.38-2.45; P = .69). There was also no difference in subsequent ICU admission rates or in PCU length of stay. We found no evidence that high-intensity intensivist physician staffing improves outcomes for intermediate care patients. In a strained critical care system, our study raises questions about the role of the intensivist in the graded care options between intensive and conventional ward care. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Physiological and psychological effects of delivering medical news using a simulated physician-patient scenario.

    Science.gov (United States)

    Cohen, Lorenzo; Baile, Walter F; Henninger, Evelyn; Agarwal, Sandeep K; Kudelka, Andrzej P; Lenzi, Renato; Sterner, Janet; Marshall, Gailen D

    2003-10-01

    We examined the acute stress response associated with having to deliver either bad or good medical news using a simulated physician-patient scenario. Twenty-five healthy medical students were randomly assigned to a bad medical news (BN), a good medical news (GN), or a control group that read magazines during the session. Self-report measures were obtained before and after the task. Blood pressure and heart rate were measured throughout the task period. Four blood samples were obtained across the task period. The BN and GN tasks produced significant increases in self-reported distress and cardiovascular responses compared with the control group. There was also a significant increase in natural killer cell function 10 min into the task in the BN group compared with the control group. The BN task was also somewhat more stressful than the GN task, as shown by the self-report and cardiovascular data. These findings suggest that a simulated physician-patient scenario produces an acute stress response in the "physician," with the delivery of bad medical news more stressful than the delivery of good medical news.

  20. Yield-increasing additives in kraft pulping: Effect on carbohydrate retention, composition and handsheet properties

    Energy Technology Data Exchange (ETDEWEB)

    Vaaler, David Andre Grimsoeen

    2008-07-01

    In this thesis, increased hemicellulose retention during kraft pulping has been studied. The work has been divided into three parts: i) Development of an accessible and reliable method for determination of carbohydrate composition of kraft pulps ii) Investigation of the composition and molecular mass distributions of the carbohydrates in kraft pulps with increased hemicellulose content iii) Investigation of the effect of increased hemicellulose content on the sheet properties of kraft pulps with increased hemicellulose content. A method for carbohydrate determination was developed. In this method, enzymes are used to hydrolyse the pulp into monosaccharides. A relatively mild acid hydrolysis is performed prior to detection on an HPLC with an RI-detector. The pulp is not derivatized and no pre-treatment (mechanical or chemical) is needed to determine the carbohydrate composition using the method developed here. Peak deconvolution software is used to improve the accuracy. Polysulphide and H2S primarily increase the glucomannan yield, which can be boosted by up to 7 % on o.d. wood. However, the cellulose yield is more affected by the cooking time and the maximum yield increase of cellulose is approximately 2 % on o.d. wood compared to an ordinary kraft pulp. The cooking time is influenced by sulphide ion concentration, AQ addition and the final Kappa number. The xylan yield is remarkably stable, however the alkali profile during the cook may influence the xylan yield. Surface xylan content of the fibres depends on residual alkali concentration in the black liquor. The molecular mass distributions of cellulose and hemicellulose were determined for pulps with increased hemicellulose content using size exclusion chromatography. Deconvolution by peak separation software is used to gain information about the degree of polymerization for cellulose and hemicellulose. The average DP of glucomannan in the kraft fibre was found to be 350 +- 30 and the average DP of xylan in the

  1. Effect of air-abrasion on the retention of zirconia ceramic crowns luted with different cements before and after artificial aging.

    Science.gov (United States)

    Shahin, Ramez; Kern, Matthias

    2010-09-01

    The purpose of this in vitro study was to evaluate the effect of intaglio surface air-abrasion on the retention of CAD/CAM produced zirconia ceramic crowns cemented with three different types of cement. In addition the influence of artificial aging in masticatory simulator and thermocycling was tested. Extracted human premolars were prepared for all-ceramic crowns (12 degrees taper, 3 mm axial length). CAD/CAM zirconia crowns were manufactured. Half of the crowns were air-abraded with 50 microm alumina particles at 0.25 MPa, the rest was left as machined. The crowns were luted with zinc phosphate cement (Hoffmann), glass ionomer cement (Ketac Cem), or composite resin (Panavia 21), subgroups were either stored for 3 days in 37 degrees water bath or stored for 150 days in 37 degrees water bath, with additional 37,500 thermal cycles (5-55 degrees) and 300,000 cycles dynamic loading with 5 kg in a masticatory simulator. Then crown retention was measured in tension at a crosshead speed of 2 mm/min using a universal testing machine. Statistical analysis was performed with three-way ANOVA. Mean retention values were ranged from 2.8 to 7.1 MPa after 3 days and from 1.6 to 6.1 MPa after artificial aging. Air-abrasion significantly increased crown retention (partificial aging decreased retention (p=0.017). In addition, the luting material had a significant influence on retention (p<0.001) with the adhesive luting resin providing the highest retention. The use of phosphate monomer containing composite resin on air-abraded zirconia ceramic can be recommended as most retentive luting method. Copyright 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  2. Water Retention Capacity of Argillite from the VE Test - Phase II at Mont Terri: Effect of Ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Villar, M. V.; Fernandez, A. M.; Melon, A. M.

    2009-10-12

    The VE (ventilation) test carried out at the Mont Terri underground laboratory in Switzerland intended to evaluate in situ the behaviour of a consolidated clay formation when subjected to alternate periods of flow of wet and dry air during several months. For that, a 10-m gallery was excavated in the Opalinus Clay formation and carefully instrumented. Before and after a second ventilation phase boreholes were drilled. Samples were taken from the drill cores and were analysed from mineralogical and geochemical points of view. Also, the retention curves of these samples were determined in the laboratory following drying paths performed under free volume conditions at 20 degree centigrade, what is the content of this report. Although there are not large differences in the WRC of samples taken from different boreholes, at different distances from the gallery wall or before or after ventilation, those samples taken near the gallery wall and after ventilation tend to show a higher water retention capacity. This has been correlated to the higher salinity of the pore water of these samples, what increases their osmotic suction. This effect is attenuated towards high suctions. (Author) 10 refs.

  3. Effects of two retraining strategies on nursing students' acquisition and retention of BLS/AED skills: A cluster randomised trial.

    Science.gov (United States)

    Hernández-Padilla, José Manuel; Suthers, Fiona; Granero-Molina, José; Fernández-Sola, Cayetano

    2015-08-01

    To determine and compare the effects of two different retraining strategies on nursing students' acquisition and retention of BLS/AED skills. Nursing students (N = 177) from two European universities were randomly assigned to either an instructor-directed (IDG) or a student-directed (SDG) 4-h retraining session in BLS/AED. A multiple-choice questionnaire, the Cardiff Test, Laerdal SkillReporter(®) software and a self-efficacy scale were used to assess students' overall competency (knowledge, psychomotor skills and self-efficacy) in BLS/AED at pre-test, post-test and 3-month retention-test. GEE, chi-squared and McNemar tests were performed to examine statistical differences amongst groups across time. There was a significant increase in the proportion of students who achieved competency for all variables measuring knowledge, psychomotor skills and self-efficacy between pre-test and post-test in both groups (all p-valuesstudy demonstrated that using a student-directed strategy to retrain BLS/AED skills has resulted in a higher proportion of nursing students achieving and retaining competency in BLS/AED at three months when compared to an instructor-directed strategy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. The effect of bacon pump retention levels following thermal processing on bacon slice composition and sensory characteristics.

    Science.gov (United States)

    Sivendiran, T; Wang, L M; Huang, S; Bohrer, B M

    2018-06-01

    The objective was to evaluate the effect of belly pump uptake and cook yield during processing on bacon slice composition and sensory attributes. A total of forty-four bellies were commercially sourced and randomly assigned to two experiments. Each experiment consisted of one smokehouse cooking cycle. Within each experiment, bellies were separated at the medial point and one belly half was assigned to a high pump uptake treatment (HIGH; target of 30% uptake) and the remaining belly half was assigned to a normal pump uptake treatment (NORM; target of 15% uptake). In experiment-1, cook yields were 107.79% for the HIGH bellies and 101.52% for the NORM bellies. In experiment-2, cook yields were 97.41% for the HIGH bellies and 94.74% for the NORM bellies. Overall, bacon slice composition and sensory attributes of bacon from bellies with greater pump retention were largely unaffected, accordingly it was concluded that cook yields ranging in level of pump retention does not affect most attributes of bacon. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Water Retention Capacity of Argillite from the VE Test - Phase II at Mont Terri: Effect of Ventilation

    International Nuclear Information System (INIS)

    Villar, M. V.; Fernandez, A. M.; Melon, A. M.

    2009-01-01

    The VE (ventilation) test carried out at the Mont Terri underground laboratory in Switzerland intended to evaluate in situ the behaviour of a consolidated clay formation when subjected to alternate periods of flow of wet and dry air during several months. For that, a 10-m gallery was excavated in the Opalinus Clay formation and carefully instrumented. Before and after a second ventilation phase boreholes were drilled. Samples were taken from the drill cores and were analysed from mineralogical and geochemical points of view. Also, the retention curves of these samples were determined in the laboratory following drying paths performed under free volume conditions at 20 degree centigrade, what is the content of this report. Although there are not large differences in the WRC of samples taken from different boreholes, at different distances from the gallery wall or before or after ventilation, those samples taken near the gallery wall and after ventilation tend to show a higher water retention capacity. This has been correlated to the higher salinity of the pore water of these samples, what increases their osmotic suction. This effect is attenuated towards high suctions. (Author) 10 refs

  6. Effect of enzyme-induced pulmonary emphysema in Syrian hamsters on the deposition and retention of inhaled particles

    International Nuclear Information System (INIS)

    Hahn, F.F.; Hobbs, C.H.

    1974-01-01

    Experimental emphysema was induced in Syrian hamsters by intratracheal injection of elastase or by inhaled papain aerosols. Control hamsters were injected with saline or exposed to enzyme diluent aerosols. After 3 weeks, all groups were simultaneously exposed to an aerosol of relatively insoluble 137 Cs in fused clay particles with an activity median aerodynamic diameter of 1.4 to 1.6 and a geometric standard deviation of 1.6. The initial pulmonary deposition of particles (measured 3 hours after inhalation) was significantly lower in treated hamsters, 45 percent of controls with elastase and 65 percent with papain aerosols. The effect of both enzyme treatments on the retention of particles was similar in spite of the fact that the pulmonary lesions were not the same. Elastase I.T. caused a diffuse destruction and enlargement of alveoli with a loss of pulmonary elastic recoil. Papain aerosols caused a focal destruction and enlargement of alveoli with no loss of elastic recoil. The common feature of both lesions was an increased number of alveolar macrophages which may account for the early increased clearance of particles. The prolonged retention of particles may be due to focal accumulations of macrophages in distal alveoli. (U.S.)

  7. The effect of emotion and physician communication behaviors on surrogates' life-sustaining treatment decisions: a randomized simulation experiment.

    Science.gov (United States)

    Barnato, Amber E; Arnold, Robert M

    2013-07-01

    Surrogate decision makers for critically ill patients experience strong negative emotional states. Emotions influence risk perception, risk preferences, and decision making. We sought to explore the effect of emotional state and physician communication behaviors on surrogates' life-sustaining treatment decisions. 5 × 2 between-subject randomized factorial experiment. Web-based simulated interactive video meeting with an intensivist to discuss code status. Community-based participants 35 and older who self-identified as the surrogate for a parent or spouse recruited from eight U.S. cities through public advertisements. Block random assignment to emotion arousal manipulation and each of the four physician communication behaviors. Surrogate's code status decision (cardiopulmonary resuscitation vs do not resuscitate/allow natural death). Two hundred fifty-six of 373 respondents (69%) logged-in and were randomized: average age was 50; 70% were surrogates for a parent; 63.5% were women; 76% were white, 11% black, and 9% Asian; and 81% were college educated. When asked about code status, 56% chose cardiopulmonary resuscitation. The emotion arousal manipulation increased the score on depression-dejection scale (β = 1.76 [0.58 - 2.94]) but did not influence cardiopulmonary resuscitation choice. Physician attending to emotion and framing the decision as the patient's rather than the surrogate's did not influence cardiopulmonary resuscitation choice. Framing no cardiopulmonary resuscitation as the norm rather than cardiopulmonary resuscitation resulted in fewer surrogates choosing cardiopulmonary resuscitation (48% vs 64%, odds ratio, 0.52 [95% CI, 0.32-0.87]), as did framing the alternative to cardiopulmonary resuscitation as "allow natural death" rather than do not resuscitate (49% vs 61%, odds ratio, 0.58 [95% CI, 0.35-0.96]). Experimentally induced emotional state did not influence code status decisions, although small changes in physician communication behaviors

  8. The prospective effects of workplace violence on physicians' job satisfaction and turnover intentions: the buffering effect of job control.

    Science.gov (United States)

    Heponiemi, Tarja; Kouvonen, Anne; Virtanen, Marianna; Vänskä, Jukka; Elovainio, Marko

    2014-01-17

    Health care professionals, including physicians, are at high risk of encountering workplace violence. At the same time physician turnover is an increasing problem that threatens the functioning of the health care sector worldwide. The present study examined the prospective associations of work-related physical violence and bullying with physicians' turnover intentions and job satisfaction. In addition, we tested whether job control would modify these associations. The present study was a 4-year longitudinal survey study, with data gathered in 2006 and 2010.The present sample included 1515 (61% women) Finnish physicians aged 25-63 years at baseline. Analyses of covariance (ANCOVA) were conducted while adjusting for gender, age, baseline levels, specialisation status, and employment sector. The results of covariance analyses showed that physical violence led to increased physician turnover intentions and that both bullying and physical violence led to reduced physician job satisfaction even after adjustments. We also found that opportunities for job control were able to alleviate the increase in turnover intentions resulting from bullying. Our results suggest that workplace violence is an extensive problem in the health care sector and may lead to increased turnover and job dissatisfaction. Thus, health care organisations should approach this problem through different means, for example, by giving health care employees more opportunities to control their own work.

  9. Physician Order Entry Clerical Support Improves Physician Satisfaction and Productivity.

    Science.gov (United States)

    Contratto, Erin; Romp, Katherine; Estrada, Carlos A; Agne, April; Willett, Lisa L

    2017-05-01

    To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning. Physician satisfaction, productivity, timeliness with EHR documentation, and physician attitudes toward the intervention were measured. Four months after the intervention, physicians reported improvements in overall quality of life (good quality, 71%-100%), personal balance (43%-71%), and burnout (weekly, 43%-14%; callousness, 14%-0%). Matched for quarter, productivity increased: work relative value unit (wRVU) per session increased by 20.5% (before, April-June 2014; after, April-June 2015; range -9.2% to 27.5%). Physicians reported feeling more supported, more focused on patient care, and less stressed and fatigued after the intervention. This study supports the use of physician order entry clerical personnel as a simple, cost-effective intervention to improve the work lives of primary care physicians.

  10. Inter-Provincial Migration Intentions of Family Physicians in Canada: The Roles of Income and Community Characteristics.

    Science.gov (United States)

    Mou, Haizhen; Olfert, M Rose

    2015-11-01

    The inter-provincial migration patterns of family physicians in canada show that some provinces like newfoundland and saskatchewan experience persistent net out-migration, while others, including ontario and british columbia, are destinations more often than origins of migrants. Governments in provinces exhibiting net out-migration have responded with a number of incentive and recruitment programs. In this study, we investigate the determinants of the stated interprovincial migration intentions of 3,995 rural and urban family physicians in the 2010 wave of the national physician survey. We consider a range of physician characteristics, community attributes and working conditions. We find that in the intention to move, higher compensation has a modest effect, while the community characteristics have a consistently important influence. Our results suggest that policy and program designers should acknowledge the critical role of community-level living and working conditions in their family physician recruitment and retention efforts. Copyright © 2015 Longwoods Publishing.

  11. Study for effective use of fishery byproducts as alternative earth materials focusing on their water retention

    International Nuclear Information System (INIS)

    Kobayashi, Kaoru; Nakafusa, Satoru; Nishimura, Tomoyoshi; Morii, Toshihiro

    2011-01-01

    Capillary barriers have been known and widely used in geoenvironmental engineering applications as soil cover for typical rainfall infiltration control systems. The capillary barrier is consisting of a fine-grained soil layer placed over a coarse-grained soil layer. The applications of capillary barriers are significantly useful to preventing infiltration into waste materials. Natural gravel or coarse-grained soil material had a exhaustion problems in practices. On the contrary, shells a kind of fishery byproduct, are classified as industrial waste in laws concerning waste disposal. The majority of shells are piled and left near the fishing port without controlling system. Therefore, it is proposed that the crushed shells are available to layer material instead of natural coarse-grained soil. This solution is considered to great contribute developing of recycle for fisher byproduct shells and is related to environment conservation. Water retention for crushed shells, however, never been fully investigate. This study focuses on the ability of crushed shells to capillary barrier applications. The soil-water characteristic curve for crushed shells with three different grain size distributions was determined using the modified SWCC testing apparatus. Also, it is observed using a conventional model equipment that the getting of fine sand into crushed shell layer is prevented. (author)

  12. Effect of biochar amendment on soil's retention capacity for estrogenic hormones from poultry manure treatment

    Institute of Scientific and Technical Information of China (English)

    Sukhjot MANN; Zhiming QI; Shiv O.PRASHER; Lanhai LI; Dongwei GUI; Qianjing JIANG

    2017-01-01

    Most animals,including humans,produce natural sex hormones such as estrogens:17β-estradiol (E2) and estrone (El).These compounds are able to disrupt the reproductive systems of living organisms at trace concentrations (ng.L-1).This experiment tests the hypothesis that 1% slow pyrolysis biochar-amended sandy soil could retain significant amount of estrogens (El,E2) from poultry manure in its second year of application.The experiment was conducted over 46 days and consisted of a series of lysimeters containing sandy soil with biocharamended topsoil.The application rate of poultry manure was kept at 2.47 kg.m-2.The biochar held a significant concentration of hormone during the first year of its application.However,in the following year (current study),there was no significant retention of hormones in the biochar-amended soil.During the first year after application,the biochar was fresh,so its pores were available for hydrophobic interactions and held significant concentration of hormones.As time passed there were several biotic and abiotic changes on the surface of the biochar so that after some physical fragmentation,pores on the surface were no longer available for hydrophobic interactions.The biochar started releasing dissolved organic carbon,which facilitated greater mobility of hormones from poultry manure down the soil profile.

  13. Effects of telemetry transmitter placement on egg retention in naturally spawning, captively reared steelhead

    International Nuclear Information System (INIS)

    Berejikian, Barry A.; Brown, Richard S.; Tatara, Chris P.; Cooke, Steven J.

    2007-01-01

    Maturing female anadromous salmonids receiving surgical intraperitoneally-implanted telemetry transmitters may experience difficulty depositing eggs during natural spawning. We allocated maturing adult steelhead females to three treatments: tags surgically implanted in the body cavity (internal), tags implanted between the skin and muscle tissue (subdermal), and non-tagged, and allowed them to spawn naturally in an experimental channel. Internally tagged females retained significantly more eggs than both the subdermally tagged treatment (P = 0.005) and non-tagged controls (P = 0.001); the subdermal and non-tag controls did not differ significantly (P = 0.934). The internal, subdermal and non-tag treatments retained an average of 49%, 11% and 2% of their eggs, respectively. The onset of sexual activity did not differ significantly among treatments (P = 0.413). Post-spawning mortality was 70% for both internally and subdermally tagged females and 0% for non-tagged females (P <0.01). We suggest that subdermal implantation techniques be considered in future studies during the reproductive period to reduce egg retention caused by internal implantation of transmitters

  14. Effect of chemical retention on anionic species diffusion in compacted clays

    International Nuclear Information System (INIS)

    Bazer-Bachi, Frederic

    2005-01-01

    Anionic radioisotopes are of particular importance within the framework of the calculated health risk associated with high-level and long-lived intermediate-level underground radioactive waste disposal. Therefore, the objective of this work is the construction of a transport model coupled with chemistry in order to quantify the behaviour of anionic solutes in the Callovo-Oxfordian (CO_x) argillite, the argillaceous host rock of the ANDRA Meuse/Haute-Marne underground laboratory. An experimental methodology was defined to characterize this migration, several experimental methods being implemented: batch experiments, laboratory columns and through-diffusion cells. The study of the diffusion of the non-sorbing anionic tracer "3"6Cl"- highlighted the fact that, due to anionic exclusion, anions only had access to a part of the porosity. The retention of "3"5SO_4"2"- and "1"2"5I- on CO_x argillite was then characterized, quantified by batch experiments and confirmed by other experimental methods. Nevertheless, their migration was less retarded than expected by a model based on batch experiments and on "3"6Cl"- diffusive data. This difference was explained by anion exclusion which reduced sorption site accessibility. Thus, the intensity of this phenomenon has to be considered to model anion migration in compacted clays. (author) [fr

  15. The effect of organic loading rate and retention time on hydrogen production from a methanogenic CSTR.

    Science.gov (United States)

    Pakarinen, O; Kaparaju, P; Rintala, J

    2011-10-01

    The possibility of shifting a methanogenic process for hydrogen production by changing the process parameters viz., organic loading rate (OLR) and hydraulic retention time (HRT) was evaluated. At first, two parallel semi-continuously fed continuously stirred tank reactors (CSTR) were operated as methanogenic reactors (M1 and M2) for 78 days. Results showed that a methane yield of 198-218 L/kg volatile solids fed (VS(fed)) was obtained when fed with grass silage at an OLR of 2 kgVS/m³/d and HRT of 30 days. After 78 days of operation, hydrogen production was induced in M2 by increasing the OLR from 2 to 10 kgVS/m³/d and shortening the HRT from 30 to 6 days. The highest H₂ yield of 42 L/kgVS(fed) was obtained with a maximum H₂ content of 24%. The present results thus demonstrate that methanogenic process can be shifted towards hydrogen production by increasing the OLR and decreasing HRT. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Effects of telemetry transmitter placement on egg retention in naturally spawning, captively reared steelhead

    Energy Technology Data Exchange (ETDEWEB)

    Berejikian, Barry A.; Brown, Richard S.; Tatara, Chris P.; Cooke, Steven J.

    2007-05-01

    Maturing female anadromous salmonids receiving surgical intraperitoneally-implanted telemetry transmitters may experience difficulty depositing eggs during natural spawning. We allocated maturing adult steelhead females to three treatments: tags surgically implanted in the body cavity (internal), tags implanted between the skin and muscle tissue (subdermal), and non-tagged, and allowed them to spawn naturally in an experimental channel. Internally tagged females retained significantly more eggs than both the subdermally tagged treatment (P = 0.005) and non-tagged controls (P = 0.001); the subdermal and non-tag controls did not differ significantly (P = 0.934). The internal, subdermal and non-tag treatments retained an average of 49%, 11% and 2% of their eggs, respectively. The onset of sexual activity did not differ significantly among treatments (P = 0.413). Post-spawning mortality was 70% for both internally and subdermally tagged females and 0% for non-tagged females (P <0.01). We suggest that subdermal implantation techniques be considered in future studies during the reproductive period to reduce egg retention caused by internal implantation of transmitters.

  17. Modeling the effect of continuous infusion DTPA therapy on the retention and dosimetry of inhaled actinides

    International Nuclear Information System (INIS)

    Guilmette, R.A.; Muggenburg, B.A.

    1988-01-01

    A biokinetic model of the treatment of dogs that inhaled 241 AmO 2 aerosols with continuously infused DTPA has been adapted from a model previously published by Mewhinney and Griffith. This model simulated both the tissue retention and excretion of 241 Am, and was used to estimate the cumulative radiation doses to tissues at risk from 241 Am alpha radiation. The results showed that at 64 days after exposure, the liver dose of the DTPA-treated animals was 3% that of the corresponding controls, the skeletal dose was 2%, the kidney dose was 4%, and the lung dose was 67% of controls. This paper describes a biokinetic and dosimetric model that was adapted from a previously published model. It was developed to provide a means of estimating radiation doses for cases where continuously infused DTPA therapy is used to reduce radiation dose. The model was formulated for the case of 241 Am0 2 inhalation, a physicochemical form of Am that is moderately soluble in vivo, and one to which people have been exposed. Because adequate human data, particularly tissue data, are not available from cases of accidental human exposure to 241 Am, two published data sets from experiments in which Beagle dogs inhaled 241 Am0 2 aerosols have been used to obtain parameter estimates for the model. The model simulations were then used to provide dose estimates with and without infused-DTPA therapy. (author)

  18. Retention of Root Canal Posts

    DEFF Research Database (Denmark)

    Sahafi, A; Benetti, Ana Raquel; Flury, S

    2015-01-01

    The aim of this study was to investigate the effect of the cement film thickness of a zinc phosphate or a resin cement on retention of untreated and pretreated root canal posts. Prefabricated zirconia posts (CosmoPost: 1.4 mm) and two types of luting cements (a zinc phosphate cement [DeTrey Zinc...... received tribochemical silicate coating according to the manufacturer's instructions. Posts were then luted in the prepared root canals (n=30 per group). Following water storage at 37°C for seven days, retention of the posts was determined by the pull-out method. Irrespective of the luting cement......, pretreatment with tribochemical silicate coating significantly increased retention of the posts. Increased cement film thickness resulted in decreased retention of untreated posts and of pretreated posts luted with zinc phosphate cement. Increased cement film thickness had no influence on retention...

  19. The work environment and its effect on engagement and retention of nuclear medicine technologists: differences between public and private sector workers.

    Science.gov (United States)

    Adams, Edwina J; Cox, Jennifer M; Adamson, Barbara J; Schofield, Deborah J

    2010-06-01

    The retention of Australian nuclear medicine technologists (NMTs) is poor with the future workforce size in question. As a consequence, the primary aim of this study was to determine Australian NMTs' level of work engagement and the factors influencing this to identify the issues surrounding retention. The job demands resource model assumes that each job has its own demands and resources and the balance between these can influence the level of work engagement. Lower levels of work engagement are predictive of an intention to leave. Work engagement levels can be measured using the Utrecht work engagement scale. This study used the Utrecht Work Engagement Scale in a self-report questionnaire with additional open-ended and closed-ended items designed to evaluate satisfying job characteristics. Members of the professional body in specific geographical locations of Australia were invited to participate. A 49.6% response rate was achieved (n=201); of these, 164 were practicing NMTs. Public sector workers had significantly lower total mean scores (P=0.05) on the Utrecht Work Engagement Scale and the subscale of dedication (P=0.005) compared with private NMTs. Seven of the 14 job satisfaction closed-ended items were statistically significantly lower for public NMTs: the level of decision making; feelings of importance with the tasks performed; feedback on tasks and roles; and relationships with physicians, staff and the organization. To improve the retention of NMTs, changes in the job resources and demands are needed. Advanced practice roles may improve retention by enhancing the job resources.

  20. Effects of Ultrasound Assistance on Dehydration Processes and Bioactive Component Retention of Osmo-Dried Sour Cherries.

    Science.gov (United States)

    Siucińska, Karolina; Mieszczakowska-Frąc, Monika; Połubok, Aleksandra; Konopacka, Dorota

    2016-07-01

    Despite having numerous health benefits, dried sour cherries have proven to be more acceptable to consumers when infused with sugar or other sweeteners to enhance their flavor, which, in turn, leads to serious anthocyanin losses. For this reason, a consideration was made for the application of ultrasound to accelerate solid gain and shorten drying time, thus favoring bioactive component retention. To determine the usefulness of ultrasound as a tool for sour cherry osmotic infusion enhancement, the effect of sonication time on dehydration effectiveness, as well as the stability of bioactive components during osmotic treatment and consecutive convective drying, was investigated. Fruits were osmo-dehydrated using a 60% sucrose solution for 120 min (40 °C), during which, ultrasound of 25 kHz (0.4 W/cm(2) ), was applied for 0, 30, 60, 90, and 120 min, after which, the fruits were convectively dried. In the range of the applied ultrasound energy no significant effect of sonication on mass transfer intensification was observed; moreover, longer acoustic treatment seemed to retard moisture removal during subsequent convective drying, which can be related to the breakdown of the parenchyma cell walls caused by the prolonged ultrasound (US) action. It was concluded that although US assistance could be considered neutral for bioactive component retention, excessive sonication time can lead to some anthocyanin deterioration. According to high-performance liquid chromatography analysis, the particular anthocyanin alterations, both during dehydration and final drying, occurred in a similar way. Sonication time prolongation caused approximately 10% more bioactive compound deterioration, than earlier, shorter trials. © 2016 Institute of Food Technologists®

  1. Carbamazepine behaviour and effects in an urban wastewater MBR working with high sludge and hydraulic retention time.

    Science.gov (United States)

    González-Pérez, Daniel María; Pérez, Jorge Ignacio; Nieto, Miguel Ángel Gómez

    2016-08-23

    The behaviour and fate of carbamazepine (CBZ) in urban wastewater treatment by a membrane bioreactor (MBR) and its possible effects on the system's efficiency, and on mixed microbial communities, has been studied. The experimental microfiltration MBR system, with capacity to treat 10.8 m(3) d(-1) of urban wastewater, operated with a pre-denitrification configuration with high sludge and hydraulic retention time. The CBZ concentration assayed was higher than in the usual urban wastewater, in order to provoke a strong biomass reaction. Influent, effluent, and all bioreactors of the MBR system were analysed in order to calculate a CBZ balance. Bench-scale experiments and respirometric analyses were performed, with and without the presence of CBZ, to evaluate its influence on the bacterial activity. The respirometric assays showed variations in the oxygen uptake rate (OUR) in the presence of CBZ. Negative effects were detected in the MBR bacterial community during the initial period of dosing. However, the effects were not permanent and the biomass spiked with CBZ had behaviour similar to that of the biomass without CBZ after a few hours. Biodegradation was not detected during the MBR treatment. The system showed an inefficient elimination of CBZ (less than 10%) with a high concentration in the effluent. The small percentage of CBZ removal was associated with the sludge retention and eliminated by the purge. All CBZ present in the influent was accounted for, and even an increase in the total amount of CBZ was registered in the permeate. During and after the experimental process, CBZ did not significantly affect the efficiency of the MBR system, and the quality of the effluent was not affected by the dosing of CBZ in terms of COD and nitrogen removal.

  2. Effect of subacute poisoning with bifenthrin on locomotor activity, memory retention, haematological, biochemical and histopathological parameters in mice.

    Science.gov (United States)

    Nieradko-Iwanicka, B; Borzecki, A; Jodlowska-Jedrych, B

    2015-02-01

    Bifenthrin (BIF) is a pyrethroid (PYR) insecticide. The target point for PYR's toxic action are voltage sensitive sodium channels in the central nervous system (CNS). Intoxication with PYRs results in motor activity impairment and death in insects. Although PYRs are considered to be safe for mammals, there were numerous cases of pyrethroid poisoning in humans, animals and pets described. The general population is chronically exposed to PYRs via grain products, dust and indoor air. Therefore new questions arise: whether PYRs act in a dose-additive fashion in the course of subacute poisoning, are there other target organs (but brain) for BIF and if there is one common mechanism of its' toxic action in different organs. The objective of this work was to characterize the effect of BIF at the doses of 4 or 8 mg/kg injected intraperitoneally (i.p.) daily for 28 consecutive days on memory and motor activity, hematological, biochemical and histopathological parameters in mice. BIF at the doses of 8 mg/kg or 4 mg/kg of body mass was administered i.p. daily to the mice for 28 consecutive days. Motor function was measured on day 1, 7, 14 and 28 and memory retention was tested in a passive avoidance task on day 2, 7, 14 and 28. BIF significantly impaired memory retention on day 2. BIF decreased locomotor activity at every stage of the experiment in a single dose depending manner. No behavioral cumulative effect was observed. Subacute poisoning with the higher dose of BIF caused anaemia, elevated white blood cell count (WBC), elevated alanine transaminase (ALT), superoxide dismuthase (SOD), and decreased glutathione peroxidase (GPx) activity. Lymphocyte infiltrates were visualized in the livers. subacute poisoning with BIF decreases locomotor activity in a single dose proportionate manner. BIF damages also the liver and alters blood morphology. The possible common mechanism of these effects can be oxidative stress.

  3. Nutritional support teams: the cooperation among physicians and pharmacists helps improve cost-effectiveness of home parenteral nutrition (HPN).

    Science.gov (United States)

    Pietka, Magdalena; Watrobska-Swietlikowska, Dorota; Szczepanek, Kinga; Szybinski, Piotr; Sznitowska, Małgorzata; Kłęk, Stanisław

    2014-09-12

    Modern home parenteral nutrition (HPN) requires the preparation of tailored admixtures. The physicians' demands for their composition are often at the variance with pharmaceutical principles, which causes the necessity of either the preparation of ex tempore admixtures or stability testing ensuring long shelf life. Both approaches are not cost-effective. The aim of the study was to use the cooperation among physicians and pharmacists to assure both: cost-effectiveness and patient-tailored HPN admixtures. The first part of the study consisted of the thorough analysis of prescriptions for the most demanding 47 HPN patients (27 females and 20 males, mean age 53.1 year) treated at one HPN center to create few as possible long-shelf life admixtures. The second part of the study consisted of stability testing and modifications. The analysis showed over 137 variations needed to cover all macro- and micronutrients requirements. Their cost as ex-tempore solutions was extremely high (over 110 000 EURO/month) due to logistics and similarly high if stability test for variation were to be performed (68 500 EURO). Therefore prescription was prepared de novo within team of physicians and pharmacists and four base models were designed. Water and electrolytes, particularly magnesium and calcium showed to be the major issues. Stability tests failed in one admixture due to high electrolytes concentration. It was corrected, and the new formula passes the test. Five basic models were then used for creation of new bags. Cost of such an activity were 3 700 EURO (pcooperation within the members of nutritional support team could improve the cost-effectiveness and quality of HPN. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  4. Effects of Hydraulic Retention Time on the Performance of a Membrane Bioreactor Treating Municipal Wastewater

    Directory of Open Access Journals (Sweden)

    Hadi Falahati

    2017-09-01

    Full Text Available There is an increasing demand for effluents of higher quality from wastewater treatment plants due to the more stringent quality standards as well as the increasing pressure on water resources worldwide, which calls for effluent recycle and reuse. Membrane bioreactors (MBRs have been recently gaining rapid popularity as a promising technology for wastewater treatment. In order to improve the quality of the effluent from Shiraz wastewater treatment plant, an on-site pilot-scale membrane bioreactor was operated for 9 months. The pilot plant built at Shiraz wastewater treatment plant consisted of an aerobic reactor and a membrane compartment containing one submerged hollow fiber membrane module. In this study, eleven different aerobic hydraulic retention times (HRT ranging from 2 to 12 hours were tested to determine the membrane capacity and to investigate the performance of the system in removing total ammonia nitrogen, organic matter, total suspended solids, and turbidity.The system recorded a perfectly stable removal efficiency over the whole experimental period, except for the 2-hour aerobic HRT, so that its COD and BOD reductions exceeded 95% and 99%, respectively. Moreover, the system achieved complete nitrification in a stable manner during the whole study period, except for the 2-hour aerobic operation period. TSS concentration was almost zero and turbidity was less than 1 NTU. Membrane capacity measurements showed an average flux of 5.5 Lm-2h-1 with a mean trans-membrane pressure difference of 30 kPa. Results showed that the MBR outperformed the conventional sewage treatment processes. Additionally, it was not affected by aerobic HRT changes (12, 10, 8, 6, 4, and 3h. Based on the effluent qulity, teh system may be recommended for application toward water reuse in industrial and agricultural settings

  5. Methylmercury bioaccumulation in invertebrates of boreal streams in Norway: Effects of aqueous methylmercury and diet retention

    International Nuclear Information System (INIS)

    Wit, Heleen A. de; Kainz, Martin J.; Lindholm, Markus

    2012-01-01

    Transfer of aqueous methylmercury (MeHg) to primary consumers in aquatic foodwebs is poorly understood despite its importance for bioaccumulation of MeHg. We studied bioaccumulation of MeHg in simple aquatic food chains of two humic boreal streams in relation to streamwater chemistry, food web characteristics and dietary fatty acid (FA) biomarkers. Transfer of aqueous MeHg into primary consumers was similar in both streams, resulting in higher MeHg in consumers in the MeHg-rich stream. Trophic enrichment of MeHg and dietary retention of FA biomarkers was the same in both streams, suggesting that exposure to aqueous MeHg at the base of the food chain determined levels of MeHg in biota. In addition, contents of dietary biomarkers suggested that ingestion of algae reduced MeHg bioaccumulation, while ingestion of bacteria stimulated MeHg uptake. Dietary uptake of bacteria could thus be an important pathway for MeHg-transfer at the bottom of food chains in humic streams. - Highlights: ► We examined MeHg bioaccumulation in simple food chains in two boreal streams. ► Higher MeHg in invertebrates was associated with higher aqueous MeHg. ► Dietary biomarkers showed that consumers in both streams accessed similar food sources. ► We concluded at exposure to aqueous MeHg determined bioaccumulation of MeHg. ► Seasonal variation in MeHg in biota could be related to diet using dietary biomarkers. - Exposure to aqueous methylmercury at the base of the food chain in boreal streams determines mercury in aquatic biota at higher trophic levels.

  6. Effect of transient liquid flow on retention characteristics of screen acquisition systems. [design of Space Shuttle feed system

    Science.gov (United States)

    Cady, E. C.

    1977-01-01

    A design analysis, is developed based on experimental data, to predict the effects of transient flow and pressure surges (caused either by valve or pump operation, or by boiling of liquids in warm lines) on the retention performance of screen acquisition systems. A survey of screen liquid acquisition system applications was performed to determine appropriate system environment and classification. A screen model was developed which assumed that the screen device was a uniformly distributed composite orthotropic structure, and which accounted for liquid inflow/outflow, gas ingestion quality, screen stress, and liquid spill. A series of 177 tests using 13 specimens (5 screen meshes, 4 screen device construction/backup methods, and 2 orientations) with three test fluids (isopropyl alcohol, Freon 114, and LH2) provided data which verified important features of the screen model and resulted in a design tool which could accurately predict the transient startup performance acquisition devices.

  7. Effect of Premolar Axial Wall Height on Computer-Aided Design/Computer-Assisted Manufacture Crown Retention.

    Science.gov (United States)

    Martin, Curt; Harris, Ashley; DuVall, Nicholas; Wajdowicz, Michael; Roberts, Howard Wayne

    2018-03-28

    To evaluate the effect of premolar axial wall height on the retention of adhesive, full-coverage, computer-aided design/computer-assisted manufacture (CAD/CAM) restorations. A total of 48 premolar teeth randomized into four groups (n = 12 per group) received all-ceramic CAD/CAM restorations with axial wall heights (AWH) of 3, 2, 1, and 0 mm and 16-degree total occlusal convergence (TOC). Specimens were restored with lithium disilicate material and cemented with self-adhesive resin cement. Specimens were loaded to failure after 24 hours. The 3- and 2-mm AWH specimens demonstrated significantly greater failure load. Failure analysis suggests a 2-mm minimum AWH for premolars with a TOC of 16 degrees. Adhesive technology may compensate for compromised AWH.

  8. Managing retention.

    Science.gov (United States)

    Carter, Tony

    2007-01-01

    To build this process it is necessary to consult customers for preferences, build familiarity and knowledge to build a relationship and conduct business in a customized fashion. The process takes every opportunity to build customer satisfaction with each customer contact. It is an important process to have, since customers today are more demanding, sophisticated, educated and comfortable speaking to the company as an equal (Belk, 2003). Customers have more customized expectations so they want to be reached as individuals (Raymond and Tanner, 1994). Also, a disproportionate search for new business is costly. The cost to cultivate new customers is more than maintaining existing customers (Cathcart, 1990). Other reasons that customer retention is necessary is because many unhappy customers will never buy again from a company that dissatisfied them and they will communicate their displeasure to other people. These dissatisfied customers may not even convey their displeasure but without saying anything just stop doing business with that company, which may keep them unaware for some time that there is any problem (Cathcart, 1990).

  9. The effect of amino acid lysine and methionine addition on feed toward the growth and retention on mud crab (Scylla serrata)

    Science.gov (United States)

    Alissianto, Y. R.; Sandriani, Z. A.; Rahardja, B. S.; Agustono; Rozi

    2018-04-01

    High market demand of mud crab (Scylla serrata) encourages farmers to increase the production of mud crab. However, mud crab can not synthesize essential amino acids, so it is necessary to supply essential amino acids such as lysine and methionine in the diet. This study aims to determine the effect of lysine and methionine on feeds to increase growth and retention of mud crabs (Scylla serrata). In this study the amount of lysine amino acid and methionine added to the trash fish diet were: P0 (0: 0%); P1 (0.75: 0.75%); P2 (1: 1%); P3 (1.25: 1.25%); P4 (1.5: 1.5%) with the ratio of lysine and methionine 1: 1. The parameters observed in this study were Survival Rate (SR), Specific Growth Rate (SGR), Feed Conversion Ratio (FCR), Efficiency Feed (EF), protein retention and energy retention. The results of the 35-day maintenance study showed significant differences (P protein retention and no significant effect (P> 0.05) on energy retention and Survival Rate (SR) on mud crab. The best results in this study were found in P4 treatment with addition of lysine amino acids and methionine (1.5: 1.5%).

  10. Effects of the radiation gamma on the activity and selectivity of the Al2 O3 in the retention of uranium and fission products

    International Nuclear Information System (INIS)

    Duran B, J.M.

    1996-01-01

    The study that here comes constitute a contribution for the treatment of based on waste the properties of retention of the inorganic oxides. The effect induced of the radiation has been determined gamma of the 60 Co in the Al 2 O 3 and their influence in their capacity of retention of uranium and products of fission of watery solutions strongly alkaline. In order to obtain useful information it made the superficial characterizations, structural, crystalline and of retention by means of the techniques of superficial adsorption, spectroscopy infrared, rays-X diffraction, liquid twinkling and γ- spectrometry. The obtained results show that the treatment of the Al 2 O 3 this associated with slight changes in their structural characteristics and superficialities concluding that the molecular water present in the crystalline net of the oxide was not displaced radiolytic for effect, but rather, this spread in the volume of the oxide, blocking the change in the contribution to crystalline of the oxide. (Author)

  11. Recovery of resources for advanced life support space applications: effect of retention time on biodegradation of two crop residues in a fed-batch, continuous stirred tank reactor

    Science.gov (United States)

    Strayer, R. F.; Finger, B. W.; Alazraki, M. P.; Cook, K.; Garland, J. L.

    2002-01-01

    Bioreactor retention time is a key process variable that will influence costs that are relevant to long distance space travel or long duration space habitation. However. little is known about the effects of this parameter on the microbiological treatment options that are being proposed for Advanced Life Support (ALS) systems. Two bioreactor studies were designed to examine this variable. In the first one, six retention times ranging from 1.3 to 21.3 days--were run in duplicate, 81 working-volume continuous stirred tank reactors (CSTR) that were fed ALS wheat residues. Ash-free dry weight loss, carbon mineralization, soluble TOC reduction, changes in fiber content (cellulose, hemicellulose, and lignin), bacterial numbers, and mineral recoveries were monitored. At short retention times--1.33 days--biodegradation was poor (total: 16-20%, cellulose - 12%, hemicellulose - 28%) but soluble TOC was decreased by 75-80% and recovery of major crop inorganic nutrients was adequate, except for phosphorus. A high proportion of the total bacteria (ca. 83%) was actively respiring. At the longest retention time tested, 21.3 days, biodegradation was good (total: 55-60%, cellulose ca. 70%, hemicellulose - ca. 55%) and soluble TOC was decreased by 80%. Recovery of major nutrients, except phosphorus, remained adequate. A very low proportion of total bacteria was actively respiring (ca. 16%). The second bioreactor study used potato residue to determine if even shorter retention times could be used (range 0.25-2.0 days). Although overall biodegradation deteriorated, the degradation of soluble TOC continued to be ca. 75%. We conclude that if the goal of ALS bioprocessing is maximal degradation of crop residues, including cellulose, then retention times of 10 days or longer will be needed. If the goal is to provide inorganic nutrients with the smallest volume/weight bioreactor possible, then a retention time of 1 day (or less) is sufficient.

  12. Prescribing practices amid the OxyContin crisis: examining the effect of print media coverage on opioid prescribing among physicians.

    Science.gov (United States)

    Borwein, Alexandra; Kephart, George; Whelan, Emma; Asbridge, Mark

    2013-12-01

    The pain medication OxyContin (hereafter referred to as oxycodone extended release) has been the subject of sustained, and largely negative, media attention in recent years. We sought to determine whether media coverage of oxycodone extended release in North American newspapers has led to changes in prescribing of the drug in Nova Scotia, Canada. An interrupted time-series design examined the effect of media attention on physicians' monthly prescribing of opioids. The outcome measures were, for each physician, the monthly proportions of all opioids prescribed and the proportion of strong opioids prescribed that were for oxycodone extended release. The exposure of interest was media attention defined as the number of articles published each month in 27 North American newspapers. Variations in media effects by provider characteristics (specialty, prescribing volume, and region) were assessed. Within-provider changes in the prescribing of oxycodone extended release in Nova Scotia were observed, and they followed changes in media coverage. Oxycodone extended release prescribing rose steadily prior to receiving media attention. Following peak media attention in the United States, the prescribing of oxycodone extended release slowed. Likewise, following peak coverage in Canadian newspapers, the prescribing of oxycodone extended release declined. These patterns were observed across prescriber specialties and by prescriber volume, though the magnitude of change in prescribing varied. This study demonstrates that print media reporting of oxycodone extended release in North American newspapers, and its continued portrayal as a social problem, coincided with reductions in the prescribing of oxycodone extended release by physicians in Nova Scotia. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

  13. Effect of ultrasound training of physicians working in the prehospital setting

    DEFF Research Database (Denmark)

    Krogh, Charlotte Loumann; Steinmetz, Jacob; Rudolph, Søren Steemann

    2016-01-01

    measure was US performance assessed by the total score in a modified version of the Objective Structured Assessment of Ultrasound Skills scale (mOSAUS). METHODS: Prehospital physicians participated in a four-hour US course consisting of both hands-on training and e-learning including a pre- and a post-learning...... test. Prior to the hands-on training a pre-training test was applied comprising of five videos in which the participants should identify pathology and a five-minute US examination of a healthy volunteer portraying to be a shocked patient after a blunt torso trauma. Following the pre-training test...... the study. A significant improvement was identified in e-learning performance and US performance, (37.5 (SD: 10.0)) vs. (51.3 (SD: 5.9) p = 

  14. Effects of flow sheet implementation on physician performance in the management of asthmatic patients.

    Science.gov (United States)

    Ruoff, Gary

    2002-01-01

    This project focused on increasing compliance, in a large family practice group, with quality indicators for the management of asthma. The objective was to determine if use of a flow sheet incorporating the Global Initiative for Asthma (GINA) guidelines could improve compliance with those guidelines if the flow sheet was placed in patients' medical records. After review and selection of 14 clinical quality indicators, physicians in the practice implemented a flow sheet as an intervention. These flow sheets were inserted into the records of 122 randomly selected patients with asthma. Medical records were reviewed before the flow sheets were placed in the records, and again approximately 6 months later, to determine if there was a change in compliance with the quality indicators. Improvement of documentation was demonstrated in 13 of the 14 quality indicators. The results indicate that compliance with asthma management quality indicators can improve with the use of a flow sheet.

  15. Effect of an educational intervention in primary care physicians on the compliance of indicators of good clinical practice in the treatment of type 2 diabetes mellitus [OBTEDIGA project].

    Science.gov (United States)

    Vidal-Pardo, J I; Pérez-Castro, T R; López-Álvarez, X L; Santiago-Pérez, M I; García-Soidán, F J; Muñiz, J

    2013-08-01

    To evaluate the effect of an educational intervention among primary care physicians on several indicators of good clinical practice in diabetes care. Two groups of physicians were randomly assigned to the intervention or control group (IG and CG). Every physician randomly selected two samples of patients from all type 2 diabetic patients aged 40 years and above and diagnosed more than a year ago. Baseline and final information were collected cross-sectionally 12 months apart, in two independent samples of 30 patients per physician. The educational intervention comprised: distribution of educational materials and physicians' specific bench-marking information, an on-line course and three on-site educational workshops on diabetes. External observers collected information directly from the physicians and from the medical records of the patients on personal and family history of disease and on the evolution and treatment of their disease. Baseline information was collected retrospectively in the control group. Intervention group comprised 53 physicians who included a total of 3018 patients in the baseline and final evaluations. CG comprised 50 physicians who included 2868 patients in the same evaluations. Measurement of micro-albuminuria in the last 12 months (OR = 1.6, 95% CI: 1.1-2.4) and foot examination in the last year (OR = 2.0, 95% CI: 1.1-3.6) were the indicators for which greater improvement was found in the IG. No other indicator considered showed statistically significant improvement between groups. The identification of indicators with very low level of compliance and the implementation of a simple intervention in physicians to correct them is effective in improving the quality of care of diabetic patients. © 2013 John Wiley & Sons Ltd.

  16. The effect of cognitive load and patient race on physicians' decisions to prescribe opioids for chronic low back pain: a randomized trial.

    Science.gov (United States)

    Burgess, Diana J; Phelan, Sean; Workman, Michael; Hagel, Emily; Nelson, David B; Fu, Steven S; Widome, Rachel; van Ryn, Michelle

    2014-06-01

    To test the hypothesis that racial biases in opioid prescribing would be more likely under high levels of cognitive load, defined as the amount of mental activity imposed on working memory, which may come from environmental factors such as stressful conditions, chaotic workplace, staffing insufficiency, and competing demands, one's own psychological or physiological state, as well as from demands inherent in the task at hand. Two (patient race: White vs Black) by two (cognitive load: low vs high) between-subjects factorial design. Ninety-eight primary care physicians from the Veterans Affairs Healthcare System. Web-based experimental study. Physicians were randomly assigned to read vignettes about either a Black or White patient, under low vs high cognitive load, and to indicate their likelihood of prescribing opioids. High cognitive load was induced by having physicians perform a concurrent task under time pressure. There was a three-way interaction between patient race, cognitive load, and physician gender on prescribing decisions (P = 0.034). Hypotheses were partially confirmed. Male physicians were less likely to prescribe opioids for Black than White patients under high cognitive load (12.5% vs 30.0%) and were more likely to prescribe opioids for Black than White patients under low cognitive load (30.8% vs 10.5%). By contrast, female physicians were more likely to prescribe opioids for Black than White patients in both conditions, with greater racial differences under high (39.1% vs 15.8%) vs low cognitive load (28.6% vs 21.7%). Physician gender affected the way in which patient race and cognitive load influenced decisions to prescribe opioids for chronic pain. Future research is needed to further explore the potential effects of physician gender on racial biases in pain treatment, and the effects of physician cognitive load on pain treatment. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  17. Effects of Feedback Frequency and Timing on Acquisition, Retention, and Transfer of Speech Skills in Acquired Apraxia of Speech

    Science.gov (United States)

    Hula, Shannon N. Austermann; Robin, Donald A.; Maas, Edwin; Ballard, Kirrie J.; Schmidt, Richard A.

    2008-01-01

    Purpose: Two studies examined speech skill learning in persons with apraxia of speech (AOS). Motor-learning research shows that delaying or reducing the frequency of feedback promotes retention and transfer of skills. By contrast, immediate or frequent feedback promotes temporary performance enhancement but interferes with retention and transfer.…

  18. The Effect of Retention Interval Task Difficulty on Young Children's Prospective Memory: Testing the Intention Monitoring Hypothesis

    Science.gov (United States)

    Mahy, Caitlin E. V.; Moses, Louis J.

    2015-01-01

    The current study examined the impact of retention interval task difficulty on 4- and 5-year-olds' prospective memory (PM) to test the hypothesis that children periodically monitor their intentions during the retention interval and that disrupting this monitoring may result in poorer PM performance. In addition, relations among PM, working memory,…

  19. Scale effect on the water retention curve of a volcanic ash

    Science.gov (United States)

    Damiano, Emilia; Comegna, Luca; Greco, Roberto; Guida, Andrea; Olivares, Lucio; Picarelli, Luciano

    2015-04-01

    During the last decades, a number of flowslides and debris flows triggered by intense rainfall affected a wide mountainous area surrounding the "Campania Plain" (southern Italy). The involved slopes are constituted by shallow unsaturated air-fall deposits of pyroclastic nature, which stability is guaranteed by the contribution of suction on shear strength. To reliably predict the onset of slope failure triggered by critical precipitations, is essential to understand the infiltration process and the soil suction distribution in such granular deposits. The paper presents the results of a series of investigation performed at different scales to determine the soil water retention curve (SWRC) of a volcanic ash which is an es-sential element in the analysis of the infiltration processes. The soil, a silty sand, was taken at Cervinara hillslope, 30 km East of Naples, just aside an area which had been subjected to a catastrophic flowslide. The SWRC was obtained through: - standard tests in a suction-controlled triaxial apparatus (SCTX), in a pressure plate and by the Wind technique (1968) on small natural and reconstituted soil samples (sample dimensions in the order of the 1•10-6m3) ; - infiltration tests on small-scale model slopes reconstituted in an instrumented flume (sample dimensions in the order of 5•10-3m3); - suction and water content monitoring at the automatic station installed along the Cervinara hillslope. The experimental points generally were defined by coupling suction measurements through jet-fill tensiometers and water content through TDR probes installed close each others. The obtained data sets individuate three different curves characterized by different shapes in the transition zone: at larger volume element dimensions correspond curves which exhibit steeper slopes and lower values of the water content in the transition zone. This result confirms the great role of the volume element dimensions in the de-termination of hydraulic characteristics

  20. The relationship between physician humility, physician-patient communication, and patient health.

    Science.gov (United States)

    Ruberton, Peter M; Huynh, Ho P; Miller, Tricia A; Kruse, Elliott; Chancellor, Joseph; Lyubomirsky, Sonja

    2016-07-01

    Cultural portrayals of physicians suggest an unclear and even contradictory role for humility in the physician-patient relationship. Despite the social importance of humility, however, little empirical research has linked humility in physicians with patient outcomes or the characteristics of the doctor-patient visit. The present study investigated the relationship between physician humility, physician-patient communication, and patients' perceptions of their health during a planned medical visit. Primary care physician-patient interactions (297 patients across 100 physicians) were rated for the physician's humility and the effectiveness of the physician-patient communication. Additionally, patients reported their overall health and physicians and patients reported their satisfaction with the interaction. Within-physician fluctuations in physician humility and self-reported patient health positively predicted one another, and mean-level differences in physician humility predicted effective physician-patient communication, even when controlling for the patient's and physician's satisfaction with the visit and the physician's frustration with the patient. The results suggest that humble, rather than paternalistic or arrogant, physicians are most effective at working with their patients. Interventions to improve physician humility may promote better communication between health care providers and patients, and, in turn, better patient outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. The effect of soy products in the diet on retention of non-heme iron from radiolabeled test meals fed to marginally iron-deficient young rats

    International Nuclear Information System (INIS)

    Thompson, D.B.

    1984-01-01

    Diets based either on casein or soy products and containing about 25 ppm iron were fed to weanling rats for 13 days. Rats were fasted overnight and fed a 59 Fe-radiolabeled casein test meal the morning of day 14. On day 21 less 59 Fe was retained by rats fed various diets based on selected soy products than by rats fed the casein-based diet. A similar adverse effect of diet components on 59 Fe retention from a casein test meal was observed for lactalbumin and for psyllium husk. No adverse effect of diet on 59 Fe retention was observed for the fiber of soy cotyledons or for rapeseed protein concentrate. For a commercial soy protein isolated (SPI) fed throughout the 21-day experiment, the adverse effect of diet on 59 Fe retention was observed to the sum of the effect of dietary SPI previous to the 59 Fe-radiolabeled casein test meal fed on day 14 and the effect of dietary SPI subsequent to the casein test meal. An effect of dietary soy products on 59 Fe retention from a casein test meal was not observed with diets containing higher iron levels (83 ppm) or when diets were fed for a longer period prior to the test meal (56 days). The present work shows that in some circumstances the concept of iron bioavailability must be expanded to include not only the influence of meal composition, but also the influence of diet previous to and subsequent to a meal

  2. Interactive effects of vitamin D3 and strontium on performance, nutrient retention and bone mineral composition in laying hens.

    Science.gov (United States)

    Browning, Linda C; Cowieson, Aaron J

    2015-03-30

    Strontium is currently prescribed for patients with osteoporosis to increase bone density and reduce bone fractures but its relevance in animal nutrition is obscure. In order to investigate the effect of supplemental strontium and vitamin D3 on performance, egg quality and skeletal integrity in poultry a total of 108 laying hens, 99 weeks of age, were fed three levels of strontium (0, 500, 1000 mg kg(-1) ) and two levels of vitamin D3 (2500, 5,000 iu kg(-1)) over a 12-week period. There was an improvement (P < 0.05) in egg production and feed conversion efficiency with strontium at 500 mg kg(-1) and a significant increase in egg weight in those hens fed additional vitamin D3 . Supplemental strontium increased phosphorus, sodium and strontium retention in birds fed 2500 iu D3 kg(-1) but reduced phosphorus, sodium and strontium retention in birds fed 5000 iu D3 kg(-1), resulting in an interaction (P < 0.01) between strontium and vitamin D3 . Addition of 5000 iu D3 kg(-1) increased egg weight (P < 0.05); predominantly by increased albumen content (P < 0.05), whereas strontium supplementation reduced egg weight (P < 0.001). Similarly, 5000 iu kg(-1) D3 increased apparent metabolizable energy (P < 0.05); in contrast, strontium supplementation reduced (P < 0.05) apparent metabolizable energy. The addition of 500 mg kg(-1) strontium significantly improved egg production and feed efficiency; however, further investigation needs to be undertaken to refine the optimum level of strontium required to maximize hen performance. The interrelationship between strontium and vitamin D3 requires further exploratory study. © 2014 Society of Chemical Industry.

  3. Effective Recruiting and Intrusive Retention Strategies for Diversifying the Geosciences through a Research Experiences for Undergraduate Program

    Science.gov (United States)

    Liou-Mark, J.; Blake, R.; Norouzi, H.; Yuen-Lau, L.; Ikramova, M.

    2016-12-01

    Worse than in most Science, Technology, Engineering, and Mathematics (STEM) fields, underrepresented minority (URM) groups in the geosciences are reported to be farthest beneath the national benchmarks. Even more alarming, the geosciences have the lowest diversity of all the STEM disciplines at all three levels of higher education. In order to increase the number of underrepresented groups in the geosciences, a National Science Foundation funded Research Experiences for Undergraduates (REU) program at the New York City College of Technology has implemented effective recruitment strategies to attract and retain diverse student cohorts. Recruitment efforts include: 1) establishing partnership with the local community colleges; 2) forging collaborations with scientists of color; 3) reaching out to the geoscience departments; and 4) forming relationships with STEM organizations. Unlike the other REU programs which primarily provide a summer-only research experience, this REU program engages students in a year-long research experience. Students begin their research in the summer for nine weeks, and they continue their research one day a week in the fall and spring semesters. During the academic year, they present their projects at conferences. They also serve as STEM ambassadors to community and high school outreach events. This one-year triad connection of 1) professional organizations/conferences, 2) continual research experience, and 3) service constituent has resulted in higher retention and graduation rates of URMs in the STEM disciplines. Both formative and summative program assessment have uncovered and shown that strong recruitment efforts accompanied by intrusive retention strategies are essential to: a) sustain and support STEM URMs in developing confidence as scientists; b) create formal and informal STEM communities; and c) provide a clear pathway to advanced degrees and to the geoscience workforce. This project is supported by NSF REU Grant #1560050.

  4. Effects of night shift on the cognitive load of physicians and urinary steroid hormone profiles - a randomized crossover trial.

    Science.gov (United States)

    Osterode, Wolf; Schranz, Sandra; Jordakieva, Galateja

    2018-03-21

    Mental and physical stress is common in physicians during night shifts. Neurocognitive effects of sleep deprivation as well as alterations in hormonal and metabolic parameters have previously been described. The aim of this crossover study was to evaluate the effects of night-shift work with partial sleep deprivation on steroid hormone excretion and possible associations with mood, sleep characteristics and cognitive functions in physicians. In total, 34 physicians (mean age 42 ± 8.5 years, 76.5% male) from different departments of the General Hospital of Vienna, Austria, were randomly assigned to two conditions: a regular day shift (8 h on duty, condition 1) and a continuous day-night shift (24 h on duty, condition 2). In both conditions, physicians collected a 24 h urine sample for steroid hormone concentration analysis and further completed psychological tests, including the sleep questionnaire (SF-A), the questionnaire for mental state (MDBF) and the computer-assisted visual memory test (FVW) before and at the end of their shifts, respectively. Although mean sleep deprivation during night shift was relatively small (~1.5 h) the impairment in participants' mental state was high in all three dimensions (mood, vigilance and agitation, p ≤ 0.001). Sleep quality (SQ), feeling of being recovered after sleep and mental balance decreased (p ≤ 0.001), whereas mental exhaustion increased (p night shift (p = 0.011), however, mostly in incorrectly identified items and not in correctly identified ones (FVW). SQ and false identified items were negatively correlated, whereas SQ and time of reaction were positively associated. It is assumed that after night shift, a tendency exists to make faster wrong decisions. SQ did not influence correctly identified items in FVW. In contrast to previous investigations, we found that only excretion rates for pregnanetriol and androsterone/etiocholanolone ratios (p night shift. A considerable stimulation of the

  5. The Effect of Column and Eluent Fluorination on the Retention and Separation of non-Fluorinated Amino Acids and Proteins by HPLC

    Science.gov (United States)

    Joyner, Katherine; Wang, Weizhen; Yu, Yihua Bruce

    2011-01-01

    The effect of column and eluent fluorination on the retention and separation of non-fluorinated amino acids and proteins in HPLC is investigated. A side-by-side comparison of fluorocarbon column and eluents (F-column and F-eluents) with their hydrocarbon counterparts (H-column and H-eluents) in the separation of a group of 33 analytes, including 30 amino acids and 3 proteins, is conducted. The H-column and the F-column contain the n-C8H17 group and n-C8F17 group, respectively, in their stationary phases. The H-eluents include ethanol (EtOH) and isopropanol (ISP) while the F-eluents include trifluoroethanol (TFE) and hexafluorosopropanol (HFIP). The 2 columns and 4 eluents generated 8 (column, eluent) pairs that produce 264 retention time data points for the 33 analytes. A statistical analysis of the retention time data reveals that although the H-column is better than the F-column in analyte separation and H-eluents are better than F-eluents in analyte retention, the more critical factor is the proper pairing of column with eluent. Among the conditions explored in this project, optimal retention and separation is achieved when the fluorocarbon column is paired with ethanol, even though TFE is the most polar one among the 4 eluents. This result shows fluorocarbon columns have much potential in chromatographic analysis and separation of non-fluorinated amino acids and proteins. PMID:21318121

  6. The Exnovation of Chronic Care Management Processes by Physician Organizations.

    Science.gov (United States)

    Rodriguez, Hector P; Henke, Rachel Mosher; Bibi, Salma; Ramsay, Patricia P; Shortell, Stephen M

    2016-09-01

    Policy Points The rate of adoption of chronic care management processes (CMPs) by physician organizations has been fairly slow in spite of demonstrated effectiveness of CMPs in improving outcomes of chronic care. Exnovation (ie, removal of innovations) by physician organizations largely explains the slow population-level increases in practice use of CMPs over time. Expanded health information technology functions may aid practices in retaining CMPs. Low provider reimbursement by Medicaid programs, however, may contribute to disinvestment in CMPs by physician organizations. Exnovation is the process of removal of innovations that are not effective in improving organizational performance, are too disruptive to routine operations, or do not fit well with the existing organizational strategy, incentives, structure, and/or culture. Exnovation may contribute to the low overall adoption of care management processes (CMPs) by US physician organizations over time. Three national surveys of US physician organizations, which included common questions about organizational characteristics, use of CMPs, and health information technology