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Sample records for individual physician performance

  1. Evaluating physician performance at individualizing care: a pilot study tracking contextual errors in medical decision making.

    Science.gov (United States)

    Weiner, Saul J; Schwartz, Alan; Yudkowsky, Rachel; Schiff, Gordon D; Weaver, Frances M; Goldberg, Julie; Weiss, Kevin B

    2007-01-01

    Clinical decision making requires 2 distinct cognitive skills: the ability to classify patients' conditions into diagnostic and management categories that permit the application of research evidence and the ability to individualize or-more specifically-to contextualize care for patients whose circumstances and needs require variation from the standard approach to care. The purpose of this study was to develop and test a methodology for measuring physicians' performance at contextualizing care and compare it to their performance at planning biomedically appropriate care. First, the authors drafted 3 cases, each with 4 variations, 3 of which are embedded with biomedical and/or contextual information that is essential to planning care. Once the cases were validated as instruments for assessing physician performance, 54 internal medicine residents were then presented with opportunities to make these preidentified biomedical or contextual errors, and data were collected on information elicitation and error making. The case validation process was successful in that, in the final iteration, the physicians who received the contextual variant of cases proposed an alternate plan of care to those who received the baseline variant 100% of the time. The subsequent piloting of these validated cases unmasked previously unmeasured differences in physician performance at contextualizing care. The findings, which reflect the performance characteristics of the study population, are presented. This pilot study demonstrates a methodology for measuring physician performance at contextualizing care and illustrates the contribution of such information to an overall assessment of physician practice.

  2. Physician-industry relations. Part 1: individual physicians.

    Science.gov (United States)

    Coyle, Susan L

    2002-03-05

    This is part 1 of a 2-part paper on ethics and physician-industry relationships. Part 1 offers advice to individual physicians; part 2 gives recommendations to medical education providers and medical professional societies. Physicians and industry have a shared interest in advancing medical knowledge. Nonetheless, the primary ethic of the physician is to promote the patient's best interests, while the primary ethic of industry is to promote profitability. Although partnerships between physicians and industry can result in impressive medical advances, they also create opportunities for bias and can result in unfavorable public perceptions. Many physicians and physicians-in-training think they are impervious to commercial influence. However, recent studies show that accepting industry hospitality and gifts, even drug samples, can compromise judgment about medical information and subsequent decisions about patient care. It is up to the physician to judge whether a gift is acceptable. A very general guideline is that it is ethical to accept modest gifts that advance medical practice. It is clearly unethical to accept gifts or services that obligate the physician to reciprocate. Conflicts of interest can arise from other financial ties between physicians and industry, whether to outside companies or self-owned businesses. Such ties include honorariums for speaking or writing about a company's product, payment for participating in clinic-based research, and referrals to medical resources. All of these relationships have the potential to influence a physician's attitudes and practices. This paper explores the ethical quandaries involved and offers guidelines for ethical business relationships.

  3. Physician Perceptions of Performance Feedback in a Quality Improvement Activity.

    Science.gov (United States)

    Eden, Aimee R; Hansen, Elizabeth; Hagen, Michael D; Peterson, Lars E

    2017-10-01

    Physician performance and peer comparison feedback can affect physician care quality and patient outcomes. This study aimed to understand family physician perspectives of the value of performance feedback in quality improvement (QI) activities. This study analyzed American Board of Family Medicine open-ended survey data collected between 2004 and 2014 from physicians who completed a QI module that provided pre- and post-QI project individual performance data and peer comparisons. Physicians made 3480 comments in response to a question about this performance feedback, which were generally positive in nature (86%). Main themes that emerged were importance of accurate feedback data, enhanced detail in the content of feedback, and ability to customize peer comparison groups to compare performance to peers with similar patient populations or practice characteristics. Meaningful and tailored performance feedback may be an important tool for physicians to improve their care quality and should be considered an integral part of QI project design.

  4. Physicians' professional performance: an occupational health psychology perspective.

    Science.gov (United States)

    Scheepers, Renée A

    2017-12-01

    Physician work engagement is considered to benefit physicians' professional performance in clinical teaching practice. Following an occupational health psychology perspective, this PhD report presents research on how physicians' professional performance in both doctor and teacher roles can be facilitated by work engagement and how work engagement is facilitated by job resources and personality traits. First, we conducted a systematic review on the impact of physician work engagement and related constructs (e. g. job satisfaction) on physicians' performance in patient care. We additionally investigated physician work engagement and job resources in relation to patient care experience with physicians' performance at ten outpatient clinics covering two hospitals. In a following multicentre survey involving 61 residency training programs of 18 hospitals, we studied associations between physician work engagement and personality traits with resident evaluations of physicians' teaching performance. The findings showed that physician work engagement was associated with fewer reported medical errors and that job satisfaction was associated with better communication and patient satisfaction. Autonomy and learning opportunities were positively associated with physician work engagement. Work engagement was positively associated with teaching performance. In addition, physician work engagement was most likely supported by personality trait conscientiousness (e. g. responsibility). Given the reported associations of physician work engagement with aspects of their professional performance, hospitals could support physician work engagement in service of optimal performance in residency training and patient care. This could be facilitated by worker health surveillance, peer support or promoting job crafting at the individual or team level.

  5. Physician Performance Assessment: Prevention of Cardiovascular Disease

    Science.gov (United States)

    Lipner, Rebecca S.; Weng, Weifeng; Caverzagie, Kelly J.; Hess, Brian J.

    2013-01-01

    Given the rising burden of healthcare costs, both patients and healthcare purchasers are interested in discerning which physicians deliver quality care. We proposed a methodology to assess physician clinical performance in preventive cardiology care, and determined a benchmark for minimally acceptable performance. We used data on eight…

  6. Physicians' professional performance: an occupational health psychology perspective

    NARCIS (Netherlands)

    Scheepers, Renée A.

    2017-01-01

    Physician work engagement is considered to benefit physicians' professional performance in clinical teaching practice. Following an occupational health psychology perspective, this PhD report presents research on how physicians' professional performance in both doctor and teacher roles can be

  7. The comprehensive care project: measuring physician performance in ambulatory practice.

    Science.gov (United States)

    Holmboe, Eric S; Weng, Weifeng; Arnold, Gerald K; Kaplan, Sherrie H; Normand, Sharon-Lise; Greenfield, Sheldon; Hood, Sarah; Lipner, Rebecca S

    2010-12-01

    To investigate the feasibility, reliability, and validity of comprehensively assessing physician-level performance in ambulatory practice. Ambulatory-based general internists in 13 states participated in the assessment. We assessed physician-level performance, adjusted for patient factors, on 46 individual measures, an overall composite measure, and composite measures for chronic, acute, and preventive care. Between- versus within-physician variation was quantified by intraclass correlation coefficients (ICC). External validity was assessed by correlating performance on a certification exam. Medical records for 236 physicians were audited for seven chronic and four acute care conditions, and six age- and gender-appropriate preventive services. Performance on the individual and composite measures varied substantially within (range 5-86 percent compliance on 46 measures) and between physicians (ICC range 0.12-0.88). Reliabilities for the composite measures were robust: 0.88 for chronic care and 0.87 for preventive services. Higher certification exam scores were associated with better performance on the overall (r = 0.19; pmeasures and by sampling feasible numbers of patients for each condition. © Health Research and Educational Trust.

  8. 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

  9. Relationships of multitasking, physicians' strain, and performance: an observational study in ward physicians.

    Science.gov (United States)

    Weigl, Matthias; Müller, Andreas; Sevdalis, Nick; Angerer, Peter

    2013-03-01

    Simultaneous task performance ("multitasking") is common in hospital physicians' work and is implicated as a major determinant for enhanced strain and detrimental performance. The aim was to determine the impact of multitasking by hospital physicians on their self reported strain and performance. A prospective observational time-and-motion study in a Community Hospital was conducted. Twenty-seven hospital physicians (surgical and internal specialties) were observed in 40 full-shift observations. Observed physicians reported twice on their self-monitored strain and performance during the observation time. Associations of observed multitasking events and subsequent strain and performance appraisals were calculated. About 21% of the working time physicians were engaged in simultaneous activities. The average time spent in multitasking activities correlated significantly with subsequently reported strain (r = 0.27, P = 0.018). The number of instances of multitasking activities correlated with self-monitored performance to a marginally significant level (r = 0.19, P = 0.098). Physicians who engage in multitasking activities tend to self-report better performance but at the cost of enhanced psychophysical strain. Hence, physicians do not perceive their own multitasking activities as a source for deficient performance, for example, medical errors. Readjustment of workload, improved organization of work for hospital physicians, and training programs to improve physicians' skills in dealing with multiple clinical demands, prioritization, and efficient task allocation may be useful avenues to explore to reduce the potentially negative impact of simultaneous task performance in clinical settings.

  10. Organizational and market influences on physician performance on patient experience measures.

    Science.gov (United States)

    Rodriguez, Hector P; von Glahn, Ted; Rogers, William H; Safran, Dana Gelb

    2009-06-01

    To examine the extent to which medical group and market factors are related to individual primary care physician (PCP) performance on patient experience measures. This study employs Clinician and Group CAHPS survey data (n=105,663) from 2,099 adult PCPs belonging to 34 diverse medical groups across California. Medical group directors were interviewed to assess the magnitude and nature of financial incentives directed at individual physicians and the adoption of patient experience improvement strategies. Primary care services area (PCSA) data were used to characterize the market environment of physician practices. We used multilevel models to estimate the relationship between medical group and market factors and physician performance on each Clinician and Group CAHPS measure. Models statistically controlled for respondent characteristics and accounted for the clustering of respondents within physicians, physicians within medical groups, and medical groups within PCSAs using random effects. Compared with physicians belonging to independent practice associations, physicians belonging to integrated medical groups had better performance on the communication ( p=.007) and care coordination ( p=.03) measures. Physicians belonging to medical groups with greater numbers of PCPs had better performance on all measures. The use of patient experience improvement strategies was not associated with performance. Greater emphasis on productivity and efficiency criteria in individual physician financial incentive formulae was associated with worse access to care ( p=.04). Physicians located in PCSAs with higher area-level deprivation had worse performance on the access to care ( p=.04) and care coordination ( pintegrated medical groups and groups with greater numbers of PCPs performed better on several patient experience measures, suggesting that organized care processes adopted by these groups may enhance patients' experiences. Physicians practicing in markets with high

  11. Clinical performance feedback and quality improvement opportunities for perioperative physicians

    Directory of Open Access Journals (Sweden)

    Kaye AD

    2014-05-01

    Full Text Available Alan David Kaye,1 Olutoyin J Okanlawon,2 Richard D Urman21Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, 2Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston MA, USAAbstract: Clinical performance feedback is an important component of the ongoing development and education of health care practitioners. For physicians, feedback about their clinical practice and outcomes is central to developing both confidence and competence at all stages of their medical careers. Cultural and financial infrastructures need to be in place, and the concept of feedback needs to be readily embraced and encouraged by clinical leadership and other stakeholders. The "buy-in" includes the expectation and view that feedback occurs on a routine basis, and those engaged in the process are both encouraged to participate and held accountable. Feedback must be part of an overarching quality improvement and physician education agenda; it is not meant to be an isolated, fragmented initiative that is typically undermined by lack of resources or systemic barriers to gaining improvement within programs. Effective feedback should be an integral part of clinical practice. Anesthesiologists and other perioperative physicians are identifying specialty-specific indicators that can be used when creating a broader quality improvement agenda. Placing a more immediate formal feedback strategy that focuses on goal-oriented behavior is rapidly becoming a mainstay. Physicians may use their individual feedback reports for reflection and designing personal development plans as lifelong learners and leaders in improving patient care.Keywords: physician education, outcomes measurement, performance improvement, anesthesiology

  12. Physician performance feedback in a Canadian academic center.

    Science.gov (United States)

    Garvin, Dennis; Worthington, James; McGuire, Shaun; Burgetz, Stephanie; Forster, Alan J; Patey, Andrea; Gerin-Lajoie, Caroline; Turnbull, Jeffrey; Roth, Virginia

    2017-10-02

    Purpose This paper aims at the implementation and early evaluation of a comprehensive, formative annual physician performance feedback process in a large academic health-care organization. Design/methodology/approach A mixed methods approach was used to introduce a formative feedback process to provide physicians with comprehensive feedback on performance and to support professional development. This initiative responded to organization-wide engagement surveys through which physicians identified effective performance feedback as a priority. In 2013, physicians primarily affiliated with the organization participated in a performance feedback process, and physician satisfaction and participant perceptions were explored through participant survey responses and physician leader focus groups. Training was required for physician leaders prior to conducting performance feedback discussions. Findings This process was completed by 98 per cent of eligible physicians, and 30 per cent completed an evaluation survey. While physicians endorsed the concept of a formative feedback process, process improvement opportunities were identified. Qualitative analysis revealed the following process improvement themes: simplify the tool, ensure leaders follow process, eliminate redundancies in data collection (through academic or licensing requirements) and provide objective quality metrics. Following physician leader training on performance feedback, 98 per cent of leaders who completed an evaluation questionnaire agreed or strongly agreed that the performance feedback process was useful and that training objectives were met. Originality/value This paper introduces a physician performance feedback model, leadership training approach and first-year implementation outcomes. The results of this study will be useful to health administrators and physician leaders interested in implementing physician performance feedback or improving physician engagement.

  13. Can visual arts training improve physician performance?

    Science.gov (United States)

    Katz, Joel T; Khoshbin, Shahram

    2014-01-01

    Clinical educators use medical humanities as a means to improve patient care by training more self-aware, thoughtful, and collaborative physicians. We present three examples of integrating fine arts - a subset of medical humanities - into the preclinical and clinical training as models that can be adapted to other medical environments to address a wide variety of perceived deficiencies. This novel teaching method has promise to improve physician skills, but requires further validation.

  14. Can Visual Arts Training Improve Physician Performance?

    Science.gov (United States)

    Katz, Joel T.; Khoshbin, Shahram

    2014-01-01

    Clinical educators use medical humanities as a means to improve patient care by training more self-aware, thoughtful, and collaborative physicians. We present three examples of integrating fine arts — a subset of medical humanities — into the preclinical and clinical training as models that can be adapted to other medical environments to address a wide variety of perceived deficiencies. This novel teaching method has promise to improve physician skills, but requires further validation. PMID:25125749

  15. Poor physician performance in the Netherlands: characteristics, causes, and prevalence.

    NARCIS (Netherlands)

    Goor, M.M.P.G. van den; Wagner, C.; Lombarts, K.M.J.M.H.

    2015-01-01

    Introduction: Poor physician performance has a profound impact on patient safety and society's trust in the health care system. The attention that this topic has received in the media suggests that it is a large-scale issue. However, research about physician performance is still scant; there is

  16. Investigating performance of rural family physicians in Fars province working as part of Family Physician Program

    Directory of Open Access Journals (Sweden)

    Mansour Kashfi

    2016-09-01

    Full Text Available Background & Objective: Health family physician program is a complete system which eliminates the bewilderment of people and increases the satisfaction with health services as its most important results in medical care. The aim of this study was to evaluate the performance of family physicians and their strengths and weaknesses. Material & Methods: In this study, 52 family physicians were chosen via Random Stratified Sampling to participate in the study. A questionnaire titled “Performance of Family Physicians” with 5 domains of management, performance, contract guidelines, community involvement and results was used to collect data. Data were analyzed using SPSS-19 via t-test, ANOVA, Pearson correlation coefficient, and non-parametric tests. Results: Among the 52 studied family physicians, 56.9% were female and 43.1% were male. The lowest and the highest scores were obtained for the community involvement and results, respectively. Based on the results of this study, there were significant relationships among most of the domains. However, there was no significant correlation between the gender and different domains. Conclusion: In order to solve the problems of family physician program and improve the quality of services, more researches should be carried out soon to determine the types and causes of referring to the family physicians. Accordingly, appropriate interventions should be implemented to reduce the burden of visits and improve the quality of health services by guiding the society towards the prevention measures.

  17. Physician practice management organizations: their prospects and performance.

    Science.gov (United States)

    Conrad, D A; Koos, S; Harney, A; Haase, M

    1999-09-01

    As physician organizations adapt their incentives, processes, and structures to accommodate the demands of an increasingly competitive and performance-sensitive external environment, the development of more effective administrative and managerial mechanisms becomes critical to success. The emergence of physician practice management companies (PPMCs) represents a potentially positive step for physician practices seeking increased economies of scale through consolidation, as well as enhanced access to financial capital. However, economic and finance theory, coupled with some empirical "arithmetic" regarding the financial and operational performance of leading publicly traded PPMCs, suggest caution in one's forecasts of the future prospects for these evolving corporate forms.

  18. Perceiving individuality in harpsichord performance.

    Science.gov (United States)

    Koren, Réka; Gingras, Bruno

    2014-01-01

    Can listeners recognize the individual characteristics of unfamiliar performers playing two different musical pieces on the harpsichord? Six professional harpsichordists, three prize-winners and three non prize-winners, made two recordings of two pieces from the Baroque period (a variation on a Partita by Frescobaldi and a rondo by François Couperin) on an instrument equipped with a MIDI console. Short (8 to 15 s) excerpts from these 24 recordings were subsequently used in a sorting task in which 20 musicians and 20 non-musicians, balanced for gender, listened to these excerpts and grouped together those that they thought had been played by the same performer. Twenty-six participants, including 17 musicians and nine non-musicians, performed significantly better than chance, demonstrating that the excerpts contained sufficient information to enable listeners to recognize the individual characteristics of the performers. The grouping accuracy of musicians was significantly higher than that observed for non-musicians. No significant difference in grouping accuracy was found between prize-winning performers and non-winners or between genders. However, the grouping accuracy was significantly higher for the rondo than for the variation, suggesting that the features of the two pieces differed in a way that affected the listeners' ability to sort them accurately. Furthermore, only musicians performed above chance level when matching variation excerpts with rondo excerpts, suggesting that accurately assigning recordings of different pieces to their performer may require musical training. Comparisons between the MIDI performance data and the results of the sorting task revealed that tempo and, to a lesser extent, note onset asynchrony were the most important predictors of the perceived distance between performers, and that listeners appeared to rely mostly on a holistic percept of the excerpts rather than on a comparison of note-by-note expressive patterns.

  19. Perceiving individuality in harpsichord performance

    Directory of Open Access Journals (Sweden)

    Réka eKoren

    2014-02-01

    Full Text Available Can listeners recognize the individual characteristics of unfamiliar performers playing two different musical pieces on the harpsichord? Six professional harpsichordists, three prize-winners and three non prize-winners, made two recordings of two pieces from the Baroque period (a variation on a partita by Frescobaldi and a rondo by François Couperin on an instrument equipped with a MIDI console. Short (8 to 15 seconds excerpts from these 24 recordings were subsequently used in a sorting task in which twenty musicians and twenty non-musicians, balanced for gender, listened to these excerpts and grouped together those that they thought had been played by the same performer. Twenty-six participants, including 17 musicians and 9 non-musicians, performed significantly better than chance, demonstrating that the excerpts contained sufficient information to enable listeners to recognize the individual characteristics of the performers. The grouping accuracy of musicians was significantly higher than that observed for non‐musicians. No significant difference in grouping accuracy was found between prize-winning performers and non-winners or between genders. However, the grouping accuracy was significantly higher for the rondo than for the variation, suggesting that the features of the two pieces differed in a way that affected the listeners’ ability to sort them accurately. Furthermore, only musicians performed above chance level when matching variation excerpts with rondo excerpts, suggesting that accurately assigning recordings of different pieces to their performer may require musical training. Comparisons between the MIDI performance data and the results of the sorting task revealed that tempo and, to a lesser extent, note onset asynchrony were the most important predictors of the perceived distance between performers, and that listeners appeared to rely mostly on a holistic percept of the excerpts rather than on a comparison of note

  20. Perceiving individuality in harpsichord performance

    Science.gov (United States)

    Koren, Réka; Gingras, Bruno

    2014-01-01

    Can listeners recognize the individual characteristics of unfamiliar performers playing two different musical pieces on the harpsichord? Six professional harpsichordists, three prize-winners and three non prize-winners, made two recordings of two pieces from the Baroque period (a variation on a Partita by Frescobaldi and a rondo by François Couperin) on an instrument equipped with a MIDI console. Short (8 to 15 s) excerpts from these 24 recordings were subsequently used in a sorting task in which 20 musicians and 20 non-musicians, balanced for gender, listened to these excerpts and grouped together those that they thought had been played by the same performer. Twenty-six participants, including 17 musicians and nine non-musicians, performed significantly better than chance, demonstrating that the excerpts contained sufficient information to enable listeners to recognize the individual characteristics of the performers. The grouping accuracy of musicians was significantly higher than that observed for non-musicians. No significant difference in grouping accuracy was found between prize-winning performers and non-winners or between genders. However, the grouping accuracy was significantly higher for the rondo than for the variation, suggesting that the features of the two pieces differed in a way that affected the listeners’ ability to sort them accurately. Furthermore, only musicians performed above chance level when matching variation excerpts with rondo excerpts, suggesting that accurately assigning recordings of different pieces to their performer may require musical training. Comparisons between the MIDI performance data and the results of the sorting task revealed that tempo and, to a lesser extent, note onset asynchrony were the most important predictors of the perceived distance between performers, and that listeners appeared to rely mostly on a holistic percept of the excerpts rather than on a comparison of note-by-note expressive patterns. PMID:24605104

  1. Variation in Primary Cesarean Delivery Rates by Individual Physician within a Single Hospital Laborist Model

    Science.gov (United States)

    METZ, Torri D.; ALLSHOUSE, Amanda A.; GILBERT, Sara A Babcock; DOYLE, Reina; TONG, Angie; CAREY, J. Christopher

    2016-01-01

    Background Laborist practice models are associated with lower cesarean delivery rates than individual private practice models in several studies; however, this effect is not uniform. Further exploration of laborist models may help us better understand the observed reduction in cesarean delivery rates in some hospitals with implementation of a laborist model. Objective Our objective was to evaluate the degree of variation in primary cesarean delivery rates by individual laborists within a single institution employing a laborist model. In addition, we sought to evaluate whether differences in cesarean delivery rates resulted in different maternal or short-term neonatal outcomes. Study Design At this teaching institution, one laborist (either a generalist or maternal-fetal medicine attending physician) is directly responsible for labor and delivery management during each shift. No patients are followed in a private practice model nor are physicians incentivized to perform deliveries. We retrospectively identified all laborists who delivered nulliparous, term women with cephalic singletons at this institution from 2007-14. Overall and individual primary cesarean delivery rates were reported as percentages with exact Pearson 95% CI. Laborists were grouped by tertile as having low, medium or high cesarean delivery rates. Characteristics of the women delivered, indications for cesarean delivery, and short-term neonatal outcomes were compared between these groups. A binomial regression model of cesarean delivery was estimated, where the relative rates of each laborist compared to the lowest-unadjusted laborist rate were calculated; a second model was estimated to adjust for patient-level maternal characteristics. Results Twenty laborists delivered 2,224 nulliparous, term women with cephalic singletons. The overall cesarean delivery rate was 24.1% (95% CI 21.4-26.8). In an unadjusted binomial model, the overall effect of individual laborist was significant (pcesarean

  2. Improved radiation protection for physicians performing cardiac catheterization

    International Nuclear Information System (INIS)

    Gertz, E.W.; Wisneski, J.A.; Gould, R.G.; Akin, J.R.

    1982-01-01

    Physicians and their assistants performing diagnostic angiography must be concerned with the radiation exposure they receive. The introduction of hemiaxial projections for imaging has increased diagnostic accuracy but has also greatly increased the physicians' exposure to scattered radiation. This increase is especially critical for the eyes and thyroid of the physician who routinely performs these procedures. To reduce such exposure a ceiling-suspended shield (60 x 45 cm), made of 6.4 mm glass with a 19.5 kg/m2 (4 lb/ft2) lead equivalency, was developed. During procedures the shield is interposed between the physician and the region of the patient acting as the source of scattered radiation. The degree of radiation protection to the operator was assessed by measuring the distribution of scattered radiation in the vicinity of the operator with and without the shield. The effectiveness of the shield was determined in the 30 degrees right anterior oblique (RAO), 5 degrees left anterior oblique (LAO), 35 degrees LAO, and 50 degrees LAO-15 degrees cranial angulations. At critical heights such as the level of the eyes and thyroid, scattered radiation levels were reduced by 85% or greater in all angulations. Without interfering with the physician's ability to observe the patient or manipulate the catheter, this shield can significantly reduce the physician's exposure to radiation

  3. Emergency medicine physicians performed ultrasound for pediatric intussusceptions

    Directory of Open Access Journals (Sweden)

    Yi-Jung Chang

    2013-08-01

    Full Text Available Background: Intussusception is the common acute abdomen in children with difficult clinical diagnosis. The routine ultrasound has recently been proposed as the initial diagnostic modality with high accuracy, but is not available for 24 h by gastroenterologists. We aimed to evaluate the validation of bedside ultrasound for intussusceptions performed by pediatric emergency physicians with ultrasound training during the night or holiday. Methods: A retrospective study was conducted in children with suspected intussusceptions when routine ultrasounds by gastroenterologists were not available over the period from July 2004 to July 2008. Patients were divided into two groups: those diagnosed by emergency physicians with ultrasound training and without training. The clinical characteristics and course for all patients were reviewed and compared for seeking the difference. Results: A total of 186 children were included. One hundred and thirteen (61% children were diagnosed by pediatric emergency physician with ultrasound training. The clinical symptoms were not statistically different between the two groups. The diagnostic sensitivity of the ultrasound training group was significantly higher (90% vs. 79%, p = 0.034. Children of the training group also had significantly shorter hospital stay duration at emergency departments before reduction (2.41 ± 2.01 vs. 4.58 ± 4.80 h, p = 0.002. Conclusion: Bedside ultrasound performed by pediatric emergency physicians with ultrasound training is a sensitive test for detecting intussusceptions. Knowledge and use of bedside ultrasound can aid the emergency physician in the diagnosis of pediatric intussusceptions with less delay in treatment.

  4. The Kubler-Ross model, physician distress, and performance reporting.

    Science.gov (United States)

    Smaldone, Marc C; Uzzo, Robert G

    2013-07-01

    Physician performance reporting has been proposed as an essential component of health-care reform, with the aim of improving quality by providing transparency and accountability. Despite strong evidence demonstrating regional variation in practice patterns and lack of evidence-based care, public outcomes reporting has been met with resistance from medical professionals. Application of the Kubler-Ross 'five stages of grief' model--a conceptual framework consisting of a series of emotional stages (denial, anger, bargaining, depression, and acceptance) inspired by work with terminally ill patients--could provide some insight into why physicians are reluctant to accept emerging quality-reporting mechanisms. Physician-led quality-improvement initiatives are vital to contemporary health-care reform efforts and applications in urology, as well as other medical disciplines, are currently being explored.

  5. Effect of exposure to good vs poor medical trainee performance on attending physician ratings of subsequent performances

    OpenAIRE

    Yeates, Peter; O'Neill, Paul; Mann, Karen; Eva, Kevin W.

    2012-01-01

    Context: Competency-based models of education require assessments to be based on individuals' capacity to perform, yet the nature of human judgment may fundamentally limit the extent to which such assessment is accurately possible. Objective: To determine whether recent observations of the Mini Clinical Evaluation Exercise (Mini-CEX) performance of postgraduate year 1 physicians influence raters' scores of subsequent performances, consistent with either anchoring bias (scores biased similar t...

  6. Responsiveness of the individual work performance questionnaire.

    NARCIS (Netherlands)

    Koopmans, L.; Coffeng, J.K.; Bernaards, C.M.; Boot, C.R.L.; Hildebrandt, V.H.; Vet, H.C.W. de; Beek, A.J. van der

    2014-01-01

    Background: Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed.

  7. Responsiveness of the individual work performance questionnaire

    NARCIS (Netherlands)

    Koopmans, L.; Coffeng, J.K.; Bernaards, C.M.; Boot, C.R.; Hildebrandt, V.H.; Vet, H.C. de; Beek, A.J. van der

    2014-01-01

    Background: Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed.

  8. High-performance teams and the physician leader: an overview.

    Science.gov (United States)

    Majmudar, Aalap; Jain, Anshu K; Chaudry, Joseph; Schwartz, Richard W

    2010-01-01

    The complexity of health care delivery within the United States continues to escalate in an exponential fashion driven by an explosion of medical technology, an ever-expanding research enterprise, and a growing emphasis on evidence-based practices. The delivery of care occurs on a continuum that spans across multiple disciplines, now requiring complex coordination of care through the use of novel clinical teams. The use of teams permeates the health care industry and has done so for many years, but confusion about the structure and role of teams in many organizations contributes to limited effectiveness and suboptimal outcomes. Teams are an essential component of graduate medical education training programs. The health care industry's relative lack of focus regarding the fundamentals of teamwork theory has contributed to ineffective team leadership at the physician level. As a follow-up to our earlier manuscripts on teamwork, this article clarifies a model of teamwork and discusses its application to high-performance teams in health care organizations. Emphasized in this discussion is the role played by the physician leader in ensuring team effectiveness. By educating health care professionals on the fundamentals of high-performance teamwork, we hope to stimulate the development of future physician leaders who use proven teamwork principles to achieve the goals of trainee education and excellent patient care. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Development of an Individual Work Performance Questionnaire

    NARCIS (Netherlands)

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; van Buuren, S.; van der Beek, A.J.; de Vet, H.C.W.

    2013-01-01

    The purpose of the current study is to develop a generic and short questionnaire to measure work performance at the individual level – the Individual Work Performance Questionnaire (IWPQ). The IWPQ was based on a four-dimensional conceptual framework, in which individual work performance consisted

  10. [Medical student perception of physician values in practice by individual characteristics and preferred medical specialty field].

    Science.gov (United States)

    Park, Kwi Hwa; Yoo, Hyo Hyun; Yim, Jun

    2014-12-01

    Medical students' values figure prominently in their choice of medical specialty; yet, little research has been performed on this topic. The purpose of this study was to analyze the differences in values according to medical students' individual characteristics (medical educational system, gender, and grade) and preferred medical specialty. A total of 905 medical students participated in the study; 426 were graduate-entry medical students (GEMS), and 479 were undergraduate medical students (UMS). Further, 561 were male and 316 were female; 356 were in year 1, 219 were in year 2, 230 were in year 3, and 100 were in year 4. Students completed the Physician Values in Practice Scale (PVIPS). The PVIPS comprises six dimensions: autonomy, management, prestige, service, lifestyle, and scholarly pursuits. The data were analyzed by t-test and analysis of variance. GEMS had higher scores for service, management, and scholarly pursuits than UMS. Males had higher scores for prestige, lifestyle, and management, whereas female scored higher on service and scholarly pursuits. Higher grade was associated with increased scores for prestige, lifestyle, and management. The differences in lifestyle and scholarly pursuits were significant between preferred specialties. Students in support specialties scored significantly higher on lifestyle. With regard to scholarly pursuits, basic science specialties scored significantly higher than other specialties. There were significant differences in PVIPS according to individual characteristics and preferred medical specialty. This result could be useful in developing a medical specialty choice program for medical students.

  11. Personality traits affect teaching performance of attending physicians: results of a multi-center observational study

    NARCIS (Netherlands)

    Scheepers, Renée A.; Lombarts, Kiki M. J. M. H.; van Aken, Marcel A. G.; Heineman, Maas Jan; Arah, Onyebuchi A.

    2014-01-01

    Worldwide, attending physicians train residents to become competent providers of patient care. To assess adequate training, attending physicians are increasingly evaluated on their teaching performance. Research suggests that personality traits affect teaching performance, consistent with studied

  12. Physician attitudes regarding pregnancy, fertility care, and assisted reproductive technologies for HIV-infected individuals and couples.

    Science.gov (United States)

    Yudin, Mark H; Money, Deborah M; Cheung, Matthew C; Loutfy, Mona R

    2012-01-01

    Family and pregnancy planning are important for HIV-infected individuals and couples. There is a paucity of data regarding physician attitudes with respect to reproduction in this population, but some evidence suggests that attitudes can influence the information, advice, and services they will provide. To determine physician attitudes toward pregnancy, fertility care, and access to assisted reproductive technologies for HIV-infected individuals, and to determine whether attitudes differed based on specific physician characteristics. A survey was sent electronically to obstetrician/gynecologists and infectious disease specialists in Canada. Items were grouped into 5 key domains: physician demographics, physician attitudes toward pregnancy and adoption, physician attitudes toward fertility care, physician attitudes toward assisted reproductive technology, and challenges for an HIV-infected population. Attitudes were determined based on answers to individual questions and also for each domain. Univariate and logistic regression analyses were used to determine the influence of specific physician characteristics on attitudes. Completed surveys were received from 165 physicians. Most had positive attitudes regarding pregnancy or adoption (89%), fertility care (72%), and assisted reproductive technology (79%). In multivariate analyses, having cared for HIV-infected patients was significantly associated with having a positive attitude toward fertility care or assisted reproductive technology. In this national survey of Canadian physicians, most had positive attitudes toward pregnancy, adoption, fertility care, and use of assisted reproductive technology among HIV-infected persons. Physicians who had cared for HIV-infected individuals in the past were more likely to have positive attitudes than those who had not.

  13. Exploring the differential impact of individual and organizational factors on organizational commitment of physicians and nurses.

    Science.gov (United States)

    Miedaner, Felix; Kuntz, Ludwig; Enke, Christian; Roth, Bernhard; Nitzsche, Anika

    2018-03-15

    Physician and nursing shortages in acute and critical care settings require research on factors which might drive their commitment, an important predictor of absenteeism and turnover. However, the degree to which the commitment of a physician or a nurse is driven by individual or organizational characteristics in hospitals remains unclear. In addition, there is a need for a greater understanding of how antecedent-commitment relationships differ between both occupational groups. Based on recent findings in the literature and the results of a pilot study, we investigate the degree to which selected individual and organizational characteristics might enhance an employee's affective commitment working in the field of neonatal intensive care. Moreover, our aim is to examine the different antecedent-commitment relationships across the occupational groups of nurses and physicians. Information about individual factors affecting organizational commitment was derived from self-administered staff questionnaires, while additional information about organizational structures was taken from hospital quality reports and a self-administered survey completed by hospital department heads. Overall, 1486 nurses and 540 physicians from 66 Neonatal Intensive Care Units participated in the study. We used multilevel modeling to account for different levels of analysis. Although organizational characteristics can explain differences in an employee's commitment, the differences can be largely explained by his or her individual characteristics and work experiences. Regarding occupational differences, individual support by leaders and colleagues was shown to influence organizational commitment more strongly in the physicians' group. In contrast, the degree of autonomy in the units and perceived quality of care had a larger impact on the nurses' organizational commitment. With the growing number of hospitals facing an acute shortage of highly-skilled labor, effective strategies on the

  14. Clinical problems with the performance of euthanasia and physician-assisted suicide in The Netherlands

    NARCIS (Netherlands)

    J.H. Groenewoud (Hanny); A. van der Heide (Agnes); B.D. Onwuteaka-Philipsen (Bregje); D.L. Willems (Dick); P.J. van der Maas (Paul); G. van der Wal (Gerrit)

    2000-01-01

    textabstractBACKGROUND AND METHODS: The characteristics and frequency of clinical problems with the performance of euthanasia and physician-assisted suicide are uncertain. We analyzed data from two studies of euthanasia and physician-assisted suicide in The

  15. Physicians' professional performance: An occupational health psychology perspective

    NARCIS (Netherlands)

    Scheepers, R.A.

    2016-01-01

    In modern medical practice, multiple demands and high workloads challenge physician well-being. Physician well-being is considered a precondition for optimal health care. Physicians’ work-related well-being can be indicated by their work engagement, which is considered the opposite of burnout. We

  16. Responsiveness of the individual work performance questionnaire

    OpenAIRE

    Koopmans, Linda; Coffeng, Jennifer K; Bernaards, Claire M; Boot, Cécile RL; Hildebrandt, Vincent H; de Vet, Henrica CW; van der Beek, Allard J

    2014-01-01

    Background: Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed. The aim of the current study was to gain insight into the responsiveness of the IWPQ. Methods. Data were used from the Be Active & Relax randomized controlled trial. The aim of the trial was to inves...

  17. Physician exposure to violence: a study performed in Turkey.

    Science.gov (United States)

    Baykan, Zeynep; Öktem, İbrahim Suat; Çetinkaya, Fevziye; Naçar, Melis

    2015-01-01

    Recently, in Turkey, there has been an increase in the number of violent acts against healthcare workers, towards doctors in particular. This study aimed to investigate the extent of violence, the causes of violence and to evaluate proposed solutions to violence. Out of 597 physicians, 86.4% indicated that they were exposed to at least one type of violence (physical, verbal, sexual) throughout their careers. Among the physicians participating in the study, 27.5% suffered physical threats and 68.6% suffered verbal violence in the past year. Only 40.4% reported the physical violence to their institution. Physicians indicated that the top three causes of violent behavior were excessive demands of patients, the expectation that the issue will be solved immediately and blaming physicians for their problems. To stop violence against themselves, physicians need to raise their voices, along with those of their personal or professional organizations, and should report and follow up incidents.

  18. Night shift decreases cognitive performance of ICU physicians.

    Science.gov (United States)

    Maltese, François; Adda, Mélanie; Bablon, Amandine; Hraeich, Sami; Guervilly, Christophe; Lehingue, Samuel; Wiramus, Sandrine; Leone, Marc; Martin, Claude; Vialet, Renaud; Thirion, Xavier; Roch, Antoine; Forel, Jean-Marie; Papazian, Laurent

    2016-03-01

    The relationship between tiredness and the risk of medical errors is now commonly accepted. The main objective of this study was to assess the impact of an intensive care unit (ICU) night shift on the cognitive performance of a group of intensivists. The influence of professional experience and the amount of sleep on cognitive performance was also investigated. A total of 51 intensivists from three ICUs (24 seniors and 27 residents) were included. The study participants were evaluated after a night of rest and after a night shift according to a randomized order. Four cognitive skills were tested according to the Wechsler Adult Intelligence Scale and the Wisconsin Card Sorting Test. All cognitive abilities worsened after a night shift: working memory capacity (11.3 ± 0.3 vs. 9.4 ± 0.3; p night shift. The cognitive abilities of intensivists were significantly altered following a night shift in the ICU, regardless of either the amount of professional experience or the duration of sleep during the shift. The consequences for patients' safety and physicians' health should be further evaluated.

  19. Does psychosocial competency training for junior physicians working in pediatric medicine improve individual skills and perceived job stress.

    Science.gov (United States)

    Bernburg, Monika; Baresi, Lisa; Groneberg, David; Mache, Stefanie

    2016-12-01

    Pediatricians' job performance, work engagement, and job satisfaction are essential for both the individual physician and quality of care for their little patients and parents. Therefore, it is important to maintain or possibly augment pediatricians' individual and professional competencies. In this study, we developed and implemented a psychosocial competency training (PCT) teaching different psychosocial competencies and stress coping techniques. We investigated (1) the influence of the PCT on work-related characteristics: stress perception, work engagement, job satisfaction and (2) explored pediatricians' outcomes and satisfaction with PCT. Fifty-four junior physicians working in pediatric hospital departments participated in the training and were randomized in an intervention (n = 26) or a control group (n = 28). In the beginning, at follow-up 1 and 2, both groups answered a self-rated questionnaire on perceived training outcomes and work-related factors. The intervention group showed that their job satisfaction significantly increased while perceived stress scores decreased after taking part in the PCT. No substantial changes were observed with regard to pediatricians' work engagement. Participating physicians evaluated PCT with high scores for training design, content, received outcome, and overall satisfaction with the training. Professional psychosocial competency training could improve junior pediatricians' professional skills, reduce stress perception, increase their job satisfaction, and psychosocial skills. In addition, this study indicates that the PCT is beneficial to be implemented as a group training program for junior pediatricians at work. What is Known: • Junior pediatricians often report experiencing high levels of job strain and little supervisory support. • High levels of job demands make pediatricians vulnerable for mental health problems and decreased work ability. What is New: • Development, implementation, and evaluation of a

  20. Option trading and individual investor performance

    NARCIS (Netherlands)

    Bauer, R.; Cosemans, M.; Eichholtz, P.

    2009-01-01

    This paper examines the impact of option trading on individual investor performance. The results show that most investors incur substantial losses on their option investments, which are much larger than the losses from equity trading. We attribute the detrimental impact of option trading on investor

  1. Effect of exposure to good vs poor medical trainee performance on attending physician ratings of subsequent performances.

    Science.gov (United States)

    Yeates, Peter; O'Neill, Paul; Mann, Karen; Eva, Kevin W

    2012-12-05

    Competency-based models of education require assessments to be based on individuals' capacity to perform, yet the nature of human judgment may fundamentally limit the extent to which such assessment is accurately possible. To determine whether recent observations of the Mini Clinical Evaluation Exercise (Mini-CEX) performance of postgraduate year 1 physicians influence raters' scores of subsequent performances, consistent with either anchoring bias (scores biased similar to previous experience) or contrast bias (scores biased away from previous experience). Internet-based randomized, blinded experiment using videos of Mini-CEX assessments of postgraduate year 1 trainees interviewing new internal medicine patients. Participants were 41 attending physicians from England and Wales experienced with the Mini-CEX, with 20 watching and scoring 3 good trainee performances and 21 watching and scoring 3 poor performances. All then watched and scored the same 3 borderline video performances. The study was completed between July and November 2011. The primary outcome was scores assigned to the borderline videos, using a 6-point Likert scale (anchors included: 1, well below expectations; 3, borderline; 6, well above expectations). Associations were tested in a multivariable analysis that included participants' sex, years of practice, and the stringency index (within-group z score of initial 3 ratings). The mean rating scores assigned by physicians who viewed borderline video performances following exposure to good performances was 2.7 (95% CI, 2.4-3.0) vs 3.4 (95% CI, 3.1-3.7) following exposure to poor performances (difference of 0.67 [95% CI, 0.28-1.07]; P = .001). Borderline videos were categorized as consistent with failing scores in 33 of 60 assessments (55%) in those exposed to good performances and in 15 of 63 assessments (24%) in those exposed to poor performances (P performances compared with 25 of 63 assessments (39.5%) in those exposed to poor performances (P poor

  2. As good as it gets? Managing risks of cardiovascular disease in California's top-performing physician organizations.

    Science.gov (United States)

    Rodriguez, Hector P; Ivey, Susan L; Raffetto, Brian J; Vaughn, Jennifer; Knox, Margae; Hanley, Hattie Rees; Mangione, Carol M; Shortell, Stephen M

    2014-04-01

    The California Right Care Initiative (RCI) accelerates the adoption of evidence-based guidelines and improved care management practices for conditions for which the gap between science and practice is significant, resulting in preventable disability and death. Medical directors and quality improvement leaders from 11 of the 12 physician organizations that met the 2010 national 90th percentile performance benchmarks for control of hyperlipidemia and glycated hemoglobin in 2011 were interviewed in 2012. Interviews, as well as surveys, assessed performance reporting and feedback to individual physicians; medication management protocols; team-based care management; primary care team huddles; coordination of care between primary care clinicians and specialists; implementation of shared medical appointments; and telephone visits for high-risk patients. All but 1 of 11 organizations implemented electronic health records. Electronic information exchange between primary care physicians and specialists, however, was uncommon. Few organizations routinely used interdisciplinary team approaches, shared medical appointments, or telephonic strategies for managing cardiovascular risks among patients. Implementation barriers included physicians' resistance to change, limited resources and reimbursement for team approaches, and limited organizational capacity for change. Implementation facilitators included routine use of reliable data to guide improvement, leadership facilitation of change, physician buy-in, health information technology use, and financial incentives. To accelerate improvements in managing cardiovascular risks, physician organizations may need to implement strategies involving extensive practice reorganization and work flow redesign.

  3. The Influence of Time Pressure and Case Complexity on Physicians׳ Diagnostic Performance

    Directory of Open Access Journals (Sweden)

    Dalal A. ALQahtani

    2016-12-01

    Conclusions: Time pressure did not impact the diagnostic performance, whereas the complexity of the clinical case negatively influenced the diagnostic accuracy. Further studies with the enhanced experimental manipulation of time pressure are needed to reveal the effect of time pressure, if any, on a physician׳s diagnostic performance.

  4. Effects of Individual Physician-Level and Practice-Level Financial Incentives on Hypertension Care: A Cluster Randomized Trial

    Science.gov (United States)

    Petersen, Laura A.; Simpson, Kate; Pietz, Kenneth; Urech, Tracy H.; Hysong, Sylvia J.; Profit, Jochen; Conrad, Douglas A.; Dudley, R. Adams; Woodard, LeChauncy D.

    2014-01-01

    Importance Pay for performance is intended to align incentives to promote high quality care, but results have been contradictory. Objective To test the effect of explicit financial incentives to reward guideline-recommended hypertension care. Design, Setting, and Participants Cluster randomized controlled trial of 12 Veterans Affairs hospital-based outpatient clinics with five performance periods and a 12-month washout. We enrolled 83 primary care physicians and 42 non-physician personnel (e.g., nurses, pharmacists) working with physicians to deliver hypertension care. Interventions Clinics randomized to one of four groups: physician-level (individual) incentives; practice-level incentives; individual- plus practice-level incentives (combined); or none. Intervention participants received up to five payments every four months; all participants could access feedback reports. Main outcome measures For each four-month period, the number of hypertensive patients among a random sample who achieved guideline-recommended blood pressure thresholds or received an appropriate response to uncontrolled blood pressure; and/or been prescribed guideline-recommended medications and the number who developed hypotension. Results Mean (standard deviation) total payments over the study were $4,270 ($459), $2,672 ($153), and $1,648 ($248) for the combined, individual, and practice-level interventions, respectively. The adjusted change over the study in patients meeting the combined blood pressure/appropriate response measure was 8.84 percentage points (95% confidence interval [CI], 4.20–11.80) for the individual-level, 3.70 (95% CI, 0.24–7.68) for the practice-level, 5.54 (95% CI, 1.92–9.52) for the combined, and 0.47 (95% CI, −3.12–4.04) for the control groups. For medications, the change was 9.07 (95% CI, 4.52–13.44), 4.98 (95% CI, 0.64–10.08), 7.26 (95% CI, 2.92–12.48), and 4.35 (95% CI, −0.28–9.28) percentage points, respectively. The adjusted estimated

  5. Online physician ratings fail to predict actual performance on measures of quality, value, and peer review.

    Science.gov (United States)

    Daskivich, Timothy J; Houman, Justin; Fuller, Garth; Black, Jeanne T; Kim, Hyung L; Spiegel, Brennan

    2018-04-01

    Patients use online consumer ratings to identify high-performing physicians, but it is unclear if ratings are valid measures of clinical performance. We sought to determine whether online ratings of specialist physicians from 5 platforms predict quality of care, value of care, and peer-assessed physician performance. We conducted an observational study of 78 physicians representing 8 medical and surgical specialties. We assessed the association of consumer ratings with specialty-specific performance scores (metrics including adherence to Choosing Wisely measures, 30-day readmissions, length of stay, and adjusted cost of care), primary care physician peer-review scores, and administrator peer-review scores. Across ratings platforms, multivariable models showed no significant association between mean consumer ratings and specialty-specific performance scores (β-coefficient range, -0.04, 0.04), primary care physician scores (β-coefficient range, -0.01, 0.3), and administrator scores (β-coefficient range, -0.2, 0.1). There was no association between ratings and score subdomains addressing quality or value-based care. Among physicians in the lowest quartile of specialty-specific performance scores, only 5%-32% had consumer ratings in the lowest quartile across platforms. Ratings were consistent across platforms; a physician's score on one platform significantly predicted his/her score on another in 5 of 10 comparisons. Online ratings of specialist physicians do not predict objective measures of quality of care or peer assessment of clinical performance. Scores are consistent across platforms, suggesting that they jointly measure a latent construct that is unrelated to performance. Online consumer ratings should not be used in isolation to select physicians, given their poor association with clinical performance.

  6. Responsiveness of the individual work performance questionnaire

    Science.gov (United States)

    2014-01-01

    Background Individual work performance is an important outcome measure in studies in the workplace. Nevertheless, its conceptualization and measurement has proven challenging. To overcome limitations of existing scales, the Individual Work Performance Questionnaire (IWPQ) was recently developed. The aim of the current study was to gain insight into the responsiveness of the IWPQ. Methods Data were used from the Be Active & Relax randomized controlled trial. The aim of the trial was to investigate the effectiveness of an intervention to stimulate physical activity and relaxation of office workers, on need for recovery. Individual work performance was a secondary outcome measure of the trial. In total, 39 hypotheses were formulated concerning correlations between changes on the IWPQ scales and changes on similar constructs (e.g., presenteeism) and distinct constructs (e.g., need for recovery) used in the trial. Results 260 Participants completed the IWPQ at both baseline and 12 months of follow-up. For the IWPQ scales, 23%, 15%, and 38%, respectively, of the hypotheses could be confirmed. In general, the correlations between change scores were weaker than expected. Nevertheless, at least 85% of the correlations were in the expected direction. Conclusions Based on results of the current study, no firm conclusions can be drawn about the responsiveness of the IWPQ. Several reasons may account for the weaker than expected correlations. Future research on the IWPQ’s responsiveness should be conducted, preferably in other populations and intervention studies, where greater changes over time can be expected. PMID:24885593

  7. Poorly Performing Physicians: Does the Script Concordance Test Detect Bad Clinical Reasoning?

    Science.gov (United States)

    Goulet, Francois; Jacques, Andre; Gagnon, Robert; Charlin, Bernard; Shabah, Abdo

    2010-01-01

    Introduction: Evaluation of poorly performing physicians is a worldwide concern for licensing bodies. The College des Medecins du Quebec currently assesses the clinical competence of physicians previously identified with potential clinical competence difficulties through a day-long procedure called the Structured Oral Interview (SOI). Two peer…

  8. Personality traits affect teaching performance of attending physicians: results of a multi-center observational study.

    Science.gov (United States)

    Scheepers, Renée A; Lombarts, Kiki M J M H; van Aken, Marcel A G; Heineman, Maas Jan; Arah, Onyebuchi A

    2014-01-01

    Worldwide, attending physicians train residents to become competent providers of patient care. To assess adequate training, attending physicians are increasingly evaluated on their teaching performance. Research suggests that personality traits affect teaching performance, consistent with studied effects of personality traits on job performance and academic performance in medicine. However, up till date, research in clinical teaching practice did not use quantitative methods and did not account for specialty differences. We empirically studied the relationship of attending physicians' personality traits with their teaching performance across surgical and non-surgical specialties. We conducted a survey across surgical and non-surgical specialties in eighteen medical centers in the Netherlands. Residents evaluated attending physicians' overall teaching performance, as well as the specific domains learning climate, professional attitude, communication, evaluation, and feedback, using the validated 21-item System for Evaluation of Teaching Qualities (SETQ). Attending physicians self-evaluated their personality traits on a 5-point scale using the validated 10-item Big Five Inventory (BFI), yielding the Five Factor model: extraversion, conscientiousness, neuroticism, agreeableness and openness. Overall, 622 (77%) attending physicians and 549 (68%) residents participated. Extraversion positively related to overall teaching performance (regression coefficient, B: 0.05, 95% CI: 0.01 to 0.10, P = 0.02). Openness was negatively associated with scores on feedback for surgical specialties only (B: -0.10, 95% CI: -0.15 to -0.05, Pwork on development paths of attending physicians in medical education.

  9. Detection of Local Cancer Recurrence After Stereotactic Ablative Radiation Therapy for Lung Cancer: Physician Performance Versus Radiomic Assessment

    International Nuclear Information System (INIS)

    Mattonen, Sarah A.; Palma, David A.; Johnson, Carol; Louie, Alexander V.; Landis, Mark; Rodrigues, George; Chan, Ian; Etemad-Rezai, Roya; Yeung, Timothy P.C.; Senan, Suresh; Ward, Aaron D.

    2016-01-01

    Purpose: Stereotactic ablative radiation therapy (SABR) is a guideline-specified treatment option for early-stage lung cancer. However, significant posttreatment fibrosis can occur and obfuscate the detection of local recurrence. The goal of this study was to assess physician ability to detect timely local recurrence and to compare physician performance with a radiomics tool. Methods and Materials: Posttreatment computed tomography (CT) scans (n=182) from 45 patients treated with SABR (15 with local recurrence matched to 30 with no local recurrence) were used to measure physician and radiomic performance in assessing response. Scans were individually scored by 3 thoracic radiation oncologists and 3 thoracic radiologists, all of whom were blinded to clinical outcomes. Radiomic features were extracted from the same images. Performances of the physician assessors and the radiomics signature were compared. Results: When taking into account all CT scans during the whole follow-up period, median sensitivity for physician assessment of local recurrence was 83% (range, 67%-100%), and specificity was 75% (range, 67%-87%), with only moderate interobserver agreement (κ = 0.54) and a median time to detection of recurrence of 15.5 months. When determining the early prediction of recurrence within <6 months after SABR, physicians assessed the majority of images as benign injury/no recurrence, with a mean error of 35%, false positive rate (FPR) of 1%, and false negative rate (FNR) of 99%. At the same time point, a radiomic signature consisting of 5 image-appearance features demonstrated excellent discrimination, with an area under the receiver operating characteristic curve of 0.85, classification error of 24%, FPR of 24%, and FNR of 23%. Conclusions: These results suggest that radiomics can detect early changes associated with local recurrence that are not typically considered by physicians. This decision support system could potentially allow for early salvage therapy of

  10. Detection of Local Cancer Recurrence After Stereotactic Ablative Radiation Therapy for Lung Cancer: Physician Performance Versus Radiomic Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Mattonen, Sarah A. [Department of Medical Biophysics, The University of Western Ontario, London, Ontario (Canada); Baines Imaging Research Laboratory, London Regional Cancer Program, London, Ontario (Canada); Palma, David A., E-mail: david.palma@lhsc.on.ca [Department of Medical Biophysics, The University of Western Ontario, London, Ontario (Canada); Baines Imaging Research Laboratory, London Regional Cancer Program, London, Ontario (Canada); Department of Oncology, The University of Western Ontario, London, Ontario (Canada); Johnson, Carol [Baines Imaging Research Laboratory, London Regional Cancer Program, London, Ontario (Canada); Louie, Alexander V. [Department of Oncology, The University of Western Ontario, London, Ontario (Canada); Landis, Mark [Department of Diagnostic Radiology, London Health Sciences Centre, London, Ontario (Canada); Rodrigues, George [Department of Oncology, The University of Western Ontario, London, Ontario (Canada); Chan, Ian; Etemad-Rezai, Roya [Department of Diagnostic Radiology, London Health Sciences Centre, London, Ontario (Canada); Yeung, Timothy P.C. [Department of Medical Biophysics, The University of Western Ontario, London, Ontario (Canada); Baines Imaging Research Laboratory, London Regional Cancer Program, London, Ontario (Canada); Senan, Suresh [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Ward, Aaron D. [Department of Medical Biophysics, The University of Western Ontario, London, Ontario (Canada); Baines Imaging Research Laboratory, London Regional Cancer Program, London, Ontario (Canada); Department of Oncology, The University of Western Ontario, London, Ontario (Canada)

    2016-04-01

    Purpose: Stereotactic ablative radiation therapy (SABR) is a guideline-specified treatment option for early-stage lung cancer. However, significant posttreatment fibrosis can occur and obfuscate the detection of local recurrence. The goal of this study was to assess physician ability to detect timely local recurrence and to compare physician performance with a radiomics tool. Methods and Materials: Posttreatment computed tomography (CT) scans (n=182) from 45 patients treated with SABR (15 with local recurrence matched to 30 with no local recurrence) were used to measure physician and radiomic performance in assessing response. Scans were individually scored by 3 thoracic radiation oncologists and 3 thoracic radiologists, all of whom were blinded to clinical outcomes. Radiomic features were extracted from the same images. Performances of the physician assessors and the radiomics signature were compared. Results: When taking into account all CT scans during the whole follow-up period, median sensitivity for physician assessment of local recurrence was 83% (range, 67%-100%), and specificity was 75% (range, 67%-87%), with only moderate interobserver agreement (κ = 0.54) and a median time to detection of recurrence of 15.5 months. When determining the early prediction of recurrence within <6 months after SABR, physicians assessed the majority of images as benign injury/no recurrence, with a mean error of 35%, false positive rate (FPR) of 1%, and false negative rate (FNR) of 99%. At the same time point, a radiomic signature consisting of 5 image-appearance features demonstrated excellent discrimination, with an area under the receiver operating characteristic curve of 0.85, classification error of 24%, FPR of 24%, and FNR of 23%. Conclusions: These results suggest that radiomics can detect early changes associated with local recurrence that are not typically considered by physicians. This decision support system could potentially allow for early salvage therapy of

  11. Physicians in health care management: 2. Managing performance: who, what, how and when?

    OpenAIRE

    Lemieux-Charles, L

    1994-01-01

    Physicians are becoming more involved in performance management as hospitals restructure to increase effectiveness. Although physicians are not hospital employees, they are subject to performance appraisals because the hospitals are accountable to patients and the community for the quality of hospital services. The performance of a health care professional may be appraised by the appropriate departmental manager, by other professionals in a team or program or by peers, based on prior agreemen...

  12. Invited Article: Threats to physician autonomy in a performance-based reimbursement system.

    Science.gov (United States)

    Larriviere, Daniel G; Bernat, James L

    2008-06-10

    Physician autonomy is currently threatened by the external application of pay for performance standards and required conformity to practice guidelines. This phenomenon is being driven by concerns over the economic viability of increasing per capita health care expenditures without a concomitant rise in favorable health outcomes and by the unjustified marked variations among physicians' practice patterns. Proponents contend that altering the reimbursement system to encourage physicians to make choices based upon the best available evidence would be one way to ensure better outcomes per health care dollar spent. Although physician autonomy is most easily justified when decisions are made by appealing to the best available evidence, incentivizing decision-making risks sacrificing physician autonomy to political and social forces if the limitations of evidence-based medicine are not respected. Any reimbursement system designed to encourage physicians to utilize the best available evidence by providing financial incentives must recognize physicians who try to play to the numbers as well as physicians who refuse to follow the best available evidence if doing so would conflict with good medicine or patient preferences. By designing, promulgating, and updating evidence-based clinical practice guidelines, medical specialty societies can limit threats to physician autonomy while improving medical practice.

  13. 42 CFR 414.50 - Physician or other supplier billing for diagnostic tests performed or interpreted by a physician...

    Science.gov (United States)

    2010-10-01

    ... HEALTH SERVICES Physicians and Other Practitioners § 414.50 Physician or other supplier billing for... services through such billing physician or other supplier. The “substantially all” requirement will be satisfied if, at the time the billing physician or other supplier submits a claim for a service furnished by...

  14. The role of direct-to-consumer pharmaceutical advertisements and individual differences in getting people to talk to physicians.

    Science.gov (United States)

    Krezmien, Elyse; Wanzer, Melissa Bekelja; Servoss, Timothy; LaBelle, Sara

    2011-09-01

    In this study, 384 respondents provided quantitative and descriptive information about direct-to-consumer (DTC) pharmaceutical advertisements and factors related to message reception and drug adoption. The authors applied M. Booth-Butterfield's ( 2008 ) Standard Model to explain how DTC advertising is used in getting individuals to talk to their doctors about pharmaceutical drugs. The researchers predicted that individuals who talked with their physicians about a pharmaceutical drug (referred to as talkers) would differ from those who did not talk with their physicians (referred to as nontalkers) in a number of meaningful ways. Findings from this data set indicate that individuals who talked with their physician about a specific medication were more likely to be female, older, higher in need for cognition, and reported higher physician satisfaction. Total number of channels (TV, radio, newspaper, magazines, and the Internet) was negatively associated with talking to a physician about a specific medication, as was exposure to DTC advertisement on television. The authors offer explanations for these findings along with descriptive accounts of how talkers and nontalkers differed in their recall of DTC advertisement information. Copyright © Taylor & Francis Group, LLC

  15. Usefulness of non-lead aprons in radiation protection for physicians performing interventional procedures

    International Nuclear Information System (INIS)

    Zuguchi, M.; Chida, K.; Taura, M.; Inaba, Y.; Ebata, A.; Yamada, S.

    2008-01-01

    At present, interventional radiology (IVR) tends to involve long procedures (long radiation duration), and physicians are near to the source of scattered radiation. Hence, shielding is critical in protecting physicians from radiation. Protective aprons and additional lead-shielding devices, such as table-side lead drapes, are important means of protecting the physician from scattered radiation. The purpose of this study was to evaluate whether non-lead aprons are effective in protecting physicians from radiation during IVR procedures. In this study, the radiation protection effects of commercially available protective lead and non-lead aprons, when exposed to diagnostic X rays, are compared. The performance of these non-lead and lead aprons was similar for scattered X rays at tube voltages of 60-120 kV. Properly designed non-lead aprons are thus more suitable for physicians because they weigh ∼20% less than the lead aprons, and are non-toxic. (authors)

  16. Can outcome-based continuing medical education improve performance of immigrant physicians?

    Science.gov (United States)

    Castel, Orit Cohen; Ezra, Vered; Alperin, Mordechai; Nave, Rachel; Porat, Tamar; Golan, Avivit Cohen; Vinker, Shlomo; Karkabi, Khaled

    2011-01-01

    Immigrant physicians are a valued resource for physician workforces in many countries. Few studies have explored the education and training needs of immigrant physicians and ways to facilitate their integration into the health care system in which they work. Using an educational program developed for immigrant civilian physicians working in military primary care clinics at the Israel Defence Force, we illustrate how an outcome-based CME program can address practicing physicians' needs for military-specific primary care education and improve patient care. Following an extensive needs assessment, a 3-year curriculum was developed. The curriculum was delivered by a multidisciplinary educational team. Pre/post multiple-choice examinations, objective structured clinical examinations (OSCE), and end-of-program evaluations were administered for curriculum evaluation. To evaluate change in learners' performance, data from the 2003 (before-program) and 2006 (after-program) work-based assessments were retrieved retrospectively. Change in the performance of program participants was compared with that of immigrant physicians who did not participate in the program. Out of 28 learners, 23 (82%) completed the program. Learners did significantly better in the annual post-tests compared with the pretests (p educators, facing the challenge of integrating immigrant physicians to fit their health care system, may consider adapting our approach. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  17. Financial Advice and Individual Investor Portfolio Performance

    NARCIS (Netherlands)

    Kramer, M.M.

    2012-01-01

    This paper investigates whether financial advisers add value to individual investors portfolio decisions by comparing portfolios of advised and self-directed (execution-only) Dutch individual investors. The results indicate significant differences in characteristics and portfolios between these

  18. Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.

    Science.gov (United States)

    Klerman, Elizabeth B; Beckett, Scott A; Landrigan, Christopher P

    2016-09-13

    In 2011 the U.S. Accreditation Council for Graduate Medical Education began limiting first year resident physicians (interns) to shifts of ≤16 consecutive hours. Controversy persists regarding the effectiveness of this policy for reducing errors and accidents while promoting education and patient care. Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, we quantitatively compared predictions for traditional intern schedules to those that limit work to ≤ 16 consecutive hours. We simulated two traditional schedules and three novel schedules using the mathematical model. The traditional schedules had extended duration work shifts (≥24 h) with overnight work shifts every second shift (including every third night, Q3) or every third shift (including every fourth night, Q4) night; the novel schedules had two different cross-cover (XC) night team schedules (XC-V1 and XC-V2) and a Rapid Cycle Rotation (RCR) schedule. Predicted objective performance and subjective alertness for each work shift were computed for each individual's schedule within a team and then combined for the team as a whole. Our primary outcome was the amount of time within a work shift during which a team's model-predicted objective performance and subjective alertness were lower than that expected after 16 or 24 h of continuous wake in an otherwise rested individual. The model predicted fewer hours with poor performance and alertness, especially during night-time work hours, for all three novel schedules than for either the traditional Q3 or Q4 schedules. Three proposed schedules that eliminate extended shifts may improve performance and alertness compared with traditional Q3 or Q4 schedules. Predicted times of worse performance and alertness were at night, which is also a time when supervision of trainees is lower. Mathematical modeling provides a quantitative comparison approach with potential to aid

  19. Predictors of hyperglycaemic individuals who do not follow up with physicians after screening in Japan: a cohort study.

    Science.gov (United States)

    Tsujimura, Yuka; Takahashi, Yoshimitsu; Ishizaki, Tatsuro; Kuriyama, Akira; Miyazaki, Kikuko; Satoh, Toshihiko; Ikeda, Shunya; Kimura, Shinya; Nakayama, Takeo

    2014-08-01

    Although people screened as being hyperglycaemic often fail to follow up with physicians for clinical assessment, epidemiologic findings on the frequency and predictors of not following up (hereafter, "no follow-up") are lacking. The purpose of this study was to examine the no follow-up rate with physicians after screening for diabetes and predictors of no follow-up. We assessed cases of no follow-up with physicians within six months after screening based on medical claims data from employee-based social health insurance programs in Japan, for people aged 20 to 68 years from 2005 to 2010. Among 3878 screened participants with hyperglycaemia, 2527 (65%) did not follow up with their physicians within six months after screening. Multiple logistic regression analysis revealed that younger age and lower blood glucose level predicted no follow-up among both men and women, while lower body mass index and negative proteinuria also predicted no follow-up among men. Treatment for dyslipidaemia facilitated follow-up among both genders, and treatment for hypertension or depression facilitated follow-up among men. Approximately two thirds of individuals screened as having hyperglycaemia did not follow up with their physicians within six months after screening. Predictors of no follow-up were younger age and milder hyperglycaemia. Being on treatment for co-morbidities tended to facilitate follow-up. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice

    NARCIS (Netherlands)

    Rijssen, H.J. van; Schellart, A.J.M.; Anema, J.R.; Boer, W.E.L. de; Beek, A.J. van der

    2011-01-01

    Background Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education,

  1. Personality traits affect teaching performance of attending physicians: results of a multi-center observational study.

    Directory of Open Access Journals (Sweden)

    Renée A Scheepers

    Full Text Available BACKGROUND: Worldwide, attending physicians train residents to become competent providers of patient care. To assess adequate training, attending physicians are increasingly evaluated on their teaching performance. Research suggests that personality traits affect teaching performance, consistent with studied effects of personality traits on job performance and academic performance in medicine. However, up till date, research in clinical teaching practice did not use quantitative methods and did not account for specialty differences. We empirically studied the relationship of attending physicians' personality traits with their teaching performance across surgical and non-surgical specialties. METHOD: We conducted a survey across surgical and non-surgical specialties in eighteen medical centers in the Netherlands. Residents evaluated attending physicians' overall teaching performance, as well as the specific domains learning climate, professional attitude, communication, evaluation, and feedback, using the validated 21-item System for Evaluation of Teaching Qualities (SETQ. Attending physicians self-evaluated their personality traits on a 5-point scale using the validated 10-item Big Five Inventory (BFI, yielding the Five Factor model: extraversion, conscientiousness, neuroticism, agreeableness and openness. RESULTS: Overall, 622 (77% attending physicians and 549 (68% residents participated. Extraversion positively related to overall teaching performance (regression coefficient, B: 0.05, 95% CI: 0.01 to 0.10, P = 0.02. Openness was negatively associated with scores on feedback for surgical specialties only (B: -0.10, 95% CI: -0.15 to -0.05, P<0.001 and conscientiousness was positively related to evaluation of residents for non-surgical specialties only (B: 0.13, 95% CI: 0.03 to 0.22, p = 0.01. CONCLUSIONS: Extraverted attending physicians were consistently evaluated as better supervisors. Surgical attending physicians who display high levels of

  2. Hospital employment of physicians and supply chain performance: An empirical investigation.

    Science.gov (United States)

    Young, Gary J; Nyaga, Gilbert N; Zepeda, E David

    2016-01-01

    As hospital employment of physicians becomes increasingly common in the United States, much speculation exists as to whether this type of arrangement will promote hospital operating efficiency in such areas as supply chain management. Little empirical research has been conducted to address this question. The aim of this study was to provide an exploratory assessment of whether hospital employment of physicians is associated with better supply chain performance. Drawing from both agency and stewardship theories, we examined whether hospitals with a higher proportion of employed medical staff members have relatively better supply chain performance based on two performance measures, supply chain expenses and inventory costs. We conducted the study using a pooled, cross-sectional sample of hospitals located in California between 2007 and 2009. Key data sources were hospital annual financial reports from California's Office of Statewide Health Policy and Development and the American Hospital Association annual survey of hospitals. To examine the relationship between physician employment and supply chain performance, we specified physician employment as the proportion of total employed medical staff members as well as the proportion of employed medical staff members within key physician subgroups. We analyzed the data using generalized estimating equations. Study results generally supported our hypothesis that hospital employment of physicians is associated with better supply chain performance. Although the results of our study should be viewed as preliminary, the trend in the United States toward hospital employment of physicians may be a positive development for improved hospital operating efficiency. Hospital managers should also be attentive to training and educational resources that medical staff members may need to strengthen their role in supply chain activities.

  3. [Each person has to make their own individual decision - arguments for physician assisted suicide].

    Science.gov (United States)

    Posa, Andreas

    2016-06-01

    Since November 2015, businesslike assisted suicide is punishable in Germany. But who acts businesslike? The majority of the German population prefers to make own decisions about the circumstances of their arriving death, and many of them would also accept (physician) assisted suicide if necessary. Only a minority of physicians plead for prohibiting assisted suicide in general. In the end everyone should be able to take position on his own. No one is obliged to use or execute assisted suicide. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Quantifying the impact of cross coverage on physician's workload and performance in radiation oncology.

    Science.gov (United States)

    Mosaly, Prithima R; Mazur, Lukasz M; Jones, Ellen L; Hoyle, Lesley; Zagar, Timothy; Chera, Bhishamjit S; Marks, Lawrence B

    2013-01-01

    To quantitatively assess the difference in workload and performance of radiation oncology physicians during radiation therapy treatment planning tasks under the conditions of "cross coverage" versus planning a patient with whom they were familiar. Eight physicians (3 experienced faculty physicians and 5 physician residents) performed 2 cases. The first case represented a "cross-coverage" scenario where the physicians had no prior information about the case to be planned. The second exposure represented a "regular-coverage" scenario where the physicians were familiar with the patient case to be planned. Each case involved 3 tasks to be completed systematically. Workload was assessed both subjectively (perceived) using National Aeronautics and Space Administration-Task Load Index (NASA-TLX), and objectively (physiological) throughout the task using eye data (via monitoring pupil size and blink rate). Performance of each task and the case was measured using completion time. Subjective willingness to approve or disapprove the generated plan was obtained after completion of the case only. Forty-eight perceived and 48 physiological workload assessments were obtained. Overall, results revealed a significant increase in perceived workload (high NASA-TLX score) and decrease in performance (longer completion time and reduced approval rate) during cross coverage. There were nonsignificant increases in pupil diameter and decreases in the blink rate during cross-coverage versus regular-coverage scenario. In both cross-coverage and regular-coverage scenarios the level of experience did not affect workload and performance. The cross-coverage scenario significantly increases perceived workload and degrades performance versus regular coverage. Hence, to improve patient safety, efforts must be made to develop policies, standard operating procedures, and usability improvements to electronic medical record and treatment planning systems for "easier" information processing to deal with

  5. Joint influence of individual choices, parenting practices, and physician advice on adolescent obesity, Nebraska, 2008.

    Science.gov (United States)

    Wang, Hongmei; Kim, Jungyoon; Su, Dejun; Xu, Liyan; Chen, Li-Wu; Huang, Terry T-K

    2014-10-09

    Reducing childhood obesity remains a public health priority given its high prevalence and its association with increased risk of adult obesity and chronic diseases. The objective of this study was to examine the joint influence of multiple risk factors on adolescent overweight status. We conducted a random-digit-dialed telephone survey of adolescents aged 12 to 19 years in fall 2008 in a Midwestern city in Nebraska. On the basis of survey data for 791 youths aged 12 to 18 years, we conducted latent class analysis to group youths by the joint occurrence of dietary behavior, physical activity, parenting practices, and physician advice. We then examined the association between the groups and overweight status by using logistic regression, controlling for age, sex, race/ethnicity, and parent and family information. Youths were clustered into 3 groups. Group I (52%) were youths with healthy dietary behavior and physical activity, less permissive parenting practices, and physician advice; Group II (30%) were youths with moderately healthy dietary behavior and physical activity, less permissive parenting practices, and no physician advice; and Group III (18%) were youths with unhealthy dietary behavior and physical activity, permissive parenting practices, and physician advice. Youths in Groups I and II were less likely to be overweight than youths in Group III. Youths with healthier behavior and less permissive parenting practices were less likely to be overweight. Study findings highlight the need to address obesity risk factors among youths with unhealthy dietary behavior, inadequate exercise, permissive parenting practices, and some physician advice. Tailored interventions should be used to target youths with different obesity risk factors.

  6. Conceptual frameworks of individual work performance: A systematic review

    NARCIS (Netherlands)

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Schaufeli, W.B.; Vet, H.C.W. de; Beek, A.J. van der

    2011-01-01

    Objective: Individual work performance is differently conceptualized and operationalized in different disciplines. The aim of the current review was twofold: (1) identifying conceptual frameworks of individual work performance and (2) integrating these to reach a heuristic conceptual framework.

  7. Conceptual frameworks of individual work performance a systematic review

    NARCIS (Netherlands)

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Schaufeli, W.B.; de Vet, H.C.W.; van der Beek, A.J.

    2011-01-01

    Objective: Individual work performance is differently conceptualized and operationalized in different disciplines. The aim of the current review was twofold: (1) identifying conceptual frameworks of individual work performance and (2) integrating these to reach a heuristic conceptual framework.

  8. Cooperation within physician-nurse team in occupational medicine service in Poland - Knowledge about professional activities performed by the team-partner.

    Science.gov (United States)

    Sakowski, Piotr

    2015-01-01

    The goal of the study has been to learn about physicians' and nurses' awareness of the professional activities that are being performed by their colleague in the physician-nurse team. Postal questionnaires were sent out to occupational physicians and nurses in Poland. The analysis includes responses from 232 pairs of physician-nurse teams. The knowledge among occupational professionals about tasks performed by their colleagues in the physician-nurse team seems to be poor. Respondents were asked about who performs tasks from each of 21 groups mentioned in the Occupational Medicine Service Act. In the case of only 3 out of 21 groups of tasks, the rate of non-consistence in answers was lower than 30%. A specified number of professionals performed their tasks on the individual basis. Although in many cases their team colleagues knew about those activities, there was a major proportion of those who had no awareness of such actions. Polish occupational physicians and nurses perform a variety of tasks. Occupational nurses, besides medical role, also play important organizational roles in their units. The cooperation between the two professional groups is, however, slightly disturbed by the deficits in communication. This issue needs to be improved for the betterment of operations within the whole system. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  9. Relationships of work-related psychosocial risks, stress, individual factors and burnout – Questionnaire survey among emergency physicians and nurses

    Directory of Open Access Journals (Sweden)

    Ivana M. Ilić

    2017-04-01

    Full Text Available Background: Psychosocial risks represent a great challenge for safety and health protection at work in Europe. The purpose of this study has been to determine the relationships of psychosocial risks arising from work, stress, personal characteristics and burnout among physicians and nurses in the Emergency Medical Service (EMS. Material and Methods: We performed a cross-sectional study based on a questionnaire survey which contained the Copenhagen Psychosocial Questionnaire (COPSOQ and Copenhagen Burnout Inventory (CBI. Results: A total of 88 physicians and 80 nurses completed the survey. Physicians demonstrated higher emotional (mean (M ± standard deviation (SD = 74.57±16.85 and cognitive (M±SD = 75.95±13.74 demands as compared to nurses. Both groups had high sensory demands and responsibilities at work, in spite of the low degree of their autonomy. The meaning of work, commitment to the workplace, and insecurity at work were high for both groups. Among all participants, stressful behavior and reactions were within the limits of low values ( 60. Personal and patient-related burnout was high for both groups, where physicians were significantly affected by work-related burnout. The influence at work, degree of freedom at work, social support, sense of coherence, mental health, and problem-focused coping are negatively related to work-related burnout. Conclusions: Based on personal factors and coping styles, emergency physicians and nurses are representing a self-selective professional group that meets high work demands, great responsibility, strong commitment and insecurity at work. Burnout of physicians and nurses in the EMS tends to be ignored, although it has severe consequences on their mental and general health. Med Pr 2017;68(2:167–178

  10. Relationships of work-related psychosocial risks, stress, individual factors and burnout - Questionnaire survey among emergency physicians and nurses.

    Science.gov (United States)

    Ilić, Ivana M; Arandjelović, Mirjana Ž; Jovanović, Jovica M; Nešić, Milkica M

    2017-03-24

    Psychosocial risks represent a great challenge for safety and health protection at work in Europe. The purpose of this study has been to determine the relationships of psychosocial risks arising from work, stress, personal characteristics and burnout among physicians and nurses in the Emergency Medical Service (EMS). We performed a cross-sectional study based on a questionnaire survey which contained the Copenhagen Psychosocial Questionnaire (COPSOQ) and Copenhagen Burnout Inventory (CBI). A total of 88 physicians and 80 nurses completed the survey. Physicians demonstrated higher emotional (mean (M) ± standard deviation (SD) = 74.57±16.85) and cognitive (M±SD = 75.95±13.74) demands as compared to nurses. Both groups had high sensory demands and responsibilities at work, in spite of the low degree of their autonomy. The meaning of work, commitment to the workplace, and insecurity at work were high for both groups. Among all participants, stressful behavior and reactions were within the limits of low values ( 60). Personal and patient-related burnout was high for both groups, where physicians were significantly affected by work-related burnout. The influence at work, degree of freedom at work, social support, sense of coherence, mental health, and problem-focused coping are negatively related to work-related burnout. Based on personal factors and coping styles, emergency physicians and nurses are representing a self-selective professional group that meets high work demands, great responsibility, strong commitment and insecurity at work. Burnout of physicians and nurses in the EMS tends to be ignored, although it has severe consequences on their mental and general health. Med Pr 2017;68(2):178-178. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  11. Individualized Biomathematical Modeling of Fatigue and Performance

    Science.gov (United States)

    2008-05-29

    Interactions and Transitions 53 New Discoveries , Inventions, or Patent Disclosures 56 FA9550-06-1-0055 Individualized Biomathematical Modeling of Fatigue...Old Dominion University, not supported on grant) Daniel J. Mollicone, Ph.D. ( Pulsar Informatics, Inc., not supported on grant) Christopher G...Mott, M.S. ( Pulsar Informatics, Inc., not supported on grant) Erik Olofsen, M.S. (Leiden University, the Netherlands, not supported on grant

  12. Integrating clinical performance improvement across physician organizations: the PhyCor experience.

    Science.gov (United States)

    Loeppke, R; Howell, J W

    1999-02-01

    There is a paucity of literature describing the implementation of clinical performance improvement (CPI) efforts across geographically dispersed multispecialty group practices and independent practice associations. PhyCor, a physician management company based in Nashville, Tennessee, has integrated CPI initiatives into its operating infrastructure. PhyCor CPI INITIATIVES: The strategic framework guiding PhyCor's CPI initiatives is built around a physician-driven, patient-centered model. Physician/administrator leadership teams develop and implement a clinical and financial strategic plan for performance improvement; adopt local clinical and operational performance indicators; and agree on and gain consensus with local physician champions to engage in CPI initiatives. The area/regional leadership councils integrate and coordinate regional medical management and CPI initiatives among local groups and independent practice associations. In addition to these councils and a national leadership council, condition-specific care management councils have also been established. These councils develop condition-specific protocols and outcome measures and lead the implementation of CPI initiatives at their own clinics. Key resources supporting CPI initiatives include information/knowledge management, education and training, and patient education and consumer decision support. Localized efforts in both the asthma care and diabetes management initiatives have led to some preliminary improvements in quality of care indicators. Physician leadership and strategic vision, CPI-oriented organizational infrastructure, broad-based physician involvement in CPI, providing access to performance data, parallel incentives, and creating a sense of urgency for accelerated change are all critical success factors to the implementation of CPI strategies at the local, regional, and national levels.

  13. Measuring individual work performance: Identifying and selecting indicators

    NARCIS (Netherlands)

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; de Vet, H.C.W.; van der Beek, A.J.

    2014-01-01

    BACKGROUND: Theoretically, individual work performance (IWP) can be divided into four dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behavior. However, there is no consensus on the indicators used to measure these dimensions.

  14. Measuring individual work performance: identifying and selecting indicators

    NARCIS (Netherlands)

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Vet, H.C de; Beek, A.J. van der

    2014-01-01

    BACKGROUND: Theoretically, individual work performance (IWP) can be divided into four dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behavior. However, there is no consensus on the indicators used to measure these dimensions. OBJECTIVE: This

  15. Evaluation of physicians' professional performance: An iterative development and validation study of multisource feedback instruments

    Directory of Open Access Journals (Sweden)

    Overeem Karlijn

    2012-03-01

    Full Text Available Abstract Background There is a global need to assess physicians' professional performance in actual clinical practice. Valid and reliable instruments are necessary to support these efforts. This study focuses on the reliability and validity, the influences of some sociodemographic biasing factors, associations between self and other evaluations, and the number of evaluations needed for reliable assessment of a physician based on the three instruments used for the multisource assessment of physicians' professional performance in the Netherlands. Methods This observational validation study of three instruments underlying multisource feedback (MSF was set in 26 non-academic hospitals in the Netherlands. In total, 146 hospital-based physicians took part in the study. Each physician's professional performance was assessed by peers (physician colleagues, co-workers (including nurses, secretary assistants and other healthcare professionals and patients. Physicians also completed a self-evaluation. Ratings of 864 peers, 894 co-workers and 1960 patients on MSF were available. We used principal components analysis and methods of classical test theory to evaluate the factor structure, reliability and validity of instruments. We used Pearson's correlation coefficient and linear mixed models to address other objectives. Results The peer, co-worker and patient instruments respectively had six factors, three factors and one factor with high internal consistencies (Cronbach's alpha 0.95 - 0.96. It appeared that only 2 percent of variance in the mean ratings could be attributed to biasing factors. Self-ratings were not correlated with peer, co-worker or patient ratings. However, ratings of peers, co-workers and patients were correlated. Five peer evaluations, five co-worker evaluations and 11 patient evaluations are required to achieve reliable results (reliability coefficient ≥ 0.70. Conclusions The study demonstrated that the three MSF instruments produced

  16. Relationship between job satisfaction and performance of primary care physicians after the family physician reform of east Azerbaijan province in Northwest Iran.

    Science.gov (United States)

    Jabbari, Hossein; Pezeshki, Mohamad Zakarria; Naghavi-Behzad, Mohammad; Asghari, Mohammad; Bakhshian, Fariba

    2014-01-01

    Following the implementation of family physician program in 2004 in Iranian healthcare system, the understanding in changes in physicians' practice has become important. The objective of this study was to determine the level of family physicians' job satisfaction and its relationship with their performance level. A cross-sectional study was conducted among all 367 family physicians of East Azerbaijan province in during December 2009 to May 2011 using a self-administered, anonymous questionnaire for job satisfaction. The performance scores of primary care physicians were obtained from health deputy of Tabriz Medical University. In this study, overall response rate was 64.5%. The average score of job satisfaction was 42.10 (±18.46), and performance score was 87.52 (±5.74) out of 100. There was significant relationships between working history and job satisfaction (P = 0.014), marital status (P = 0.014), and sex (P = 0.018) with performance among different personal and organizational variables. However, there was no significant relationship between job satisfaction and performance, but satisfied people had about three times better performance than their counterparts (all P performance and job satisfaction are obvious indications for more extensive research in identifying causes and finding mechanisms to improve the situation, especially in payment methods and work condition, in existing health system.

  17. Occupational physicians' perceived value of evidence-based medicine intervention in enhancing their professional performance

    NARCIS (Netherlands)

    Hugenholtz, Nathalie I. R.; Schaafsma, Frederieke G.; Schreinemakers, Jos F.; van Dijk, Frank J. H.; Nieuwenhuijsen, Karen

    2008-01-01

    OBJECTIVES: This study evaluated how physicians in a nonclinical setting perceive the value of an intervention with multifaceted evidence-based medicine with regard to enhancing their professional performance. METHODS: A qualitative study was conducted using focus groups and face-to-face interviews

  18. Standing Out and Moving Up: Performance Appraisal of Cultural Minority Physicians

    Science.gov (United States)

    Leyerzapf, Hannah; Abma, Tineke A.; Steenwijk, Reina R.; Croiset, Gerda; Verdonk, Petra

    2015-01-01

    Despite a growing diversity within society and health care, there seems to be a discrepancy between the number of cultural minority physicians graduating and those in training for specialization (residents) or working as a specialist in Dutch academic hospitals. The purpose of this article is to explore how performance appraisal in daily medical…

  19. Physician-Pharmacist collaboration in a pay for performance healthcare environment.

    Science.gov (United States)

    Farley, T M; Izakovic, M

    2015-01-01

    Healthcare is becoming more complex and costly in both European (Slovak) and American models. Healthcare in the United States (U.S.) is undergoing a particularly dramatic change. Physician and hospital reimbursement are becoming less procedure focused and increasingly outcome focused. Efforts at Mercy Hospital have shown promise in terms of collaborative team based care improving performance on glucose control outcome metrics, linked to reimbursement. Our performance on the Centers for Medicare and Medicaid Services (CMS) post-operative glucose control metric for cardiac surgery patients increased from a 63.6% pass rate to a 95.1% pass rate after implementing interventions involving physician-pharmacist team based care.Having a multidisciplinary team that is able to adapt quickly to changing expectations in the healthcare environment has aided our institution. As healthcare becomes increasingly saturated with technology, data and quality metrics, collaborative efforts resulting in increased quality and physician efficiency are desirable. Multidisciplinary collaboration (including physician-pharmacist collaboration) appears to be a viable route to improved performance in an outcome based healthcare system (Fig. 2, Ref. 12).

  20. Palliative care professionals' willingness to perform euthanasia or physician assisted suicide.

    Science.gov (United States)

    Zenz, Julia; Tryba, Michael; Zenz, Michael

    2015-11-14

    Euthanasia and physician assisted suicide (PAS) are highly debated upon particularly in the light of medical advancement and an aging society. Little is known about the professionals' willingness to perform these practices particularly among those engaged in the field of palliative care and pain management. Thus a study was performed among those professionals. An anonymous questionnaire was handed out to all participants of a palliative care congress and a pain symposium in 2013. The questionnaire consisted of 8 questions regarding end of life decisions. Proposed patient vignettes were used. A total of 470 eligible questionnaires were returned, 198 by physicians, 272 by nurses. The response rate was 64 %. The majority of professionals were reluctant to perform euthanasia or PAS: 5.3 % of the respondents would be willing to perform euthanasia on a patient with a terminal illness if asked to do so. The reluctance grew in case of a patient with a non-terminal illness. The respondents were more willing to perform PAS than euthanasia. Nurses were more reluctant to take action as opposed to the physicians. The majority of the respondents would attempt to treat the patient's symptoms first before considering life-ending measures. As regards any decision making process the majority would consult with a colleague. This is the first German study to ask about the willingness of professionals to take action as regards euthanasia and PAS without biased phrasing. As opposed to the general acceptance that is respectively high, the actual willingness to perform life-ending measures is low. The German debate on physician assisted suicide and its possible legalization should also incorporate clarifications regarding the responsibility who should eventually perform these acts.

  1. Individual Performance Management: A Review of Current Practices

    Directory of Open Access Journals (Sweden)

    Ian O’ Boyle

    2013-05-01

    Full Text Available This paper provides a review of current practice in relation to individual performance management systems and process within the traditional business environment. There is a consensus that the role of the individual is central to the overall performance of any organization and how individual performances are managed and evaluated can have significant impacts on overall organizational success. Many organizations employ the traditional performance appraisal in order to monitor and assess individual employee performances. However, new approaches, such as 360-degree feedback have also become commonplace within the business environment. An analysis of each approach including benefits and challenges associated with each process is presented within this paper.

  2. Five-year Retrospective Review of Physician and Non-physician Performed Ultrasound in a Canadian Critical Care Helicopter Emergency Medical Service.

    Science.gov (United States)

    O'Dochartaigh, Domhnall; Douma, Matthew; MacKenzie, Mark

    2017-01-01

    To describe the use of prehospital ultrasonography (PHUS) to support interventions, when used by physician and non-physician air medical crew (AMC), in a Canadian helicopter emergency medical service (HEMS). A retrospective review was conducted of consecutive patients who underwent ultrasound examination during HEMS care from January 1, 2009 through March 10, 2014. An a priori created data form was used to record patient demographics, type of ultrasound scan performed, ultrasound findings, location of scan, type of interventions supported by PHUS, factors that affected PHUS completion, and quality indicator(s). Data analysis was performed through descriptive statistics, Student's t-test for continuous variables, Z-test for proportions, and Mann-Whitney U Test for nonparametric data. Outcomes included interventions supported by PHUS, factors associated with incomplete scans, and quality indicators associated with PHUS use. Differences between physician and AMC groups were also assessed. PHUS was used in 455 missions, 318 by AMC and 137 by physicians. In combined trauma and medical patients, in the AMC group interventions were supported by PHUS in 26% of cases (95% CI 18-34). For transport physicians the percentage support was found to be significantly greater at 45% of cases (95% CI 34-56) p = reasons included patient obesity, lack of time, patient access, and clinical reasons. Quality indicators associated with PHUS were rarely identified. The use of PHUS by both physicians and non-physicians was found to support interventions in select trauma and medical patients. Key words: emergency medical services; aircraft; helicopter; air ambulance; ultrasonography; emergency care, prehospital; prehospital emergency care.

  3. Engaging Physician Learners Through a Web-Based Platform: Individualized End-of-Life Education.

    Science.gov (United States)

    Bergman, Jonathan; Ballon-Landa, Eric; Lerman, Steven E; Kwan, Lorna; Bennett, Carol J; Litwin, Mark S

    2016-09-01

    Web-based modules provide a convenient and low-cost education platform, yet should be carefully designed to ensure that learners are actively engaged. In order to improve attitudes and knowledge in end-of-life (EOL) care, we developed a web-based educational module that employed hyperlinks to allow users access to auxiliary resources: clinical guidelines and seminal research papers. Participants took pre-test evaluations of attitudes and knowledge regarding EOL care prior to accessing the educational module, and a post-test evaluation following the module intervention. We recorded the type of hyperlinks (guideline or paper) accessed by learners, and stratified participants into groups based on link type accessed (none, either, or both). We used demographic and educational data to develop a multivariate mixed-effects regression analysis to develop adjusted predictions of attitudes and knowledge. 114 individuals participated. The majority had some professional exposure to EOL care (prior instruction 62%; EOL referral 53%; EOL discussion 56%), though most had no family (68%) or personal experience (51%). On bivariate analysis, non-partnered (p = .04), medical student training level (p = .03), prior palliative care referral (p = .02), having a family member (p = .02) and personal experience of EOL care (p improvements. Auxiliary resources accessible by hyperlink are an effective adjunct to web-based learning in end-of-life care. © The Author(s) 2015.

  4. Cross-cultural adaptation of the Individual Work Performance Questionnaire

    NARCIS (Netherlands)

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Lerner, D.; Vet, H.C.W. de; Beek, A.J. van der

    2016-01-01

    BACKGROUND: The Individual Work Performance Questionnaire (IWPQ), measuring task performance, contextual performance, and counterproductive work behavior, was developed in The Netherlands. OBJECTIVES: To cross-culturally adapt the IWPQ from the Dutch to the American-English language, and assess the

  5. Career Development, Collective Efficacy, and Individual Task Performance

    Science.gov (United States)

    Kellett, Janet B.; Humphrey, Ronald H.; Sleeth, Randall G.

    2009-01-01

    Purpose: The purpose of this paper is to test the hypothesis that perceived collective efficacy would mediate the effects of self-efficacy on individual task performance. Design/methodology/approach: An assessment center design with 147 participants in 49 three-person groups was used. Findings: It is found that for individuals working on an…

  6. Individualized Next-Generation Biomathematical Modeling of Fatigue and Performance

    National Research Council Canada - National Science Library

    Van Dongen, Hans P

    2006-01-01

    .... This project employed a cutting-edge technique called Bayesian forecasting to develop a novel biomathematical performance model to predict responses to sleep loss and circadian displacement for individual subjects...

  7. ASSESSING INDIVIDUAL PERFORMANCE ON INFORMATION TECHNOLOGY ADOPTION: A NEW MODEL

    OpenAIRE

    Diah Hari Suryaningrum

    2012-01-01

    This paper aims to propose a new model in assessing individual performance on information technology adoption. The new model to assess individual performance was derived from two different theories: decomposed theory of planned behavior and task-technology fit theory. Although many researchers have tried to expand these theories, some of their efforts might lack of theoretical assumptions. To overcome this problem and enhance the coherence of the integration, I used a theory from social scien...

  8. Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice

    Science.gov (United States)

    2011-01-01

    Background Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1) to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2) to plan an evaluation of the training course. Methods A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation. Results A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial. Conclusions The feasibility and

  9. Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice.

    Science.gov (United States)

    van Rijssen, H Jolanda; Schellart, Antonius J M; Anema, Johannes R; de Boer, Wout E L; van der Beek, Allard J

    2011-06-03

    Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1) to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2) to plan an evaluation of the training course. A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation. A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial. The feasibility and practical relevance of the communication

  10. Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice

    Directory of Open Access Journals (Sweden)

    Anema Johannes R

    2011-06-01

    Full Text Available Abstract Background Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1 to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2 to plan an evaluation of the training course. Methods A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation. Results A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial

  11. Real-time individualization of the unified model of performance.

    Science.gov (United States)

    Liu, Jianbo; Ramakrishnan, Sridhar; Laxminarayan, Srinivas; Balkin, Thomas J; Reifman, Jaques

    2017-12-01

    Existing mathematical models for predicting neurobehavioural performance are not suited for mobile computing platforms because they cannot adapt model parameters automatically in real time to reflect individual differences in the effects of sleep loss. We used an extended Kalman filter to develop a computationally efficient algorithm that continually adapts the parameters of the recently developed Unified Model of Performance (UMP) to an individual. The algorithm accomplishes this in real time as new performance data for the individual become available. We assessed the algorithm's performance by simulating real-time model individualization for 18 subjects subjected to 64 h of total sleep deprivation (TSD) and 7 days of chronic sleep restriction (CSR) with 3 h of time in bed per night, using psychomotor vigilance task (PVT) data collected every 2 h during wakefulness. This UMP individualization process produced parameter estimates that progressively approached the solution produced by a post-hoc fitting of model parameters using all data. The minimum number of PVT measurements needed to individualize the model parameters depended upon the type of sleep-loss challenge, with ~30 required for TSD and ~70 for CSR. However, model individualization depended upon the overall duration of data collection, yielding increasingly accurate model parameters with greater number of days. Interestingly, reducing the PVT sampling frequency by a factor of two did not notably hamper model individualization. The proposed algorithm facilitates real-time learning of an individual's trait-like responses to sleep loss and enables the development of individualized performance prediction models for use in a mobile computing platform. © 2017 European Sleep Research Society.

  12. Flexibility in individualized, competency-based workplace curricula with EPAs: Analyzing four cohorts of physician assistants in training.

    Science.gov (United States)

    Wiersma, Fraukje; Berkvens, Josephine; Ten Cate, Olle

    2017-05-01

    Entrustable professional activities (EPAs) were introduced as a principle for individualized physician assistant (PA) workplace curricula at the University of Applied Sciences (UAS) Utrecht in 2008. We studied how the focus on EPAs served the competency-based flexibility intention of the program. We analyzed data of those 119 students who enrolled in the program 2010 through 2013, and completed the program before April 2016. We analyzed the number of EPAs per student at start and end of the program, number changed during training and the reasons for change. Data of 101 students were suitable for evaluation. Excluded were 16 students ending the program prematurely and two with study delay. Mean number of EPAs per student at the start was 6.8 (range 4-12) and at the end 6.6 (range 3-13). On average 1.5 EPAs were altered (range 0-13). Reasons included extension of the EPA package during training (n = 10), lack of proficiency at planned moments of summative entrustment decisions (n = 9) and procedures not being suitable for PAs at closer look (n = 6). All changes resulted in a curriculum meeting the school's standards for graduation. The flexibility of the EPA concept enabled changes in the individualized curriculum of students, according to the intended competency-based nature of the educational program.

  13. Physicians' attentional performance following a 24-hour observation period: do we need to regulate sleep prior to work?

    Science.gov (United States)

    Smyth, P; Maximova, K; Jirsch, J D

    2017-08-01

    The tradition of physicians working while sleep deprived is increasingly criticised. Medical regulatory bodies have restricted resident physician duty-hours, not addressing the greater population of physicians. We aimed to assess factors such as sleep duration prior to a 24-hour observation period on physicians' attention. We studied 70 physicians (mean age 38 years old (SD 10.8 years)): 36 residents and 34 faculty from call rosters at the University of Alberta. Among 70 physicians, 52 (74%) performed overnight call; 18 did not perform overnight call and were recruited to control for the learning effect of repetitive neuropsychological testing. Attentional Network Test (ANT) measured physicians' attention at the beginning and end of the 24-hour observation period. Participants self-reported ideal sleep needs, sleep duration in the 24 hours prior to (ie, baseline) and during the 24-hour observation period (ie, follow-up). Median regression models examined effects on ANT parameters. Sleep deprivation at follow-up was associated with reduced attentional accuracy following the 24-hour observation period, but only for physicians more sleep deprived at baseline. Other components of attention were not associated with sleep deprivation after adjusting for repetitive testing. Age, years since medical school and caffeine use did not impact changes in ANT parameters. Our study suggests that baseline sleep before 24 hours of observation impacts the accuracy of physicians' attentional testing at 24 hours. Further study is required to determine if optimising physician sleep prior to overnight call shifts is a sustainable strategy to mitigate the effects of sleep deprivation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Correlations between PANCE performance, physician assistant program grade point average, and selection criteria.

    Science.gov (United States)

    Brown, Gina; Imel, Brittany; Nelson, Alyssa; Hale, LaDonna S; Jansen, Nick

    2013-01-01

    The purpose of this study was to examine correlations between first-time Physician Assistant National Certifying Exam (PANCE) scores and pass/fail status, physician assistant (PA) program didactic grade point average (GPA), and specific selection criteria. This retrospective study evaluated graduating classes from 2007, 2008, and 2009 at a single program (N = 119). There was no correlation between PANCE performance and undergraduate grade point average (GPA), science prerequisite GPA, or health care experience. There was a moderate correlation between PANCE pass/fail and where students took science prerequisites (r = 0.27, P = .003) but not with the PANCE score. PANCE scores were correlated with overall PA program GPA (r = 0.67), PA pharmacology grade (r = 0.68), and PA anatomy grade (r = 0.41) but not with PANCE pass/fail. Correlations between selection criteria and PANCE performance were limited, but further research regarding the influence of prerequisite institution type may be warranted and may improve admission decisions. PANCE scores and PA program GPA correlations may guide academic advising and remediation decisions for current students.

  15. Monitoring individual and joint action outcomes in duet music performance

    DEFF Research Database (Denmark)

    Loehr, Janeen; Kourtis, Dimitrios; Vesper, Cordula

    2013-01-01

    We investigated whether people monitor the outcomes of their own and their partners’ individual actions as well as the outcome of their combined actions when performing joint actions together. Pairs of pianists memorized both parts of a piano duet. Each pianist then performed one part while their...

  16. Hippocratic oath and conversion of ethico-regulatory aspects onto doctors as a physician, private individual and a clinical investigator

    OpenAIRE

    Imran, Mohammed; Samad, Shadab; Maaz, Mohammad; Qadeer, Ashhar; Najmi, Abul Kalam; Aqil, Mohammed

    2013-01-01

    Hippocratic Oath is a living document for ethical conduct of the physicians around the world. World Medical Association has been amending the oath as per the contemporary times. Although physicians maintain their ethical standards while treating a patient yet many a times social, administrative and ruling powers either use physicians as their tool of oppression or victimize them for conducting duties as per their oath. The Tuskegee Syphilis Study and Human Radiation Experiments in America, Na...

  17. Deterioration of neurobehavioral performance in resident physicians during repeated exposure to extended duration work shifts.

    Science.gov (United States)

    Anderson, Clare; Sullivan, Jason P; Flynn-Evans, Erin E; Cade, Brian E; Czeisler, Charles A; Lockley, Steven W

    2012-08-01

    Although acute sleep loss during 24- to 30-h extended duration work shifts (EDWS) has been shown to impair the performance of resident physicians, little is known about the effects of cumulative sleep deficiency on performance during residency training. Chronic sleep restriction induces a gradual degradation of neurobehavioral performance and exacerbates the effects of acute sleep loss in the laboratory, yet the extent to which this occurs under real-world conditions is unknown. In this study, the authors quantify the time course of neurobehavioral deterioration due to repeated exposure to EDWS during a 3-week residency rotation. A prospective, repeated-measures, within-subject design. Medical and cardiac intensive care units, Brigham and Women's Hospital, Boston, MA. Thirty-four postgraduate year one resident physicians (23 males; age 28.0 ± 1.83 (standard deviation) years) Residents working a 3-week Q3 schedule (24- to 30-h work shift starts every 3(rd) day), consisting of alternating 24- to 30-h (EDWS) and approximately 8-h shifts, underwent psychomotor vigilance testing before, during, and after each work shift. Mean response time, number of lapses, and slowest 10% of responses were calculated for each test. Residents also maintained daily sleep/wake/work logs. EDWS resulted in cumulative sleep deficiency over the 21-day rotation (6.3 h sleep obtained per day; average 2.3 h sleep obtained per extended shift). Response times deteriorated over a single 24- to 30-h shift (P Performance on the fifth and sixth shift was significantly worse than on the first shift (P performance and exacerbated the effects of acute sleep loss inherent in the 24- to 30-h EDWS that are commonly used in resident schedules.

  18. Aging and Cognitive Performance: Challenges and Implications for Physicians Practicing in the 21st Century

    Science.gov (United States)

    Durning, Steven J.; Artino, Anthony R.; Holmboe, Eric; Beckman, Thomas J.; van der Vleuten, Cees; Schuwirth, Lambert

    2010-01-01

    The demands of physician practice are growing. Some specialties face critical shortages and a significant percentage of physicians are aging. To improve health care it is paramount to understand and address challenges, including cognitive issues, facing aging physicians. In this article, we outline several issues related to cognitive performance…

  19. Individual Characteristics Influencing Physicians' Perceptions of Job Demands and Control: The Role of Affectivity, Work Engagement and Workaholism.

    Science.gov (United States)

    Mazzetti, Greta; Biolcati, Roberta; Guglielmi, Dina; Vallesi, Caryn; Schaufeli, Wilmar B

    2016-06-06

    The first purpose of the present study was to investigate the role of individual characteristics, i.e., positive and negative affectivity, in explaining the different perception of job control and job demands in a particularly demanding environment such as the healthcare setting. In addition, we aimed to explore the mediational role of work engagement and workaholism using the Job Demands-Resources Model as a theoretical framework. Data were collected using a sample of 269 Italian head physicians working in nine general hospitals. To test our hypotheses, the collected data were analyzed with structural equation modeling. Moreover, Sobel Test and bootstrapping were employed to assess the mediating hypotheses. Our results indicated that positive affectivity is related to work engagement, which, in its turn, showed a positive association with job control. In addition, workaholism mediated the relationship between negative affectivity and job demands. All in all, this study represents a first attempt to explore the role of trait affectivity as a dispositional characteristic able to foster the level of work engagement and workaholism exhibited by employees and, in turn, to increase the perceived levels of job control and job demands.

  20. Subjective and objective quantification of physician's workload and performance during radiation therapy planning tasks.

    Science.gov (United States)

    Mazur, Lukasz M; Mosaly, Prithima R; Hoyle, Lesley M; Jones, Ellen L; Marks, Lawrence B

    2013-01-01

    To quantify, and compare, workload for several common physician-based treatment planning tasks using objective and subjective measures of workload. To assess the relationship between workload and performance to define workload levels where performance could be expected to decline. Nine physicians performed the same 3 tasks on each of 2 cases ("easy" vs "hard"). Workload was assessed objectively throughout the tasks (via monitoring of pupil size and blink rate), and subjectively at the end of each case (via National Aeronautics and Space Administration Task Load Index; NASA-TLX). NASA-TLX assesses the 6 dimensions (mental, physical, and temporal demands, frustration, effort, and performance); scores > or ≈ 50 are associated with reduced performance in other industries. Performance was measured using participants' stated willingness to approve the treatment plan. Differences in subjective and objective workload between cases, tasks, and experience were assessed using analysis of variance (ANOVA). The correlation between subjective and objective workload measures were assessed via the Pearson correlation test. The relationships between workload and performance measures were assessed using the t test. Eighteen case-wise and 54 task-wise assessments were obtained. Subjective NASA-TLX scores (P .1), were significantly lower for the easy vs hard case. Most correlations between the subjective and objective measures were not significant, except between average blink rate and NASA-TLX scores (r = -0.34, P = .02), for task-wise assessments. Performance appeared to decline at NASA-TLX scores of ≥55. The NASA-TLX may provide a reasonable method to quantify subjective workload for broad activities, and objective physiologic eye-based measures may be useful to monitor workload for more granular tasks within activities. The subjective and objective measures, as herein quantified, do not necessarily track each other, and more work is needed to assess their utilities. From a

  1. Quality control of physician-performed mammography. Importance of original attempts to improve quality

    International Nuclear Information System (INIS)

    Nakayama, Takashi; Terada, Hiroshi; Kotsuma, Yoshikazu

    2006-01-01

    In order to perform effective breast cancer screening with mammography, family doctors should be encouraged to participate. At institutions without specific radiology technicians, physicians themselves are required to perform mammography and operate the equipment, otherwise it is difficult to consistently obtain good-quality mammograms. Our institutions have been given a grade ''A'' evaluation by the Central Committee for Quality Control of Mammographic Screening (CCQCMS), due largely to our own efforts and promotion. Here we report our experience in solving a number of problems that occurred during the establishment of our system. We used the SEPIO standard mammography apparatus with a MD-100/CM-H screen/filter system, and developed films using a TCX-202 automatic film processor. Problems due to asymmetry of the bilateral breasts and lack of retroglandular fat tissue space and inframammary folds seen on our initial mammograms were overcome by placing marks at the postion of the AEC sensor, and at both ends and the center of the film on a bucky table. We simplified the markers by removing several complicated ones. We tried to rectify areas of the image that were obscured due to the difference in size between the inside of the cassette and the screen. Physicians and a radiology technician attended a mammography study course once weekly, and attempted to improve the quality of mammograms and our reading ability by obtaining advice from members of the CCQCMS. Manufacturers responded with considerable delay to our attempt to overcome the troublesome appearance of numerous microcalfication-like artifact shadows caused by screens. In conclusion, in order to perform effective breast cancer screening with mammography, we must obtain mammograms of good quality, for which it is necessary to always try to seek new ways of improving. At the same time, manufacturers need to respond quickly to queries and problems related to quality control. (author)

  2. Interventions to change physician performance: the ChiPP (change in professional performance) statement

    DEFF Research Database (Denmark)

    Bro, Flemming

    2006-01-01

    Clinicians keep looking for new ways to improve patient treatment and if you are involved in health services delivery and quality development you try to improve the performance of your organisation. However, our experiences are often not communicated to others and don not contribute to an accumul...

  3. Lower levels of trust in one's physician is associated with more distress over time in more anxiously attached individuals with cancer

    NARCIS (Netherlands)

    Hinnen, Chris; Pool, Grieteke; Holwerda, Nynke; Sprangers, Mirjam; Sanderman, Robbert; Hagedoorn, Mariet

    2014-01-01

    Objective: In the present study, we investigated individual differences in the outcome of patient-physician trust when confronted with cancer from an attachment theoretical perspective. We expected that lower levels of trust are associated with more emotional distress and more physical limitations

  4. Lower levels of trust in one's physician is associated with more distress over time in more anxiously attached individuals with cancer

    NARCIS (Netherlands)

    Hinnen, Chris; Pool, Grieteke; Holwerda, Nynke; Sprangers, Mirjam; Sanderman, Robbert; Hagedoorn, Margriet

    2014-01-01

    Objective In the present study, we investigated individual differences in the outcome of patient–physician trust when confronted with cancer from an attachment theoretical perspective. We expected that lower levels of trust are associated with more emotional distress and more physical limitations

  5. Lower levels of trust in one's physician is associated with more distress over time in more anxiously attached individuals with cancer

    NARCIS (Netherlands)

    Hinnen, Chris; Pool, Grieteke; Holwerda, Nynke; Sprangers, Mirjam; Sanderman, Robbert; Hagedoorn, Mariet

    2014-01-01

    In the present study, we investigated individual differences in the outcome of patient-physician trust when confronted with cancer from an attachment theoretical perspective. We expected that lower levels of trust are associated with more emotional distress and more physical limitations within the

  6. The Regression Analysis of Individual Financial Performance: Evidence from Croatia

    OpenAIRE

    Bahovec, Vlasta; Barbić, Dajana; Palić, Irena

    2017-01-01

    Background: A large body of empirical literature indicates that gender and financial literacy are significant determinants of individual financial performance. Objectives: The purpose of this paper is to recognize the impact of the variable financial literacy and the variable gender on the variation of the financial performance using the regression analysis. Methods/Approach: The survey was conducted using the systematically chosen random sample of Croatian financial consumers. The cross sect...

  7. Hippocratic oath and conversion of ethico-regulatory aspects onto doctors as a physician, private individual and a clinical investigator.

    Science.gov (United States)

    Imran, Mohammed; Samad, Shadab; Maaz, Mohammad; Qadeer, Ashhar; Najmi, Abul Kalam; Aqil, Mohammed

    2013-10-01

    Hippocratic Oath is a living document for ethical conduct of the physicians around the world. World Medical Association has been amending the oath as per the contemporary times. Although physicians maintain their ethical standards while treating a patient yet many a times social, administrative and ruling powers either use physicians as their tool of oppression or victimize them for conducting duties as per their oath. The Tuskegee Syphilis Study and Human Radiation Experiments in America, Nazi Experiments in Germany and compulsory sterilization program in India were the studies where States used physicians for the advancement of their rationality or belief. Conversely victimization of physicians in Kosovo, Sri Lanka and incarcerating physicians for treating human immunodeficiency virus/acquired immunodeficiency syndrome patients in some countries is concerning. The Nuremberg code, the Declaration of Geneva, Belmont Report and Declaration of Helsinki are ethical documents while active involvement of Food and Drug Administration through "common rule" resulted in guidelines like International Conference on Harmonization and Good Clinical Practices. Still unethical studies are found in developing countries. Studies such as experimental anticancer drugs in 24 cancer patients without adequate prior animal testing and informed consent in Kerala, studies at All India Institute of Medical Sciences in New Delhi resulted in 49 deaths of children and many more suspicious studies are rampant. Reverting back to the fundamentals of the medical profession; teaching medical ethics and enforcement of "medical neutrality" by embarking some grade of "medical immunity" on the basis of the oath is necessary for ethical conduct of physicians.

  8. Performance analysis of the TNO TLD individual monitoring service

    International Nuclear Information System (INIS)

    Dijk, J.W.E. van; Julius, H.W.

    1990-01-01

    The purpose of this study was to analyse the performance and to establish the lowest detectable occupational dose (LDOD) of the TNO TL dosemeter, in use for large scale routine individual monitoring since 1983. The TNO individual monitoring service uses three TLD reader systems and over 45000 TL dosemeters, designed to measure H s (0.07) and H p (10). Each reader system is normalised daily and each individual dosemeter is calibrated every ten readout cycles. The performance of the service is monitored by a double blind experimental set-up. A series of 10 routine dosemeters is issued every fortnight, mailed, exposed by staff not involved in the monitoring service, sent back and evaluated. The conclusion of this study is that the lowest detectable occupational dose is less than 0.04 mSv and that the integrated dose at the level of the annual dose limit is measured within 2%. (author)

  9. The prevalence of excessive daytime sleepiness among academic physicians and its impact on the quality of life and occupational performance.

    Science.gov (United States)

    Ozder, Aclan; Eker, Hasan Huseyin

    2015-01-01

    Sleep disorders can affect health and occupational performance of physicians as well as outcomes in patients. The purpose of this study was to assess the prevalence of excessive daytime sleepiness (EDS) measured by the Epworth Sleepiness Scale (ESS) among academic physicians at a tertiary academic medical center in an urban area in the northwest region of Turkey, and to establish a relationship between the self-perceived sleepiness and the quality of life using the EuroQol-5 dimensions (EQ-5D). A questionnaire prepared by the researchers after scanning the literature on the subject was e-mailed to the academic physicians of a tertiary academic medical center in Istanbul. The ESS and the EQ-5D were also included in the survey. The e-mail database of the institution directory was used to compile a list of active academic physicians who practiced clinical medicine. Paired and independent t tests were used for the data analysis at a significance level of p academic physicians were e-mailed and a total of 252 subjects replied resulting in a 63.6% response rate. There were 84 (33.3%) female and 168 (66.7%) male academic physicians participating in the study. One hundred and eight out of 252 (42.8%) academic physicians were taking night calls (p sleep and 84 (33.3%) reported napping daily (p 10) (p academic physicians was associated with a poorer quality of life (p academic physicians suffered from sleepiness. There was an association between the poor quality of life and daytime sleepiness. There was also a positive relationship between habitual napping and being sleepy during the day. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  10. Culture and individual performance management in University of ...

    African Journals Online (AJOL)

    Their success depends not only on socio-economic and political factors but also on cultural values that influence their activities. In this article, we draw upon the case of one Ghanaian university to illustrate the extent to which cultural values that individuals bring to the workplace pose challenges to performance management ...

  11. Individual Training, Performance Improvement, and the Future for Organizations

    Science.gov (United States)

    Kaufman, Roger

    2015-01-01

    Human competence is a vital element for any organization that expects to survive and then thrive. Developing individual performance ability is necessary but not sufficient because trained people alone will not make an organization successful. We must determine what people should deliver and why it should be delivered in order to add measurable…

  12. Quantifying the performance of individual players in a team activity.

    Science.gov (United States)

    Duch, Jordi; Waitzman, Joshua S; Amaral, Luís A Nunes

    2010-06-16

    Teamwork is a fundamental aspect of many human activities, from business to art and from sports to science. Recent research suggest that team work is of crucial importance to cutting-edge scientific research, but little is known about how teamwork leads to greater creativity. Indeed, for many team activities, it is not even clear how to assign credit to individual team members. Remarkably, at least in the context of sports, there is usually a broad consensus on who are the top performers and on what qualifies as an outstanding performance. In order to determine how individual features can be quantified, and as a test bed for other team-based human activities, we analyze the performance of players in the European Cup 2008 soccer tournament. We develop a network approach that provides a powerful quantification of the contributions of individual players and of overall team performance. We hypothesize that generalizations of our approach could be useful in other contexts where quantification of the contributions of individual team members is important.

  13. Quantifying the performance of individual players in a team activity.

    Directory of Open Access Journals (Sweden)

    Jordi Duch

    2010-06-01

    Full Text Available Teamwork is a fundamental aspect of many human activities, from business to art and from sports to science. Recent research suggest that team work is of crucial importance to cutting-edge scientific research, but little is known about how teamwork leads to greater creativity. Indeed, for many team activities, it is not even clear how to assign credit to individual team members. Remarkably, at least in the context of sports, there is usually a broad consensus on who are the top performers and on what qualifies as an outstanding performance.In order to determine how individual features can be quantified, and as a test bed for other team-based human activities, we analyze the performance of players in the European Cup 2008 soccer tournament. We develop a network approach that provides a powerful quantification of the contributions of individual players and of overall team performance.We hypothesize that generalizations of our approach could be useful in other contexts where quantification of the contributions of individual team members is important.

  14. Vocal performance reflects individual quality in a nonpasserine

    NARCIS (Netherlands)

    Janicke, T.; Hahn, S.M.; Ritz, M.S.; Peter, H.-U.

    2008-01-01

    Recent studies on mate-quality recognition in passerines showed that females use subtle differences in sound production to assess males. We analysed long calls of brown skuas, Catharacta antarctica lonnbergi, to test whether vocal performance could serve as an indicator of individual quality in a

  15. Individual Investor Perceptions, Behavior, and Performance During the Financial Crisis

    NARCIS (Netherlands)

    Hoffmann, A.O.I.; Post, T.; Pennings, J.M.E.

    2011-01-01

    Abstract: We study how during the financial crisis individual investor perceptions change, impact trading and risk-taking behavior, and explain performance. Based on monthly survey data and matching brokerage records from April 2008 to March 2009, we find that successful investors had higher return

  16. Individual Investor Perceptions, Behavior, and Performance During the Financial Crisis

    NARCIS (Netherlands)

    Hoffmann, A.O.I.; Pennings, J.M.E.; Post, T.

    2011-01-01

    We study how during the financial crisis individual investor perceptions change, impact trading and risk-taking behavior, and explain performance. Based on monthly survey data and matching brokerage records from April 2008 to March 2009, we find that successful investors had higher return

  17. Hospital versus individual surgeon’s performance in laparoscopic hysterectomy

    NARCIS (Netherlands)

    Driessen, Sara R C; Wallwiener, Markus; Taran, Florin Andrei; Cohen, Sarah L.; Kraemer, Bernhard; Wallwiener, Christian W.; Van Zwet, Erik W.; Brucker, Sara Y.; Jansen, F.W.

    2017-01-01

    Purpose: To compare hospital versus individual surgeon’s perioperative outcomes for laparoscopic hysterectomy (LH), and to assess the relationship between surgeon experience and perioperative outcomes. Methods: A retrospective analysis of all prospective collected LHs performed from 2003 to 2010

  18. Construct validity of the Individual Work Performance Questionnaire.

    NARCIS (Netherlands)

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Vet, H.C.W. de; Beek, A.J. van der

    2014-01-01

    Objective: To examine the construct validity of the Individual Work Performance Questionnaire (IWPQ). Methods: A total of 1424 Dutch workers from three occupational sectors (blue, pink, and white collar) participated in the study. First, IWPQ scores were correlated with related constructs

  19. Improving the Individual Work Performance Questionnaire using Rasch analysis.

    NARCIS (Netherlands)

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Buuren, S. van; Beek, A.J. van der; Vet, H.C.W. de

    2014-01-01

    Recently, the Individual Work Performance Questionnaire (IWPQ) version 0.2 was developed using Rasch analysis. The goal of the current study was to improve targeting of the IWPQ scales by including additional items. The IWPQ 0.2 (original) and 0.3 (including additional items) were examined using

  20. Construct validity of the individual work performance questionnaire

    NARCIS (Netherlands)

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Vet, H.C.W. de; Beek, A.J. van der

    2014-01-01

    OBJECTIVE:: To examine the construct validity of the Individual Work Performance Questionnaire (IWPQ). METHODS:: A total of 1424 Dutch workers from three occupational sectors (blue, pink, and white collar) participated in the study. First, IWPQ scores were correlated with related constructs

  1. Can Emergency Physicians Perform Common Carotid Doppler Flow Measurements to Assess Volume Responsiveness?

    Directory of Open Access Journals (Sweden)

    Stolz, Lori A.

    2015-02-01

    Full Text Available Introduction: Common carotid flow measurements may be clinically useful to determine volume responsiveness. The objective of this study was to assess the ability of emergency physicians (EP to obtain sonographic images and measurements of the common carotid artery velocity time integral (VTi for potential use in assessing volume responsiveness in the clinical setting. Methods: In this prospective observational study, we showed a five-minute instructional video demonstrating a technique to obtain common carotid ultrasound images and measure the common carotid VTi to emergency medicine (EM residents. Participants were then asked to image the common carotid artery and obtain VTi measurements. Expert sonographers observed participants imaging in real time and recorded their performance on nine performance measures. An expert sonographer graded image quality. Participants were timed and answered questions regarding ease of examination and their confidence in obtaining the images. Results: A total of 30 EM residents participated in this study and each performed the examination twice. Average time required to complete one examination was 2.9 minutes (95% CI [2.4-3.4 min]. Participants successfully completed all performance measures greater than 75% of the time, with the exception of obtaining measurements during systole, which was completed in 65% of examinations. Median resident overall confidence in accurately performing carotid VTi measurements was 3 (on a scale of 1 [not confident] to 5 [confident]. Conclusion: EM residents at our institution learned the technique for obtaining common carotid artery Doppler flow measurements after viewing a brief instructional video. When assessed at performing this examination, they completed several performance measures with greater than 75% success. No differences were found between novice and experienced groups. [West J Emerg Med. 2015;16(2:255–259.

  2. Individual Alpha Peak Frequency in Ice Hockey Shooting Performance

    Directory of Open Access Journals (Sweden)

    Sommer Christie

    2017-05-01

    Full Text Available There are several important inter- and intra-individual variations in individual alpha peak frequency (IAPF in the cognitive domain. The rationale for the present study was to extend the research on IAPF in the cognitive domain to IAPF in the sport domain. Specifically, the purpose of the present study was twofold: (a to explore whether baseline IAPF is related to performance in an ice hockey shooting task and (b to explore whether a shooting task has an effect on IAPF variability. The present investigation is one of the first studies to examine links between IAPF and sport performance. Study results did not show significant changes in IAPF when comparing baseline IAPF and pre- to post-task IAPF across three performance levels. The findings support previous literature in the cognitive domain suggesting that IAPF is a stable neurophysiological marker. Future research should consider the following methodological suggestions: (a measuring IAPF during sport performance instead of at a resting state, (b changing the pre-performance resting baseline instructions to take into account sport-specific mental preparation, (c exploring an expert-novice paradigm to accentuate performance ability differences between groups (d comparing tasks with different levels of complexity, and (e analyzing the possible correlation between IAPF and performance on different days.

  3. Physician medical direction and clinical performance at an established emergency medical services system.

    Science.gov (United States)

    Munk, Marc-David; White, Shaun D; Perry, Malcolm L; Platt, Thomas E; Hardan, Mohammed S; Stoy, Walt A

    2009-01-01

    Few developed emergency medical services (EMS) systems operate without dedicated medical direction. We describe the experience of Hamad Medical Corporation (HMC) EMS, which in 2007 first engaged an EMS medical director to develop and implement medical direction and quality assurance programs. We report subsequent changes to system performance over time. Over one year, changes to the service's clinical infrastructure were made: Policies were revised, paramedic scopes of practice were adjusted, evidence-based clinical protocols were developed, and skills maintenance and education programs were implemented. Credentialing, physician chart auditing, clinical remediation, and online medical command/hospital notification systems were introduced. Following these interventions, we report associated improvements to key indicators: Chart reviews revealed significant improvements in clinical quality. A comparison of pre- and post-intervention audited charts reveals a decrease in cases requiring remediation (11% to 5%, odds ratio [OR] 0.43 [95% confidence interval (CI) 0.20-0.85], p = 0.01). The proportion of charts rated as clinically acceptable rose from 48% to 84% (OR 6 [95% CI 3.9-9.1], p < 0.001). The proportion of misplaced endotracheal tubes fell (3.8% baseline to 0.6%, OR 0.16 [95% CI 0.004-1.06], (exact) p = 0.05), corresponding to improved adherence to an airway placement policy mandating use of airway confirmation devices and securing devices (0.7% compliance to 98%, OR 714 [95% CI 64-29,334], (exact) p < 0.001). Intravenous catheter insertion in unstable cases increased from 67% of cases to 92% (OR 1.31 [95% CI 1.09-1.71], p = 0.004). EMS administration of aspirin to patients with suspected ischemic chest pain improved from 2% to 77% (OR 178 [95% CI 35-1,604], p < 0.001). We suggest that implementation of a physician medical direction is associated with improved clinical indicators and overall quality of care at an established EMS system.

  4. Individual and team performance in team-handball: a review.

    Science.gov (United States)

    Wagner, Herbert; Finkenzeller, Thomas; Würth, Sabine; von Duvillard, Serge P

    2014-12-01

    Team handball is a complex sport game that is determined by the individual performance of each player as well as tactical components and interaction of the team. The aim of this review was to specify the elements of team-handball performance based on scientific studies and practical experience, and to convey perspectives for practical implication. Scientific studies were identified via data bases of PubMed, Web of Knowledge, SPORT Discus, Google Scholar, and Hercules. A total of 56 articles met the inclusion criteria. In addition, we supplemented the review with 13 additional articles, proceedings and book sections. It was found that the specific characteristics of team-handball with frequent intensity changes, team-handball techniques, hard body confrontations, mental skills and social factors specify the determinants of coordination, endurance, strength and cognition. Although we found comprehensive studies examining individual performance in team-handball players of different experience level, sex or age, there is a lack of studies, particularly for team-handball specific training, as well as cognition and social factors. Key PointsThe specific characteristics of team-handball with frequent intensity changes, specific skills, hard body confrontations, mental skills and social factors define the determinants of coordination, endurance, strength and cognition.To increase individual and team performance in team-handball specific training based on these determinants have been suggested.Although there are comprehensive studies examining individual performance in team-handball players of different experience level, sex, or age are published, there is a lack of training studies, particularly for team-handball specific techniques and endurance, as well as cognition and social factors.

  5. Hippocratic oath and conversion of ethico-regulatory aspects onto doctors as a physician, private individual and a clinical investigator

    Directory of Open Access Journals (Sweden)

    Mohammed Imran

    2013-01-01

    Full Text Available Hippocratic Oath is a living document for ethical conduct of the physicians around the world. World Medical Association has been amending the oath as per the contemporary times. Although physicians maintain their ethical standards while treating a patient yet many a times social, administrative and ruling powers either use physicians as their tool of oppression or victimize them for conducting duties as per their oath. The Tuskegee Syphilis Study and Human Radiation Experiments in America, Nazi Experiments in Germany and compulsory sterilization program in India were the studies where States used physicians for the advancement of their rationality or belief. Conversely victimization of physicians in Kosovo, Sri Lanka and incarcerating physicians for treating human immunodeficiency virus/acquired immunodeficiency syndrome patients in some countries is concerning. The Nuremberg code, the Declaration of Geneva, Belmont Report and Declaration of Helsinki are ethical documents while active involvement of Food and Drug Administration through "common rule" resulted in guidelines like International Conference on Harmonization and Good Clinical Practices. Still unethical studies are found in developing countries. Studies such as experimental anticancer drugs in 24 cancer patients without adequate prior animal testing and informed consent in Kerala, studies at All India Institute of Medical Sciences in New Delhi resulted in 49 deaths of children and many more suspicious studies are rampant. Reverting back to the fundamentals of the medical profession; teaching medical ethics and enforcement of "medical neutrality" by embarking some grade of "medical immunity" on the basis of the oath is necessary for ethical conduct of physicians.

  6. Construct validity of the Individual Work Performance Questionnaire.

    OpenAIRE

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Vet, H.C.W. de; Beek, A.J. van der

    2014-01-01

    Objective: To examine the construct validity of the Individual Work Performance Questionnaire (IWPQ). Methods: A total of 1424 Dutch workers from three occupational sectors (blue, pink, and white collar) participated in the study. First, IWPQ scores were correlated with related constructs (convergent validity). Second, differences between known groups were tested (discriminative validity). Results: First, IWPQ scores correlated weakly to moderately with absolute and relative presenteeism, and...

  7. Effects of Individual Success on Globally Distributed Team Performance

    OpenAIRE

    Yılmaz, Onur

    2013-01-01

    Necessity of different competencies with high level of knowledge makes it inevitable that software development is a team work. With the today's technology, teams can communicate both synchronously and asynchronously using different online collaboration tools throughout the world. Researches indicate that there are many factors that affect the team success and in this paper, effect of individual success on globally distributed team performance will be analyzed. Student team projects undertaken...

  8. Treating individuals with debilitating performance anxiety: An introduction.

    Science.gov (United States)

    Powell, Douglas H

    2004-08-01

    Clinicians often see clients who have debilitating performance anxiety. They suffer from public speaking anxiety, stage fright, test-taking anxiety, and writing block. Their condition is so severe as to threaten to end their academic or professional career. Musicians and athletes also seek help because their anxiety before and during an event causes them to perform at a level well below their demonstrated capabilities. An estimated 2% of the U.S. population is afflicted by debilitating performance anxiety. Effective treatments are now available. This article reviews those behavioral, cognitive, and technological therapies that have shown great promise for treating individuals who have debilitating performance anxiety and introduces this issue of the Journal of Clinical Psychology: In Session devoted to this topic. Copyright 2004 Wiley Periodicals, Inc.

  9. Anticipatory synergy adjustments reflect individual performance of feedforward force control.

    Science.gov (United States)

    Togo, Shunta; Imamizu, Hiroshi

    2016-10-06

    We grasp and dexterously manipulate an object through multi-digit synergy. In the framework of the uncontrolled manifold (UCM) hypothesis, multi-digit synergy is defined as the coordinated control mechanism of fingers to stabilize variable important for task success, e.g., total force. Previous studies reported anticipatory synergy adjustments (ASAs) that correspond to a drop of the synergy index before a quick change of the total force. The present study compared ASA's properties with individual performances of feedforward force control to investigate a relationship of those. Subjects performed a total finger force production task that consisted of a phase in which subjects tracked target line with visual information and a phase in which subjects produced total force pulse without visual information. We quantified their multi-digit synergy through UCM analysis and observed significant ASAs before producing total force pulse. The time of the ASA initiation and the magnitude of the drop of the synergy index were significantly correlated with the error of force pulse, but not with the tracking error. Almost all subjects showed a significant increase of the variance that affected the total force. Our study directly showed that ASA reflects the individual performance of feedforward force control independently of target-tracking performance and suggests that the multi-digit synergy was weakened to adjust the multi-digit movements based on a prediction error so as to reduce the future error. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Measuring individual work performance: identifying and selecting indicators.

    Science.gov (United States)

    Koopmans, Linda; Bernaards, Claire M; Hildebrandt, Vincent H; de Vet, Henrica C W; van der Beek, Allard J

    2014-01-01

    Theoretically, individual work performance (IWP) can be divided into four dimensions: task performance, contextual performance, adaptive performance, and counterproductive work behavior. However, there is no consensus on the indicators used to measure these dimensions. This study was designed to (1) identify indicators for each dimension, (2) select the most relevant indicators, and (3) determine the relative weight of each dimension in ratings of work performance. IWP indicators were identified from multiple research disciplines, via literature, existing questionnaires, and expert interviews. Subsequently, experts selected the most relevant indicators per dimension and scored the relative weight of each dimension in ratings of IWP. In total, 128 unique indicators were identified. Twenty-three of these indicators were selected by experts as most relevant for measuring IWP. Task performance determined 36% of the work performance rating, while the other three dimensions respectively determined 22%, 20% and 21% of the rating. Notable consensus was found on relevant indicators of IWP, reducing the number from 128 to 23 relevant indicators. This provides an important step towards the development of a standardized, generic and short measurement instrument for assessing IWP.

  11. Can physician examiners overcome their first impression when examinee performance changes?

    Science.gov (United States)

    Wood, Timothy J; Pugh, Debra; Touchie, Claire; Chan, James; Humphrey-Murto, Susan

    2018-03-20

    There is an increasing focus on factors that influence the variability of rater-based judgments. First impressions are one such factor. First impressions are judgments about people that are made quickly and are based on little information. Under some circumstances, these judgments can be predictive of subsequent decisions. A concern for both examinees and test administrators is whether the relationship remains stable when the performance of the examinee changes. That is, once a first impression is formed, to what degree will an examiner be willing to modify it? The purpose of this study is to determine the degree that first impressions influence final ratings when the performance of examinees changes within the context of an objective structured clinical examination (OSCE). Physician examiners (n = 29) viewed seven videos of examinees (i.e., actors) performing a physical exam on a single OSCE station. They rated the examinees' clinical abilities on a six-point global rating scale after 60 s (first impression or FIGR). They then observed the examinee for the remainder of the station and provided a final global rating (GRS). For three of the videos, the examinees' performance remained consistent throughout the videos. For two videos, examinee performance changed from initially strong to weak and for two videos, performance changed from initially weak to strong. The mean FIGR rating for the Consistent condition (M = 4.80) and the Strong to Weak condition (M = 4.87) were higher compared to their respective GRS ratings (M = 3.93, M = 2.73) with a greater decline for the Strong to Weak condition. The mean FIGR rating for the Weak to Strong condition was lower (3.60) than the corresponding mean GRS (4.81). This pattern of findings suggests that raters were willing to change their judgments based on examinee performance. Future work should explore the impact of making a first impression judgment explicit versus implicit and the role of context on the

  12. Disclosure of Individual Surgeon's Performance Rates During Informed Consent

    Science.gov (United States)

    Burger, Ingrid; Schill, Kathryn; Goodman, Steven

    2007-01-01

    Objective: The purpose of the paper is to examine the ethical arguments for and against disclosing surgeon-specific performance rates to patients during informed consent, and to examine the challenges that generating and using performance rates entail. Methods: Ethical, legal, and statistical theory is explored to approach the question of whether, when, and how surgeons should disclosure their personal performance rates to patients. The main ethical question addressed is what type of information surgeons owe their patients during informed consent. This question comprises 3 related, ethically relevant considerations that are explored in detail: 1) Does surgeon-specific performance information enhance patient decision-making? 2) Do patients want this type of information? 3) How do the potential benefits of disclosure balance against the risks? Results: Calculating individual performance measures requires tradeoffs and involves inherent uncertainty. There is a lack of evidence regarding whether patients want this information, whether it facilitates their decision-making for surgery, and how it is best communicated to them. Disclosure of personal performance rates during informed consent has the potential benefits of enhancing patient autonomy, improving patient decision-making, and improving quality of care. The major risks of disclosure include inaccurate and misleading performance rates, avoidance of high-risk cases, unjust damage to surgeon's reputations, and jeopardized patient trust. Conclusion: At this time, we think that, for most conditions, surgical procedures, and outcomes, the accuracy of surgeon- and patient-specific performance rates is illusory, obviating the ethical obligation to communicate them as part of the informed consent process. Nonetheless, the surgical profession has the duty to develop information systems that allow for performance to be evaluated to a high degree of accuracy. In the meantime, patients should be informed of the quantity of

  13. Individual Performance: From Common Source Bias to Institutionalized Assessment

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Heinesen, Eskil; Pedersen, Lene Holm

    2016-01-01

    theory and the sociology of professions. Empirically, we ask whether different measures of individual performance produce different results. The investigated performance measures vary with regard to risk of common data source bias, standardization of assessment criteria, and external verification...... dimension for the same teachers: the teachers' self-reported contributions to students' academic skills, the students' marks for the year's work given by the teacher, marks in oral exams with one external examiner and the teacher, and marks in written exams with at least one external examiner....... The associations are systematically stronger when the performance measure comes from the same data source as the explanatory variables, but when separate data sources are used and the measurement scale is institutionalized, the level of external verification does not matter much. Based on institutional theory...

  14. DEVELOPING OF INDIVIDUAL INSTRUMENT PERFORMANCE ANXIETY SCALE: VALIDITY - RELIABILITY STUDY

    Directory of Open Access Journals (Sweden)

    Esra DALKIRAN

    2014-07-01

    Full Text Available The purpose of this study is to develop a scale unique to our culture, concerning  individual instrument performance anxiety of the students  who are getting instrument training  in the Department of Music Education. In the study, the descriptive research model is used and qualitative research techniques are utilized. The study population consists of the students attending the 23 universities which has Music Education Department. The sample of the study consists of 438 girls and 312 boys, totally 750 students  who are studying in the Department of Music Education of randomly selected 10 universities. As a result of the explanatory and confirmatory factor analyses that were performed, a one-dimensional structure consisting of 14 items was obtained. Also, t-scores and  the coefficient scores of total item correlation concerning the distinguishing power of the items, the difference in the scores of the set of lower and upper 27% was calculated, and it was observed that the items are distinguishing as a result of both analyses. Of the scale, Cronbach's alpha coefficient of internal consistency was calculated as .94, and test-retest reliability coefficient was calculated as .93. As a result, a valid and reliable assessment and evaluation instrument that measures the exam performance anxiety of the students studying in the Department of Music Education, has been developed.Extended AbstractsIntroductionAnxiety is a universal phenomenon which people experience once or a few times during lives. It was accepted as concern for the future or as an unpleasant emotional experience regarding probable hitches of the events (Di Tomasso & Gosch, 2002.In general, the occasions on which negative feelings are experienced cause anxiety to arise (Baltaş and Baltaş, 2000. People also feel anxious in dangerous situations. Anxiety may lead a person to be creative, while it may have hindering characteristics. Anxiety is that an individual considers him

  15. Asking the Stakeholders: Perspectives of Individuals With Aphasia, Their Family Members, and Physicians Regarding Communication in Medical Interactions.

    Science.gov (United States)

    Burns, Michael; Baylor, Carolyn; Dudgeon, Brian J; Starks, Helene; Yorkston, Kathryn

    2015-08-01

    The purpose of this study was to explore the experiences of patients with aphasia, their family members, and physicians related to communication during medical interactions. Face-to-face, semistructured interviews were conducted with 18 participants—6 patients with aphasia, 6 family members involved in patient care, and 6 practicing physicians. A qualitative description approach was used to collect and summarize narratives from participants' perspectives and experiences. Participants were asked about experiences with communication during medical interactions in which the family member accompanied the patient. Interviews were audio- and/or video-recorded, transcribed, and then coded to identify main themes. Patients and family members generally described their communication experiences as positive, yet all participants discussed challenges and frustrations. Three themes emerged: (a) patients and family members work as a team, (b) patients and family members want physicians to "just try" to communicate with the patient, and (c) physicians want to interact with patients but may not know how. Participants discussed the need for successful accommodation, or changing how one communicates, to help facilitate the patients' increased understanding and ability to express themselves. Over- and underaccommodation with communication were commonly reported as problems. Speech-language pathologists have a role to play in helping to improve communication during medical interactions. Implications for current speech-language pathologist practice and future directions of research are discussed.

  16. How physicians identify with predetermined personalities and links to perceived performance and wellness outcomes: a cross-sectional study.

    Science.gov (United States)

    Lemaire, Jane B; Wallace, Jean E

    2014-11-29

    Certain personalities are ascribed to physicians. This research aims to measure the extent to which physicians identify with three predetermined personalities (workaholic, Type A and control freak) and to explore links to perceptions of professional performance, and wellness outcomes. This is a cross-sectional study using a mail-out questionnaire sent to all practicing physicians (2957 eligible, 1178 responses, 40% response rate) in a geographical health region within a western Canadian province. Survey items were used to assess the extent to which participants felt they are somewhat of a workaholic, Type A and/or control freak, and if they believed that having these personalities makes one a better doctor. Participants' wellness outcomes were also measured. Zero-order correlations were used to determine the relationships between physicians identifying with a personality and feeling it makes one a better doctor. T-tests were used to compare measures of physician wellness for those who identified with the personality versus those who did not. 53% of participants identified with the workaholic personality, 62% with the Type A, and 36% with the control freak. Identifying with any one of the personalities was correlated with feeling it makes one a better physician. There were statistically significant differences in several wellness outcomes comparing participants who identified with the personalities versus those who did not. These included higher levels of emotional exhaustion (workaholic, Type A and control freak), higher levels of anxiety (Type A and control freak) and higher levels of depression, poorer mental health and lower levels of job satisfaction (control freak). Participants who identified with the workaholic personality versus those who did not reported higher levels of job satisfaction, rewarding patient experiences and career commitment. Most participants identified with at least one of the three personalities. The beliefs of some participants that

  17. Improving the Individual Work Performance Questionnaire using Rasch analysis.

    OpenAIRE

    Koopmans, L.; Bernaards, C.M.; Hildebrandt, V.H.; Buuren, S. van; Beek, A.J. van der; Vet, H.C.W. de

    2014-01-01

    Recently, the Individual Work Performance Questionnaire (IWPQ) version 0.2 was developed using Rasch analysis. The goal of the current study was to improve targeting of the IWPQ scales by including additional items. The IWPQ 0.2 (original) and 0.3 (including additional items) were examined using Rasch analysis. Additional items that showed misfit or did not improve targeting were removed from the IWPQ 0.3, resulting in a final IWPQ 1.0. Subsequently, the scales showed good model fit and relia...

  18. Correlation of hospital magnet status with the quality of physicians performing neurosurgical procedures in New York State.

    Science.gov (United States)

    Bekelis, Kimon; Missios, Symeon; MacKenzie, Todd A

    2018-01-24

    The quality of physicians practicing in hospitals recognized for nursing excellence by the American Nurses Credentialing Center has not been studied before. We investigated whether Magnet hospital recognition is associated with higher quality of physicians performing neurosurgical procedures. We performed a cohort study of patients undergoing neurosurgical procedures from 2009-2013, who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database. Propensity score adjusted multivariable regression models were used to adjust for known confounders, with mixed effects methods to control for clustering at the facility level. An instrumental variable analysis was used to control for unmeasured confounding and simulate the effect of a randomized trial. During the study period, 185,277 patients underwent neurosurgical procedures, and met the inclusion criteria. Of these, 66,607 (35.6%) were hospitalized in Magnet hospitals, and 118,670 (64.4%) in non-Magnet institutions. Instrumental variable analysis demonstrated that undergoing neurosurgical operations in Magnet hospitals was associated with a 13.6% higher chance of being treated by a physician with superior performance in terms of mortality (95% CI, 13.2% to 14.1%), and a 4.3% higher chance of being treated by a physician with superior performance in terms of length-of-stay (LOS) (95% CI, 3.8% to 4.7%) in comparison to non-Magnet institutions. The same associations were present in propensity score adjusted mixed effects models. Using a comprehensive all-payer cohort of neurosurgical patients in New York State we identified an association of Magnet hospital recognition with superior physician performance.

  19. Basics of elder law and legal liabilities of negligence and malpractice for physicians as they apply to individuals with disabilities.

    Science.gov (United States)

    Ullman, David; Zuller, Michael E

    2005-02-01

    This article provides information regarding the issues that physicians face when dealing with elderly patients with cognitive deficits. It includes a discussion of basic legal terms and concepts that medical personnel should understand, various difficulties encountered by patients and families in crisis situations, and how the legal system deals with these issues. It concludes with a general discussion of the legal liabilities of negligence and malpractice.

  20. Cross-cultural adaptation of the Individual Work Performance Questionnaire.

    Science.gov (United States)

    Koopmans, Linda; Bernaards, Claire M; Hildebrandt, Vincent H; Lerner, Debra; de Vet, Henrica C W; van der Beek, Allard J

    2015-01-01

    The Individual Work Performance Questionnaire (IWPQ), measuring task performance, contextual performance, and counterproductive work behavior, was developed in The Netherlands. To cross-culturally adapt the IWPQ from the Dutch to the American-English language, and assess the questionnaire's internal consistency and content validity in the American-English context. A five stage translation and adaptation process was used: forward translation, synthesis, back-translation, expert committee review, and pilot-testing. During the pilot-testing, cognitive interviews with 40 American workers were performed, to examine the comprehensibility, applicability, and completeness of the American-English IWPQ. Questionnaire instructions were slightly modified to aid interpretation in the American-English language. Inconsistencies with verb tense were identified, and it was decided to consistently use simple past tense. The wording of five items was modified to better suit the American-English language. In general, participants were positive on the comprehensibility, applicability and completeness of the questionnaire during the pilot-testing phase. Furthermore, the study showed positive results concerning the internal consistency (Cronbach's alphas for the scales between 0.79-0.89) and content validity of the American-English IWPQ. The results indicate that the cross-cultural adaptation of the American-English IWPQ was successful and that the measurement properties of the translated version are promising.

  1. Factors Influencing Individual Performance In An Indonesian Government Office

    Directory of Open Access Journals (Sweden)

    Azizatul Munawaroh

    2013-11-01

    Full Text Available 1024x768 Reformation in Indonesian government offices leads to many substantial changes, and demands improved job performances while arguably loading employees with more work. This research aims to understand factors that potentially influence job performance in Indonesian government offices that carries on such reformation. Using adapted scales from previous studies, this research investigates the role of workload, responsibility for others (level of responsibility to care for other people and need for achievement on employee’s performance.  A survey to all full-time workers in an Indonesian government office is conducted. Contrary to expectation, workload does not influence employee’s performance. Instead, regression analysis demonstrates that, employee’s need for achievement and responsibility for others are significant factors affecting individual performance. These results are important because they highlight the significance of need for achievement for the success of reformation in this office, and by extension for reformation in Indonesia. The results are also interesting because this is the first study that points out to the role of responsibility for others in influencing individual performance in Indonesia which is characterized by collectivistic culture. This paper discusses the contributions of these results for theory and practice.   Keywords: Indonesian public, need for achievement, responsibility for others, workload. Normal 0 false false false IN X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso

  2. The prevalence of excessive daytime sleepiness among academic physicians and its impact on the quality of life and occupational performance

    Directory of Open Access Journals (Sweden)

    Aclan Ozder

    2015-08-01

    Full Text Available Objectives: Sleep disorders can affect health and occupational performance of physicians as well as outcomes in patients. The purpose of this study was to assess the prevalence of excessive daytime sleepiness (EDS measured by the Epworth Sleepiness Scale (ESS among academic physicians at a tertiary academic medical center in an urban area in the northwest region of Turkey, and to establish a relationship between the self-perceived sleepiness and the quality of life using the EuroQol-5 dimensions (EQ-5D. Material and Methods: A questionnaire prepared by the researchers after scanning the literature on the subject was e-mailed to the academic physicians of a tertiary academic medical center in Istanbul. The ESS and the EQ-5D were also included in the survey. The e-mail database of the institution directory was used to compile a list of active academic physicians who practiced clinical medicine. Paired and independent t tests were used for the data analysis at a significance level of p 10 (p < 0.001. In the case of the EQ-5D index and visual analogue scale of the EQ-5D questionnaire (EQ-5D VAS, the status of sleepiness of academic physicians was associated with a poorer quality of life (p < 0.001. Conclusions: More than a 1/4 of the academic physicians suffered from sleepiness. There was an association between the poor quality of life and daytime sleepiness. There was also a positive relationship between habitual napping and being sleepy during the day.

  3. "Hand surgeons probably don't starve": Patient's perceptions of physician reimbursements for performing an open carpal tunnel release.

    Science.gov (United States)

    Kokko, Kyle P; Lipman, Adam J; Sapienza, Anthony; Capo, John T; Barfield, William R; Paksima, Nader

    2015-12-01

    The purpose of this study is to evaluate patient's perceptions of physician reimbursement for the most commonly performed surgery on the hand, a carpal tunnel release (CTR). Anonymous physician reimbursement surveys were given to patients and non-patients in the waiting rooms of orthopaedic hand physicians' offices and certified hand therapist's offices. The survey consisted of 13 questions. Respondents were asked (1) what they thought a surgeon should be paid to perform a carpal tunnel release, (2) to estimate how much Medicare reimburses the surgeon, and (3) about how health care dollars should be divided among the surgeon, the anesthesiologist, and the hospital or surgery center. Descriptive subject data included age, gender, income, educational background, and insurance type. Patients thought that hand surgeons should receive $5030 for performing a CTR and the percentage of health care funds should be distributed primarily to the hand surgeon (56 %), followed by the anesthesiologist (23 %) and then the hospital/surgery center (21 %). They estimated that Medicare reimburses the hand surgeon $2685 for a CTR. Most patients (86 %) stated that Medicare reimbursement was "lower" or "much lower" than what it should be. Respondents believed that hand surgeons should be reimbursed greater than 12 times the Medicare reimbursement rate of approximately $412 and that the physicians (surgeons and anesthesiologist) should command most of the health care funds allocated to this treatment. This study highlights the discrepancy between patient's perceptions and actual physician reimbursement as it relates to federal health care. Efforts should be made to educate patients on this discrepancy.

  4. Mixed results in the safety performance of computerized physician order entry.

    Science.gov (United States)

    Metzger, Jane; Welebob, Emily; Bates, David W; Lipsitz, Stuart; Classen, David C

    2010-04-01

    Computerized physician order entry is a required feature for hospitals seeking to demonstrate meaningful use of electronic medical record systems and qualify for federal financial incentives. A national sample of sixty-two hospitals voluntarily used a simulation tool designed to assess how well safety decision support worked when applied to medication orders in computerized order entry. The simulation detected only 53 percent of the medication orders that would have resulted in fatalities and 10-82 percent of the test orders that would have caused serious adverse drug events. It is important to ascertain whether actual implementations of computerized physician order entry are achieving goals such as improved patient safety.

  5. Scapular muscle performance in individuals with lateral epicondylalgia.

    Science.gov (United States)

    Day, Joseph M; Bush, Heather; Nitz, Arthur J; Uhl, Tim L

    2015-05-01

    Descriptive, laboratory-based, cross-sectional study. To describe scapular musculature strength, endurance, and change in thickness in individuals with unilateral lateral epicondylalgia (LE) compared to the uninvolved limb and the corresponding limb of a matched comparison group. Reported poor long-term outcomes for the nonsurgical management of individuals with LE suggest a less-than-optimal rehabilitation process. Knowledge of scapular muscle function in a working population of individuals with LE may help to further refine conservative management of this condition. Twenty-eight patients with symptomatic LE and 28 controls matched by age and sex were recruited to participate in the study. Strength of the middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) was measured with a handheld dynamometer. A scapular isometric muscle endurance task was performed in prone. Changes in muscle thickness of the SA and LT were measured with ultrasound imaging. Analysis-of-variance models were used to determine within- and between-group differences. The involved side of the group with LE had significantly lower values for MT strength (P = .031), SA strength (PLE had significantly lower strength of the LT (P = .023) and SA (P = .016) when compared to the uninvolved limb; however, these differences were small and of potentially limited clinical significance. When compared to a matched comparison group, there were impairments of scapular musculature strength and endurance in patients with LE, suggesting that the scapular musculature should be assessed and potentially treated in this population. Cause and effect cannot be established, as the weakness of the scapular musculature could be a result of LE.

  6. Standing out and moving up: performance appraisal of cultural minority physicians

    NARCIS (Netherlands)

    Leyerzapf, H.; Abma, T.A.; Steenwijk, R.R.; Croiset, G.; Verdonk, P.

    2015-01-01

    Despite a growing diversity within society and health care, there seems to be a discrepancy between the number of cultural minority physicians graduating and those in training for specialization (residents) or working as a specialist in Dutch academic hospitals. The purpose of this article is to

  7. X-ray exposure hazards for physicians performing ablation procedures and device implantation

    DEFF Research Database (Denmark)

    Marinskis, Germanas; Bongiorni, Maria Grazia; Dagres, Nikolaos

    2013-01-01

    The purpose of the survey was to evaluate physician's and authorities policies and clinical practices when using occupational X-ray during ablation procedures and device implantation. This survey shows infrequent use of lead gloves, radiation absorbing pads, and lead glass cabins, but increasing ...

  8. Empathy in clinical practice: how individual dispositions, gender, and experience moderate empathic concern, burnout, and emotional distress in physicians.

    Directory of Open Access Journals (Sweden)

    Ezequiel Gleichgerrcht

    Full Text Available To better understand clinical empathy and what factors can undermine its experience and outcome in care-giving settings, a large-scale study was conducted with 7,584 board certified practicing physicians. Online validated instruments assessing different aspects of empathy, distress, burnout, altruistic behavior, emotional awareness, and well-being were used. Compassion satisfaction was strongly associated with empathic concern, perspective taking and altruism, while compassion fatigue (burnout and secondary traumatic stress was more closely related to personal distress and alexithymia. Gender had a highly selective effect on empathic concern, with women displaying higher values, which led to a wide array of negative and devalued feelings. Years of experience did not influence dispositional measures per se after controlling for the effect of age and gender. Participants who experienced compassion fatigue with little to no compassion satisfaction showed the highest scores on personal distress and alexithymia as well as the strongest indicators of compassion fatigue. Physicians who have difficulty regulating their negative arousal and describing and identifying emotions seem to be more prone to emotional exhaustion, detachment, and a low sense of accomplishment. On the contrary, the ability to engage in self-other awareness and regulate one's emotions and the tendency to help others, seem to contribute to the sense of compassion that comes from assisting patients in clinical practice.

  9. Effects of compression and individual variability on face recognition performance

    Science.gov (United States)

    McGarry, Delia P.; Arndt, Craig M.; McCabe, Steven A.; D'Amato, Donald P.

    2004-08-01

    The Enhanced Border Security and Visa Entry Reform Act of 2002 requires that the Visa Waiver Program be available only to countries that have a program to issue to their nationals machine-readable passports incorporating biometric identifiers complying with applicable standards established by the International Civil Aviation Organization (ICAO). In June 2002, the New Technologies Working Group of ICAO unanimously endorsed the use of face recognition (FR) as the globally interoperable biometric for machine-assisted identity confirmation with machine-readable travel documents (MRTDs), although Member States may elect to use fingerprint and/or iris recognition as additional biometric technologies. The means and formats are still being developed through which biometric information might be stored in the constrained space of integrated circuit chips embedded within travel documents. Such information will be stored in an open, yet unalterable and very compact format, probably as digitally signed and efficiently compressed images. The objective of this research is to characterize the many factors that affect FR system performance with respect to the legislated mandates concerning FR. A photograph acquisition environment and a commercial face recognition system have been installed at Mitretek, and over 1,400 images have been collected of volunteers. The image database and FR system are being used to analyze the effects of lossy image compression, individual differences, such as eyeglasses and facial hair, and the acquisition environment on FR system performance. Images are compressed by varying ratios using JPEG2000 to determine the trade-off points between recognition accuracy and compression ratio. The various acquisition factors that contribute to differences in FR system performance among individuals are also being measured. The results of this study will be used to refine and test efficient face image interchange standards that ensure highly accurate recognition, both

  10. A Two-Step Method to Identify Positive Deviant Physician Organizations of Accountable Care Organizations with Robust Performance Management Systems.

    Science.gov (United States)

    Pimperl, Alexander F; Rodriguez, Hector P; Schmittdiel, Julie A; Shortell, Stephen M

    2018-06-01

    To identify positive deviant (PD) physician organizations of Accountable Care Organizations (ACOs) with robust performance management systems (PMSYS). Third National Survey of Physician Organizations (NSPO3, n = 1,398). Organizational and external factors from NSPO3 were analyzed. Linear regression estimated the association of internal and contextual factors on PMSYS. Two cutpoints (75th/90th percentiles) identified PDs with the largest residuals and highest PMSYS scores. A total of 65 and 41 PDs were identified using 75th and 90th percentiles cutpoints, respectively. The 90th percentile more strongly differentiated PDs from non-PDs. Having a high proportion of vulnerable patients appears to constrain PMSYS development. Our PD identification method increases the likelihood that PD organizations selected for in-depth inquiry are high-performing organizations that exceed expectations. © Health Research and Educational Trust.

  11. Study on radiation dose and its protection for the physician performing the retrograde urethrography for male

    International Nuclear Information System (INIS)

    Inui, Saburo; Suzuki, Toshiyuki; Kashino, Teiichi; Abe, Hitoshi.

    1982-01-01

    The status quo of the various techniques used in retrograde urethrography (R.U.) is examined by the questionnaire method with the data of radiation doses to medical personnels, and new methods are devised to reduce unnecessary radiation dose. Manual injection of the radio-opaquee contrast medium has been employed by 92.5% out of 8,259 physicians in 67 institutions. They expose themselves as well as patients to the radiation during the course of the examination. In most of these occasions the physician is not sufficiently protected from radiation leaving the possibility of his somatic damage. From these observations, the followings were studied: 1) Application of our newly developed protective barrier, exclusive for R.U., made of lead-impregnated acryl-resin plate (KYOW GLAS-XA). 2) Employment of the high speed screen made of rare earth metal. The results were encouraging in reducing the radiation exposure dose. In conclusion, the employment of the above two methods are efficient in obviating unnecessary radiation exposure to the physician during R.U. (author)

  12. Association of Practice-Level Social and Medical Risk With Performance in the Medicare Physician Value-Based Payment Modifier Program.

    Science.gov (United States)

    Chen, Lena M; Epstein, Arnold M; Orav, E John; Filice, Clara E; Samson, Lok Wong; Joynt Maddox, Karen E

    2017-08-01

    Medicare recently launched the Physician Value-Based Payment Modifier (PVBM) Program, a mandatory pay-for-performance program for physician practices. Little is known about performance by practices that serve socially or medically high-risk patients. To compare performance in the PVBM Program by practice characteristics. Cross-sectional observational study using PVBM Program data for payments made in 2015 based on performance of large US physician practices caring for fee-for-service Medicare beneficiaries in 2013. High social risk (defined as practices in the top quartile of proportion of patients dually eligible for Medicare and Medicaid) and high medical risk (defined as practices in the top quartile of mean Hierarchical Condition Category risk score among fee-for-service beneficiaries). Quality and cost z scores based on a composite of individual measures. Higher z scores reflect better performance on quality; lower scores, better performance on costs. Among 899 physician practices with 5 189 880 beneficiaries, 547 practices were categorized as low risk (neither high social nor high medical risk) (mean, 7909 beneficiaries; mean, 320 clinicians), 128 were high medical risk only (mean, 3675 beneficiaries; mean, 370 clinicians), 102 were high social risk only (mean, 1635 beneficiaries; mean, 284 clinicians), and 122 were high medical and social risk (mean, 1858 beneficiaries; mean, 269 clinicians). Practices categorized as low risk performed the best on the composite quality score (z score, 0.18 [95% CI, 0.09 to 0.28]) compared with each of the practices categorized as high risk (high medical risk only: z score, -0.55 [95% CI, -0.77 to -0.32]; high social risk only: z score, -0.86 [95% CI, -1.17 to -0.54]; and high medical and social risk: -0.78 [95% CI, -1.04 to -0.51]) (P risk only performed the best on the composite cost score (z score, -0.52 [95% CI, -0.71 to -0.33]), low risk had the next best cost score (z score, -0.18 [95% CI, -0.25 to -0.10]), then

  13. INDIVIDUAL DIFFERENCES IN WORKING MEMORY PERFORMANCE: «OVERLOAD» EFFECT

    Directory of Open Access Journals (Sweden)

    Yuri G. Pavlov

    2015-01-01

    Full Text Available The aim of this research is to study the relationship betweenfrontal midline theta rhythm changes and individual differences in working memory performance.Methods. The methods involve behavioural testing on the basis of the program for a presentation of stimulus and registration of answers «PsyTask»; method of EEG (electroencephalography; a technique of measurement of efficiency of working memory; the comparative analysis. Software packages EEGLab for Matlab and Fieldtrip are applied while data processing.Results. After the behavioral test all subjects were separated into 2 groups according to their performance: with «highly productive» and «low productive» memory. Specially prepared author’s complete set of the tasks which complexity varied from average to ultrahigh level was offered to participants of experiment –students and employees of the Ural Federal University and Ural Legal Institute of the Ministry of Internal Affairs. Working memory tasks included sets of verbal stimuli for memorizing in strict order without any mental manipulation and sets of similar stimuli for memorizing in alphabetical order (with manipulations. Measured characteristics of theta-rhythm of EEG during information deduction in memory were compared of two groups’ representatives. The obtained data has shown rather uniform and similar dynamics of decrease in quantity of right answers in process of increasing tasks’ complexity. However, changes of a thetarhythm in different groups had sharply expressed distinctions. «Highly productive» examinees have systematic expansion of a theta-rhythm in the central assignments with stabilisation on the most difficult tasks; «low productive» – while tasks performance of average complexity, a sharp falling of theta-rhythm activity is observed after achievement of its maximum activation.Scientific novelty. The working memory «overload» effect and its EEG correlates are demonstrated on a big sample of

  14. Examining the influence of family physician supply on district health system performance in South Africa: An ecological analysis of key health indicators.

    Science.gov (United States)

    Von Pressentin, Klaus B; Mash, Bob J; Esterhuizen, Tonya M

    2017-04-28

    The supply of appropriate health workers is a key building block in the World Health Organization's model of effective health systems. Primary care teams are stronger if they contain doctors with postgraduate training in family medicine. The contribution of such family physicians to the performance of primary care systems has not been evaluated in the African context. Family physicians with postgraduate training entered the South African district health system (DHS) from 2011. This study aimed to evaluate the impact of family physicians within the DHS of South Africa. The objectives were to evaluate the impact of an increase in family physician supply in each district (number per 10 000 population) on key health indicators. All 52 South African health districts were included as units of analysis. An ecological study evaluated the correlations between the supply of family physicians and routinely collected data on district performance for two time periods: 2010/2011 and 2014/2015. Five years after the introduction of the new generation of family physicians, this study showed no demonstrable correlation between family physician supply and improved health indicators from the macro-perspective of the district. The lack of a measurable impact at the level of the district is most likely because of the very low supply of family physicians in the public sector. Studies which evaluate impact closer to the family physician's circle of control may be better positioned to demonstrate a measurable impact in the short term.

  15. Management training of physician executives, their leadership style, and care management performance: an empirical study.

    Science.gov (United States)

    Xirasagar, Sudha; Samuels, Michael E; Curtin, Thomas F

    2006-02-01

    To examine associations between management training of physician executives and their leadership styles, as well as effectiveness in achieving disease management goals. Cross-sectional national survey. Executive directors of community health centers (269 respondents; response rate = 40.9%) were surveyed regarding their perceptions of the medical director's leadership, and for quantitative information on the center's achievement of clinical (mostly disease management) goals. The dependent variables were the medical director's scores (as perceived by the executive director) on transformational, transactional, and laissez-faire leadership, effectiveness, satisfaction with the leader, and subordinate extra effort, using an adapted Multifactor Leadership Questionnaire (43 items; 5-point Likert scale). The independent variable was the medical director's management training status. Compared with medical directors with or =30 days of in-service training, had 0.32, 0.35, 0.30, 0.36, and 0.37 higher scores on transformational leadership, transactional leadership, rated effectiveness, satisfaction, and subordinate extra effort, respectively, and 0.31 lower score on laissez-faire leadership (all P management degrees but with > or =30 days of in-service training had 0.34, 0.36, 0.50, and 0.47 higher scores on transformational leadership, transactional leadership, rated effectiveness, and satisfaction with the leader (all P management goals. Training may enable physician executives to develop leadership styles that are effective in influencing clinical providers' adoption of disease management guidelines under managed care.

  16. Attitudes of developing world physicians to where medical research is performed and reported

    Directory of Open Access Journals (Sweden)

    Kongpatanakul Supornchai

    2003-01-01

    Full Text Available Abstract Background Little is known about the influence of the site of research or publication on the impact of the research findings on clinical practice, particularly in developing countries. The International Clinical Epidemiology Network (INCLEN is dedicated to improving the quality of health research in the Developing World through institutional capacity building for evidence based medicine, and provided the opportunity to examine the likely impact of research location and journal location on physicians' practice in a number of the participating countries. Methods Physicians from secondary and tertiary hospitals in six cities located in China, Thailand, India, Egypt and Kenya were enrolled in a cross-sectional questionnaire survey. The primary outcome measures were scores on a Likert scale reflecting stated likelihood of changing clinical practice depending on the source of the research or its publication. Results Overall, local research and publications were most likely to effect change in clinical practice, followed by North American, European and regional research/publications respectively, although there were significant variations between countries. The impact of local and regional research would be greater if the perceived research quality improved in those settings. Conclusion Conducting high quality local research is likely to be an effective way of getting research findings into practice in developing countries.

  17. CITTP: Computerized Individual Trainer for Team Performance, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — CITTP provides an intelligent tutor system (ITS) framework for individuals to rehearsing their team tasks using computer based high-fidelity simulations. CITTP is...

  18. Individuality in harpsichord performance: disentangling performer- and piece-specific influences on interpretive choices.

    Science.gov (United States)

    Gingras, Bruno; Asselin, Pierre-Yves; McAdams, Stephen

    2013-01-01

    Although a growing body of research has examined issues related to individuality in music performance, few studies have attempted to quantify markers of individuality that transcend pieces and musical styles. This study aims to identify such meta-markers by discriminating between influences linked to specific pieces or interpretive goals and performer-specific playing styles, using two complementary statistical approaches: linear mixed models (LMMs) to estimate fixed (piece and interpretation) and random (performer) effects, and similarity analyses to compare expressive profiles on a note-by-note basis across pieces and expressive parameters. Twelve professional harpsichordists recorded three pieces representative of the Baroque harpsichord repertoire, including three interpretations of one of these pieces, each emphasizing a different melodic line, on an instrument equipped with a MIDI console. Four expressive parameters were analyzed: articulation, note onset asynchrony, timing, and velocity. LMMs showed that piece-specific influences were much larger for articulation than for other parameters, for which performer-specific effects were predominant, and that piece-specific influences were generally larger than effects associated with interpretive goals. Some performers consistently deviated from the mean values for articulation and velocity across pieces and interpretations, suggesting that global measures of expressivity may in some cases constitute valid markers of artistic individuality. Similarity analyses detected significant associations among the magnitudes of the correlations between the expressive profiles of different performers. These associations were found both when comparing across parameters and within the same piece or interpretation, or on the same parameter and across pieces or interpretations. These findings suggest the existence of expressive meta-strategies that can manifest themselves across pieces, interpretive goals, or expressive devices.

  19. Individuality in harpsichord performance: Disentangling performer- and piece-specific influences on interpretive choices

    Directory of Open Access Journals (Sweden)

    Bruno eGingras

    2013-11-01

    Full Text Available Although a growing body of research has examined issues related to individuality in music performance, few studies have attempted to quantify markers of individuality that transcend pieces and musical styles. This study aims to identify such meta-markers by discriminating between influences linked to specific pieces or interpretive goals and performer-specific playing styles, using two complementary statistical approaches: linear mixed models (LMMs to estimate fixed (piece and interpretation and random (performer effects, and similarity analyses to compare expressive profiles on a note-by-note basis across pieces and expressive parameters. Twelve professional harpsichordists recorded three pieces representative of the Baroque harpsichord repertoire, including three interpretations of one of these pieces, each emphasizing a different melodic line, on an instrument equipped with a MIDI console. Four expressive parameters were analyzed: articulation, note onset asynchrony, timing, and velocity. LMMs showed that piece-specific influences were much larger for articulation than for other parameters, for which performer-specific effects were predominant, and that piece-specific influences were generally larger than effects associated with interpretive goals. Some performers consistently deviated from the mean values for articulation and velocity across pieces and interpretations, suggesting that global measures of expressivity may in some cases constitute valid markers of artistic individuality. Similarity analyses detected significant associations among the magnitudes of the correlations between the expressive profiles of different performers. These associations were found both when comparing across parameters and within the same piece or interpretation, or on the same parameter and across pieces or interpretations. These findings suggest the existence of expressive meta-strategies that can manifest themselves across pieces, interpretive goals, or

  20. First and foremost, physicians: the clinical versus leadership identities of physician leaders.

    Science.gov (United States)

    Quinn, Joann Farrell; Perelli, Sheri

    2016-06-20

    Purpose - Physicians are commonly promoted into administrative and managerial roles in US hospitals on the basis of clinical expertise and often lack the skills, training or inclination to lead. Several studies have sought to identify factors associated with effective physician leadership, yet we know little about how physician leaders themselves construe their roles. The paper aims to discuss these issues. Design/methodology/approach - Phenomenological interviews were performed with 25 physicians at three organizational levels with physicians affiliated or employed by four hospitals within one health care organization in the USA between August and September 2010. A rigorous comparative methodology of data collection and analysis was employed, including the construction of analytic codes for the data and its categorization based on emergent ideas and themes that are not preconceived and logically deduced hypotheses, which is characteristic of grounded theory. Findings - These interviews reveal differences in how part- vs full-time physician leaders understand and value leadership roles vs clinical roles, claim leadership status, and identify as physician leaders on individual, relational and organizational basis. Research limitations/implications - Although the physicians in the sample were affiliated with four community hospitals, all of them were part of a single not-for-profit health care system in one geographical locale. Practical implications - These findings may be of interest to hospital administrators and boards seeking deeper commitment and higher performance from physician leaders, as well as assist physicians in transitioning into a leadership role. Social implications - This work points to a broader and more fundamental need - a modified mindset about the nature and value of physician leadership. Originality/value - This study is unique in the exploration of the nature of physician leadership from the perspective of the physician on an individual, peer

  1. 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.

  2. Performance Feedback: Individual Based Reflections and the Effect on Motivation

    OpenAIRE

    Kaymaz, Kurtulus

    2011-01-01

    There is also enough scientific research proved the positive effect of performance on motivation. The common idea is that the performance feedback improve the technical and behavioral effectiveness of employees which then reflect on the job motivation. Around this idea, performance feedback effect motivation via reducing the performance ambiguity, improving the manager-subordinate relationships, making more easy to achieve goals, supporting the personal development and adapting to change. In ...

  3. Factors influencing variation in physician adenoma detection rates: a theory-based approach for performance improvement.

    Science.gov (United States)

    Atkins, Louise; Hunkeler, Enid M; Jensen, Christopher D; Michie, Susan; Lee, Jeffrey K; Doubeni, Chyke A; Zauber, Ann G; Levin, Theodore R; Quinn, Virginia P; Corley, Douglas A

    2016-03-01

    Interventions to improve physician adenoma detection rates for colonoscopy have generally not been successful, and there are little data on the factors contributing to variation that may be appropriate targets for intervention. We sought to identify factors that may influence variation in detection rates by using theory-based tools for understanding behavior. We separately studied gastroenterologists and endoscopy nurses at 3 Kaiser Permanente Northern California medical centers to identify potentially modifiable factors relevant to physician adenoma detection rate variability by using structured group interviews (focus groups) and theory-based tools for understanding behavior and eliciting behavior change: the Capability, Opportunity, and Motivation behavior model; the Theoretical Domains Framework; and the Behavior Change Wheel. Nine factors potentially associated with adenoma detection rate variability were identified, including 6 related to capability (uncertainty about which types of polyps to remove, style of endoscopy team leadership, compromised ability to focus during an examination due to distractions, examination technique during withdrawal, difficulty detecting certain types of adenomas, and examiner fatigue and pain), 2 related to opportunity (perceived pressure due to the number of examinations expected per shift and social pressure to finish examinations before scheduled breaks or the end of a shift), and 1 related to motivation (valuing a meticulous examination as the top priority). Examples of potential intervention strategies are provided. By using theory-based tools, this study identified several novel and potentially modifiable factors relating to capability, opportunity, and motivation that may contribute to adenoma detection rate variability and be appropriate targets for future intervention trials. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  4. Evaluation of Physicians' Cognitive Styles.

    Science.gov (United States)

    Djulbegovic, Benjamin; Beckstead, Jason W; Elqayam, Shira; Reljic, Tea; Hozo, Iztok; Kumar, Ambuj; Cannon-Bowers, Janis; Taylor, Stephanie; Tsalatsanis, Athanasios; Turner, Brandon; Paidas, Charles

    2014-07-01

    Patient outcomes critically depend on accuracy of physicians' judgment, yet little is known about individual differences in cognitive styles that underlie physicians' judgments. The objective of this study was to assess physicians' individual differences in cognitive styles relative to age, experience, and degree and type of training. Physicians at different levels of training and career completed a web-based survey of 6 scales measuring individual differences in cognitive styles (maximizing v. satisficing, analytical v. intuitive reasoning, need for cognition, intolerance toward ambiguity, objectivism, and cognitive reflection). We measured psychometric properties (Cronbach's α) of scales; relationship of age, experience, degree, and type of training; responses to scales; and accuracy on conditional inference task. The study included 165 trainees and 56 attending physicians (median age 31 years; range 25-69 years). All 6 constructs showed acceptable psychometric properties. Surprisingly, we found significant negative correlation between age and satisficing (r = -0.239; P = 0.017). Maximizing (willingness to engage in alternative search strategy) also decreased with age (r = -0.220; P = 0.047). Number of incorrect inferences negatively correlated with satisficing (r = -0.246; P = 0.014). Disposition to suppress intuitive responses was associated with correct responses on 3 of 4 inferential tasks. Trainees showed a tendency to engage in analytical thinking (r = 0.265; P = 0.025), while attendings displayed inclination toward intuitive-experiential thinking (r = 0.427; P = 0.046). However, trainees performed worse on conditional inference task. Physicians capable of suppressing an immediate intuitive response to questions and those scoring higher on rational thinking made fewer inferential mistakes. We found a negative correlation between age and maximizing: Physicians who were more advanced in their careers were less willing to spend time and effort in an

  5. How is individualization in constraint-induced movement therapy performed?

    DEFF Research Database (Denmark)

    Hansen, Gunhild Mo; Pallesen, Hanne; Normann, Britt

    2016-01-01

    compensatory strategies in the more affected upper limb. Non-participatory observations of four individuals undergoing CIMT group training with a physiotherapist were conducted, followed by theme-based content analysis using concepts from practice knowledge and movement analysis as analytical tools...

  6. Individual differences in infant fearfulness and cognitive performance: a testing, performance, or competence effect?

    Science.gov (United States)

    Rieser-Danner, Loretta A

    2003-02-01

    The author conducted 2 studies to examine the relations between infant fear and cognitive testing performance in 12-month-old infants. In Study 1, fear was assessed by using 2 standard temperament questionnaires and a laboratory-based, standardized stranger approach. Individual differences in cognitive development were assessed using the Object Permanence Scale of the Infant Psychological Development Scales (I. C. Uzgiris & J. M. Hunt, 1975). All 3 assessments of fear significantly predicted object permanence performance, with correlations ranging from -.32 to -.35. In Study 2, fear was assessed via a maternal report questionnaire, and habituation performance was assessed via a basic-level categorization task. Familiarity with the examiner and with the testing environment was manipulated to test for a familiarity influence on performance. Testing revealed individual differences in both fear and habituation. Results suggest that highly fearful infants required more trials to habituate and were less likely to meet the habituation criterion than infants who were less fearful. Methodological and conceptual implications of these results are discussed.

  7. Physician Appraisals: Key Challenges

    Directory of Open Access Journals (Sweden)

    Klich Jacek

    2017-06-01

    Full Text Available The main purpose of the article is to identify key criteria being used for physician appraisals and to find how communication skills of physicians are valued in those appraisals. ScienceDirect and EBSCOhost databases were used for this search. The results show that a physician appraisal is underestimated both theoretically and empirically. The particular gap exists with respect to the communication skills of physicians, which are rarely present in medical training syllabi and physician assessments. The article contributes to the theoretical discourse on physician appraisals and points out at the inconsistency between the high status of physicians as a key hospital resource on the one hand and, on the other hand, at inadequate and poorly researched assessment of their performance with a special emphasis on communication skills. The article may inspire health managers to develop and implement up-to-date assessment forms for physicians and good managerial practices in this respect in hospitals and other health care units.

  8. The Leapfrog initiative for intensive care unit physician staffing and its impact on intensive care unit performance: a narrative review.

    Science.gov (United States)

    Gasperino, James

    2011-10-01

    The field of critical care has changed markedly in recent years to accommodate a growing population of chronically critically ill patients. New administrative structures have evolved to include divisions, departments, and sections devoted exclusively to the practice of critical care medicine. On an individual level, the ability to manage complex multisystem critical illnesses and to introduce invasive monitoring devices defines the intensivist. On a systems level, critical care services managed by an intensivist-led multidisciplinary team are now recognized by their ability to efficiently utilize hospital resources and improve patient outcomes. Due to the numerous cost and quality issues related to the delivery of critical care medicine, intensive care unit physician staffing (IPS) has become a charged subject in recent years. Although the federal government has played a large role in regulating best practices by physicians, other third parties have entered the arena. Perhaps the most influential of these has been The Leapfrog Group, a consortium representing 130 employers and 65 Fortune 500 companies that purchase health care for their employees. This group has proposed specific regulatory guidelines for IPS that are purported to result in substantial cost containment and improved quality of care. This narrative review examines the impact of The Leapfrog Group's recommendations on critical care delivery in the United States. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. Creativity in online gaming: Individual and dyadic performance in Minecraft

    Directory of Open Access Journals (Sweden)

    Voiskounsky A.E.

    2017-12-01

    Full Text Available Objective: This study was designed to examine possible new aspects of creative activity related to virtual environments. Design: The online gaming interface Minecraft was used to construct (on computer screens complex structures such as buildings from ready-made blocks. Two modes were used: individual and dyadic. Participants (N=49, 29 males and 20 females, 18 to 29 years old, recruited on a snow-ball basis were required to build staying at a distance two complex structures — a ship and a house; each structure was required to be highly creative, i.e. unusual and never seen before. Creativity was evaluated not by the final structure but by the number of ideas generated by the participants and produced either in practice or verbally. Each participant participated once in an individual and once in a dyadic session; the partners were selected randomly. The participants’ verbal activity and digital operations with the Minecraft interface were recorded using the FastStone Capture software package. All the ideas produced by participants were classified in accordance with the following criteria: type (conceptual, functional, selective, corrective, and intentional; level of the structure which the ideas referred to (the whole structure, a particular component of the structure, or an element of the structure; and the status of the verbalized ideas (implemented or unimplemented. Results and Conclusion: The results show that participants produced significantly more ideas and took significantly less time to build the prescribed structure (a house or a ship within the individual session compared to the dyadic session. The originality of their ideas was measured by two psychologists independently: the two measures turned out to be close (r=0.876; the number of original ideas produced during individual and dyadic sessions do not differ significantly. Analysis of the implementation of the ideas showed that, within the dyadic sessions, participants produced

  10. N-Back auditory test performance in normal individuals

    Directory of Open Access Journals (Sweden)

    Vanessa Tomé Gonçalves

    Full Text Available Abstract The working memory construct refers to the capacity to maintain information for a limited time. Objectives: To devise stimuli and adapt the 5-back test and to verify the effect of age in normal Brazilian individuals. Methods: 31 healthy adults (15 young adults and 16 older adults were evaluated by batteries of auditory stimuli to verify the inter-group differences (age effect in working memory span, total correct answers and intrusions, and the intra-group effect of type of stimulus. Results: There was no intra-group stimulus effect. Individuals from both groups processed di and tri-syllables similarly. No difference between groups (no age effect was observed for any N-Back parameters: total score, span, number of intrusions, in either di or tri-syllable presentation. Conclusion: the processing capacity of 5 elements in phonological working memory was not affected by age.

  11. When should we perform a repeat training on adrenaline auto-injector use for physician trainees?

    Science.gov (United States)

    Topal, E; Bakirtas, A; Yilmaz, O; Karagol, I H E; Arga, M; Demirsoy, M S; Turktas, I

    2014-01-01

    Studies demonstrate that both doctors and patients may use adrenaline auto-injector improperly and the usage skills are improved by training. In this study, we aimed to determine the appropriate frequency of training to maintain skills for adrenaline auto-injector use. We invited all interns of 2011-2012 training period. At baseline, all participants were given theoretical and practical training on adrenaline auto-injector use. The participants were randomly assigned into two groups. We asked those in group 1 to demonstrate the use of adrenaline auto-injector trainer in the third month and those in group 2 in the sixth month. One hundred and sixty interns were enrolled. Compared with the beginning score, demonstration of skills at all the steps and total scores did not change for the group tested in the third month (p=0.265 and p=0.888, respectively). However; for the group examined in the sixth month; the demonstration of skills for proper use of the auto-injector at all steps and the mean time to administer adrenaline decreased (p=0.018 and padrenaline (p<0.001) and presumptive self-injection into thumb (p=0.029). Auto-injector usage skills of physician trainees decrease after the sixth month and are better in those who had skill reinforcement at 3 months, suggesting continued education and skill reinforcement may be useful. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.

  12. American College of Physicians

    Science.gov (United States)

    ... Plus In this Section Clinical Guidelines & Recommendations Performance Measures Journals & Publications Clinical Resources & Products High Value Care Ethics & Professionalism Practice Resources Physician and Practice Timeline Upcoming important dates ...

  13. The Power of Individual-level Drivers of Inventive Performance

    DEFF Research Database (Denmark)

    Zwick, Thomas; Frosch, Katharina; Hoisl, Karin

    2017-01-01

    (KSAO) model. We link survey information spanning the inventors’ entire careers and psychometric test evidence with patent history data for more than 1000 inventors. We also control for variables that have traditionally been used in studies of inventive performance including inventor age, applicant type......, technology, patent, and time information. We show that educational level, skills acquired during the career, personality traits, career motivation, cognitive ability, and cognitive problem-solving style are significantly related to inventive performance....

  14. Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice.

    NARCIS (Netherlands)

    Essers, G.; Dulmen, S. van; Weel, C. van; Vleuten, C. van der; Kramer, A.

    2011-01-01

    BACKGROUND: Communication is a key competence for health care professionals. Analysis of registrar and GP communication performance in daily practice, however, suggests a suboptimal application of communication skills. The influence of context factors could reveal why communication performance

  15. Predicting Performance Under Acute Stress : The Role of Individual Characteristics

    NARCIS (Netherlands)

    Delahaij, R.; Dam, K. van; Gaillard, A.W.K.; Soeters, J.

    2011-01-01

    This prospective study examined how differences in coping style, coping self-efficacy, and metacognitive awareness influence coping behavior and performance during a realistic acute stressful exercise in 2 military samples (n = 122 and n = 132). Results showed that coping self-efficacy and coping

  16. Individual match approach to Bowling performance measures in ...

    African Journals Online (AJOL)

    Match conditions can play a significant role in player performances in a cricket match. If the pitch is in a good condition, the batsmen can achieve good scores, making it difficult for the bowlers. In the case of an uneven pitch or adverse weather conditions, the bowlers may have the upper hand. In order to measure bowlers' ...

  17. Effects of medication reviews performed by a physician on treatment with fracture-preventing and fall-risk-increasing drugs in older adults with hip fracture-a randomized controlled study.

    Science.gov (United States)

    Sjöberg, Christina; Wallerstedt, Susanna M

    2013-09-01

    To investigate whether medication reviews increase treatment with fracture-preventing drugs and decrease treatment with fall-risk-increasing drugs. Randomized controlled trial (1:1). Departments of orthopedics, geriatrics, and medicine at Sahlgrenska University Hospital, Gothenburg, Sweden. One hundred ninety-nine consecutive individuals with hip fracture aged 65 and older. Medication reviews, based on assessments of risks of falls and fractures, regarding fracture-preventing and fall-risk-increasing drugs, performed by a physician, conveyed orally and in written form to hospital physicians during the hospital stay, and to general practitioners after discharge. Primary outcomes were changes in treatment with fracture-preventing and fall-risk-increasing drugs 12 months after discharge. Secondary outcomes were falls, fractures, deaths, and physicians' attitudes toward the intervention. At admission, 26% of intervention and 29% of control participants were taking fracture-preventing drugs, and 12% and 11%, respectively, were taking bone-active drugs, predominantly bisphosphonates. After 12 months, 77% of intervention and 58% of control participants were taking fracture-preventing drugs (P = .01), and 29% and 15%, respectively, were taking bone-active drugs (P = .04). Mean number of fall-risk-increasing drugs per participants was 3.1 (intervention) and 3.1 (control) at admission and 2.9 (intervention) and 3.1 (control) at 12 months (P = .62). No significant differences in hard endpoints were found. The responding physicians (n = 65) appreciated the intervention; on a scale from 1 (very bad) to 6 (very good), the median rating was 5 (interquartile range (IQR) 4-6) for the oral part and 5 (IQR 4-5.5) for the text part. Medication reviews performed and conveyed by a physician increased treatment with fracture-preventing drugs but did not significantly decrease treatment with fall-risk-increasing drugs in older adults with hip fracture. Prescribing physicians appreciated

  18. Individual performance and leader's laterality in interactive contests.

    Science.gov (United States)

    Mukherjee, Satyam

    2017-05-01

    Left-handedness is known to provide an intrinsic and tactical advantage at top level in many sports involving interactive contests. Again, most of the renowned leaders of the world are known to have been left-handed. Leadership plays an important role in politics, sports and mentorship. In this paper we show that Cricket captains who bat left-handed have a strategic advantage over the right-handed captains in One Day International (ODI) and Test matches. The present study involving 46 left-handed captains and 148 right-handed captains in ODI matches, reveal a strong relation between leader's laterality and team member performance, demonstrating the critical importance of left-handedness and successful leadership. The odds for superior batting performance in an ODI match under left-handed captains are 89% higher than the odds under right-handed captains. Our study shows that left-handed captains are more successful in extracting superior performance from the batsmen and bowlers in ODI and Test matches; perhaps indicating left-handed leaders are better motivators as leaders when compared to right-handed captains.

  19. Physician Self-Audit: A Scoping Review

    Science.gov (United States)

    Gagliardi, Anna R.; Brouwers, Melissa C.; Finelli, Antonio; Campbell, Craig E.; Marlow, Bernard A.; Silver, Ivan L.

    2011-01-01

    Introduction: Self-audit involves self-collection of personal performance data, reflection on gaps between performance and standards, and development and implementation of learning or quality improvement plans by individual care providers. It appears to stimulate learning and quality improvement, but few physicians engage in self-audit. The…

  20. Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice.

    NARCIS (Netherlands)

    Essers, G.T.J.M.; Dulmen, A.M. van; Weel, C. van; Vleuten, C.P.M. van der; Kramer, A.W.

    2011-01-01

    ABSTRACT: BACKGROUND: Communication is a key competence for health care professionals. Analysis of registrar and GP communication performance in daily practice, however, suggests a suboptimal application of communication skills. The influence of context factors could reveal why communication

  1. CLRP: Individual evaluation of model performance for scenario S

    International Nuclear Information System (INIS)

    Krajewski, P.

    1996-01-01

    The model CLRP was created in 1989 as a part of research project ''Long-Lived Post-Chernobyl Radioactivity and Radiation Protection Criteria for Risk Reduction'' performed in cooperation with US Environmental Protection Agency. The aim of this project was to examine the fate of long-lived radionuclides in the terrestrial ecosystem. Concentrations of Cs-137 and Cs-134 in the particular components of terrestrial ecosystem e.g. soil, vegetation, animal tissues and animal products are calculated as a function of time following deposition from the atmosphere. Based on this data the whole body contents of radionuclide as a function of time is calculated and dose to a specific organ for the radionuclide may be estimated as an integral of the resultant dose rate over a sufficient period. In addition, the model allows estimation of inhalation dose from time integrated air concentration and external dose from total deposition using simple conversion factors. The program is designed to allow the simulation of many different radiological situations (chronic or acute releases) and dose affecting countermeasures. Figs, tabs

  2. Measuring Provider Performance for Physicians Participating in the Merit-Based Incentive Payment System.

    Science.gov (United States)

    Squitieri, Lee; Chung, Kevin C

    2017-07-01

    In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program. The Merit-Based Incentive Payment System path replaces existing quality-reporting programs and adds several new measures to evaluate providers using four categories of data: (1) quality, (2) cost/resource use, (3) improvement activities, and (4) advancing care information. These categories will be combined to calculate a weighted composite score for each provider or provider group. Composite Merit-Based Incentive Payment System scores based on 2017 performance data will be used to adjust reimbursed payment in 2019. In this article, the authors provide relevant background for understanding value-based provider performance measurement. The authors also discuss Merit-Based Incentive Payment System reporting requirements and scoring methodology to provide plastic surgeons with the necessary information to critically evaluate their own practice capabilities in the context of current performance metrics under the Quality Payment Program.

  3. Individual Differences in Cognitive and Noncognitive Abilities and Team Performance in Dynamic Task Environments

    National Research Council Canada - National Science Library

    Doane, Stephanie

    2004-01-01

    The specific goal of this research was to examine the role of individual differences in cognitive and non-cognitive abilities on individual and team performance in a real-time dynamic team-task environment...

  4. Simulation-based team training improved the self-assessed ability of physicians, nurses and midwives to perform neonatal resuscitation.

    Science.gov (United States)

    Malmström, B; Nohlert, E; Ewald, U; Widarsson, M

    2017-08-01

    The use of simulation-based team training in neonatal resuscitation has increased in Sweden during the last decade, but no formal evaluation of this training method has been performed. This study evaluated the effect of simulation-based team training on the self-assessed ability of personnel to perform neonatal resuscitation. We evaluated a full-day simulation-based team training course in neonatal resuscitation, by administering a questionnaire to 110 physicians, nurses and midwives before and after the training period. The questionnaire focused on four important domains: communication, leadership, confidence and technical skills. The study was carried out in Sweden from 2005 to 2007. The response rate was 84%. Improvements in the participants' self-assessed ability to perform neonatal resuscitation were seen in all four domains after training (p technical skills domain compared to experienced personnel (p = 0.001). No differences were seen between professions or time since training in any of the four domains. Personnel with less previous experience with neonatal resuscitation showed improved confidence (p = 0.007) and technical skills (p = 0.003). A full-day course on simulation-based team training with video-supported debriefing improved the participants' self-assessed ability to perform neonatal resuscitation. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  5. Multiple goals and time constraints: perceived impact on physicians' performance of evidence-based behaviours

    Directory of Open Access Journals (Sweden)

    Francis Jillian J

    2009-11-01

    Full Text Available Abstract Background Behavioural approaches to knowledge translation inform interventions to improve healthcare. However, such approaches often focus on a single behaviour without considering that health professionals perform multiple behaviours in pursuit of multiple goals in a given clinical context. In resource-limited consultations, performing these other goal-directed behaviours may influence optimal performance of a particular evidence-based behaviour. This study aimed to investigate whether a multiple goal-directed behaviour perspective might inform implementation research beyond single-behaviour approaches. Methods We conducted theory-based semi-structured interviews with 12 general medical practitioners (GPs in Scotland on their views regarding two focal clinical behaviours--providing physical activity (PA advice and prescribing to reduce blood pressure (BP to Results Most GPs reported strong intention to prescribe to reduce BP but expressed reasons why they would not. Intention to provide PA advice was variable. Most GPs reported that time constraints and patient preference detrimentally affected their control over providing PA advice and prescribing to reduce BP, respectively. Most GPs perceived many of their other goal-directed behaviours as interfering with providing PA advice, while fewer GPs reported goal-directed behaviours that interfere with prescribing to reduce BP. Providing PA advice and prescribing to reduce BP were perceived to be facilitated by similar diabetes-related behaviours (e.g., discussing cholesterol. While providing PA advice was perceived to be mainly facilitated by providing other lifestyle-related clinical advice (e.g., talking about weight, BP prescribing was reported as facilitated by pursuing ongoing standard consultation-related goals (e.g., clearly structuring the consultation. Conclusion GPs readily relate their other goal-directed behaviours with having a facilitating and interfering influence on their

  6. 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...

  7. Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice.

    Science.gov (United States)

    Essers, Geurt; van Dulmen, Sandra; van Weel, Chris; van der Vleuten, Cees; Kramer, Anneke

    2011-12-13

    Communication is a key competence for health care professionals. Analysis of registrar and GP communication performance in daily practice, however, suggests a suboptimal application of communication skills. The influence of context factors could reveal why communication performance levels, on average, do not appear adequate. The context of daily practice may require different skills or specific ways of handling these skills, whereas communication skills are mostly treated as generic. So far no empirical analysis of the context has been made. Our aim was to identify context factors that could be related to GP communication. A purposive sample of real-life videotaped GP consultations was analyzed (N = 17). As a frame of reference we chose the MAAS-Global, a widely used assessment instrument for medical communication. By inductive reasoning, we analyzed the GP behaviour in the consultation leading to poor item scores on the MAAS-Global. In these cases we looked for the presence of an intervening context factor, and how this might explain the actual GP communication behaviour. We reached saturation after having viewed 17 consultations. We identified 19 context factors that could potentially explain the deviation from generic recommendations on communication skills. These context factors can be categorized into doctor-related, patient-related, and consultation-related factors. Several context factors seem to influence doctor-patient communication, requiring the GP to apply communication skills differently from recommendations on communication. From this study we conclude that there is a need to explicitly account for context factors in the assessment of GP (and GP registrar) communication performance. The next step is to validate our findings.

  8. [Evaluation of diabetic retinopathy screening using non-mydriatic fundus camera performed by physicians' assistants in the endocrinology service].

    Science.gov (United States)

    Barcatali, M-G; Denion, E; Miocque, S; Reznik, Y; Joubert, M; Morera, J; Rod, A; Mouriaux, F

    2015-04-01

    Since 2010, the High Authority for health (HAS) recommends the use of non-mydriatic fundus camera for diabetic retinopathy screening. The purpose of this study is to evaluate the results of screening for diabetic retinopathy using the non-mydriatic retinal camera by a physician's assistant in the endocrinology service. This is a retrospective study of all diabetic patients hospitalized in the endocrinology department between May 2013 and November 2013. For each endocrinology patient requiring screening, a previously trained physician's assistant performed fundus photos. The ophthalmologist then provided a written interpretation of the photos on a consultant's sheet. Of the 120 patients screened, 40 (33.3%) patients had uninterpretable photos. Among the 80 interpretable photos, 64 (53.4%) patients had no diabetic retinopathy, and 16 (13.3%) had diabetic retinopathy. No patient had diabetic maculopathy. Specific quality criteria were established by the HAS for screening for diabetic retinopathy using the non-mydriatic retinal camera in order to ensure sufficient sensitivity and specificity. In our study, the two quality criteria were not achieved: the rates of uninterpretable photos and the total number of photos analyzed in a given period. In our center, we discontinued this method of diabetic retinopathy screening due to the high rate of uninterpretable photos. Due to the logistic impossibility of the ophthalmologists taking all the fundus photos, we proposed that the ophthalmic nurses take the photos. They are better trained in the use of the equipment, and can confer directly with an ophthalmologist in questionable cases and to obtain pupil dilation as necessary. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Individual Differences in Cognitive and Noncognitive Abilities and Team Performance in Dynamic Task Environments

    National Research Council Canada - National Science Library

    Doane, Stephanie

    2004-01-01

    .... We completed an experiment that required administration of multiple ability tests, developing teams based on ability, and development of computer software to measure individual and team performance...

  10. Efeitos de variáveis individuais e contextuais sobre desempenho individual no trabalho Effects of individuals and contextual variables on individual performance at work

    Directory of Open Access Journals (Sweden)

    Francisco Antonio Coelho Junior

    2011-08-01

    Full Text Available O presente trabalho objetivou testar empiricamente um modelo teórico multinível de predição de desempenho individual no trabalho. As variáveis antecedentes investigadas, isoladas ou em interação, corresponderam à idade, gênero, cargo, grau de escolaridade, tempo de serviço e percepção de suporte à aprendizagem, medidas no nível individual e de contexto, e satisfação no trabalho, de nível individual. A pesquisa foi realizada em uma empresa pública, do ramo de pesquisas agropecuária e atuação nacional. A amostra (N = 808 contou com funcionários distribuídos em 45 unidades centralizadas e descentralizadas da empresa pelo Brasil. A coleta de dados foi realizada à distância, via e-mail. Os resultados multiníveis corroboraram o modelo teórico de pesquisa hipotetizado e evidenciaram que a variância de desempenho foi explicada por distintos preditores de nível individual e de contexto, isoladamente ou em interação.This paper aims to empirically test a theoretical multilevel model for the prediction of individual performance at work. Antecedent variables, isolated or in interaction, were age, gender, function, scholarity, period of function and perception of learning support, in the individual and contextual levels, and satisfaction at work, an individual variable. This study was accomplished in a public corporation which deals with agricultural research in a national scope. The participants (N = 808 were distribute in 45 central and noncentral units for the Brazil. Data collection was done online, by e-mail. The multilevel results confirm the hypothetic theoretical model and make evident that the performance's variance were predicted by different individuals and context variables, isolated or in interaction.

  11. Diagnosis of regional cerebral blood flow abnormalities using SPECT: agreement between individualized statistical parametric maps and visual inspection by nuclear medicine physicians with different levels of expertise in nuclear neurology

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, Euclides Timoteo da, E-mail: euclidestimoteo@uol.com.b [Fundacao Pio XII, Barretos, SP (Brazil). Hospital de Cancer. Dept. de Medicina Nuclear; Buchpiguel, Carlos Alberto [Hospital do Coracao, Sao Paulo, SP (Brazil). Dept. de Medicina Nuclear; Nitrini, Ricardo [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Neurologia; Tazima, Sergio [Hospital Alemao Oswaldo Cruz (HAOC), Sao Paulo, SP (Brazil). Dept. de Medicina Nuclear; Peres, Stela Verzinhase [Fundacao Pio XII, Barretos, SP (Brazil). Hospital de Cancer; Busatto Filho, Geraldo [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Div. de Medicina Nuclear

    2009-07-01

    Introduction: visual analysis is widely used to interpret regional cerebral blood flow (rCBF) SPECT images in clinical practice despite its limitations. Automated methods are employed to investigate between-group rCBF differences in research studies but have rarely been explored in individual analyses. Objectives: to compare visual inspection by nuclear physicians with the automated statistical parametric mapping program using a SPECT dataset of patients with neurological disorders and normal control images. Methods: using statistical parametric mapping, 14 SPECT images from patients with various neurological disorders were compared individually with a databank of 32 normal images using a statistical threshold of p<0.05 (corrected for multiple comparisons at the level of individual voxels or clusters). Statistical parametric mapping results were compared with visual analyses by a nuclear physician highly experienced in neurology (A) as well as a nuclear physician with a general background of experience (B) who independently classified images as normal or altered, and determined the location of changes and the severity. Results: of the 32 images of the normal databank, 4 generated maps showing rCBF abnormalities (p<0.05, corrected). Among the 14 images from patients with neurological disorders, 13 showed rCBF alterations. Statistical parametric mapping and physician A completely agreed on 84.37% and 64.28% of cases from the normal databank and neurological disorders, respectively. The agreement between statistical parametric mapping and ratings of physician B were lower (71.18% and 35.71%, respectively). Conclusion: statistical parametric mapping replicated the findings described by the more experienced nuclear physician. This finding suggests that automated methods for individually analyzing rCBF SPECT images may be a valuable resource to complement visual inspection in clinical practice. (author)

  12. [Individual physical performance capacity with physiological and biochemical indicators of stress].

    Science.gov (United States)

    Bergert, K D; Nestler, K; Böttger, H; Schettler, R

    1989-09-01

    22 health male subjects were exposed by a combination of physical exercises and heat. Strain related physiological and biochemical parameters were measured. Different individual reactions were obtained under controlled conditions. In dependence on the individual performance an increased mobilisation of lactat, free fatty acids and catecholamines were found. The determination of aerob physical performance can be applied for the evaluation of working capacity.

  13. Core review: physician-performed ultrasound: the time has come for routine use in acute care medicine.

    Science.gov (United States)

    Royse, Colin F; Canty, David J; Faris, John; Haji, Darsim L; Veltman, Michael; Royse, Alistair

    2012-11-01

    The use of ultrasound in the acute care specialties of anesthesiology, intensive care, emergency medicine, and surgery has evolved from discrete, office-based echocardiographic examinations to the real-time or point-of-care clinical assessment and interventions. "Goal-focused" transthoracic echocardiography is a limited scope (as compared with comprehensive examination) echocardiographic examination, performed by the treating clinician in acute care medical practice, and is aimed at addressing specific clinical concerns. In the future, the practice of surface ultrasound will be integrated into the everyday clinical practice as ultrasound-assisted examination and ultrasound-guided procedures. This evolution should start at the medical student level and be reinforced throughout specialist training. The key to making ultrasound available to every physician is through education programs designed to facilitate uptake, rather than to prevent access to this technology and education by specialist craft groups. There is evidence that diagnosis is improved with ultrasound examination, yet data showing change in management and improvement in patient outcome are few and an important area for future research.

  14. Individualized performance prediction during total sleep deprivation: accounting for trait vulnerability to sleep loss.

    Science.gov (United States)

    Ramakrishnan, Sridhar; Laxminarayan, Srinivas; Thorsley, David; Wesensten, Nancy J; Balkin, Thomas J; Reifman, Jaques

    2012-01-01

    Individual differences in vulnerability to sleep loss can be considerable, and thus, recent efforts have focused on developing individualized models for predicting the effects of sleep loss on performance. Individualized models constructed using a Bayesian formulation, which combines an individual's available performance data with a priori performance predictions from a group-average model, typically need at least 40 h of individual data before showing significant improvement over the group-average model predictions. Here, we improve upon the basic Bayesian formulation for developing individualized models by observing that individuals may be classified into three sleep-loss phenotypes: resilient, average, and vulnerable. For each phenotype, we developed a phenotype-specific group-average model and used these models to identify each individual's phenotype. We then used the phenotype-specific models within the Bayesian formulation to make individualized predictions. Results on psychomotor vigilance test data from 48 individuals indicated that, on average, ∼85% of individual phenotypes were accurately identified within 30 h of wakefulness. The percentage improvement of the proposed approach in 10-h-ahead predictions was 16% for resilient subjects and 6% for vulnerable subjects. The trade-off for these improvements was a slight decrease in prediction accuracy for average subjects.

  15. Effect of an EBM course in combination with case method learning sessions: an RCT on professional performance, job satisfaction, and self-efficacy of occupational physicians

    NARCIS (Netherlands)

    Hugenholtz, Nathalie I. R.; Schaafsma, Frederieke G.; Nieuwenhuijsen, Karen; van Dijk, Frank J. H.

    2008-01-01

    Objective An intervention existing of an evidence-based medicine (EBM) course in combination with case method learning sessions (CMLSs) was designed to enhance the professional performance, self-efficacy and job satisfaction of occupational physicians. Methods A cluster randomized controlled trial

  16. Self-employed individuals performing different types of work have different occupational safety and health problems.

    Science.gov (United States)

    Park, Jungsun; Han, Boyoung; Kim, Yangho

    2018-05-22

    We assessed the occupational safety and health (OSH) issues of self-employed individuals in Korea. The working conditions and OSH issues in three groups were analyzed using the Korean Working Conditions Survey of 2014. Among self-employed individuals, "Physical work" was more common among males, whereas "Emotional work" was more common among females. Self-employed individuals performing "Mental work" had more education, higher incomes, and the lowest exposure to physical/chemical and ergonomic hazards in the workplace. In contrast, those performing "Physical work" were older, had less education, lower incomes, greater exposure to physical/chemical and ergonomic hazards in the workplace, and more health problems. Individuals performing "Physical work" were most vulnerable to OSH problems. The self-employed are a heterogeneous group of individuals. We suggest development of specific strategies that focus on workers performing "Physical work" to improve the health and safety of self-employed workers in Korea. © 2018 Wiley Periodicals, Inc.

  17. Inpatient iron deficiency detection and management: how do general physicians and gastroenterologists perform in a tertiary care hospital?

    Science.gov (United States)

    Fazal, Muhammad W; Andrews, Jane M; Thomas, Josephine; Saffouri, Eliana

    2017-08-01

    Iron deficiency (ID) is often an indicator of underlying pathology. Early detection and treatment avoids long-term morbidity and allows for prompt iron repletion, avoiding ID anaemia (IDA) and the need for blood transfusion. To evaluate the management of ID in two internal medicine units (general medical (GM) and gastroenterology (GE)) in a large metropolitan hospital and compare it to international guidelines. All consecutive inpatient admissions in the GM and GE units were retrospectively reviewed until 40 patients in each service were identified with anaemia and/or microcytic hypochromic blood counts. Patient records and electronic discharge summaries were then reviewed to assess the recognition, investigation and management of these abnormalities. Overall, only 60% (48/80) of the cases of microcytic hypochromic picture and/or anaemia were recognised. Cases were more likely to be detected under the GE unit, 77.5% (31/40) versus 42% (17/40) in GM (P < 0.002). Of the 31 recognised GE cases, 28 (90%) were investigated further with iron studies and/or endoscopic procedures. ID was confirmed in nearly half (5/11) of those tested; however, only 2 of 5 received iron replacement. Among GM patients, only 11 of the 17 recognised cases (64%) were investigated further. Iron studies were performed in all 11, confirming IDA in 4 (36%), all of whom received intravenous iron. A faecal human haemoglobin test was performed in two GM patients and one GE patient. There remains significant room for improvement in the recognition, investigation and management of ID in hospital practice in Australia. © 2017 Royal Australasian College of Physicians.

  18. Napping on the Night Shift: A Study of Sleep, Performance, and Learning in Physicians-in-Training.

    Science.gov (United States)

    McDonald, Jennifer; Potyk, Darryl; Fischer, David; Parmenter, Brett; Lillis, Teresa; Tompkins, Lindsey; Bowen, Angela; Grant, Devon; Lamp, Amanda; Belenky, Gregory

    2013-12-01

    Physicians in training experience fatigue from sleep loss, high workload, and working at an adverse phase of the circadian rhythm, which collectively degrades task performance and the ability to learn and remember. To minimize fatigue and sustain performance, learning, and memory, humans generally need 7 to 8 hours of sleep in every 24-hour period. In a naturalistic, within-subjects design, we studied 17 first- and second-year internal medicine residents working in a tertiary care medical center, rotating between day shift and night float every 4 weeks. We studied each resident for 2 weeks while he/she worked the day shift and for 2 weeks while he/she worked the night float, objectively measuring sleep by wrist actigraphy, vigilance by the Psychomotor Vigilance Task test, and visual-spatial and verbal learning and memory by the Brief Visuospatial Memory Test-Revised and the Rey Auditory-Verbal Learning Test. Residents, whether working day shift or night float, slept approximately 7 hours in every 24-hour period. Residents, when working day shift, consolidated their sleep into 1 main sleep period at night. Residents working night float split their sleep, supplementing their truncated daytime sleep with nighttime on-duty naps. There was no difference in vigilance or learning and memory, whether residents worked day shift or night float. Off-duty sleep supplemented with naps while on duty appears to be an effective strategy for sustaining vigilance, learning, and memory when working night float.

  19. Effects of Student-Performed Point-of-Care Ultrasound on Physician Diagnosis and Management of Patients in the Emergency Department.

    Science.gov (United States)

    Udrea, Daniel S; Sumnicht, Andrew; Lo, Deanna; Villarreal, Logan; Gondra, Stephanie; Chyan, Richard; Wisham, Audra; Dinh, Vi Am

    2017-07-01

    Despite the increasing integration of ultrasound training into medical education, there is an inadequate body of research demonstrating the benefits and practicality of medical student-performed point-of-care ultrasound (SP-POCUS) in the clinical setting. The primary purpose of this study was to evaluate the effects that SP-POCUS can have on physician diagnosis and management of patients in the emergency department, with a secondary purpose of evaluating the diagnostic accuracy of SP-POCUS. SP-POCUS examinations were performed in the emergency department by medical students who completed year one of a 4-year medical school curriculum with integrated ultrasound training. Scans were evaluated by an emergency physician who then completed a survey to record any changes in diagnosis and management. A total of 641 scans were performed on the 482 patients enrolled in this study. SP-POCUS resulted in a change in management in 17.3% of scans performed. For 12.4% of scans, SP-POCUS discovered a new diagnosis. SP-POCUS reduced time to disposition 33.5% of the time. Because of SP-POCUS, physicians avoided ordering an additional imaging study for 53.0% of the scans performed. There was 94.7% physician agreement with SP-POCUS diagnosis. This study showed that SP-POCUS is feasible and may potentially have a meaningful impact on physician diagnosis and management of patients in the emergency department. In addition, the implementation of SP-POCUS could serve as an ideal method of developing ultrasound skills in medical school while positively impacting patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Between-individual comparisons in performance evaluation: a perspective from prospect theory.

    Science.gov (United States)

    Wong, Kin Fai Ellick; Kwong, Jessica Y Y

    2005-03-01

    This article examines how between-individual comparisons influence performance evaluations in rating tasks. The authors demonstrated a systematic change in the perceived difference across ratees as a result of changing the way performance information is expressed. Study 1 found that perceived performance difference between 2 individuals was greater when their objective performance levels were presented with small numbers (e.g., absence rates of 2% vs. 5%) than when they were presented with large numbers (e.g., attendance rates of 98% vs. 95%). Extending this finding to situations involving trade-offs between multiple performance attributes across ratees, Study 2 showed that the relative preference for 1 ratee over another actually reversed when the presentation format of the performance information changed. The authors draw upon prospect theory to offer a theoretical framework describing the between-individual comparison aspect of performance evaluation.

  1. Quality Assurance in Individual Monitoring: 10 Years of Performance Monitoring of the TLD Based TNO Individual Monitoring Service (invited paper)

    International Nuclear Information System (INIS)

    Dijk, J.W.E. van

    1998-01-01

    The QA subscription forms the nucleus of the Quality Assurance (QA) programme of the TLD-based Individual Monitoring Service of TNO-CSD. This QA subscription is the subscription of a dummy customer to the service. As this customer is treated exactly like a normal customer, all aspects of the service are monitored by the QA subscription. An overview is given of 10 years of monitoring the performance of the service. Various improvements over the past decade have resulted in a standard deviation in a low dose measurement of 0.01 mSv and a relative standard deviation at higher doses of 5%. These figures represent the performance under routine circumstances and thus include variations due to variations in the natural background from place to place and, for example, due to transport. (author)

  2. Quality Assurance in Individual Monitoring: 10 Years of Performance Monitoring of the TLD Based TNO Individual Monitoring Service (invited paper)

    Energy Technology Data Exchange (ETDEWEB)

    Dijk, J.W.E. van

    1998-07-01

    The QA subscription forms the nucleus of the Quality Assurance (QA) programme of the TLD-based Individual Monitoring Service of TNO-CSD. This QA subscription is the subscription of a dummy customer to the service. As this customer is treated exactly like a normal customer, all aspects of the service are monitored by the QA subscription. An overview is given of 10 years of monitoring the performance of the service. Various improvements over the past decade have resulted in a standard deviation in a low dose measurement of 0.01 mSv and a relative standard deviation at higher doses of 5%. These figures represent the performance under routine circumstances and thus include variations due to variations in the natural background from place to place and, for example, due to transport. (author)

  3. Motor performance of individuals with cerebral palsy in a virtual game using a mobile phone.

    Science.gov (United States)

    de Paula, Juliana Nobre; de Mello Monteiro, Carlos Bandeira; da Silva, Talita Dias; Capelini, Camila Miliani; de Menezes, Lilian Del Cielo; Massetti, Thais; Tonks, James; Watson, Suzanna; Nicolai Ré, Alessandro Hervaldo

    2017-11-01

    Cerebral palsy (CP) is a permanent disorder of movement, muscle tone or posture that is caused by damage to the immature and developing brain. Research has shown that Virtual Reality (VR) technology can be used in rehabilitation to support the acquisition of motor skills and the achievement of functional tasks. The aim of this study was to explore for improvements in the performance of individuals with CP with practice in the use of a virtual game on a mobile phone and to compare their performance with that of the control group. Twenty-five individuals with CP were matched for age and sex with twenty-five, typically developing individuals. Participants were asked to complete a VR maze task as fast as possible on a mobile phone. All participants performed 20 repetitions in the acquisition phase, five repetitions for retention and five more repetitions for transfer tests, in order to evaluate motor learning from the task. The CP group improved their performance in the acquisition phase and maintained the performance, which was shown by the retention test; in addition, they were able to transfer the performance acquired in an opposite maze path. The CP group had longer task-execution compared to the control group for all phases of the study. Individuals with cerebral palsy were able to learn a virtual reality game (maze task) using a mobile phone, and despite their differences from the control group, this kind of device offers new possibilities for use to improve function. Implications for rehabilitation A virtual game on a mobile phone can enable individuals with Cerebral Palsy (CP) to improve performance. This illustrates the potential for use of mobile phone games to improve function. Individuals with CP had poorer performance than individuals without CP, but they demonstrated immediate improvements from using a mobile phone device. Individuals with CP were able to transfer their skills to a similar task indicating that they were able to learn these motor skills by

  4. Flexible working, individual performance and employee attitudes: comparing formal and informal arrangements

    OpenAIRE

    De Menezes, Lilian M.; Kelliher, Clare

    2016-01-01

    In the context of a wider trend to individualize HRM, this paper examines the relationship between flexible working arrangements and individual performance. Drawing on a range of theories, it examines potential indirect effects on employee performance via job satisfaction and organizational commitment and analyses whether these relationships vary according to whether the arrangement was set up through a formal process, or negotiated informally between the employee and their line manager. Exta...

  5. Memory for self-performed actions in individuals with Asperger syndrome.

    OpenAIRE

    Tiziana Zalla; Elena Daprati; Anca-Maria Sav; Pauline Chaste; Daniele Nico; Marion Leboyer

    2010-01-01

    Memory for action is enhanced if individuals are allowed to perform the corresponding movements, compared to when they simply listen to them (enactment effect). Previous studies have shown that individuals with Autism Spectrum Disorders (ASD) have difficulties with processes involving the self, such as autobiographical memories and self performed actions. The present study aimed at assessing memory for action in Asperger Syndrome (AS). We investigated whether adults with AS would benefit from...

  6. Organizational commitment of military physicians.

    Science.gov (United States)

    Demir, Cesim; Sahin, Bayram; Teke, Kadir; Ucar, Muharrem; Kursun, Olcay

    2009-09-01

    An individual's loyalty or bond to his or her employing organization, referred to as organizational commitment, influences various organizational outcomes such as employee motivation, job satisfaction, performance, accomplishment of organizational goals, employee turnover, and absenteeism. Therefore, as in other sectors, employee commitment is crucial also in the healthcare market. This study investigates the effects of organizational factors and personal characteristics on organizational commitment of military physicians using structural equation modeling (SEM) on a self-report, cross-sectional survey that consisted of 635 physicians working in the 2 biggest military hospitals in Turkey. The results of this study indicate that professional commitment and organizational incentives contribute positively to organizational commitment, whereas conflict with organizational goals makes a significantly negative contribution to it. These results might help develop strategies to increase employee commitment, especially in healthcare organizations, because job-related factors have been found to possess greater impact on organizational commitment than personal characteristics.

  7. Classification Systems for Individual Differences in Multiple-task Performance and Subjective Estimates of Workload

    Science.gov (United States)

    Damos, D. L.

    1984-01-01

    Human factors practitioners often are concerned with mental workload in multiple-task situations. Investigations of these situations have demonstrated repeatedly that individuals differ in their subjective estimates of workload. These differences may be attributed in part to individual differences in definitions of workload. However, after allowing for differences in the definition of workload, there are still unexplained individual differences in workload ratings. The relation between individual differences in multiple-task performance, subjective estimates of workload, information processing abilities, and the Type A personality trait were examined.

  8. Physician Migration to and from Canada: The Challenge of Finding the Ethical and Political Balance between the Individual's Right to Mobility and Recruitment to Underserved Communities

    Science.gov (United States)

    Dauphinee, W. Dale

    2005-01-01

    Physician migration to and from countries results from many local causes and international influences. These factors operate in the context of an increasingly globalized economy. From an ethical point of view, selective and targeted "raiding" of developing countries' medical workforce by wealthier countries is not acceptable. However,…

  9. Individual reactions to stress predict performance during a critical aviation incident.

    Science.gov (United States)

    Vine, Samuel J; Uiga, Liis; Lavric, Aureliu; Moore, Lee J; Tsaneva-Atanasova, Krasimira; Wilson, Mark R

    2015-01-01

    Understanding the influence of stress on human performance is of theoretical and practical importance. An individual's reaction to stress predicts their subsequent performance; with a "challenge" response to stress leading to better performance than a "threat" response. However, this contention has not been tested in truly stressful environments with highly skilled individuals. Furthermore, the effect of challenge and threat responses on attentional control during visuomotor tasks is poorly understood. Thus, this study aimed to examine individual reactions to stress and their influence on attentional control, among a cohort of commercial pilots performing a stressful flight assessment. Sixteen pilots performed an "engine failure on take-off" scenario, in a high-fidelity flight simulator. Reactions to stress were indexed via self-report; performance was assessed subjectively (flight instructor assessment) and objectively (simulator metrics); gaze behavior data were captured using a mobile eye tracker, and measures of attentional control were subsequently calculated (search rate, stimulus driven attention, and entropy). Hierarchical regression analyses revealed that a threat response was associated with poorer performance and disrupted attentional control. The findings add to previous research showing that individual reactions to stress influence performance and shed light on the processes through which stress influences performance.

  10. The effect of individual characteristics of decision making and judgment on stock-flow performance

    NARCIS (Netherlands)

    Raaijmakers, S.; Korzilius, H.P.L.M.; Rouwette, E.A.J.A.; Vennix, J.A.M.

    2012-01-01

    Extending the line of research on stock-flow performance we examined the impact of personality characteristics on task performance. It was assumed that the need for cognition, the need for closure and the preference for intuition and deliberation would relate to individual variations in

  11. Job crafting at the team and individual level: Implications for work engagement and performance

    NARCIS (Netherlands)

    Tims, M.; Bakker, A.B.; Derks, D.; Rhenen, van W.

    2013-01-01

    Previous research suggests that employee job crafting is positively related to job performance through employee work engagement. The present study expands this individual-level perspective to the team level by hypothesizing that team job crafting relates positively to team performance through team

  12. Psychosocial challenges facing physicians of today.

    Science.gov (United States)

    Arnetz, B B

    2001-01-01

    leadership and the physician team impact on the overall work atmosphere. Physicians unaware of the goals of the department as well as the hospital, that do not receive management performance feedback, and who do not get annual performance appraisals and career guidance, rate their psychosocial environment as more adverse than their colleagues. There is also a great need to offer personally targeted competence development plans. Heads of department and senior physicians rate their work environment as of higher quality than more junior and mid-career physicians. More specifically, less senior physicians perceive similar work demands as their senior colleagues but rate influence over work, skills utilization, and intellectual stimulation at work as significantly worse. In order to combat negative stressors in the physicians' work environment, enhancement initiatives should be considered both at the individual, group, and structural level. Successful resources used by physicians to manage the stress of everyday medicine should be identified. Physicians are a key group to ensure a well-functioning health care system. In order to be able to change and adapt to the ongoing evolution of the Western health care system, more focus needs to be put on the psychosocial aspects of physicians' work.

  13. Long-term and within-day variability of working memory performance and EEG in individuals.

    Science.gov (United States)

    Gevins, Alan; McEvoy, Linda K; Smith, Michael E; Chan, Cynthia S; Sam-Vargas, Lita; Baum, Cliff; Ilan, Aaron B

    2012-07-01

    Assess individual-subject long-term and within-day variability of a combined behavioral and EEG test of working memory. EEGs were recorded from 16 adults performing n-back working memory tasks, with 10 tested in morning and afternoon sessions over several years. Participants were also tested after ingesting non-prescription medications or recreational substances. Performance and EEG measures were analyzed to derive an Overall score and three constituent sub-scores characterizing changes in performance, cortical activation, and alertness from each individual's baseline. Long-term and within-day variability were determined for each score; medication effects were assessed by reference to each individual's normal day-to-day variability. Over the several year period, the mean Overall score and sub-scores were approximately zero with standard deviations less than one. Overall scores were lower and their variability higher in afternoon relative to morning sessions. At the group level, alcohol, diphenhydramine and marijuana produced significant effects, but there were large individual differences. Objective working memory measures incorporating performance and EEG are stable over time and sensitive at the level of individual subjects to interventions that affect neurocognitive function. With further research these measures may be suitable for use in individualized medical care by providing a sensitive assessment of incipient illness and response to treatment. Published by Elsevier Ireland Ltd.

  14. Identification of Resilient Individuals and Those at Risk for Performance Deficits under Stress

    Directory of Open Access Journals (Sweden)

    Brent eWinslow

    2015-09-01

    Full Text Available Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. Here we measure the effects of stress on physiological response and performance through behavior, physiological sensors, and subjective ratings, and identify which individuals are at risk for stress-related performance decrements. Participants performed military-relevant training tasks under stress in a virtual environment, with autonomic and hypothalamic-pituitary-adrenal axis (HPA reactivity analyzed. Self-reported stress, as well as physiological indices of stress, increased in the group pre-exposed to socioevaluative stress. Stress response was effectively captured via electrodermal and cardiovascular measures of heart rate and skin conductance level. A resilience classification algorithm was developed based upon physiological reactivity, which correlated with baseline unstressed physiological and self-reported stress values. Outliers were identified in the experimental group that had a significant mismatch between self-reported stress and salivary cortisol. Baseline stress measurements were predictive of individual resilience to stress, including the impact stress had on physiological reactivity and performance. Such an approach may have utility in identifying individuals at risk for problems performing under severe stress. Continuing work has focused on adapting this method for military personnel, and assessing the utility of various coping and decision-making strategies on performance and physiological stress.

  15. Identification of resilient individuals and those at risk for performance deficits under stress.

    Science.gov (United States)

    Winslow, Brent D; Carroll, Meredith B; Martin, Jonathan W; Surpris, Glenn; Chadderdon, George L

    2015-01-01

    Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. Here we measure the effects of stress on physiological response and performance through behavior, physiological sensors, and subjective ratings, and identify which individuals are at risk for stress-related performance decrements. Participants performed military-relevant training tasks under stress in a virtual environment, with autonomic and hypothalamic-pituitary-adrenal axis (HPA) reactivity analyzed. Self-reported stress, as well as physiological indices of stress, increased in the group pre-exposed to socioevaluative stress. Stress response was effectively captured via electrodermal and cardiovascular measures of heart rate and skin conductance level. A resilience classification algorithm was developed based upon physiological reactivity, which correlated with baseline unstressed physiological and self-reported stress values. Outliers were identified in the experimental group that had a significant mismatch between self-reported stress and salivary cortisol. Baseline stress measurements were predictive of individual resilience to stress, including the impact stress had on physiological reactivity and performance. Such an approach may have utility in identifying individuals at risk for problems performing under severe stress. Continuing work has focused on adapting this method for military personnel, and assessing the utility of various coping and decision-making strategies on performance and physiological stress.

  16. Family physicians' ability to perform population management is associated with adoption of other aspects of the patient-centered medical home.

    Science.gov (United States)

    Ottmar, Jessica; Blackburn, Brenna; Phillips, Robert L; Peterson, Lars E; Jaén, Carlos Roberto

    2015-04-01

    The patient-centered medical home (PCMH) model is considered a promising approach to improving population health, but how elements of these advanced practice models relate to population health capability is unknown. To measure associations between family physicians' performance of population management with PCMH components, a cross-sectional survey was conducted with physicians accessing the American Board of Family Medicine Web site in 2011. Bivariate analysis and logistic regression tested associations between physician and practice demographics and specific PCMH features. The primary outcome was performance of population management. The final sample included 3855 physicians, 37.3% of whom reported performing population management. Demographic characteristics significantly associated with greater use of population management were female sex and graduation from an international medical school. PCMH components that remained associated with population management after adjustment were access to clinical case managers (odds ratio [OR]=2.01, 95% confidence interval [95% CI]: 1.69, 2.39), behavioral health collaboration (OR=1.49, 95% CI: 1.26, 1.77), having an electronic health record that supports meaningful use (OR=1.47, 95% CI: 1.25, 1.74), recent participation in a quality improvement project (OR=2.47, 95% CI: 2.12, 2.89), and routine measurement of patient difficulty securing an appointment (OR=2.87, 95% CI: 2.45, 3.37). Performance of population management was associated with several PCMH elements and resources not present in traditional primary care offices. Attention to these elements likely will enhance delivery of population management services in primary care.

  17. Role of Leadership and Employee Engagement towards Individual Performance of Pharmacy Employees

    Directory of Open Access Journals (Sweden)

    Susi A. Rahayu

    2012-09-01

    Full Text Available Employees dissatisfaction to the head of the hospital pharmacy will decrease employees performance and unsatisfied customers. To solve the problems, employees should be based on performance as customer expectations in providing services. One of the ways to improve the performance of the employees, they must feel engage to the work. One of the factors to improve employee engagement is the leadership factor. Therefore, it is necessary to study the impact of leadership on individual performance employee in hospital pharmacy and also the influence of employee engagement as a mediator. A total of 79 employees from the pharmacy in two private hospitals in Bandung became the participants. This study used the technique of partial least squares to test the hypothesized relationships. The results showed that there were significant between leadership to employee engagement (t value (12,84 > t-table (1.64, the significance of employee engagement on individual performance (t value (3.83 > t-table (1.64. In contrast, there was no influence and significance in leadership on individual performance (t value (0.45 < t-table (1.64. Employee engagement fully mediated the relationship between leadership and individual performance. Therefore, improving pharmacy services is a set of actions and involvement of pharmacy employees who are consistent, sustainable and clear.

  18. Face recognition performance of individuals with Asperger syndrome on the Cambridge Face Memory Test.

    Science.gov (United States)

    Hedley, Darren; Brewer, Neil; Young, Robyn

    2011-12-01

    Although face recognition deficits in individuals with Autism Spectrum Disorder (ASD), including Asperger syndrome (AS), are widely acknowledged, the empirical evidence is mixed. This in part reflects the failure to use standardized and psychometrically sound tests. We contrasted standardized face recognition scores on the Cambridge Face Memory Test (CFMT) for 34 individuals with AS with those for 42, IQ-matched non-ASD individuals, and age-standardized scores from a large Australian cohort. We also examined the influence of IQ, autistic traits, and negative affect on face recognition performance. Overall, participants with AS performed significantly worse on the CFMT than the non-ASD participants and when evaluated against standardized test norms. However, while 24% of participants with AS presented with severe face recognition impairment (>2 SDs below the mean), many individuals performed at or above the typical level for their age: 53% scored within +/- 1 SD of the mean and 9% demonstrated superior performance (>1 SD above the mean). Regression analysis provided no evidence that IQ, autistic traits, or negative affect significantly influenced face recognition: diagnostic group membership was the only significant predictor of face recognition performance. In sum, face recognition performance in ASD is on a continuum, but with average levels significantly below non-ASD levels of performance. Copyright © 2011, International Society for Autism Research, Wiley-Liss, Inc.

  19. Employee engagement, organisational performance and individual wellbeing: Exploring the evidence, developing the theory

    OpenAIRE

    Truss, C.; Shantz, A.; Soane, E.; Emma, C.; Alfes, K.; Delbridge, R.

    2013-01-01

    The development of mainstream human resource management (HRM) theory has long been concerned with how people management can enhance performance outcomes. It is only very recently that interest has been shown in the parallel stream of research on the link between employee engagement and performance, bringing the two together to suggest that engagement may constitute the mechanism through which HRM practices impact individual and organisational performance. However, engagement has emerged as a ...

  20. The Influence of Individual Personalities Towards Team Performance at PT. Bpr Prisma Dana Manado

    OpenAIRE

    Untu, Mario Rahmat

    2014-01-01

    In today€™s global and competitive environment, one of the more often debated issues in the study of organizational behavior is the effects of workforce diversity such as personality on team performance. Workforce diversity refers to employee€™s individual differences and similarities. It stands for individuality that includes personality, gender, race, nationality, ethnicity, region, income, marital status, work experience, perceptions among others. The purpose of this study was to examine h...

  1. Predicting Performance during Chronic Sleep Loss: Identification of Factors Sensitive to Individual Fatigue Resistance

    Science.gov (United States)

    2015-03-18

    fatigue-related performance impairments for a given schedule. However, these models fail to account for individual differences in fatigue susceptibility...Tool, FAST ™ ), yet these models fail to take into account important individual differences in fatigue states and susceptibility to fatigue. However...Venkatraman et al., 2007) and confusion ( Drury et al., 2012). However, sustained or continuous operations in high tempo, wartime operations often

  2. Memory for self-performed actions in individuals with Asperger syndrome.

    Directory of Open Access Journals (Sweden)

    Tiziana Zalla

    2010-10-01

    Full Text Available Memory for action is enhanced if individuals are allowed to perform the corresponding movements, compared to when they simply listen to them (enactment effect. Previous studies have shown that individuals with Autism Spectrum Disorders (ASD have difficulties with processes involving the self, such as autobiographical memories and self performed actions. The present study aimed at assessing memory for action in Asperger Syndrome (AS. We investigated whether adults with AS would benefit from the enactment effect when recalling a list of previously performed items vs. items that were only visually and verbally experienced through three experimental tasks (Free Recall, Old/New Recognition and Source Memory. The results showed that while performance on Recognition and Source Memory tasks was preserved in individuals with AS, the enactment effect for self-performed actions was not consistently present, as revealed by the lower number of performed actions being recalled on the Free Recall test, as compared to adults with typical development. Subtle difficulties in encoding specific motor and proprioceptive signals during action execution in individuals with AS might affect retrieval of relevant personal episodic information. These disturbances might be associated to an impaired action monitoring system.

  3. Memory for self-performed actions in individuals with Asperger syndrome.

    Science.gov (United States)

    Zalla, Tiziana; Daprati, Elena; Sav, Anca-Maria; Chaste, Pauline; Nico, Daniele; Leboyer, Marion

    2010-10-12

    Memory for action is enhanced if individuals are allowed to perform the corresponding movements, compared to when they simply listen to them (enactment effect). Previous studies have shown that individuals with Autism Spectrum Disorders (ASD) have difficulties with processes involving the self, such as autobiographical memories and self performed actions. The present study aimed at assessing memory for action in Asperger Syndrome (AS). We investigated whether adults with AS would benefit from the enactment effect when recalling a list of previously performed items vs. items that were only visually and verbally experienced through three experimental tasks (Free Recall, Old/New Recognition and Source Memory). The results showed that while performance on Recognition and Source Memory tasks was preserved in individuals with AS, the enactment effect for self-performed actions was not consistently present, as revealed by the lower number of performed actions being recalled on the Free Recall test, as compared to adults with typical development. Subtle difficulties in encoding specific motor and proprioceptive signals during action execution in individuals with AS might affect retrieval of relevant personal episodic information. These disturbances might be associated to an impaired action monitoring system.

  4. Visual determinants of reduced performance on the Stroop color-word test in normal aging individuals.

    Science.gov (United States)

    van Boxtel, M P; ten Tusscher, M P; Metsemakers, J F; Willems, B; Jolles, J

    2001-10-01

    It is unknown to what extent the performance on the Stroop color-word test is affected by reduced visual function in older individuals. We tested the impact of common deficiencies in visual function (reduced distant and close acuity, reduced contrast sensitivity, and color weakness) on Stroop performance among 821 normal individuals aged 53 and older. After adjustment for age, sex, and educational level, low contrast sensitivity was associated with more time needed on card I (word naming), red/green color weakness with slower card 2 performance (color naming), and reduced distant acuity with slower performance on card 3 (interference). Half of the age-related variance in speed performance was shared with visual function. The actual impact of reduced visual function may be underestimated in this study when some of this age-related variance in Stroop performance is mediated by visual function decrements. It is suggested that reduced visual function has differential effects on Stroop performance which need to be accounted for when the Stroop test is used both in research and in clinical settings. Stroop performance measured from older individuals with unknown visual status should be interpreted with caution.

  5. The Effects of Creatine Supplementation on Explosive Performance and Optimal Individual Postactivation Potentiation Time

    Directory of Open Access Journals (Sweden)

    Chia-Chi Wang

    2016-03-01

    Full Text Available Creatine plays an important role in muscle energy metabolism. Postactivation potentiation (PAP is a phenomenon that can acutely increase muscle power, but it is an individualized process that is influenced by muscle fatigue. This study examined the effects of creatine supplementation on explosive performance and the optimal individual PAP time during a set of complex training bouts. Thirty explosive athletes performed tests of back squat for one repetition maximum (1RM strength and complex training bouts for determining the individual optimal timing of PAP, height and peak power of a counter movement jump before and after the supplementation. Subjects were assigned to a creatine or placebo group and then consumed 20 g of creatine or carboxymethyl cellulose per day for six days. After the supplementation, the 1RM strength in the creatine group significantly increased (p < 0.05. The optimal individual PAP time in the creatine group was also significant earlier than the pre-supplementation and post-supplementation of the placebo group (p < 0.05. There was no significant difference in jump performance between the groups. This study demonstrates that creatine supplementation improves maximal muscle strength and the optimal individual PAP time of complex training but has no effect on explosive performance.

  6. Longitudinal intra and inter-individual variability in young swimmers performance and determinant factors

    OpenAIRE

    Morais, Jorge; Costa, Mário; Moreira, Marc; Forte, Pedro; Silva, António; Marinho, Daniel; Barbosa, Tiago

    2014-01-01

    The aim of study was to follow-up the intra-individual and inter-individual stability of talented swimmers’ performance and its anthropometrics, kinematics, hydrodynamics and efficiency during two competitive seasons. Thirty talented swimmers (14 boys: 12.33 ± 0.65 years; and 16 girls: 11.15 ± 0.55 years) were followed-up. Performance (100-m freestyle), anthropometrics (body mass, height, arm span, chest perimeter, trunk transverse surface area, hand and foot surface area), kinematics (stroke...

  7. International trade shows: Structure, strategy and performance of exhibitors at individual booths vs. joint booths

    DEFF Research Database (Denmark)

    Hansen, Kåre

    2000-01-01

    This paper examines differences in exhibitors who participate at international trade shows at joint booths and those who participate at individual booths. The structure, strategy, and trade show performance of exhibitors at joint booths and those at individual booths are analysed. The analysis...... implications for exhibitors at interna-tional trade shows and export marketing programmes and other marketing programmes offering services to international trade show exhibitors....... of exhibitors at the international food shows SIAL (Paris) and ANUGA (Cologne) showed several significant differences with regard to structure and strategy. However, no significant differences in the performance assessments between the two partici-pation modes were found. The findings have important...

  8. Communication skills training for physicians performing work disability assessments increases knowledge and self-efficacy: results of a randomised controlled trial.

    Science.gov (United States)

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

    2015-07-21

    It was assessed whether a post-graduate communication skills training course would increase physicians' competence and knowledge with regard to communication during work disability assessment interviews, and would change the determinants of their communication behaviour. A randomised controlled trial was performed. At baseline and at follow-up, 42 physicians completed questionnaires. The primary outcome measures were competence and knowledge about communication. The secondary outcome measures were 21 self-reported determinants of communication behaviour. One-way analyses of variance and covariance were performed. There was no significant difference between the intervention and control groups in overall competence, but there was for the introduction phase (intervention: mean = 7.0, SD 2.7; control: mean = 4.8, SD 2.7; p = 0.014). Knowledge about communication was significantly higher (p = 0.001) in the intervention group (mean = 79.6, SD 9.2) than in the control group (mean = 70.9, SD 6.7), especially concerning the information-gathering phase of the interview (intervention: mean = 80.0, SD 10.2; control: mean = 69.4, SD 8.9; p = 0.001). The intervention group scored significantly better on 7 of the 21 self-reported determinants (secondary outcomes), including self-efficacy, intentions, skills and knowledge. The communication skills training course may improve some aspects of physician communication, but not all. Because physicians were unanimously positive about the course, further development is warranted. Implications for Rehabilitation Even though optimal communication is essential in face-to-face assessment interviews for determining entitlement to work disability benefits, and there is a lot at stake for the claimants, this issue has scarcely been addressed in scientific research. A tailor-made two-day communication skills training course, based on scientific research, increases physicians' knowledge about communication

  9. 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.

  10. Orthopedic board certification and physician performance: an analysis of medical malpractice, hospital disciplinary action, and state medical board disciplinary action rates.

    Science.gov (United States)

    Kocher, Mininder S; Dichtel, Laura; Kasser, James R; Gebhardt, Mark C; Katz, Jeffery N

    2008-02-01

    Specialty board certification status has become the de facto standard of competency by which the profession and the public recognize physician specialists. However, the relationship between orthopedic board certification and physician performance has not been established. Rates of medical malpractice claims, hospital disciplinary actions, and state medical board disciplinary actions were compared between 1309 board-certified (BC) and 154 non-board-certified (NBC) orthopedic surgeons in 3 states. There was no significant difference between BC and NBC surgeons in medical malpractice claim proportions (BC, 19.1% NBC, 16.9% P = .586) or in hospital disciplinary action proportions (BC, 0.9% NBC, 0.8% P = 1.000). There was a significantly higher proportion of state medical board disciplinary action for NBC surgeons (BC, 7.6% NBC, 13.0% P = .028). An association between board certification status and physician performance is necessary to validate its status as the de facto standard of competency. In this study, BC surgeons had lower rates of state medical board disciplinary action.

  11. Individual differences in chronotypes associated with academic performance among Chilean University students.

    Science.gov (United States)

    Valladares, Macarena; Ramírez-Tagle, Rodrigo; Muñoz, Miss Alexandra; Obregón, Ana María

    2018-04-01

    A chronotype is an individual trait that determines circadian rhythm (dark/light cycle) characteristics, associated with bedtime, waking, and other daily activities. A chronotype is classified as morning, intermediate, and evening. The objective is to associate chronotypes with academic performance in university students. A cross-sectional study was performed to evaluate the chronotype of university students (n = 703) by Horne-Ostberg questionnaire and associated with academic performance. The group with higher GPAs had higher chronotype scores (p = 0.002). Morning and intermediate chronotypes exhibited better academic performance; however, more studies are necessary to determine the underlying causes, which could influence cognitive aspects.

  12. Multiple mini-interview as a predictor of performance in the objective structured clinical examination among Physician Associates in the United Kingdom: a cohort study

    Science.gov (United States)

    Kumar, Narendra; Bhardwaj, Shailaja; Rahman, Eqram

    2018-01-01

    Introduction Patient satisfaction and health care outcomes are directly linked to useful communication skills. Therefore, excellent interpersonal skills are imperative for health care professionals. Multiple mini-interview (MMI) is designed as a selection tool to assess the communication skills of applicants in medical schools during the admission process. However, objective structured clinical examination (OSCE) assesses students’ communication and clinical skills at the end of their academic terms. Recently, Anglia Ruskin University, Chelmsford, UK, adopted MMI in the selection process for the first cohort of MSc Physician Associate trainees for the academic year 2015–2016. This study aimed to determine the likelihood of MMI as a predictor of future performance of communication skills in the OSCE. Materials and methods The anonymous data of the average scores of communication skills attained in MMI and OSCE at the end of year 1 were collected for 30 students from the Physician Associate program team. Subsequently, Pearson’s correlation was computed to determine the relationship between the average scores of communication skills attained in MMI, and OSCE during trimester 2 and trimester 3 by the Physician Associate trainees. Results The study showed positive correlation between the scores of communication skills attained in MMI and OSCE during trimester 2 (r=0.956, n=30, p<0.001) and trimester 3 (r=0.966, n=30, p<0.001). Conclusion The study provides empirical evidence for the validity of MMI as a predictor of future performance of Physician Associate trainees’ communication skills during subsequent OSCEs. PMID:29695944

  13. Using individual differences to predict job performance: correcting for direct and indirect restriction of range.

    Science.gov (United States)

    Sjöberg, Sofia; Sjöberg, Anders; Näswall, Katharina; Sverke, Magnus

    2012-08-01

    The present study investigates the relationship between individual differences, indicated by personality (FFM) and general mental ability (GMA), and job performance applying two different methods of correction for range restriction. The results, derived by analyzing meta-analytic correlations, show that the more accurate method of correcting for indirect range restriction increased the operational validity of individual differences in predicting job performance and that this increase primarily was due to general mental ability being a stronger predictor than any of the personality traits. The estimates for single traits can be applied in practice to maximize prediction of job performance. Further, differences in the relative importance of general mental ability in relation to overall personality assessment methods was substantive and the estimates provided enables practitioners to perform a correct utility analysis of their overall selection procedure. © 2012 The Authors. Scandinavian Journal of Psychology © 2012 The Scandinavian Psychological Associations.

  14. Ability of aphasic individuals to perform numerical processing and calculation tasks

    Directory of Open Access Journals (Sweden)

    Gabriela De Luccia

    2014-03-01

    Full Text Available Objective To compare performance on EC301 battery calculation task between aphasic subjects and normal controls of the same sex, age, and education. Method Thirty-two aphasic patients who had suffered a single left hemisphere stroke were evaluated. Forty-four healthy volunteers were also selected. All subjects underwent a comprehensive arithmetic battery to assess their numerical and calculation skills. Performances on numerical processing and calculation tasks were then analyzed. Results Aphasic individuals showed changes in their ability to perform numerical processing and calculation tasks that were not observed in the healthy population. Conclusion Compared with healthy subjects of the same age and education level, individuals with aphasia had difficulty performing various tasks that involved numerical processing and calculation.

  15. Physicians' obligations in radiation issues

    International Nuclear Information System (INIS)

    Loken, M.K.

    1986-01-01

    Physicians have responsibilities to develop effective radiation programs that will (1) protect the public's physical and emotional health, (2) prevent and/or minimize illnesses and injury, and (3) treat and rehabilitate all exposed individuals. To accomplish these goals, physicians should understand the basic elements of radiation physics, radiation biology, benefit/risk, radiation regulations, nuclear power production, and world energy needs

  16. Palliative Care Physicians' Attitudes Toward Patient Autonomy and a Good Death in East Asian Countries.

    Science.gov (United States)

    Morita, Tatsuya; Oyama, Yasuhiro; Cheng, Shao-Yi; Suh, Sang-Yeon; Koh, Su Jin; Kim, Hyun Sook; Chiu, Tai-Yuan; Hwang, Shinn-Jang; Shirado, Akemi; Tsuneto, Satoru

    2015-08-01

    Clarification of the potential differences in end-of-life care among East Asian countries is necessary to provide palliative care that is individualized for each patient. The aim was to explore the differences in attitude toward patient autonomy and a good death among East Asian palliative care physicians. A cross-sectional survey was performed involving palliative care physicians in Japan, Taiwan, and Korea. Physicians' attitudes toward patient autonomy and physician-perceived good death were assessed. A total of 505, 207, and 211 responses were obtained from Japanese, Taiwanese, and Korean physicians, respectively. Japanese (82%) and Taiwanese (93%) physicians were significantly more likely to agree that the patient should be informed first of a serious medical condition than Korean physicians (74%). Moreover, 41% and 49% of Korean and Taiwanese physicians agreed that the family should be told first, respectively; whereas 7.4% of Japanese physicians agreed. Physicians' attitudes with respect to patient autonomy were significantly correlated with the country (Japan), male sex, physician specialties of surgery and oncology, longer clinical experience, and physicians having no religion but a specific philosophy. In all 12 components of a good death, there were significant differences by country. Japanese physicians regarded physical comfort and autonomy as significantly more important and regarded preparation, religion, not being a burden to others, receiving maximum treatment, and dying at home as less important. Taiwanese physicians regarded life completion and being free from tubes and machines as significantly more important. Korean physicians regarded being cognitively intact as significantly more important. There are considerable intercountry differences in physicians' attitudes toward autonomy and physician-perceived good death. East Asia is not culturally the same; thus, palliative care should be provided in a culturally acceptable manner for each country

  17. Effects of sweeteners on individual feed intake characteristics and performance in group-housed weanling pigs

    NARCIS (Netherlands)

    Sterk, A.R.; Schlegel, P.; Mul, A.J.; Ubbink-Blanksma, M.; Bruininx, E.M.A.M.

    2008-01-01

    To assess the effects of 2 high intensity sodium saccharine based sweeteners on individual feed intake characteristics and performance of group-housed weaned pigs, 198 26-d-old weanling pigs were given ad libitum access to 3 dietary treatments: containing no additional sweetener (Control), 150 mg

  18. The Effects of Diversity Management on Job Satisfaction and Individual Performance of Teachers

    Science.gov (United States)

    Ordu, Aydan

    2016-01-01

    In this research, the effects of teachers' perceptions of the diversity management on their job satisfaction and individual performance were examined. Teachers who are working in public high schools during 2014 to 2015 academic year constituted the study group of the research. The data of the research in which quantitative method used were…

  19. Effects of Individual Characteristics on Expatriates' Adjustment and Job Performance

    Science.gov (United States)

    Bhatti, Muhammad Awais; Kaur, Sharan; Battour, Mohamed Mohamed

    2013-01-01

    Purpose: Researchers have been focusing on the predictors of expatriates' adjustment and job performance at different levels (individual level, organizational level and societal level), but still some of the predictors have been ignored or unclear in the expatriate literature. The purpose of this paper is to develop a comprehensive framework…

  20. The Impact of Individual, Competitive, and Collaborative Mathematics Game Play on Learning, Performance, and Motivation

    Science.gov (United States)

    Plass, Jan L.; O'Keefe, Paul A.; Homer, Bruce D.; Case, Jennifer; Hayward, Elizabeth O.; Stein, Murphy; Perlin, Ken

    2013-01-01

    The present research examined how mode of play in an educational mathematics video game impacts learning, performance, and motivation. The game was designed for the practice and automation of arithmetic skills to increase fluency and was adapted to allow for individual, competitive, or collaborative game play. Participants (N = 58) from urban…

  1. When and why creativity-related conflict with coworkers can hamper creative employees' individual job performance

    NARCIS (Netherlands)

    Janssen, Onne; Giebels, Ellen

    2013-01-01

    We examined when and why focal employees' creativity-related conflict with coworkers is related to their individual job performance. As hypothesized, a survey among 113 employees in 14 manufacturing work groups showed that creativity-related conflict with coworkers escalates into dysfunctional

  2. The Best and the Rest: Revisiting the Norm of Normality of Individual Performance

    Science.gov (United States)

    O'Boyle, Ernest, Jr.; Aguinis, Herman

    2012-01-01

    We revisit a long-held assumption in human resource management, organizational behavior, and industrial and organizational psychology that individual performance follows a Gaussian (normal) distribution. We conducted 5 studies involving 198 samples including 633,263 researchers, entertainers, politicians, and amateur and professional athletes.…

  3. SPSP Phase III Recruiting, Selecting, and Developing Secure Power Systems Professionals. Individual and Team Performance Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    O' Neil, Lori Ross [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Conway, T. J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Tobey, D. H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Greitzer, Frank L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Dalton, Angela C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pusey, Portia K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-03-01

    The Secure Power Systems Professional Phase III final report was released last year which an appendix of Individual and Team Performance Guidelines. This new report is that appendix broken out as a standalone document to assist utilities in recruiting and developing Secure Power Systems Professionals at their site.

  4. A method to evaluate performance reliability of individual subjects in laboratory research applied to work settings.

    Science.gov (United States)

    1978-10-01

    This report presents a method that may be used to evaluate the reliability of performance of individual subjects, particularly in applied laboratory research. The method is based on analysis of variance of a tasks-by-subjects data matrix, with all sc...

  5. Identification of the Predictive Power of Five Factor Personality Traits for Individual Instrument Performance Anxiety

    Science.gov (United States)

    Özdemir, Gökhan; Dalkiran, Esra

    2017-01-01

    This study, with the aim of identifying the predictive power of the five-factor personality traits of music teacher candidates on individual instrument performance anxiety, was designed according to the relational screening model. The study population was students attending the Music Education branch of Fine Arts Education Departments in…

  6. Individual Differences Influencing Immediate Effects of Internal and External Focus Instructions on Children's Motor Performance.

    Science.gov (United States)

    van Abswoude, Femke; Nuijen, Nienke B; van der Kamp, John; Steenbergen, Bert

    2018-06-01

    A large pool of evidence supports the beneficial effect of an external focus of attention on motor skill performance in adults. In children, this effect has been studied less and results are inconclusive. Importantly, individual differences are often not taken into account. We investigated the role of working memory, conscious motor control, and task-specific focus preferences on performance with an internal and external focus of attention in children. Twenty-five children practiced a golf putting task in both an internal focus condition and external focus condition. Performance was defined as the average distance toward the hole in 3 blocks of 10 trials. Task-specific focus preference was determined by asking how much effort it took to apply the instruction in each condition. In addition, working memory capacity and conscious motor control were assessed. Children improved performance in both the internal focus condition and external focus condition (ŋ p 2  = .47), with no difference between conditions (ŋ p 2  = .01). Task-specific focus preference was the only factor moderately related to the difference between performance with an internal focus and performance with an external focus (r = .56), indicating better performance for the preferred instruction in Block 3. Children can benefit from instruction with both an internal and external focus of attention to improve short-term motor performance. Individual, task-specific focus preference influenced the effect of the instructions, with children performing better with their preferred focus. The results highlight that individual differences are a key factor in the effectiveness in children's motor performance. The precise mechanisms underpinning this effect warrant further research.

  7. Cognitive performance patterns in healthy individuals with substantia nigra hyperechogenicity and early Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Rezzak Yilmaz

    2016-11-01

    Full Text Available Introduction: Hyperechogenicity of the substantia nigra (SN+ is a risk marker for Parkinson’s disease (PD which can be detected before the diagnosis. In healthy individuals, SN+ has been associated with slight deficits in specific cognitive functions, suggesting cognitive impairment as a possible pre-diagnostic marker for PD. However, the pattern of cognitive deficits associated with SN+ has not yet been compared with those present in PD.Methods: Data of 262 healthy individuals with normal echogenicity (SN- and 48 healthy individuals with SN+ were compared with 82 early stage PD patients using the Consortium to Establish a Registry for Alzheimer’s disease test battery. First, the test clusters (factors were identified using a principal component analysis (PCA. Mean group performance of cognitive tests belonging to distinct factors, according to the PCA, and single subtest performances were compared using analyses of variance. Second, the number of individuals with abnormal cognitive performances (z-score <-1.0 were compared between groups. Results: Verbal memory, semantic and executive function, and praxis were identified as components of cognitive performances. The SN+ group performed significantly worse than the SN- group in tests assessing semantic and executive function, with a non-significant decrease in verbal memory. On the subtest level, individuals of the SN+ group scored significantly lower than the SN- group on the Boston Naming Test (BNT (p=0.008. In all subtests, the percentages of PD patients with values below the cut-off for abnormal performance were higher than in the SN- group. Moreover, more individuals from the SN+ group scored below the cut-off in the BNT (SN-=8.4%, SN+=20.8%, p=0.01 and TMT-B (SN-=6.9%, SN+=16.7%, p=0.02, compared to the SN- group. Conclusion: This study confirms poorer performance of healthy individuals with SN+ compared to SN- in specific cognitive domains. However, against the SN- group, the cognitive

  8. Deferred Personal Life Decisions of Women Physicians.

    Science.gov (United States)

    Bering, Jamie; Pflibsen, Lacey; Eno, Cassie; Radhakrishnan, Priya

    2018-05-01

    Inadequate work-life balance can have significant implications regarding individual performance, retention, and on the future of the workforce in medicine. The purpose of this study was to determine whether women physicians defer personal life decisions in pursuit of their medical career. We conducted a survey study of women physicians ages 20-80 from various medical specialties using a combination of social media platforms and women physicians' professional listservs with 801 survey responses collected from May through November 2015. The primary endpoint was whether women physicians deferred personal life decisions in pursuit of their medical career. Secondary outcomes include types of decisions deferred and correlations with age, hours worked per week, specialty, number of children, and career satisfaction. Respondents were categorized into deferred and nondeferred groups. Personal decision deferments were reported by 64% of respondents. Of these, 86% reported waiting to have children and 22% reported waiting to get married. Finally, while 85% of women in the nondeferment group would choose medicine again as a career, only 71% of women in the deferment group would do so (p job satisfaction, and insurance/administrative burden. The results of this survey have significant implications on the future of the workforce in medicine. Overall, our analysis shows that 64% of women physicians defer important life decisions in pursuit of their medical career. With an increase in the number of women physicians entering the workforce, lack of support and deferred personal decisions have a potential negative impact on individual performance and retention. Employers must consider the economic impact and potential workforce shortages that may develop if these issues are not addressed.

  9. A monitoring tool for performance improvement in plastic surgery at the individual level.

    Science.gov (United States)

    Maruthappu, Mahiben; Duclos, Antoine; Orgill, Dennis; Carty, Matthew J

    2013-05-01

    The assessment of performance in surgery is expanding significantly. Application of relevant frameworks to plastic surgery, however, has been limited. In this article, the authors present two robust graphic tools commonly used in other industries that may serve to monitor individual surgeon operative time while factoring in patient- and surgeon-specific elements. The authors reviewed performance data from all bilateral reduction mammaplasties performed at their institution by eight surgeons between 1995 and 2010. Operative time was used as a proxy for performance. Cumulative sum charts and exponentially weighted moving average charts were generated using a train-test analytic approach, and used to monitor surgical performance. Charts mapped crude, patient case-mix-adjusted, and case-mix and surgical-experience-adjusted performance. Operative time was found to decline from 182 minutes to 118 minutes with surgical experience (p factors is essential for correct interpretation of performance in plastic surgery at the individual surgeon level. Cumulative sum and exponentially weighted moving average charts represent accurate methods of monitoring operative time to control and potentially improve surgeon performance over the course of a career.

  10. Driven by fear: the effect of success and failure information on passionate individuals' performance.

    Science.gov (United States)

    Bélanger, Jocelyn J; Lafrenière, Marc-André K; Vallerand, Robert J; Kruglanski, Arie W

    2013-01-01

    Four studies investigated the impact of success and failure information on passionate individuals' performance. Obsessive passion, characterized by a rigid and defensive mode of functioning, predicted greater performance in domains both related and unrelated to the passionate activity in response to exposure to failure information. Conversely, harmonious passion, characterized by a flexible, nondefensive mode of functioning, was found to be unaffected by success or failure information. These performance effects were deeply ingrained, did not require conscious thought, and were automatically activated after unconscious exposure to failure-related words. In addition, the present research evinced that following failure information, obsessive passion predicted increases of performance through its effect on fear of failure. However, performance augmented only when the performance task was framed in such a way that failure would entail important negative consequences for the self and not when framed as inconsequential.

  11. Type of High School Predicts Academic Performance at University Better than Individual Differences.

    Science.gov (United States)

    Banai, Benjamin; Perin, Višnja

    2016-01-01

    Psychological correlates of academic performance have always been of high relevance to psychological research. The relation between psychometric intelligence and academic performance is one of the most consistent and well-established findings in psychology. It is hypothesized that intelligence puts a limit on what an individual can learn or achieve. Moreover, a growing body of literature indicates a relationship between personality traits and academic performance. This relationship helps us to better understand how an individual will learn or achieve their goals. The aim of this study is to further investigate the relationship between psychological correlates of academic performance by exploring the potentially moderating role of prior education. The participants in this study differed in the type of high school they attended. They went either to gymnasium, a general education type of high school that prepares students specifically for university studies, or to vocational school, which prepares students both for the labour market and for further studies. In this study, we used archival data of psychological testing during career guidance in the final year of high school, and information about the university graduation of those who received guidance. The psychological measures included intelligence, personality and general knowledge. The results show that gymnasium students had greater chances of performing well at university, and that this relationship exceeds the contribution of intelligence and personality traits to university graduation. Moreover, psychological measures did not interact with type of high school, which indicates that students from different school types do not profit from certain individual characteristics.

  12. Meeting the Imperative to Improve Physician Well-being: Assessment of an Innovative Program

    Science.gov (United States)

    Arnetz, Bengt B.; Christensen, John F.; Homer, Louis

    2007-01-01

    BACKGROUND Improving physician health and performance is critical to successfully meet the challenges facing health systems that increasingly emphasize productivity. Assessing long-term efficacy and sustainability of programs aimed at enhancing physician and organizational well-being is imperative. OBJECTIVE To determine whether data-guided interventions and a systematic improvement process to enhance physician work-life balance and organizational efficacy can improve physician and organizational well-being. DESIGN AND PARTICIPANTS From 2000 to 2005, 22–32 physicians regularly completed 3 questionnaires coded for privacy. Results were anonymously reported to physicians and the organization. Data-guided interventions to enhance physician and organizational well-being were built on physician control over the work environment, order in the clinical setting, and clinical meaning. MEASUREMENTS Questionnaires included an ACP/ASIM survey on physician satisfaction, the Maslach Burnout Inventory (MBI), and the Quality Work Competence (QWC) survey. RESULTS Emotional and work-related exhaustion decreased significantly over the study period (MBI, p = 0.002; QWC, p = 0.035). QWC measures of organizational health significantly improved initially and remained acceptable and stable during the rest of the study. CONCLUSIONS A data-guided program on physician well-being, using validated instruments and process improvement methods, enhanced physician and organizational well-being. Given the increases in physician burnout, organizations are encouraged to urgently create individual and systems approaches to lessen burnout risk. PMID:17891503

  13. Meeting the imperative to improve physician well-being: assessment of an innovative program.

    Science.gov (United States)

    Dunn, Patrick M; Arnetz, Bengt B; Christensen, John F; Homer, Louis

    2007-11-01

    Improving physician health and performance is critical to successfully meet the challenges facing health systems that increasingly emphasize productivity. Assessing long-term efficacy and sustainability of programs aimed at enhancing physician and organizational well-being is imperative. To determine whether data-guided interventions and a systematic improvement process to enhance physician work-life balance and organizational efficacy can improve physician and organizational well-being. From 2000 to 2005, 22-32 physicians regularly completed 3 questionnaires coded for privacy. Results were anonymously reported to physicians and the organization. Data-guided interventions to enhance physician and organizational well-being were built on physician control over the work environment, order in the clinical setting, and clinical meaning. Questionnaires included an ACP/ASIM survey on physician satisfaction, the Maslach Burnout Inventory (MBI), and the Quality Work Competence (QWC) survey. Emotional and work-related exhaustion decreased significantly over the study period (MBI, p = 0.002; QWC, p = 0.035). QWC measures of organizational health significantly improved initially and remained acceptable and stable during the rest of the study. A data-guided program on physician well-being, using validated instruments and process improvement methods, enhanced physician and organizational well-being. Given the increases in physician burnout, organizations are encouraged to urgently create individual and systems approaches to lessen burnout risk.

  14. Longitudinal intra- and inter-individual variability in young swimmers' performance and determinant competition factors

    Directory of Open Access Journals (Sweden)

    Jorge Estrela Morais

    2014-09-01

    Full Text Available The main purpose of this study was to follow-up the intra- and inter-individual variability of young swimmers' performance and determinant factors over two competitive seasons. Thirty young swimmers (14 boys: 12.33±0.65 years-old; 16 girls: 11.15±0.55 years-old were followed-up throughout two consecutive seasons (seven evaluation moments. Performance (100m freestyle, anthropometric, kinematic, hydrodynamic and efficiency features were evaluated. A gender and skill-level effect was observed. Boys improved in a higher amount (% comparing to girls. Overall, swimmers in skill-level 2 (both genders presented a higher intra-individual variability. Performance and anthropometrics showed a significant inter-individual variability in most moments, but hydrodynamics, kinematics and efficiency did not. Within each skill-level hydrodynamics, kinematics and efficiency were the variables that showed a high inter-individual variability. As a gender and skill-level effect was noticed in an age-group of young swimmers, coaches and practitioners should put the focus in specific and customized training plans for each skill-level of swimmers.

  15. Teori Adult Learning, Ekspriental Learning Cycle Dan Perubahan Performance Individu Dalam Pendidikan Dan Pelatihan

    Directory of Open Access Journals (Sweden)

    Moh. Dannur

    2017-07-01

    Full Text Available Teori belajar merupakan hal yang sangat penting dalam Manajmen Pendidikan dan Pelatihan apabila ingin meraih hasil yang maksimal dalam proses transformasi pengetahuan. Adult Learning dan Ekspriental Learning Cycle salah satu teori yang paling masyhur di dalamnya. Dalam upaya meraih hasil yang maksimal juga perlu adanya pengetahuan tentang motivasi dan faktor-faktor dalam pengembangan individu, perubahan performanya, serta dinamika individu kelompok. Sehingga dengan pengetahuan yang dimilikiakan dengan mudah merealisasikan yang diinginkan. Kata kunci: Adult learning, expriental learning cycle, performance.  Learning theory is very important in Management of Education and Training if you want to achieve the maximum results in the transformation process of knowledge. Adult Learning and Expriental Learning Cycle are the most famous theories within it. In the effort to achieve the maximum results also needs the knowledge about motivation, the factors in the development of individuals, the changes of performance, and the dynamics of individual groups. So with this knowledge you will easily realize the thing you desired. Keywords: Adult learning, expriental learning cycle, performance.

  16. Physician Compare National Downloadable File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Physician Compare National Downloadable File is organized at the individual eligible professional level; each line is unique at the professional/enrollment...

  17. Evaluation of performance of electronic dosimeters for individual monitoring: tests in laboratory

    International Nuclear Information System (INIS)

    Garzon, W.J.; Khoury, H.J.; Barros, V.S.M. de; Medeiros, R.B.

    2015-01-01

    Electronic dosimeters based on direct ion storage technology are being widely used in many countries for individual monitoring in many applications of ionizing radiation. However, their use as routine dosimeter has been established in a few countries due to lack of accreditation or intercomparison programs. The objective of this study is to evaluate the performance of two direct íon storage dosimeters model available in the international market: the Miriom-Instadose-1 and RADOS DIS-1 to be eventually accepted for individual monitoring in Brazil. (author)

  18. Superior sensory, motor, and cognitive performance in elderly individuals with multi-year dancing activities

    Directory of Open Access Journals (Sweden)

    Jan-Christoph Kattenstroth

    2010-07-01

    Full Text Available Aging is associated with a progressive decline of mental and physical abilities. Considering the current demographic changes in many civilizations there is an urgent need for measures permitting an independent lifestyle into old age. The critical role of physical exercise in mediating and maintaining physical and mental fitness is well-acknowledged. Dance, in addition to physical activity, combines emotions, social interaction, sensory stimulation, motor coordination and music, thereby creating enriched environmental conditions for human individuals. Here we demonstrate the impact of multi-year (average 16.5 years amateur dancing (AD in a group of elderly subjects (aged 65 to 84 years as compared to education-, gender- and aged-matched controls (CG having no record of dancing or sporting activities. Besides posture and balance parameters, we tested reaction times, motor behavior, tactile and cognitive performance. In each of the different domains investigated, the AD group had a superior performance as compared to the non-dancer CG group. Analysis of individual performance revealed that the best participants of the AD group were not better than individuals of the CG group. Instead, the AD group lacked individuals showing poor performance, which was frequently observed for the CG group. This observation implies that maintaining a regular schedule of dancing into old age can preserve cognitive, motor and perceptual abilities and prevent them from degradation. We conclude that the far-reaching beneficial effects found in the AD group make dance, beyond its ability to facilitate balance and posture, a prime candidate for the preservation of everyday life competence of elderly individuals.

  19. Effect of an EBM course in combination with case method learning sessions: an RCT on professional performance, job satisfaction, and self-efficacy of occupational physicians.

    Science.gov (United States)

    Hugenholtz, Nathalie I R; Schaafsma, Frederieke G; Nieuwenhuijsen, Karen; van Dijk, Frank J H

    2008-10-01

    An intervention existing of an evidence-based medicine (EBM) course in combination with case method learning sessions (CMLSs) was designed to enhance the professional performance, self-efficacy and job satisfaction of occupational physicians. A cluster randomized controlled trial was set up and data were collected through questionnaires at baseline (T0), directly after the intervention (T1) and 7 months after baseline (T2). The data of the intervention group [T0 (n = 49), T1 (n = 31), T2 (n = 29)] and control group [T0 (n = 49), T1 (n = 28), T2 (n = 28)] were analysed in mixed model analyses. Mean scores of the perceived value of the CMLS were calculated in the intervention group. The overall effect of the intervention over time comparing the intervention with the control group was statistically significant for professional performance (p Job satisfaction and self-efficacy changes were small and not statistically significant between the groups. The perceived value of the CMLS to gain new insights and to improve the quality of their performance increased with the number of sessions followed. An EBM course in combination with case method learning sessions is perceived as valuable and offers evidence to enhance the professional performance of occupational physicians. However, it does not seem to influence their self-efficacy and job satisfaction.

  20. Application of individually performed titanium mesh in infraorbital wall fracture reconstruction

    Directory of Open Access Journals (Sweden)

    Kai-Jian Sun

    2016-04-01

    Full Text Available AIM:To discuss the application effect of individually performed titanium mesh in infraorbital wall fracture reconstruction. METHODS:Sixty-seven patients(67 eyesdiagnosed as infraorbital fracture from January 2011 to February 2014 were performed reconstruction with individually performed titanium mesh. The recovery of incision, visual acuity, eyeball mobility, diplopia and proptosis were monitored by post-operation follow-up which lasted for 1a. RESULTS:No infection, titanium mesh transposition, prolapse, deformities, exclusion or ectropion were occurred in the follow-up period. The eyeball embole was less than 2mm by bilateral proptosis contrast. The diplopia in 5 eyes were disappeared in 4 and approved in one. The eyeball descent in 2 cases was disappeared. The visual acuity was the same compared with pre-operation. The rate of disappeared diplopia at primary position was 93% and improved significantly in the other 3 patients. The rate of disappeared diplopia at peripheral visual field was 86% and improved significantly in the other 2 patients.CONCLUSION:The reconstruction effect of individually performed titanium mesh in infraorbital wall fracture was satisfied and safe.

  1. TU-D-209-06: Head and Neck Tissue Dose From X-Ray Scatter to Physicians Performing Cardiovascular Procedures

    Energy Technology Data Exchange (ETDEWEB)

    Fetterly, K; Schueler, B; Grams, M [Mayo Clinic, Rochester, MN (United States); Sturchio, G [Mayo Clinic, Jacksonville, FL (United States)

    2016-06-15

    Purpose: The purpose of this work was to characterize the spatial distribution of scatter radiation to the head and neck of a physician performing an x-ray interventional procedure and assess brain, eye lens, and carotid artery dose. Methods: Radiographic x-ray beams were tuned to match the peak energy (56 to 106 keV) and HVL (3.5 to 6.5 mm Al) of x-ray scatter originating from a patient during a fluoroscopic procedure. The radiographic beam was directed upon a Rando phantom from an inferior-left location to mimic a typical patient-operator geometric relationship. A lead-equivalent protective garment was secured to the phantom. Direct exposure Gafchromic film (XRQA2) was placed between the transverse plane layers of the head and neck region of the phantom and exposed with 4 scatter-equivalent radiographic beams. A 3×3 cm{sup 2} film placed at the left collar of the phantom was used to monitor incident dose in the position of a radiation monitoring badge. The films were converted to 2D dose distribution maps using FilmQA Pro software and an Epson 11000-XL scanner. The 2D dose distributions maps were normalized by the left collar dose and the percent of left collar dose (%LCD) was calculated for select tissues. Results: The dose maps had high dynamic range (10{sub 4}) and spatial detail. Considering all transverse planes and 4 scatter beam qualities, the median %LCD values were: whole brain 8.5%, left brain 13%, right brain 5.4%, left eye lens 67%, right eye lens 25%, left carotid artery 72%, and right carotid artery 28%. Conclusion: Scatter radiation dose to an operator can be simulated using a tuned radiographic beam and used to expose a phantom and Gafchromic film, thereby creating detailed 2D dose distribution maps. This work facilitates individualized estimation of dose to select head and neck tissues based on an operator’s radiation monitoring badge value.

  2. Individual differences in object permanence performance at 8 months: locomotor experience and brain electrical activity.

    Science.gov (United States)

    Bell, M A; Fox, N A

    1997-12-01

    This work was designed to investigate individual differences in hands-and-knees crawling and frontal brain electrical activity with respect to object permanence performance in 76 eight-month-old infants. Four groups of infants (one prelocomotor and 3 with varying lengths of hands-and-knees crawling experience) were tested on an object permanence scale in a research design similar to that used by Kermoian and Campos (1988). In addition, baseline EEG was recorded and used as an indicator of brain development, as in the Bell and Fox (1992) longitudinal study. Individual differences in frontal and occipital EEG power and in locomotor experience were associated with performance on the object permanence task. Infants successful at A-not-B exhibited greater frontal EEG power and greater occipital EEG power than unsuccessful infants. In contrast to Kermoian and Campos (1988), who noted that long-term crawling experience was associated with higher performance on an object permanence scale, infants in this study with any amount of hands and knees crawling experience performed at a higher level on the object permanence scale than prelocomotor infants. There was no interaction among brain electrical activity, locomotor experience, and object permanence performance. These data highlight the value of electrophysiological research and the need for a brain-behavior model of object permanence performance that incorporates both electrophysiological and behavioral factors.

  3. An Integrated, Multifactorial Approach to Periodization for Optimal Performance in Individual and Team Sports.

    Science.gov (United States)

    Mujika, Iñigo; Halson, Shona; Burke, Louise M; Balagué, Gloria; Farrow, Damian

    2018-05-01

    Sports periodization has traditionally focused on the exercise aspect of athletic preparation, while neglecting the integration of other elements that can impact an athlete's readiness for peak competition performances. Integrated periodization allows the coordinated inclusion of multiple training components best suited for a given training phase into an athlete's program. The aim of this article is to review the available evidence underpinning integrated periodization, focusing on exercise training, recovery, nutrition, psychological skills, and skill acquisition as key factors by which athletic preparation can be periodized. The periodization of heat and altitude adaptation, body composition, and physical therapy is also considered. Despite recent criticism, various methods of exercise training periodization can contribute to performance enhancement in a variety of elite individual and team sports, such as soccer. In the latter, both physical and strategic periodization are useful tools for managing the heavy travel schedule, fatigue, and injuries that occur throughout a competitive season. Recovery interventions should be periodized (ie, withheld or emphasized) to influence acute and chronic training adaptation and performance. Nutrient intake and timing in relation to exercise and as part of the periodization of an athlete's training and competition calendar can also promote physiological adaptations and performance capacity. Psychological skills are a central component of athletic performance, and their periodization should cater to each athlete's individual needs and the needs of the team. Skill acquisition can also be integrated into an athlete's periodized training program to make a significant contribution to competition performance.

  4. The Comparison of Mental Rotation Performance in Team and Individual Sports of Students

    Directory of Open Access Journals (Sweden)

    Fatemeh Pasand

    2015-01-01

    Full Text Available As a practical and causal-comparative study, the present study was aimed at comparing the mental rotation performance in team and individual sports among students. The statistical population included all of the female and male athletes (N=1500 from different districts of Shiraz, Iran who participated in the sport clubs. The participants of this study included 240 students between 12-14 years old (120 girls and 120 boys who were selected randomly from four sport fields (Volleyball, Basketball, Karate, and Gymnastics. Finally, 30 athletes were selected from each field. The Mentrat Program, a kind of software for the Mental Rotation Test was used as an evaluation tool. Analyses of variance (ANOVA with repeated measures were conducted to analysis of data. The results indicated that the impact of the rotational angle was significant in both team and individual groups (p0.05. It was also observed that there was a significant difference between the mental rotation scores of the males in the individual groups contrary to the ones in the team groups (p<0.05. As a whole, it seems that as the rotational angle increases, the ability of the mental rotation in the individual fields of sport (males will be higher compared to the team groups. Keywords: Mental Rotation, Rotational Angle, Team and Individual Sports, Students

  5. External supports improve knee performance in anterior cruciate ligament reconstructed individuals with higher kinesiophobia levels.

    Science.gov (United States)

    Harput, Gulcan; Ulusoy, Burak; Ozer, Hamza; Baltaci, Gul; Richards, Jim

    2016-10-01

    The objectives of this study were to investigate the effects of knee brace (KB) and kinesiotaping (KT) on functional performance and self-reported function in individuals six months post-ACLR who desired to return to their pre-injury activity levels but felt unable to do so due to kinesiophobia. This was a cross-sectional study involving 30 individuals six months post-ACLR with Tampa Kinesiophobia Scores >37. Individuals were tested under three conditions: no intervention, KB and KT in a randomized order. Isokinetic concentric quadriceps and hamstring strength tests, one leg hop test, star excursion balance test and global rating scale were assessed under the three conditions. The involved side showed that KT and KB significantly increased the hop distance (P=0.01, P=0.04) and improved balance (P=0.01, P=0.04), respectively, but only KB was found to increase the quadriceps and hamstring peak torques compared to no intervention (P<0.05). Individuals reported having better knee function with KB when compared to no intervention (P<0.001) and KT (P=0.03). Both KB and KT have positive effects in individuals post-ACLR which may assist in reducing kinesiophobia when returning to their pre-injury activity levels, with the KB appearing to offer the participants better knee function compared to KT. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. [Influence of Nurses' Self-leadership on Individual and Team Members' Work Role Performance].

    Science.gov (United States)

    Kim, Se Young; Kim, Eun Kyung; Kim, Byungsoo; Lee, Eunpyo

    2016-06-01

    The purpose of this study was to examine correlations between nurses' self-leadership and individual work role performance and correlations between self-leadership in nursing units and team members' work role performance. Participants were 202 conveniently selected general nurses from 5 general hospitals in Korea. The study was carried out on 35 nursing units. Data were collected during February 2015 with self-report questionnaires. For factors affecting individual work role performance, self-expectation, self-goal setting, constructive thought, clinical career in the present nursing unit and marital status accounted for 44.0% of proficiency, while self-expectation, self-goal setting, constructive thought, and marital status accounted for 42.3% of adaptivity. Self-expectation, self-goal setting, constructive thought, self-reward, clinical career in the present nursing unit and position accounted for 26.4% of proactivity. In terms of team members' work role performance, self-reward and self-expectation in nursing units explained 29.0% of team members' proficiency. Self-reward and self-expectation in nursing units explained 31.6% of team members' adaptivity, and self-reward in nursing units explained 16.8% of team members' proactivity. The results confirm that nurses' self-leadership affects not only individual self-leadership but also team members' work role performance. Accordingly, to improve nurses' work role performance in nursing units of nursing organizations, improvement in nursing environment based on self-leadership education is necessary and nurses' tasks rearranged so they can appreciate work-autonomy and challenges of work.

  7. Cortical Brain Atrophy and Intra-Individual Variability in Neuropsychological Test Performance in HIV Disease

    Science.gov (United States)

    HINES, Lindsay J.; MILLER, Eric N.; HINKIN, Charles H.; ALGER, Jeffery R.; BARKER, Peter; GOODKIN, Karl; MARTIN, Eileen M.; MARUCA, Victoria; RAGIN, Ann; SACKTOR, Ned; SANDERS, Joanne; SELNES, Ola; BECKER, James T.

    2015-01-01

    Objective To characterize the relationship between dispersion-based intra-individual variability (IIVd) in neuropsychological test performance and brain volume among HIV seropositive and seronegative men and to determine the effects of cardiovascular risk and HIV infection on this relationship. Methods Magnetic Resonance Imaging (MRI) was used to acquire high-resolution neuroanatomic data from 147 men age 50 and over, including 80 HIV seropositive (HIV+) and 67 seronegative controls (HIV−) in this cross-sectional cohort study. Voxel Based Morphometry was used to derive volumetric measurements at the level of the individual voxel. These brain structure maps were analyzed using Statistical Parametric Mapping (SPM2). IIVd was measured by computing intra-individual standard deviations (ISD’s) from the standardized performance scores of five neuropsychological tests: Wechsler Memory Scale-III Visual Reproduction I and II, Logical Memory I and II, Wechsler Adult Intelligence Scale-III Letter Number Sequencing. Results Total gray matter (GM) volume was inversely associated with IIVd. Among all subjects, IIVd -related GM atrophy was observed primarily in: 1) the inferior frontal gyrus bilaterally, the left inferior temporal gyrus extending to the supramarginal gyrus, spanning the lateral sulcus; 2) the right superior parietal lobule and intraparietal sulcus; and, 3) dorsal/ventral regions of the posterior section of the transverse temporal gyrus. HIV status, biological, and cardiovascular disease (CVD) variables were not linked to IIVd -related GM atrophy. Conclusions IIVd in neuropsychological test performance may be a sensitive marker of cortical integrity in older adults, regardless of HIV infection status or CVD risk factors, and degree of intra-individual variability links with volume loss in specific cortical regions; independent of mean-level performance on neuropsychological tests. PMID:26303224

  8. The Relationship of Some Personality and Individual Characteristics with an Individual's Commitment to an Ideal Vision for Performance Improvement.

    Science.gov (United States)

    Watkins, Ryan

    2001-01-01

    Examined the relationship among specified personality and individual characteristics of university students with their level of commitment to a measurable, results-focused statement of an ideal vision. Discusses locus of control, generativity, self-efficacy, values, and risk taking in the use of an ideal vision for strategic planning, needs…

  9. Touch Screen Performance by Individuals With and Without Motor Control Disabilities

    Science.gov (United States)

    Chen, Karen B.; Savage, Anne B.; Chourasia, Amrish O.; Wiegmann, Douglas A.; Sesto, Mary E.

    2012-01-01

    Touch technology is becoming more prevalent as functionality improves and cost decreases. Therefore, it is important that this technology is accessible to users with diverse abilities. The objective of this study was to investigate the effects of button and gap size on performance by individuals with varied motor abilities. Participants with (n=38) and without (n=15) a motor control disability completed a digit entry task. Button size ranged from 10 to 30 mm and gap size was either 1 or 3 mm. Results indicated that as button size increased, there was a decrease in misses, errors, and time to complete tasks. Performance for the non-disabled group plateaued at button size 20mm, with minimal, if any gains observed with larger button sizes. In comparison, the disabled group’s performance continued to improve as button size increased. Gap size did not affect user performance. These results may help to improve accessibility of touch technology. PMID:23021630

  10. Portraying the Contribution of Individual Behaviors to Team Cohesion and Performance

    Science.gov (United States)

    Parke, Bonny; Orasanu, Judith

    2012-01-01

    Behaviors of individuals in teams both contribute to and are molded by team dynamics. How they do so has been the subject of much research. A method of portraying individuals' behaviors in teams, the Team Diagramming Method (TDM) is presented. Behaviors are rated by other team members on three important dimensions: positivity/negativity, dominant/submissive, and task-orientedness/expressiveness. A study of 5-person teams engaging in a 3-day moon simulation task demonstrated that measures of these perceived behaviors as well as the variances of these behaviors correlated with cohesion measures and performance. The method shows strengths and weaknesses of particular teams and, by comparison with high-performing teams, suggests interventions based on individual as well as team behaviors. The primary goal of this study was to determine the extent to which these team level variables, derived from all team members' rated behaviors, were associated with previous methods of measuring cohesion and with performance. A secondary goal was to determine the stability of TDM measures over time by comparing team level variables based on ratings early and later in the team s work together.

  11. Effects of Sleep Deprivation on Brain Bioenergetics, Sleep, and Cognitive Performance in Cocaine-Dependent Individuals

    Science.gov (United States)

    Trksak, George H.; Bracken, Bethany K.; Jensen, J. Eric; Plante, David T.; Penetar, David M.; Tartarini, Wendy L.; Maywalt, Melissa A.; Dorsey, Cynthia M.; Renshaw, Perry F.; Lukas, Scott E.

    2013-01-01

    In cocaine-dependent individuals, sleep is disturbed during cocaine use and abstinence, highlighting the importance of examining the behavioral and homeostatic response to acute sleep loss in these individuals. The current study was designed to identify a differential effect of sleep deprivation on brain bioenergetics, cognitive performance, and sleep between cocaine-dependent and healthy control participants. 14 healthy control and 8 cocaine-dependent participants experienced consecutive nights of baseline, total sleep deprivation, and recovery sleep in the research laboratory. Participants underwent [31]P magnetic resonance spectroscopy (MRS) brain imaging, polysomnography, Continuous Performance Task, and Digit Symbol Substitution Task. Following recovery sleep, [31]P MRS scans revealed that cocaine-dependent participants exhibited elevated global brain β-NTP (direct measure of adenosine triphosphate), α-NTP, and total NTP levels compared to those of healthy controls. Cocaine-dependent participants performed worse on the Continuous Performance Task and Digit Symbol Substitution Task at baseline compared to healthy control participants, but sleep deprivation did not worsen cognitive performance in either group. Enhancements of brain ATP levels in cocaine dependent participants following recovery sleep may reflect a greater impact of sleep deprivation on sleep homeostasis, which may highlight the importance of monitoring sleep during abstinence and the potential influence of sleep loss in drug relapse. PMID:24250276

  12. Callosotomy affects performance IQ: A meta-analysis of individual participant data.

    Science.gov (United States)

    Westerhausen, René; Karud, Celine M R

    2018-02-05

    Morphometric neuroimaging studies on healthy adult individuals regularly report a positive association between intelligence test performance (IQ) and structural properties of the corpus callosum (CC). At the same time, studies examining the effect of callosotomy on epilepsy patients report only negligible changes in IQ as result of the surgery, partially contradicting the findings of the morphometry studies. Objective of the present meta-analysis of individual participant data (IPD) of 87 cases from 16 reports was to re-investigate the effect of callosotomy on full scale IQ as well as on the verbal and performance subscale under special consideration of two possible moderating factors: pre-surgical IQ levels and the extent of the surgery (complete vs. anterior transsection). The main finding was that callosotomy selectively affects performance IQ, whereby the effect is modulated by the pre-surgical level of performance. Patients with an above-median pre-surgery performance IQ level show a significant average decrease of -5.44 (CI 95% : - 8.33 to - 2.56) IQ points following the surgery, while the below-median group does not reveal a significant change in IQ (mean change: 1.01 IQ points; CI 95% : -1.83 to 3.86). Thus, the present analyses support the notion that callosotomy has a negative effect on the patients' performance IQ, but only in those patients, who at least have an average performance levels before the surgery. This observation also lends support to the findings of previous morphometry studies, indicating that the frequently observed CC-IQ correlation might indeed reflect a functional contribution of callosal interhemispheric connectivity to intelligence-test performance. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  13. 20 CFR 410.686b - Fee for services performed for an individual before the Social Security Administration.

    Science.gov (United States)

    2010-04-01

    ... Representation of Parties § 410.686b Fee for services performed for an individual before the Social Security... person or in writing; (ii) There was a death or serious illness in the individual's family; (iii...

  14. Cognitive control over memory - individual differences in memory performance for emotional and neutral material.

    Science.gov (United States)

    Wierzba, M; Riegel, M; Wypych, M; Jednoróg, K; Grabowska, A; Marchewka, A

    2018-02-28

    It is widely accepted that people differ in memory performance. The ability to control one's memory depends on multiple factors, including the emotional properties of the memorized material. While it was widely demonstrated that emotion can facilitate memory, it is unclear how emotion modifies our ability to suppress memory. One of the reasons for the lack of consensus among researchers is that individual differences in memory performance were largely neglected in previous studies. We used the directed forgetting paradigm in an fMRI study, in which subjects viewed neutral and emotional words, which they were instructed to remember or to forget. Subsequently, subjects' memory of these words was tested. Finally, they assessed the words on scales of valence, arousal, sadness and fear. We found that memory performance depended on instruction as reflected in the engagement of the lateral prefrontal cortex (lateral PFC), irrespective of emotional properties of words. While the lateral PFC engagement did not differ between neutral and emotional conditions, it correlated with behavioural performance when emotional - as opposed to neutral - words were presented. A deeper understanding of the underlying brain mechanisms is likely to require a study of individual differences in cognitive abilities to suppress memory.

  15. Performance of Brazilian Companies: Year Effects, Line of Business and Individual Firms

    Directory of Open Access Journals (Sweden)

    Luiz Artur Ledur Brito

    2004-07-01

    Full Text Available Performance varies. This simple statement conceals many intricacies of strategic management. Because performance varies among individual firms, researchers can explore factors that differentiate these firms and explain why some firms are consistently outperforming others. Because performance varies among industries, researchers can explore structural characteristics of different branches of accounting as a source of explanation. Because performance varies with time, researchers can explore environmental and internal dynamic elements that drive strategic decision-making. In reality,measuring and analyzing performance is a very complicated issue when performance varies simultaneously from firm to firm, from industry to industry and from year to year. The theoretical discussion behind this question is the relative importance of the industrial organization derived approach to strategy versus the resource-based view. This paper analyzes the composition of performance variance of a set of Brazilian firms from 1998 to 2001. The results demonstrate that firm effects are still dominant, with year and industry effects being lower, as previous studies with North American firms have indicated.

  16. Individual styles of professional operator's performance for the needs of interplanetary mission.

    Science.gov (United States)

    Boritko, Yaroslav; Gushin, Vadim; Zavalko, Irina; Smoleevskiy, Alexandr; Dudukin, Alexandr

    Maintenance of the cosmonaut’s professional performance reliability is one of the priorities of long-term space flights safety. Cosmonaut’s performance during long-term space flight decreases due to combination of the microgravity effects and inevitable degradation of skills during prolonged breaks in training. Therefore, the objective of the elaboration of countermeasures against skill decrement is very relevant. During the experiment with prolonged isolation "Mars-500" in IMBP two virtual models of professional operator’s activities were used to investigate the influence of extended isolation, monotony and confinement on professional skills degradation. One is well-known “PILOT-1” (docking to the space station), another - "VIRTU" (manned operations of planet exploration). Individual resistance to the artificial sensory conflict was estimated using computerized version of “Mirror koordinograf” with GSR registration. Two different individual performance styles, referring to the different types of response to stress, have been identified. Individual performance style, called "conservative control", manifested in permanent control of parameters, conditions and results of the operator’s activity. Operators with this performance style demonstrate high reliability in performing tasks. The drawback of the style is intensive resource expenditure - both the operator (physiological "cost") and the technical system operated (fuel, time). This style is more efficient while executing tasks that require long work with high reliability required according to a detailed protocol, such as orbital flight. Individual style, called "exploratory ", manifested in the search of new ways of task fulfillment. This style is accompanied by partial, periodic lack of control of the conditions and result of operator’s activity due to flexible approach to the tasks perfect implementation. Operators spent less resource (fuel, time, lower physiological "cost") due to high self

  17. Effect of upper body plyometric training on physical performance in healthy individuals: A systematic review.

    Science.gov (United States)

    Singla, Deepika; Hussain, M Ejaz; Moiz, Jamal Ali

    2018-01-01

    To determine the impact of upper body plyometric training (UBPT) on physical performance parameters such as strength, ball throwing speed, ball throw distance and power in healthy individuals. PubMed, Scopus, ResearchGate and ERIC databases were searched up to August 2017. Selection of articles was done if they described the outcomes of an upper body plyometric exercise intervention; included measures of strength, ball throwing speed, ball throw distance, or power; included healthy individuals; used a randomized control trial; and had full text available in English language. The exclusion criteria were unpublished research work and clubbing of UBPT with some other type(s) of training apart from routine sports training. PEDro scale was used to rate the quality of studies eligible for this review. Initially 264 records were identified and out of them only 11 articles met the eligibility criteria and were selected (PEDro score = 4 to 6). Though large to very small effects observed in improving ball throwing velocity, ball throwing distance, power and strength of upper limb muscles after UBPT, the results should be implemented with caution. Inconclusive results obtained preclude any strong conclusion regarding the efficacy of UBPT on physical performance in healthy individuals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Impact of a poka-yoke device on job performance of individuals with cognitive impairments.

    Science.gov (United States)

    Erlandson, R F; Noblett, M J; Phelps, J A

    1998-09-01

    Job performance and production related issues are important not only to successful vocational training and ultimate job placement for individuals with cognitive disabilities, but also for their ability to have expanded vocational options. This study hypothesized that the application of Kaizen philosophy, and poka-yoke techniques in particular, could create job opportunities and improve productivity of individuals with cognitive disabilities. Poka-yoke or error-proofing techniques are part of the collection of Kaizen techniques. Kaizen refers to continuous improvement in performance, cost/effectiveness, and quality. Kaizen strives to empower the worker, increase worker satisfaction, facilitate a sense of accomplishment, and thereby create pride-of-work. These techniques typically reduce the physical and cognitive demands of a task and thereby render the task more accessible. The job was a fuel clamp assembly. A redesigned assembly fixture was the poka-yoke intervention. Consistent with poka-yoke principles, the intervention improved the productivity of everyone attempting the assembly. In particular, the workers in this study showed an 80% increase in productivity and an average percent error drop from 52% to about 1% after the process redesign. Furthermore, the workers showed improved morale, self-esteem, and pride-of-work. Prior to the process redesign, only the higher functioning workers could successfully perform the assembly. After the redesign a greater number of workers could successfully perform the assembly. These results not only validated the study hypothesis, but demonstrated that the success facilitated by applying Kaizen techniques had similar results with individuals with cognitive disabilities as with nondisabled workers.

  19. Prehospital anaesthesia performed by physician/critical care paramedic teams in a major trauma network in the UK: a 12 month review of practice.

    Science.gov (United States)

    McQueen, Carl; Crombie, Nicholas; Hulme, Jonathan; Cormack, Stef; Hussain, Nageena; Ludwig, Frank; Wheaton, Steve

    2015-01-01

    In the West Midlands region of the UK, delivery of pre-hospital care has been remodelled through introduction of a 24 h Medical Emergency Response Incident Team (MERIT). Teams including physicians and critical care paramedics (CCP) are deployed to incidents on land-based and helicopter-based platforms. Clinical practice, including delivery of rapid sequence induction of anaesthesia (RSI), is underpinned by standard operating procedures (SOP). This study describes the first 12 months experience of prehospital RSI in the MERIT scheme in the West Midlands. Retrospective review of the MERIT clinical database for the 12 months following the launch of the scheme. Data was collected relating to the number of RSIs performed; indication for RSI; number of intubation attempts; grade of view on laryngoscopy and the base speciality/grade of the operator performing intubation. MERIT teams were activated 1619 times, attending scene in 1029 cases. RSI was performed 142 times (13.80% of scene attendances). There was one recorded case of failure to intubate requiring insertion of a supraglottic airway device (0.70%). In over a third of RSI cases, CCPs performed laryngoscopy and intubation (n=53, 37.32%). Proficiency of obtaining Grade I view at laryngoscopy was similar for physicians (74.70%) and CCPs (77.36%). Intubation was successful at the first attempt in over 90% of cases. This study demonstrates that operation within a system that provides high levels of exposure, underpinned by comprehensive and robust training and governance frameworks, promotes levels of performance in successful prehospital RSI regardless of base speciality or profession. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. [Electronic and structural properties of individual nanometer-size supported metallic clusters]. Final performance report

    Energy Technology Data Exchange (ETDEWEB)

    Reifenberger, R.

    1993-09-01

    This report summarizes the work performed under contract DOE-FCO2-84ER45162. During the past ten years, our study of electron emission from laser-illuminated field emission tips has taken on a broader scope by addressing problems of direct interest to those concerned with the unique physical and chemical properties of nanometer-size clusters. The work performed has demonstrated that much needed data can be obtained on individual nanometer-size clusters supported on a wide-variety of different substrates. The work was performed in collaboration with R.P. Andres in the School of Chemical Engineering at Purdue University. The Multiple Expansion Cluster Source developed by Andres and his students was essential for producing the nanometer-size clusters studied. The following report features a discussion of these results. This report provides a motivation for studying the properties of nanometer-size clusters and summarizes the results obtained.

  1. The influence of schooling on working memory performance in elderly individuals without cognitive decline

    Directory of Open Access Journals (Sweden)

    Juliana Nery de Souza-Talarico

    Full Text Available Abstract Over recent decades, research on cognition has been developed rapidly toward better understanding the cognitive changes that usually occur during normal aging. There is evidence that elderly individuals have worse working memory performance than young adults. However, the effect of education on this cognitive function remains unclear. Objectives: To analyze the performance of healthy elderly subjects on working memory tasks and to verify the influence of educational level on this performance. Methods: Forty elderly individuals without cognitive impairment and fully independent, were randomly chosen from a group of subjects participating in cultural activities at the university campus. The Digit Span Forward (DSF test was used to evaluate attention performance. The working memory performance was assessed by the Digit Span Backward (DSB and the difference between DSF and DSB. The data were statistically analyzed using the Spearman's correlation coefficient to verify the correlation between the Digit Span (DS scores and the variables age and schooling, while the Multiple Linear Regression Model was used to verify the effect of these variables on the DS scores. Results: A significant positive correlation (r=0.41, p<0.01 as well as a significant association (b=0.506; p=0.001; CI 95%= 0.064/0.237 were found between years of schooling and DSB scores. It was not observed statistical correlation (r= -0.08, p=0.64 or association (b=0.41; p=0.775; CI 95%= -0.049/0.065 between age and DSB scores. Conclusion: In this study, higher levels of schooling were associated with better working memory performance in cognitively healthy elders.

  2. Performance of four computer-coded verbal autopsy methods for cause of death assignment compared with physician coding on 24,000 deaths in low- and middle-income countries

    Science.gov (United States)

    2014-01-01

    Background Physician-coded verbal autopsy (PCVA) is the most widely used method to determine causes of death (CODs) in countries where medical certification of death is uncommon. Computer-coded verbal autopsy (CCVA) methods have been proposed as a faster and cheaper alternative to PCVA, though they have not been widely compared to PCVA or to each other. Methods We compared the performance of open-source random forest, open-source tariff method, InterVA-4, and the King-Lu method to PCVA on five datasets comprising over 24,000 verbal autopsies from low- and middle-income countries. Metrics to assess performance were positive predictive value and partial chance-corrected concordance at the individual level, and cause-specific mortality fraction accuracy and cause-specific mortality fraction error at the population level. Results The positive predictive value for the most probable COD predicted by the four CCVA methods averaged about 43% to 44% across the datasets. The average positive predictive value improved for the top three most probable CODs, with greater improvements for open-source random forest (69%) and open-source tariff method (68%) than for InterVA-4 (62%). The average partial chance-corrected concordance for the most probable COD predicted by the open-source random forest, open-source tariff method and InterVA-4 were 41%, 40% and 41%, respectively, with better results for the top three most probable CODs. Performance generally improved with larger datasets. At the population level, the King-Lu method had the highest average cause-specific mortality fraction accuracy across all five datasets (91%), followed by InterVA-4 (72% across three datasets), open-source random forest (71%) and open-source tariff method (54%). Conclusions On an individual level, no single method was able to replicate the physician assignment of COD more than about half the time. At the population level, the King-Lu method was the best method to estimate cause-specific mortality

  3. Global precedence effects account for individual differences in both face and object recognition performance.

    Science.gov (United States)

    Gerlach, Christian; Starrfelt, Randi

    2018-03-20

    There has been an increase in studies adopting an individual difference approach to examine visual cognition and in particular in studies trying to relate face recognition performance with measures of holistic processing (the face composite effect and the part-whole effect). In the present study we examine whether global precedence effects, measured by means of non-face stimuli in Navon's paradigm, can also account for individual differences in face recognition and, if so, whether the effect is of similar magnitude for faces and objects. We find evidence that global precedence effects facilitate both face and object recognition, and to a similar extent. Our results suggest that both face and object recognition are characterized by a coarse-to-fine temporal dynamic, where global shape information is derived prior to local shape information, and that the efficiency of face and object recognition is related to the magnitude of the global precedence effect.

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

    Science.gov (United States)

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

    2014-03-01

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

  5. Dynamic working memory performance in individuals with single-domain amnestic mild cognitive impairment.

    Science.gov (United States)

    Guild, Emma B; Vasquez, Brandon P; Maione, Andrea M; Mah, Linda; Ween, Jon; Anderson, Nicole D

    2014-01-01

    Previous studies have observed poorer working memory performance in individuals with amnestic mild cognitive impairment than in healthy older adults. It is unclear, however, whether these difficulties are true only of the multiple-domain clinical subtype in whom poorer executive functioning is common. The current study examined working memory, as measured by the self-ordered pointing task (SOPT) and an n-back task, in healthy older adults and adults with single-domain amnestic mild cognitive impairment (aMCI). Individuals with single-domain aMCI committed more errors and required longer to develop an organizational strategy on the SOPT. The single-domain aMCI group did not differ from healthy older adults on the 1-back or 2-back, but had poorer discrimination on the 3-back task. This is, to our knowledge, the first characterization of dynamic working memory performance in a single-domain aMCI group. These results lend support for the idea that clinical amnestic MCI subtypes may reflect different stages on a continuum of progression to dementia and question whether standardized measures of working memory (span tasks) are sensitive enough to capture subtle changes in performance.

  6. Subjective overachievement: individual differences in self-doubt and concern with performance.

    Science.gov (United States)

    Oleson, K C; Poehlmann, K M; Yost, J H; Lynch, M E; Arkin, R M

    2000-06-01

    We discuss the construct of doubt about one's competence and suggest that doubt can have myriad consequences (e.g., self-handicapping, defensive pessimism). We focus on the effect of self-doubt when it is combined with a concern with performance and assert that this combination leads to the phenomenon of subjective overachievement. In two studies, we present a new 17-item Subjective Overachievement Scale (SOS), which includes two independent subscales measuring individual differences in self-doubt and concern with performance. The first study, consisting of two large samples (Ns = 2,311 and 1,703), provides evidence that the scale has high internal consistency and a clear two-factor structure. Additionally, the subscales have adequate test-retest reliability (Ns = 67 and 115). A second study reveals that the SOS has good convergent and discriminant validity. Both subscales are unrelated to social desirability but exhibit the predicted patterns of associations with other related constructs. The Concern with Performance Subscale is correlated with achievement motivation, whereas the Self-Doubt Subscale is correlated with scales assessing negative affectivity (e.g., self-esteem, social anxiety) and other self-related strategies associated with concerns about one's competence (e.g., self-handicapping, defensive pessimism, impostor phenomenon). The SOS, which combines the two subscales, appears to tap a unique strategy that individuals may use to deal with doubts about their own competence.

  7. Relationship between touch sensation of the affected hand and performance of valued activities in individuals with chronic stroke.

    Science.gov (United States)

    Hill, Valerie A; Fisher, Thomas; Schmid, Arlene A; Crabtree, Jeffrey; Page, Stephen J

    2014-01-01

    To investigate the association between touch sensation of the affected hand and performance and satisfaction with performance of valued activities in individuals with chronic stroke. Using a cross-sectional study design, this study correlated factors related to hand sensation and activity performance in individuals with chronic stroke. The Touch Test Evaluators and Canadian Occupational Performance Measure (COPM) were used. Correlations were used to determine the relationships between touch sensation of the affected hand and individuals' performance and satisfaction with performance of valued activities. There was a good to excellent relationship between sensation and performance and satisfaction with performance of valued activities for individuals with intact touch sensation of the affected hand who scored higher on the COPM. There was little to no relationship between touch sensation of the affected hand and performance of valued activities for individuals with impaired sensation. This is the first study to relate touch sensation of the affected hand and performance and satisfaction with performance of valued activities in individuals with stroke. The findings suggest that rehabilitation therapists need to continue to address sensory function in evaluation and intervention as it relates to performance in valued activities. This study serves as a foundation for future research in sensation and performance of valued activities in individuals with chronic stroke.

  8. Physicians and Insider Trading.

    Science.gov (United States)

    Kesselheim, Aaron S; Sinha, Michael S; Joffe, Steven

    2015-12-01

    Although insider trading is illegal, recent high-profile cases have involved physicians and scientists who are part of corporate governance or who have access to information about clinical trials of investigational products. Insider trading occurs when a person in possession of information that might affect the share price of a company's stock uses that information to buy or sell securities--or supplies that information to others who buy or sell--when the person is expected to keep such information confidential. The input that physicians and scientists provide to business leaders can serve legitimate social functions, but insider trading threatens to undermine any positive outcomes of these relationships. We review insider-trading rules and consider approaches to securities fraud in the health care field. Given the magnitude of the potential financial rewards, the ease of concealing illegal conduct, and the absence of identifiable victims, the temptation for physicians and scientists to engage in insider trading will always be present. Minimizing the occurrence of insider trading will require robust education, strictly enforced contractual provisions, and selective prohibitions against high-risk conduct, such as participation in expert consulting networks and online physician forums, by those individuals with access to valuable inside information.

  9. Individually adapted imagery improves brain-computer interface performance in end-users with disability.

    Science.gov (United States)

    Scherer, Reinhold; Faller, Josef; Friedrich, Elisabeth V C; Opisso, Eloy; Costa, Ursula; Kübler, Andrea; Müller-Putz, Gernot R

    2015-01-01

    Brain-computer interfaces (BCIs) translate oscillatory electroencephalogram (EEG) patterns into action. Different mental activities modulate spontaneous EEG rhythms in various ways. Non-stationarity and inherent variability of EEG signals, however, make reliable recognition of modulated EEG patterns challenging. Able-bodied individuals who use a BCI for the first time achieve - on average - binary classification performance of about 75%. Performance in users with central nervous system (CNS) tissue damage is typically lower. User training generally enhances reliability of EEG pattern generation and thus also robustness of pattern recognition. In this study, we investigated the impact of mental tasks on binary classification performance in BCI users with central nervous system (CNS) tissue damage such as persons with stroke or spinal cord injury (SCI). Motor imagery (MI), that is the kinesthetic imagination of movement (e.g. squeezing a rubber ball with the right hand), is the "gold standard" and mainly used to modulate EEG patterns. Based on our recent results in able-bodied users, we hypothesized that pair-wise combination of "brain-teaser" (e.g. mental subtraction and mental word association) and "dynamic imagery" (e.g. hand and feet MI) tasks significantly increases classification performance of induced EEG patterns in the selected end-user group. Within-day (How stable is the classification within a day?) and between-day (How well does a model trained on day one perform on unseen data of day two?) analysis of variability of mental task pair classification in nine individuals confirmed the hypothesis. We found that the use of the classical MI task pair hand vs. feed leads to significantly lower classification accuracy - in average up to 15% less - in most users with stroke or SCI. User-specific selection of task pairs was again essential to enhance performance. We expect that the gained evidence will significantly contribute to make imagery-based BCI technology

  10. Individually adapted imagery improves brain-computer interface performance in end-users with disability.

    Directory of Open Access Journals (Sweden)

    Reinhold Scherer

    Full Text Available Brain-computer interfaces (BCIs translate oscillatory electroencephalogram (EEG patterns into action. Different mental activities modulate spontaneous EEG rhythms in various ways. Non-stationarity and inherent variability of EEG signals, however, make reliable recognition of modulated EEG patterns challenging. Able-bodied individuals who use a BCI for the first time achieve - on average - binary classification performance of about 75%. Performance in users with central nervous system (CNS tissue damage is typically lower. User training generally enhances reliability of EEG pattern generation and thus also robustness of pattern recognition. In this study, we investigated the impact of mental tasks on binary classification performance in BCI users with central nervous system (CNS tissue damage such as persons with stroke or spinal cord injury (SCI. Motor imagery (MI, that is the kinesthetic imagination of movement (e.g. squeezing a rubber ball with the right hand, is the "gold standard" and mainly used to modulate EEG patterns. Based on our recent results in able-bodied users, we hypothesized that pair-wise combination of "brain-teaser" (e.g. mental subtraction and mental word association and "dynamic imagery" (e.g. hand and feet MI tasks significantly increases classification performance of induced EEG patterns in the selected end-user group. Within-day (How stable is the classification within a day? and between-day (How well does a model trained on day one perform on unseen data of day two? analysis of variability of mental task pair classification in nine individuals confirmed the hypothesis. We found that the use of the classical MI task pair hand vs. feed leads to significantly lower classification accuracy - in average up to 15% less - in most users with stroke or SCI. User-specific selection of task pairs was again essential to enhance performance. We expect that the gained evidence will significantly contribute to make imagery-based BCI

  11. Physician Networks and Ambulatory Care-sensitive Admissions.

    Science.gov (United States)

    Casalino, Lawrence P; Pesko, Michael F; Ryan, Andrew M; Nyweide, David J; Iwashyna, Theodore J; Sun, Xuming; Mendelsohn, Jayme; Moody, James

    2015-06-01

    Research on the quality and cost of care traditionally focuses on individual physicians or medical groups. Social network theory suggests that the care a patient receives also depends on the network of physicians with whom a patient's physician is connected. The objectives of the study are: (1) identify physician networks; (2) determine whether the rate of ambulatory care-sensitive hospital admissions (ACSAs) varies across networks--even different networks at the same hospital; and (3) determine the relationship between ACSA rates and network characteristics. We identified networks by applying network detection algorithms to Medicare 2008 claims for 987,000 beneficiaries in 5 states. We estimated a fixed-effects model to determine the relationship between networks and ACSAs and a multivariable model to determine the relationship between network characteristics and ACSAs. We identified 417 networks. Mean size: 129 physicians; range, 26-963. In the fixed-effects model, ACSA rates varied significantly across networks: there was a 46% difference in rates between networks at the 25th and 75th performance percentiles. At 95% of hospitals with admissions from 2 networks, the networks had significantly different ACSA rates; the mean difference was 36% of the mean ACSA rate. Networks with a higher percentage of primary-care physicians and networks in which patients received care from a larger number of physicians had higher ACSA rates. Physician networks have a relationship with ACSAs that is independent of the physicians in the network. Physician networks could be an important focus for understanding variations in medical care and for intervening to improve care.

  12. Improved reading performance using individualized compensation filters for observers with losses in central vision

    Science.gov (United States)

    Lawton, Teri B.

    1989-01-01

    A method to improve the reading performance of subjects with losses in central vision is proposed in which the amplitudes of the intermediate spatial frequencies are boosted relative to the lower spatial frequencies. In the method, words are filtered using an image enhancement function which is based on a subject's losses in visual function relative to a normal subject. It was found that 30-70 percent less magnification was necessary, and that reading rates were improved 2-3 times, using the method. The individualized compensation filters improved the clarity and visibility of words. The shape of the enhancement function was shown to be important in determining the optimum compensation filter for improving reading performance.

  13. Potential contributions of training intensity on locomotor performance in individuals with chronic stroke.

    Science.gov (United States)

    Holleran, Carey L; Rodriguez, Kelly S; Echauz, Anthony; Leech, Kristan A; Hornby, T George

    2015-04-01

    Many interventions can improve walking ability of individuals with stroke, although the training parameters that maximize recovery are not clear. For example, the contribution of training intensity has not been well established and may contribute to the efficacy of many locomotor interventions. The purpose of this preliminary study was to evaluate the effects of locomotor training intensity on walking outcomes in individuals with gait deficits poststroke. Using a randomized cross-over design, 12 participants with chronic stroke (>6-month duration) performed either high-intensity (70%-80% of heart rate reserve; n = 6) or low-intensity (30%-40% heart rate reserve; n = 6) locomotor training for 12 or fewer sessions over 4 to 5 weeks. Four weeks following completion, the alternate training intervention was performed. Training intensity was manipulated by adding loads or applying resistance during walking, with similar speeds, durations, and amount of stepping practice between conditions. Greater increases in 6-Minute Walk Test performance were observed following high-intensity training compared with low-intensity training. A significant interaction of intensity and order was also observed for 6-Minute Walk Test and peak treadmill speed, with the largest changes in those who performed high-intensity training first. Moderate correlations were observed between locomotor outcomes and measures of training intensity. This study provides the first evidence that the intensity of locomotor practice may be an important independent determinant of walking outcomes poststroke. In the clinical setting, the intensity of locomotor training can be manipulated in many ways, although this represents only 1 parameter to consider.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A90).

  14. Assessing physician job satisfaction and mental workload.

    Science.gov (United States)

    Boultinghouse, Oscar W; Hammack, Glenn G; Vo, Alexander H; Dittmar, Mary Lynne

    2007-12-01

    Physician job satisfaction and mental workload were evaluated in a pilot study of five physicians engaged in a telemedicine practice at The University of Texas Medical Branch at Galveston Electronic Health Network. Several previous studies have examined physician satisfaction with specific telemedicine applications; however, few have attempted to identify the underlying factors that contribute to physician satisfaction or lack thereof. One factor that has been found to affect well-being and functionality in the workplace-particularly with regard to human interaction with complex systems and tasks as seen in telemedicine-is mental workload. Workload is generally defined as the "cost" to a person for performing a complex task or tasks; however, prior to this study, it was unexplored as a variable that influences physician satisfaction. Two measures of job satisfaction were used: The Job Descriptive Index and the Job In General scales. Mental workload was evaluated by means of the National Aeronautics and Space Administration Task Load Index. The measures were administered by means of Web-based surveys and were given twice over a 6-month period. Nonparametric statistical analyses revealed that physician job satisfaction was generally high relative to that of the general population and other professionals. Mental workload scores associated with the practice of telemedicine in this environment are also high, and appeared stable over time. In addition, they are commensurate with scores found in individuals practicing tasks with elevated information-processing demands, such as quality control engineers and air traffic controllers. No relationship was found between the measures of job satisfaction and mental workload.

  15. The effect of additional joint mobilization on neuromuscular performance in individuals with functional ankle instability.

    Science.gov (United States)

    Shih, Yi-Fen; Yu, Hsiang-Ting; Chen, Wen-Yin; Liao, Kwong-Kum; Lin, Hsiu-Chen; Yang, Yea-Ru

    2018-03-01

    To examine the effects of joint mobilization and exercise training on neuromuscular performance in individuals with functional ankle instability (FAI). A cross-sectional study. Forty five subjects with FAI were randomized into three groups: control (CG, n = 15, 27.9 ± 6.6yr), training (TG, n = 15, 26.9 ± 5.8yr) and mobilization with training group (MTG, n = 15, 26.5 ± 4.8yr). Four weeks of neuromuscular training for TG; neuromuscular training and joint mobilization for MTG. Electromyography of the peroneus longus (PL), tibialis anterior (TA), and soleus (SOL) and the reaching distance of the Y balance test (YBT), dorsiflexion range of motion (DFROM), Cumberland ankle instability tool (CAIT), and global rating scale (GRS). Two-way repeated measures MANOVA were used with the significance level p Joint mobilization resulted in additional benefits on self-reported ankle instability severity, dorsiflexion mobility, and posterolateral balance performance in individuals with FAI, but its effects on general improvement, muscle activation, and other balance tasks remained uncertain. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Ethical principles for physician rating sites.

    Science.gov (United States)

    Strech, Daniel

    2011-12-06

    During the last 5 years, an ethical debate has emerged, often in public media, about the potential positive and negative effects of physician rating sites and whether physician rating sites created by insurance companies or government agencies are ethical in their current states. Due to the lack of direct evidence of physician rating sites' effects on physicians' performance, patient outcomes, or the public's trust in health care, most contributions refer to normative arguments, hypothetical effects, or indirect evidence. This paper aims, first, to structure the ethical debate about the basic concept of physician rating sites: allowing patients to rate, comment, and discuss physicians' performance, online and visible to everyone. Thus, it provides a more thorough and transparent starting point for further discussion and decision making on physician rating sites: what should physicians and health policy decision makers take into account when discussing the basic concept of physician rating sites and its possible implications on the physician-patient relationship? Second, it discusses where and how the preexisting evidence from the partly related field of public reporting of physician performance can serve as an indicator for specific needs of evaluative research in the field of physician rating sites. This paper defines the ethical principles of patient welfare, patient autonomy, physician welfare, and social justice in the context of physician rating sites. It also outlines basic conditions for a fair decision-making process concerning the implementation and regulation of physician rating sites, namely, transparency, justification, participation, minimization of conflicts of interest, and openness for revision. Besides other issues described in this paper, one trade-off presents a special challenge and will play an important role when deciding about more- or less-restrictive physician rating sites regulations: the potential psychological and financial harms for

  17. Mechanisms underlying the bioindicator notion: spatial association between individual sexual performance and community diversity.

    Directory of Open Access Journals (Sweden)

    Paola Laiolo

    Full Text Available The bioindicator notion is an appealing concept that has received more support in applied than in basic ecology, mostly due to the difficulty in deriving general ecological rules applicable to all target organisms. However, recognizing the mechanisms that determine the association between a particular species and the well-being of many other species is important for understanding the functioning of ecosystems and the relationship among different biological levels. We examined here the processes at the individual level that cause an association between species performance and biodiversity value, by analyzing attributes that can be studied in a variety of animals with sexual reproduction, namely breeding site selection and condition-dependent sexual signals. Our study model was the Capercaillie, an indicator of forest functioning and diversity, and the associated bird community, used here as a surrogate of broader forest biodiversity. At a regional scale Capercaillie occurrence was not associated with the most diverse forest patches, but at the scale of male spring territories the sexual display grounds (arenas were located in the oldest and less disturbed forest portions, which also hosted the richest local bird communities. Social mechanisms and conspecific cueing likely concurred with habitat-driven processes in determining the long-term persistence of traditional display grounds, which were appealing to many other species because of their structural composition. Characteristics of male vocal display that honestly advertize male quality (low frequencies and rapid song rates were significantly correlated with high diversity values, resulting in a spatial association between individual and community performances. Costly or risky activities such as reproductive or social behaviors, which more than other attributes match gradients in habitat quality, are therefore contributing to functionally connect individuals with ecosystem health.

  18. Intercomparison of performance characteristics of OSLDs and TLDs used for individual monitoring

    International Nuclear Information System (INIS)

    Meye, Phillipe Ondo

    2016-07-01

    This research work performed an intercomparison on some important performance characteristics of optically stimulated luminescence (OSL) and thermoluminescence (TL) dosimetry systems used by dosimetry services in Gabon and Ghana, respectively. The study verified the status of the selected performance indicators and propose ways to improve the performances of individual monitoring services of Ghana and Gabon if found necessary. The performance indicators assessed included the zero - dose, the minimum detectability and some important reader performance characteristics. These tests were performed using statistical and experimental methods. The overall uncertainty in measurement of the dosimetry systems of Ghana and Gabon for Hp(10) was determined using the IEC technical report TR 62461, and comparisons were carried out with IAEA 99, PTB 99, IEC 1066 and IEC1283 series performance standards. The IEC 62387 standard was used to assess the linearity dependence of the response and the coefficient of variation of the two dosimetry systems. For the Harshaw TLD 6600 system of the dosimetry service of Ghana, the Reference light QC test meets the requirement given in the user manual. For the OSL system microStar of the dosimetry system of Gabon, the three QC tests, DRK count, CAL count and LED count, meet the user manual requirements. However all these tests failed the statistical test that is part of counting statistics. This led to the conclusion that there may be some abnormalities in the counting system, and that the statistical abnormalities suspected have apparently no impact on the results of the reading. It was also concluded that since the DRK count and the CAL count failed the Chi - squared test by very small margin, a Gaussian distribution could still be considered as an approximation of the experimental data distributions of these two QC measurements. The zero dose for the Harshaw 6600 and the microStar system were found to be 0.026 mSv and 0.08 mSv respectively

  19. Acceleration performance of individual European sea bass Dicentrarchus labrax measured with a sprint performance chamber: comparison with high-speed cinematography and correlates with ecological performance.

    Science.gov (United States)

    Vandamm, Joshua P; Marras, Stefano; Claireaux, Guy; Handelsman, Corey A; Nelson, Jay A

    2012-01-01

    Locomotor performance can influence the ecological and evolutionary success of a species. For fish, favorable outcomes of predator-prey encounters are often presumably due to robust acceleration ability. Although escape-response or "fast-start" studies utilizing high-speed cinematography are prevalent, little is known about the contribution of relative acceleration performance to ecological or evolutionary success in a species. This dearth of knowledge may be due to the time-consuming nature of analyzing film, which imposes a practical limit on sample sizes. Herein, we present a high-throughput potential alternative for measuring fish acceleration performance using a sprint performance chamber (SPC). The acceleration performance of a large number of juvenile European sea bass (Dicentrarchus labrax) from two populations was analyzed. Animals from both hatchery and natural ontogenies were assessed, and animals of known acceleration ability had their ecological performance measured in a mesocosm environment. Individuals from one population also had their acceleration performance assessed by both high-speed cinematography and an SPC. Acceleration performance measured in an SPC was lower than that measured by classical high-speed video techniques. However, short-term repeatability and interindividual variation of acceleration performance were similar between the two techniques, and the SPC recorded higher sprint swimming velocities. Wild fish were quicker to accelerate in an SPC and had significantly greater accelerations than all groups of hatchery-raised fish. Acceleration performance had no significant effect on ecological performance (as assessed through animal growth and survival in the mesocosms). However, it is worth noting that wild animals did survive predation in the mesocosm better than farmed ones. Moreover, the hatchery-originated fish that survived the mesocosm experiment, when no predators were present, displayed significantly increased acceleration

  20. Level of training and experience in physicians performing interhospital transfers of adult patients in the internal medicine department

    DEFF Research Database (Denmark)

    Hallas, P; Folkestad, L; Brabrand, M

    2009-01-01

    AIM: To establish the level of training doctors who participate in interhospital transfers in Denmark. METHODS: A questionnaire was sent to every hospital department in Denmark with acute internal medicine admissions. RESULTS: Eighty-nine internal medicine departments were contacted and 84...... responded (response rate 94.4%). Of the 84 hospitals, 75 (89.3%) indicated that they perform interhospital transfers. Most transfers were performed by interns (61.3%) or senior house officers (10.7%) with only a few months' experience in their current speciality. Training in interhospital transfer...

  1. Effects of caffeine ingestion on endurance performance in mentally fatigued individuals.

    Science.gov (United States)

    Azevedo, Rafael; Silva-Cavalcante, Marcos David; Gualano, Bruno; Lima-Silva, Adriano E; Bertuzzi, Romulo

    2016-12-01

    To examine the effects of caffeine ingestion on physiological and perceptual responses in mentally fatigued individuals. Eight male physically active subjects completed four cycling constant-workload tests in four experimental conditions at 80 % of maximal power output: control (C), mental fatigue (MF), mental fatigue plus caffeine ingestion (5 mg/kg) (MF-CAF), and mental fatigue plus placebo (MF-PLA). The mental fatigue was induced by a continuous performance task A-X version (AX-CPT). Before and after the AX-CPT, the profile of mood state (POMS) and blood samples for lactate measurement were collected. Oxygen consumption ([Formula: see text]), rating of perceived exertion (RPE), and electromyography (EMG) activity were measured during the cycling test. The time to exhaustion in C, MF, MF-PLA, and MF-CAF were 251 ± 30, 222 ± 23, 248 ± 28, and 285 ± 42 s, respectively. Delta values (corrected by C condition) were higher in MF-CAF than MF (P = 0.031). MF-CAF reported higher Vigor scores when compared with C (P = 0.046) and MF (P = 0.020). RPE at the first minute was significantly higher in MF-PLA than in C (P = 0.050); at the second minute, RPE was higher in MF-PLA than in C (P = 0.049) and MF-CAF (P = 0.048). EMG activity was not different between the conditions. Caffeine ingestion increased approximately 14 % endurance performance after the induction of mental fatigue. This effect was accompanied by a tendency to improvement in mood state (i.e., vigor). Therefore, caffeine ingestion can promote a beneficial effect on endurance performance in mentally fatigued individuals.

  2. It Is Not Only Mentoring: The Combined Influences of Individual-Level and Team-Level Support on Job Performance

    Science.gov (United States)

    van Emmerik, I. J. Hetty

    2008-01-01

    Purpose: The paper aims to follow social exchange theory and group social capital theory, to predict positive relationships between (informal) mentoring and various support resources for two types of performance (i.e. perceptions of individual and team performance). Design/methodology/approach: The associations of individual-level mentoring and…

  3. Antecedents and Consequences of Individual Performance Analysis of Turnover Intention Model (Empirical Study of Public Accountants in Indonesia)

    OpenAIRE

    Raza, Hendra; Maksum, Azhar; Erlina; Lumban Raja, Prihatin

    2014-01-01

    Azhar Maksum This study aims to examine empirically the antecedents of individual performance on its consequences of turnover intention in public accounting firms. There are eight variables measured which consists of auditors' empowerment, innovation professionalism, role ambiguity, role conflict, organizational commitment, individual performance and turnover intention. Data analysis is based on 163 public accountant using the Structural Equation Modeling assisted with an appli...

  4. Individual recognition of social rank and social memory performance depends on a functional circadian system.

    Science.gov (United States)

    Müller, L; Weinert, D

    2016-11-01

    In a natural environment, social abilities of an animal are important for its survival. Particularly, it must recognize its own social rank and the social rank of a conspecific and have a good social memory. While the role of the circadian system for object and spatial recognition and memory is well known, the impact of the social rank and circadian disruptions on social recognition and memory were not investigated so far. In the present study, individual recognition of social rank and social memory performance of Djungarian hamsters revealing different circadian phenotypes were investigated. Wild type (WT) animals show a clear and well-synchronized daily activity rhythm, whereas in arrhythmic (AR) hamsters, the suprachiasmatic nuclei (SCN) do not generate a circadian signal. The aim of the study was to investigate putative consequences of these deteriorations in the circadian system for animalś cognitive abilities. Hamsters were bred and kept under standardized housing conditions with food and water ad libitum and a 14l/10 D lighting regimen. Experimental animals were assigned to different groups (WT and AR) according to their activity pattern obtained by means of infrared motion sensors. Before the experiments, the animals were given to develop a dominant-subordinate relationship in a dyadic encounter. Experiment 1 dealt with individual recognition of social rank. Subordinate and dominant hamsters were tested in an open arena for their behavioral responses towards a familiar (known from the agonistic encounters) or an unfamiliar hamster (from another agonistic encounter) which had the same or an opposite social rank. The investigation time depended on the social rank of the WT subject hamster and its familiarity with the stimulus animal. Both subordinate and dominant WT hamsters preferred an unfamiliar subordinate stimulus animal. In contrast, neither subordinate nor dominant AR hamsters preferred any of the stimulus animals. Thus, disruptions in circadian

  5. Feasibility of Using Individual Differences in Emotionality as Predictors of Job Performance

    National Research Council Canada - National Science Library

    Arvey, Richard

    1998-01-01

    .... Third, the authors develop a model of how individual differences in emotional expression, combined with organizational, occupational and job demands, influence the way individuals react to triggering...

  6. Individual performance evaluation of the Brazilian Nuclear Energy Commission (CNEN): a meta-evaluative study

    International Nuclear Information System (INIS)

    Bezerra, Leonardo Ferreira

    2017-01-01

    The present study is a summative meta-evaluation that had as objective to evaluate the quality of the process of evaluation of individual performance of the servers of the National Commission of Nuclear Energy, being guided by the scientific curiosity to know to what extent the evaluation of performance the National Commission for Nuclear Energy meets the quality standards disseminated by the Joint Committee on Standards for Educational Evaluation. The methodology chosen to be used was based on the management approach and had as a guiding principle of the study the elaboration of a framework of criteria considering the aforementioned standards. The criteria established in the criteria framework guided the preparation of the items of the questionnaire sent to the National Commission of Nuclear Energy servers. In addition to the questionnaire, the observation of this author was considered in the context where the phenomenon occurred, which allowed a better reflective analysis of the data collected by the questionnaire. Regarding the results, it can be inferred that the performance evaluation developed at the National Commission of Nuclear Energy can be considered of quality, highlighting the servers' trust for the data, the communication process of the program stages, the credibility of the evaluators, the process of negotiation of goals and adaptability of the instrument over the course of the cycle. However, there are some opportunities for improvement, considering the relevance of evaluation as a tool to improve the performance of the autarchy's servers. Among the points that need to be improved is that there is currently a lack of knowledge about the legal basis and justification of the process of evaluation process by the servers and the lack of clarity regarding the content of the final evaluation report. Among the recommendations of this study, one can consider as the most relevant the need to: disseminate the results of this meta-evaluation to the

  7. Quantifying individual performance in Cricket — A network analysis of batsmen and bowlers

    Science.gov (United States)

    Mukherjee, Satyam

    2014-01-01

    Quantifying individual performance in the game of Cricket is critical for team selection in International matches. The number of runs scored by batsmen and wickets taken by bowlers serves as a natural way of quantifying the performance of a cricketer. Traditionally the batsmen and bowlers are rated on their batting or bowling average respectively. However, in a game like Cricket it is always important the manner in which one scores the runs or claims a wicket. Scoring runs against a strong bowling line-up or delivering a brilliant performance against a team with a strong batting line-up deserves more credit. A player’s average is not able to capture this aspect of the game. In this paper we present a refined method to quantify the ‘quality’ of runs scored by a batsman or wickets taken by a bowler. We explore the application of Social Network Analysis (SNA) to rate the players in a team performance. We generate a directed and weighted network of batsmen-bowlers using the player-vs-player information available for Test cricket and ODI cricket. Additionally we generate a network of batsmen and bowlers based on the dismissal record of batsmen in the history of cricket-Test (1877-2011) and ODI (1971-2011). Our results show that M. Muralitharan is the most successful bowler in the history of Cricket. Our approach could potentially be applied in domestic matches to judge a player’s performance which in turn paves the way for a balanced team selection for International matches.

  8. The immediate effects of foot orthoses on functional performance in individuals with patellofemoral pain syndrome.

    Science.gov (United States)

    Barton, C J; Menz, H B; Crossley, K M

    2011-03-01

    Patellofemoral pain syndrome (PFPS) often results in reduced functional performance. There is growing evidence for the use of foot orthoses to treat this multifactorial condition. In this study, the immediate effects of foot orthoses on functional performance and the association of foot posture and footwear with improvements in function were evaluated. Fifty-two individuals with PFPS (18-35 years) were prescribed prefabricated foot orthoses (Vasyli Pro; Vasyli International, Labrador, Australia). Functional outcome measures evaluated included the change in (1) pain and (2) ease of a single-leg squat on a five-point Likert scale, and change in the number of (3) pain-free step downs and (4) single-leg rises from sitting. The association of foot posture using the Foot Posture Index, navicular drop and calcaneal angle relative to subtalar joint neutral; and the footwear motion control properties scale score with improved function were evaluated using Spearman's ρ statistics. Prefabricated foot orthoses produced significant improvements (psquat and improvements in the number of pain-free single-leg rises from sitting when wearing foot orthoses. In addition, a more pronated foot type was also found to be associated with improved ease of completing a single-leg squat when wearing foot orthoses. Prefabricated foot orthoses provide immediate improvements in functional performance, and these improvements are associated with a more pronated foot type and poorer footwear motion control properties.

  9. The Metabolic Syndrome Predicts Longitudinal Changes in Clock Drawing Test Performance in Older Nondemented Hypertensive Individuals.

    Science.gov (United States)

    Viscogliosi, Giovanni; Chiriac, Iulia Maria; Andreozzi, Paola; Ettorre, Evaristo

    2016-05-01

    The present study evaluated the metabolic syndrome (MetS) as independent predictor of 1-year longitudinal changes in cognitive function. 104 stroke- and dementia-free older hypertensive subjects were studied. MetS was defined by NCEP ATP-III criteria. Cognitive function was assessed by the Clock Drawing Test (CDT); 1-year changes in cognitive function were expressed as annual changes in CDT performance. Brain magnetic resonance imaging studies (1.5T) were performed. Participants with MetS exhibited greater cognitive decline than those without (-1.78 ± 1.47 versus -0.74 ± 1.44 CDT points, t = 3.348, df = 102, p < 0.001). MetS predicted cognitive decline (β = -0.327, t = -3.059, df = 96, p = 0.003) independently of its components, age, baseline cognition, neuroimaging findings, blood pressure levels, and duration of hypertension. With the exception of systolic blood pressure, none of the individual components of MetS explained 1-year changes in CDT performance. MetS as an entity predicted accelerated 1-year decline in cognitive function, assessed by CDT, in a sample of older hypertensive subjects. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  10. Identifying individual changes in performance with composite quality indicators while accounting for regression to the mean.

    Science.gov (United States)

    Gajewski, Byron J; Dunton, Nancy

    2013-04-01

    Almost a decade ago Morton and Torgerson indicated that perceived medical benefits could be due to "regression to the mean." Despite this caution, the regression to the mean "effects on the identification of changes in institutional performance do not seem to have been considered previously in any depth" (Jones and Spiegelhalter). As a response, Jones and Spiegelhalter provide a methodology to adjust for regression to the mean when modeling recent changes in institutional performance for one-variable quality indicators. Therefore, in our view, Jones and Spiegelhalter provide a breakthrough methodology for performance measures. At the same time, in the interests of parsimony, it is useful to aggregate individual quality indicators into a composite score. Our question is, can we develop and demonstrate a methodology that extends the "regression to the mean" literature to allow for composite quality indicators? Using a latent variable modeling approach, we extend the methodology to the composite indicator case. We demonstrate the approach on 4 indicators collected by the National Database of Nursing Quality Indicators. A simulation study further demonstrates its "proof of concept."

  11. Individual differences in media multitasking and performance on the n-back.

    Science.gov (United States)

    Ralph, Brandon C W; Smilek, Daniel

    2017-02-01

    A number of studies have recently examined the link between individual differences in media multitasking (using the MMI) and performance on working memory paradigms. However, these studies have yielded mixed results. Here we examine the relation between media multitasking and one particular working memory paradigm-the n-back (2- and 3-back)-improving upon previous research by (a) treating media multitasking as a continuous variable and adopting a correlational approach as well as (b) using a large sample of participants. First, we found that higher scores on the MMI were associated with a greater proportion of omitted trials on both the 2-back and 3-back, indicating that heavier media multitaskers were more disengaged during the n-back. In line with such a claim, heavier media multitaskers were also more likely to confess to responding randomly during various portions of the experiment, and to report media multitasking during the experiment itself. Importantly, when controlling for the relation between MMI scores and omissions, higher scores on the MMI were associated with an increase in false alarms, but not with a change in hits. These findings refine the extant literature on media multitasking and working memory performance (specifically, performance on the n-back), and suggest that media multitasking may be related to the propensity to disengage from ongoing tasks.

  12. Developing of Individual Instrument Performance Anxiety Scale: ValidityReliability Study

    Directory of Open Access Journals (Sweden)

    Esra DALKIRAN

    2016-07-01

    Full Text Available In this study, it is intended to develop a scale unique to our culture, concerning individual instrument performance anxiety of the students who are getting instrument training in the Department of Music Education. In the study, the descriptive research model is used and qualitative research techniques are utilized. The study population consists of the students attending the 23 universities which has Music Education Department. The sample of the study consists of 438 girls and 312 boys, totally 750 students who are studying in the Department of Music Education of randomly selected 10 universities. As a result of the explanatory and confirmatory factor analyses that were performed, a onedimensional structure consisting of 14 items was obtained. Also, t-scores and the coefficient scores of total item correlation concerning the distinguishing power of the items, the difference in the scores of the set of lower and upper 27% was calculated, and it was observed that the items are distinguishing as a result of both analyses. Of the scale, Cronbach's alpha coefficient of internal consistency was calculated as .94, and test-retest reliability coefficient was calculated as .93. As a result, a valid and reliable assessment and evaluation instrument that measures the exam performance anxiety of the students studying in the Department of Music Education, has been developed.

  13. Functional capacity evaluation of work performance among individuals with pelvic injuries following motor vehicle accidents.

    Science.gov (United States)

    Ratzon, Navah Z; Ari Shevil, Eynat Ben; Froom, Paul; Friedman, Sharon; Amit, Yehuda

    2013-01-01

    Pelvic injuries following motor vehicle accidents (MVA) cause disability and affect work capabilities. This study evaluated functional, self-report, and medical-based factors that could predict work capacity as was reflected in a functional capacity evaluation (FCE) among persons who sustained a pelvic injury. It was hypothesized that self-reported functional status and bio-demographic variables would predict work capacity. Sixty-one community-dwelling adults previously hospitalized following a MVA induced pelvic injury. FCE for work performance was conducted using the Physical Work Performance Evaluation (PWPE). Additional data was collected through a demographics questionnaire and the Functional Status Questionnaire. All participants underwent an orthopedic medical examination of the hip and lower extremities. Most participants self-reported that their work capacity post-injury were lower than their job required. PWPE scores indicated below-range functional performance. Regression models predicted 23% to 51% of PWPE subtests. Participants' self-report of functioning (instrumental activities of daily living and work) and bio-demographic variables (gender and age) were better predictors of PWPE scores than factors originating from the medical examination. Results support the inclusion of FCE, in addition to self-report of functioning and medical examination, to evaluate work capacity among individuals' post-pelvic injury and interventions and discharge planning.

  14. Safety study of 38 503 intravitreal ranibizumab injections performed mainly by physicians in training and nurses in a hospital setting

    DEFF Research Database (Denmark)

    Hasler, Pascal W; Bloch, Sara Brandi; Villumsen, Jørgen

    2015-01-01

    detachment from 2007 to 2012. RESULTS: Overall, 38,503 intravitreal ranibizumab injections were performed in 4623 eyes. Injections were performed by nurses (32.5%), ophthalmology residents (61.3%) and vitreoretinal surgeons (6.2%). Severe complications to treatment were observed in 17 eyes: Endophthalmitis...... (14 eyes, 0.36 ‰ of injections whereof seven cases were culture-positive), anterior uveitis (one eye, 0.026 ‰), traumatic cataract (one eye, 0.026 ‰) and rhegmatogenous retinal detachment (one eye, 0.026 ‰). Retinal pigment epithelial tears were registered in 14 eyes in 14 subjects within the first...... year of treatment with ranibizumab. Of the 14 cases of endophthalmitis, seven occurred within a period of 5 weeks in 2010 when occasionally abnormal needle outflow resistance prompted the needle replacement in the operating room. No drug-related adverse events were recorded. CONCLUSIONS: Intravitreal...

  15. The Effect of the Family Physician Program Implementation on the Monitoring of the Performance of Health and Treatment Centers and the Producing and Distribution of Healthy Water, Food and Cosmetics

    Directory of Open Access Journals (Sweden)

    Hossein Jabari Beyrami

    2015-07-01

    Full Text Available Background and Objectives : Family physician as the leader of health team is responsible for monitoring water quality, food and cosmetic preparation settings.  This study was carried out to determine the effect of family physician program on the performance of health centers in the mentioned processes in urban areas of East Azerbaijan, Iran. Materials and Methods : In this cross-sectional descriptive study, three health centers of the East Azerbaijan province were selected as samples and data were extracted from environmental health records files for water and sampling was used for food and cosmetic distributors for two periods of time: before and after implementing family physician plan. Data were analyzed using SPSS 16 software. Results : The results showed that monitoring of chlorine in drinking water was doubled and microbial sampling of water was increased one and a half time. Furthermore, the monitoring processes of health regulations in food and cosmetic preparation settings after implementing family physician program were improved. Conclusion : In spite of improvements in drinking water monitoring process after family physician program implementation, it is necessary to revise the family physician responsibilities and performance evaluation checklists in this section.

  16. Effects of lighting illuminance levels on stair negotiation performance in individuals with visual impairment.

    Science.gov (United States)

    Shaheen, Aliah F; Sourlas, Alexandros; Horton, Khim; McLean, Christopher; Ewins, David; Gould, David; Ghoussayni, Salim

    2018-04-01

    Stair-related falls of older people cause a substantial financial and social burden. Deterioration of the visual system amongst other factors put older people at a high risk of falling. Improved lighting is often recommended. The aim of this study was to investigate the effect of lighting illuminance on stair negotiation performance in older individuals with visual impairment. Eleven participants aged 60 or over with a vision of 6/18 or worse ascended and descended a staircase under: 50 lx, 100 lx, 200 lx, 300 lx and distributed 200 lx lighting. A motion capture system was used to measure movements of the lower limb. Clearance, clearance variability, temporal and spatial parameters and joint/segment kinematics were computed. There was no effect on clearance or clearance variability. Participants had lower speed, cadence, increased cycle time and stance time in the 50 lx compared to 300 lx and distributed 200 lx lighting in descent. The minimum hip angle in ascent was increased in the 200 lx lighting. Clearance was found to be moderately correlated with balance scores. Individuals with visual impairment adopt precautionary gait in dim lighting conditions. This does not always result in improvements in the parameters associated with risk of falling (e.g. clearance). Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Citation analysis as a measure of article quality, journal influence and individual researcher performance

    International Nuclear Information System (INIS)

    Nightingale, Julie M.; Marshall, Gill

    2012-01-01

    The research-related performance of universities, as well as that of individual researchers, is increasingly evaluated through the use of objective measures, or metrics, which seek to support or in some cases even replace more traditional methods of peer review. In particular there is a growing awareness in research communities, government organisations and funding bodies around the concept of using evaluation metrics to analyse research citations. The tools available for ‘citation analysis’ are many and varied, enabling a quantification of scientific quality, academic impact and prestige. However there is increasing concern regarding the potential misuse of such tools, which have limitations in certain research disciplines. This article uses ‘real world’ examples from radiography research and scholarship to illustrate the range of currently available citation analysis tools. It explores the academic debate surrounding their strengths and limitations, and identifies the potential impact of citation analysis on the radiography research community. The article concludes that citation analysis is a valuable tool for researchers to use for personal reflection and research planning, yet there are inherent dangers if it is used inappropriately. Whilst citation analysis can give objective information regarding an individual, research group, journal or higher education institution, it should not be used as a total substitute for traditional qualitative review and peer assessment.

  18. Reprint of "Citation analysis as a measure of article quality, journal influence and individual researcher performance".

    Science.gov (United States)

    Nightingale, Julie M; Marshall, Gill

    2013-09-01

    The research-related performance of universities, as well as that of individual researchers, is increasingly evaluated through the use of objective measures, or metrics, which seek to support or in some cases even replace more traditional methods of peer review. In particular there is a growing awareness in research communities, government organisations and funding bodies around the concept of using evaluation metrics to analyse research citations. The tools available for 'citation analysis' are many and varied, enabling a quantification of scientific quality, academic impact and prestige. However there is increasing concern regarding the potential misuse of such tools, which have limitations in certain research disciplines.This article uses 'real world' examples from radiography research and scholarship to illustrate the range of currently available citation analysis tools. It explores the academic debate surrounding their strengths and limitations, and identifies the potential impact of citation analysis on the radiography research community.The article concludes that citation analysis is a valuable tool for researchers to use for personal reflection and research planning, yet there are inherent dangers if it is used inappropriately. Whilst citation analysis can give objective information regarding an individual, research group, journal or higher education institution, it should not be used as a total substitute for traditional qualitative review and peer assessment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Key demands and characteristics of occupations performed by individuals with spinal cord injury living in Switzerland.

    Science.gov (United States)

    Nützi, M; Trezzini, B; Ronca, E; Schwegler, U

    2017-08-08

    Descriptive qualitative and quantitative study using cross-sectional data from the Swiss Spinal Cord Injury Cohort Study (SwiSCI). To determine the key demands and characteristics of occupations performed by individuals with spinal cord injury (SCI). Swiss community. Job titles indicated by SwiSCI participants were linked to occupational titles from the Occupational Information Network (O*NET) and then frequency-analyzed across sociodemographic and injury-related factors. Subsequently, average O*NET relevance values ranging from 0 to 100 were calculated for the occupations' demands and characteristics, both in general and stratified by injury-related factors. The 1549 study participants indicated a total of 717 job titles and were primarily employed in administrative and management occupations (22.1% and 16.4%, respectively). The participants' occupations predominantly required verbal abilities (average relevance [AR]=68.4) and complex problem solving skills (AR=55.8) and were characterized by conventional work tasks (AR=62.9) and social relationships (AR=58.6). Both the occupations' frequency distribution as well as the average relevance levels of their demands and characteristics differed by SCI severity. Individuals with SCI perform a broad range of occupations that are mainly characterized by cognitive and communicative demands, while physical demands are of minor importance. By informing the development of job matching profiles for vocational guidance, our study facilitates the determination of well-matching jobs for persons with SCI and may contribute to a more sustainable return to work of the affected persons.Spinal Cord advance online publication, 8 August 2017; doi:10.1038/sc.2017.84.

  20. Relationship between physical performance and self-reported function in healthy individuals across the lifespan.

    Science.gov (United States)

    Baldwin, Jennifer N; McKay, Marnee J; Hiller, Claire E; Moloney, Niamh; Nightingale, Elizabeth J; Burns, Joshua

    2017-08-01

    Functional outcome measures in clinical trials of musculoskeletal conditions need to be meaningful to individuals. To investigate the relationship between physical performance and self/proxy-reported function in 1000 healthy children and adults. Cross-sectional observational study (1000 Norms Project). One thousand males and females aged 3-101 years, healthy by self-report and without major physical disability, were recruited. Twelve performance-based tests were analysed: vertical and long jump, two hand dexterity tests, four balance tests, stepping reaction time, 30-second chair stand, timed up-and-down stairs, and six-minute walk. Self/proxy-reported function was assessed using the Infant-Toddler Quality of Life questionnaire, Child Health Questionnaire, Assessment of Quality of Life (AQoL)-6D Adolescent, AQoL-8D, International Physical Activity Questionnaire and work ability question. Bivariate and multivariate correlational analyses were constructed for infants (3-4y), children (5-10y), adolescents (11-17y), adults (18-59y) and older adults (60+). Socio-demographic characteristics were similar to the Australian population. Among infants/children, greater jump and sit-to-stand performance correlated with higher proxy-reported function (p  0.05). Greater jump, dexterity, balance, reaction time, sit-to-stand, stair-climbing and six-minute walk performance correlated with higher self-reported function in adults (r = -0.097 to.231; p physical measures which could form the basis of age-appropriate functional scales for clinical trials of musculoskeletal conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Evaluation of performance of electronic dosimeters for individual monitoring: tests in laboratory; Avaliacao do desempenho de dosimetros eletronicos para monitoracao individual: testes em laboratorio

    Energy Technology Data Exchange (ETDEWEB)

    Garzon, W.J.; Khoury, H.J.; Barros, V.S.M. de, E-mail: wjaramig@gmail.com [Universidade Federal de Pernambuco (UFPE), Recife (Brazil). Departamento de Energia Nuclear. Laboratorio de Metrologia das Radiacoes Ionizantes; Medeiros, R.B. [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Departamento de Diagnostico por Imagem

    2015-07-01

    Electronic dosimeters based on direct ion storage technology are being widely used in many countries for individual monitoring in many applications of ionizing radiation. However, their use as routine dosimeter has been established in a few countries due to lack of accreditation or intercomparison programs. The objective of this study is to evaluate the performance of two direct íon storage dosimeters model available in the international market: the Miriom-Instadose-1 and RADOS DIS-1 to be eventually accepted for individual monitoring in Brazil. (author)

  2. Peer-based control in self-managing teams: linking rational and normative influence with individual and group performance.

    Science.gov (United States)

    Stewart, Greg L; Courtright, Stephen H; Barrick, Murray R

    2012-03-01

    The authors use a multilevel framework to introduce peer-based control as a motivational state that emerges in self-managing teams. The authors specifically describe how peer-based rational control, which is defined as team members perceiving the distribution of economic rewards as dependent on input from teammates, extends and interacts with the more commonly studied normative control force of group cohesion to explain both individual and collective performance in teams. On the basis of data from 587 factory workers in 45 self-managing teams at 3 organizations, peer-based rational control corresponded with higher performance for both individuals and collective teams. Results further demonstrated that the rational and normative mechanism of peer-based control interacted to explain performance at both the individual and team levels. Increased peer-based rational control corresponded with higher individual and collective performance in teams with low cohesion, but the positive effects on performance were attenuated in cohesive teams.

  3. Staying on the job: The relationship between work performance and cognition in individuals diagnosed with multiple sclerosis.

    Science.gov (United States)

    Baughman, Brandon C; Basso, Michael R; Sinclair, Robert R; Combs, Dennis R; Roper, Brad L

    2015-01-01

    People with multiple sclerosis (MS) are apt to become unemployed as the disease progresses, and most research implies that this is due to diminishing mobility. Some studies have shown that presence of cognitive impairment also predicts employment status. Yet, no studies have examined how neuropsychological factors predict vocational performance among individuals with MS who remain employed. We assessed employer- and self-rated work performance, mobility status, and neuropsychological function in a sample of 44 individuals diagnosed with MS. Results suggest that cognitive impairment is common in these employed individuals, despite largely intact mobility status. Moreover, a significant interaction emerged, such that cognitively impaired individuals' work performance was rated more poorly by supervisors. In contrast, self-ratings of work performance were higher in cognitively impaired than in unimpaired participants. These novel findings suggest that cognitive impairment may influence work performance, even in patients whose physical disability status is relatively intact.

  4. Correlations among measures of knee stiffness, gait performance and complaints in individuals with knee osteoarthritis.

    Science.gov (United States)

    Oatis, Carol A; Wolff, Edward F; Lockard, Margery A; Michener, Lori A; Robbins, Steven J

    2013-03-01

    Stiffness is a common complaint in individuals with knee osteoarthritis and is a component of the osteoarthritis diagnosis. Yet the relationship between stiffness and function is poorly understood and methods to quantify stiffness are limited. Using a cross-sectional observational design with 66 subjects with knee osteoarthritis, stiffness and damping coefficients were calculated from a relaxed knee oscillation procedure. Gait parameters were measured using an electronic walkway. Self-reported pain, stiffness, and function were measured with the Western Ontario and McMaster Osteoarthritis Index. Correlation and Alexander's normalized-t approximation analyses were used to assess associations among the variables. Subset analysis was performed on subjects with and without tibiofemoral joint crepitus. Slight to moderate correlations existed between stiffness and damping coefficients and most gait parameters ((| r |=0.30-0.56; PMcMaster Osteoarthritis Index scores and all gait parameters (| r |=0.35-0.62; Pcoefficient was only slightly associated with patient-rated Western Ontario and McMaster Osteoarthritis Index stiffness subscale scores. Subset analysis revealed significant correlations that differed between those with and without crepitus. These findings suggest that laboratory measured stiffness and damping coefficients, Western Ontario and McMaster Osteoarthritis Index scores and gait-related measurements assess different aspects related to movement in individuals with knee osteoarthritis. Stiffness and damping coefficients may offer the ability to explain gait changes in the knee that are independent of a person's perceptions particularly in the early stages of the disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Early detection of poor adherers to statins: applying individualized surveillance to pay for performance.

    Directory of Open Access Journals (Sweden)

    Andrew J Zimolzak

    Full Text Available Medication nonadherence costs $300 billion annually in the US. Medicare Advantage plans have a financial incentive to increase medication adherence among members because the Centers for Medicare and Medicaid Services (CMS now awards substantive bonus payments to such plans, based in part on population adherence to chronic medications. We sought to build an individualized surveillance model that detects early which beneficiaries will fall below the CMS adherence threshold.This was a retrospective study of over 210,000 beneficiaries initiating statins, in a database of private insurance claims, from 2008-2011. A logistic regression model was constructed to use statin adherence from initiation to day 90 to predict beneficiaries who would not meet the CMS measure of proportion of days covered 0.8 or above, from day 91 to 365. The model controlled for 15 additional characteristics. In a sensitivity analysis, we varied the number of days of adherence data used for prediction.Lower adherence in the first 90 days was the strongest predictor of one-year nonadherence, with an odds ratio of 25.0 (95% confidence interval 23.7-26.5 for poor adherence at one year. The model had an area under the receiver operating characteristic curve of 0.80. Sensitivity analysis revealed that predictions of comparable accuracy could be made only 40 days after statin initiation. When members with 30-day supplies for their first statin fill had predictions made at 40 days, and members with 90-day supplies for their first fill had predictions made at 100 days, poor adherence could be predicted with 86% positive predictive value.To preserve their Medicare Star ratings, plan managers should identify or develop effective programs to improve adherence. An individualized surveillance approach can be used to target members who would most benefit, recognizing the tradeoff between improved model performance over time and the advantage of earlier detection.

  6. Removal of Negative Feedback Enhances WCST Performance for Individuals with ASD

    Science.gov (United States)

    Broadbent, Jaclyn; Stokes, Mark A.

    2013-01-01

    Negative feedback was explored as a potential mechanism that may exacerbate perseverative behaviours in individuals with Asperger's syndrome (AS). The current study compared 50 individuals with AS and 50 typically developing (TD) individuals for their abilities to successfully complete the Wisconsin Card Sorting Task (WCST) in the presence or…

  7. ASD Is Not DLI: Individuals With Autism and Individuals With Syntactic DLI Show Similar Performance Level in Syntactic Tasks, but Different Error Patterns.

    Science.gov (United States)

    Sukenik, Nufar; Friedmann, Naama

    2018-01-01

    Do individuals with autism have a developmental syntactic impairment, DLI (formerly known as SLI)? In this study we directly compared the performance of 18 individuals with Autism Spectrum Disorder (ASD) aged 9;0-18;0 years with that of 93 individuals with Syntactic-Developmental Language Impairment (SyDLI) aged 8;8-14;6 (and with 166 typically-developing children aged 5;2-18;1). We tested them using three syntactic tests assessing the comprehension and production of syntactic structures that are known to be sensitive to syntactic impairment: elicitation of subject and object relative clauses, reading and paraphrasing of object relatives, and repetition of complex syntactic structures including Wh questions, relative clauses, topicalized sentences, sentences with verb movement, sentences with A-movement, and embedded sentences. The results were consistent across the three tasks: the overall rate of correct performance on the syntactic tasks is similar for the children with ASD and those with SyDLI. However, once we look closer, they are very different. The types of errors of the ASD group differ from those of the SyDLI group-the children with ASD provide various types of pragmatically infelicitous responses that are not evinced in the SyDLI or in the age equivalent typically-developing groups. The two groups (ASD and SyDLI) also differ in the pattern of performance-the children with SyDLI show a syntactically-principled pattern of impairment, with selective difficulty in specific sentence types (such as sentences derived by movement of the object across the subject), and normal performance on other structures (such as simple sentences). In contrast, the ASD participants showed generalized low performance on the various sentence structures. Syntactic performance was far from consistent within the ASD group. Whereas all ASD participants had errors that can originate in pragmatic/discourse difficulties, seven of them had completely normal syntax in the structures we

  8. Relation Between Physicians' Work Lives and Happiness.

    Science.gov (United States)

    Eckleberry-Hunt, Jodie; Kirkpatrick, Heather; Taku, Kanako; Hunt, Ronald; Vasappa, Rashmi

    2016-04-01

    Although we know much about work-related physician burnout and the subsequent negative effects, we do not fully understand work-related physician wellness. Likewise, the relation of wellness and burnout to physician happiness is unclear. The purpose of this study was to examine how physician burnout and wellness contribute to happiness. We sampled 2000 full-time physician members of the American Academy of Family Physicians. Respondents completed a demographics questionnaire, questions about workload, the Physician Wellness Inventory, the Maslach Burnout Inventory, and the Subjective Happiness Scale. We performed a hierarchical regression analysis with the burnout and wellness subscales as predictor variables and physician happiness as the outcome variable. Our response rate was 22%. Career purpose, personal accomplishment, and perception of workload manageability had significant positive correlations with physician happiness. Distress had a significant negative correlation with physician happiness. A sense of career meaning and accomplishment, along with a lack of distress, are important factors in determining physician happiness. The number of hours a physician works is not related to happiness, but the perceived ability to manage workload was significantly related to happiness. Wellness-promotion efforts could focus on assisting physicians with skills to manage the workload by eliminating unnecessary tasks or sharing workload among team members, improving feelings of work accomplishment, improving career satisfaction and meaning, and managing distress related to patient care.

  9. The Relationship of Individual Difference and Group Process Variables with Self-Managed Team Performance: A Field Investigation

    National Research Council Canada - National Science Library

    Jordan, Mark

    2001-01-01

    The efficacy of dispositional individual difference team composition and group process variables in explaining team performance was examined for 1,030 military officers working in 92 teams over a 5-week period...

  10. Modeling the Direct and Indirect Determinants of Different Types of Individual Job Performance

    National Research Council Canada - National Science Library

    Johnson, Jeff W; Duehr, Emily E; Hezlett, Sarah A; Muros, John P; Ferstl, Kerri L

    2008-01-01

    Despite the importance of citizenship performance and adaptive performance to Army junior commissioned officer job performance, there has been very little published research studying these constructs...

  11. ASD Is Not DLI: Individuals With Autism and Individuals With Syntactic DLI Show Similar Performance Level in Syntactic Tasks, but Different Error Patterns

    Directory of Open Access Journals (Sweden)

    Nufar Sukenik

    2018-04-01

    Full Text Available Do individuals with autism have a developmental syntactic impairment, DLI (formerly known as SLI? In this study we directly compared the performance of 18 individuals with Autism Spectrum Disorder (ASD aged 9;0–18;0 years with that of 93 individuals with Syntactic-Developmental Language Impairment (SyDLI aged 8;8–14;6 (and with 166 typically-developing children aged 5;2–18;1. We tested them using three syntactic tests assessing the comprehension and production of syntactic structures that are known to be sensitive to syntactic impairment: elicitation of subject and object relative clauses, reading and paraphrasing of object relatives, and repetition of complex syntactic structures including Wh questions, relative clauses, topicalized sentences, sentences with verb movement, sentences with A-movement, and embedded sentences. The results were consistent across the three tasks: the overall rate of correct performance on the syntactic tasks is similar for the children with ASD and those with SyDLI. However, once we look closer, they are very different. The types of errors of the ASD group differ from those of the SyDLI group—the children with ASD provide various types of pragmatically infelicitous responses that are not evinced in the SyDLI or in the age equivalent typically-developing groups. The two groups (ASD and SyDLI also differ in the pattern of performance—the children with SyDLI show a syntactically-principled pattern of impairment, with selective difficulty in specific sentence types (such as sentences derived by movement of the object across the subject, and normal performance on other structures (such as simple sentences. In contrast, the ASD participants showed generalized low performance on the various sentence structures. Syntactic performance was far from consistent within the ASD group. Whereas all ASD participants had errors that can originate in pragmatic/discourse difficulties, seven of them had completely normal syntax

  12. Minimal detectable change of the Personal and Social Performance scale in individuals with schizophrenia.

    Science.gov (United States)

    Lee, Shu-Chun; Tang, Shih-Fen; Lu, Wen-Shian; Huang, Sheau-Ling; Deng, Nai-Yu; Lue, Wen-Chyn; Hsieh, Ching-Lin

    2016-12-30

    The minimal detectable change (MDC) of the Personal and Social Performance scale (PSP) has not yet been investigated, limiting its utility in data interpretation. The purpose of this study was to determine the MDCs of the PSP administered by the same rater or different raters in individuals with schizophrenia. Participants with schizophrenia were recruited from two psychiatric community rehabilitation centers to complete the PSP assessments twice, 2 weeks apart, by the same rater or 2 different raters. MDC values were calculated from the coefficients of intra- and inter-rater reliability (i.e., intraclass correlation coefficients). Forty patients (mean age 36.9 years, SD 9.7) from one center participated in the intra-rater reliability study. Another 40 patients (mean age 44.3 years, SD 11.1) from the other center participated in the inter-rater study. The MDCs (MDC%) of the PSP were 10.7 (17.1%) for the same rater and 16.2 (24.1%) for different raters. The MDCs of the PSP appeared appropriate for clinical trials aiming to determine whether a real change in social functioning has occurred in people with schizophrenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. The Effect of Cerebellar Transcranial Direct Current Stimulation on A Throwing Task Depends on Individual Level of Task Performance.

    Science.gov (United States)

    Mizuguchi, Nobuaki; Katayama, Takashi; Kanosue, Kazuyuki

    2018-02-10

    The effect of cerebellar transcranial direct current stimulation (tDCS) on motor performance remains controversial. Some studies suggest that the effect of tDCS depends upon task-difficulty and individual level of task performance. Here, we investigated whether the effect of cerebellar tDCS on the motor performance depends upon the individual's level of performance. Twenty-four naïve participants practiced dart throwing while receiving a 2-mA cerebellar tDCS for 20 min under three stimulus conditions (anodal-, cathodal-, and sham-tDCS) on separate days with a double-blind, counter-balanced cross-over design. Task performance was assessed by measuring the distance between the center of the bull's eye and the dart's position. Although task performance tended to improve throughout the practice under all stimulus conditions, improvement within a given day was not significant as compared to the first no-stimulus block. In addition, improvement did not differ among stimulation conditions. However, the magnitude of improvement was associated with an individual's level of task performance only under cathodal tDCS condition (p performance improvement only for the sub-group of participants with lower performance levels as compared to that with sham-tDCS (p task performance. Thus, cerebellar tDCS would facilitate learning of a complex motor skill task only in a subset of individuals. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

  14. Comparison of the quality of patient referrals from physicians, physician assistants, and nurse practitioners.

    Science.gov (United States)

    Lohr, Robert H; West, Colin P; Beliveau, Margaret; Daniels, Paul R; Nyman, Mark A; Mundell, William C; Schwenk, Nina M; Mandrekar, Jayawant N; Naessens, James M; Beckman, Thomas J

    2013-11-01

    To compare the quality of referrals of patients with complex medical problems from nurse practitioners (NPs), physician assistants (PAs), and physicians to general internists. We conducted a retrospective comparison study involving regional referrals to an academic medical center from January 1, 2009, through December 31, 2010. All 160 patients referred by NPs and PAs combined and a random sample of 160 patients referred by physicians were studied. Five experienced physicians blinded to the source of referral used a 7-item instrument to assess the quality of referrals. Internal consistency, interrater reliability, and dimensionality of item scores were determined. Differences between item scores for patients referred by physicians and those for patients referred by NPs and PAs combined were analyzed by using multivariate ordinal logistical regression adjusted for patient age, sex, distance of the referral source from Mayo Clinic, and Charlson Index. Factor analysis revealed a 1-dimensional measure of the quality of patient referrals. Interrater reliability (intraclass correlation coefficient for individual items: range, 0.77-0.93; overall, 0.92) and internal consistency for items combined (Cronbach α=0.75) were excellent. Referrals from physicians were scored higher (percentage of agree/strongly agree responses) than were referrals from NPs and PAs for each of the following items: referral question clearly articulated (86.3% vs 76.0%; P=.0007), clinical information provided (72.6% vs 54.1%; P=.003), documented understanding of the patient's pathophysiology (51.0% vs 30.3%; P<.0001), appropriate evaluation performed locally (60.3% vs 39.0%; P<.0001), appropriate management performed locally (53.5% vs 24.1%; P<.0001), and confidence returning patient to referring health care professional (67.8% vs 41.4%; P<.0001). Referrals from physicians were also less likely to be evaluated as having been unnecessary (30.1% vs 56.2%; P<.0001). The quality of referrals to an

  15. Physician burnout: contributors, consequences and solutions.

    Science.gov (United States)

    West, C P; Dyrbye, L N; Shanafelt, T D

    2018-06-01

    Physician burnout, a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse effects on patients, the healthcare workforce, costs and physician health exceed 50% in studies of both physicians-in-training and practicing physicians. This problem represents a public health crisis with negative impacts on individual physicians, patients and healthcare organizations and systems. Drivers of this epidemic are largely rooted within healthcare organizations and systems and include excessive workloads, inefficient work processes, clerical burdens, work-home conflicts, lack of input or control for physicians with respect to issues affecting their work lives, organizational support structures and leadership culture. Individual physician-level factors also play a role, with higher rates of burnout commonly reported in female and younger physicians. Effective solutions align with these drivers. For example, organizational efforts such as locally developed practice modifications and increased support for clinical work have demonstrated benefits in reducing burnout. Individually focused solutions such as mindfulness-based stress reduction and small-group programmes to promote community, connectedness and meaning have also been shown to be effective. Regardless of the specific approach taken, the problem of physician burnout is best addressed when viewed as a shared responsibility of both healthcare systems and individual physicians. Although our understanding of physician burnout has advanced considerably in recent years, many gaps in our knowledge remain. Longitudinal studies of burnout's effects and the impact of interventions on both burnout and its effects are needed, as are studies of effective solutions implemented in combination. For medicine to fulfil its mission for patients and for public health, all stakeholders

  16. The Moderating Effect of Psychological Empowerment on the Relationship between Network Centrality and Individual Job Performance

    Science.gov (United States)

    2012-03-22

    analysis, KMO equaled .75, which is above the acceptable limit of 0.5 (Kaiser, 1974). The KMO values for the individual items were greater than .61...factor loadings for PE after rotation. For OCB, the overall KMO equaled .81 and the KMO for the individual items were greater than .57, both above the...after rotation. For CWB, the overall KMO equaled .75; however, one of the individual factors was less than .50 (CWB4) and had to be removed from the

  17. The role of individualism and the Five-Factor Model in the prediction of performance in a leaderless group discussion.

    Science.gov (United States)

    Waldman, David A; Atwater, Leanne E; Davidson, Ronald A

    2004-02-01

    Personality has seen a resurgence in the work performance literature. The Five-Factor Model (FFM) represents a set of personality factors that has received the most attention in recent years. Despite its popularity, the FFM may not be sufficiently comprehensive to account for relevant variation across performance dimensions or tasks. Accordingly, the present study also considers how individualism may predict additional variance in performance beyond the FFM. The study involved 152 undergraduate students who experienced a leaderless group discussion (LGD) exercise. Results showed that while the FFM accounted for variance in students' LGD performance, individualism (independence) accounted for additional, unique variance. Furthermore, analyses of the group compositions revealed curvilinear relationships between the relative amount of extraversion, conscientiousness, and individualism in relation to group-level performance.

  18. Leadership development programs for physicians: a systematic review.

    Science.gov (United States)

    Frich, Jan C; Brewster, Amanda L; Cherlin, Emily J; Bradley, Elizabeth H

    2015-05-01

    Physician leadership development programs typically aim to strengthen physicians' leadership competencies and improve organizational performance. We conducted a systematic review of medical literature on physician leadership development programs in order to characterize the setting, educational content, teaching methods, and learning outcomes achieved. Articles were identified through a search in Ovid MEDLINE from 1950 through November 2013. We included articles that described programs designed to expose physicians to leadership concepts, outlined teaching methods, and reported evaluation outcomes. A thematic analysis was conducted using a structured data entry form with categories for setting/target group, educational content, format, type of evaluation and outcomes. We identified 45 studies that met eligibility criteria, of which 35 reported on programs exclusively targeting physicians. The majority of programs focused on skills training and technical and conceptual knowledge, while fewer programs focused on personal growth and awareness. Half of the studies used pre/post intervention designs, and four studies used a comparison group. Positive outcomes were reported in all studies, although the majority of studies relied on learner satisfaction scores and self-assessed knowledge or behavioral change. Only six studies documented favorable organizational outcomes, such as improvement in quality indicators for disease management. The leadership programs examined in these studies were characterized by the use of multiple learning methods, including lectures, seminars, group work, and action learning projects in multidisciplinary teams. Physician leadership development programs are associated with increased self-assessed knowledge and expertise; however, few studies have examined outcomes at a system level. Our synthesis of the literature suggests important gaps, including a lack of programs that integrate non-physician and physician professionals, limited use of more

  19. Assessing the Effects of Organizational Culture, Rewards, and Individual Creativity on Technical Workgroup Performance

    Science.gov (United States)

    Navaresse, Daniel O.; Yauch, Charlene A.; Goff, Kathy; Fonseca, Daniel J.

    2014-01-01

    This study used an experimental approach to investigate the conditions under which creative outcomes should be expected from the interplay of individual creativity, the innovation orientation of the organizational culture, and the rewards distribution rules. The results of this study suggest that the individual creativity of technically educated…

  20. The effects of environmental and individual quality on reproductive performance : A case study on blue tits

    NARCIS (Netherlands)

    Amininasab, Seyed Mehdi

    2016-01-01

    Birds have specific energetic requirements which likely depend on the habitat type they inhabit and on specific individual traits. Here, I investigated the effects of environmental quality (habitat quality and ambient temperature) and individual quality (age and/or lifespan) on features of

  1. Unlocking the forest inventory data: relating individual tree performance to unmeasured environmental factors

    Science.gov (United States)

    Jeremy W. Lichstein; Jonathan Dushoff; Kiona Ogle; Anping Chen; Drew W. Purves; John P. Caspersen; Stephen W. Pacala

    2010-01-01

    Geographically extensive forest inventories, such as the USDA Forest Service's Forest Inventory and Analysis (FIA) program, contain millions of individual tree growth and mortality records that could be used to develop broad-scale models of forest dynamics. A limitation of inventory data, however, is that individual-level measurements of light (L) and other...

  2. MODEL OF EMERGENCY DEPARTMENT NURSE PERFORMANCE IMPROVEMENT BASED ON ASSOCIATION OF INDIVIDUAL CHARACTERISTIC, ORGANIZATION CHARACTERISTIC AND JOB CHARACTERISTIC

    Directory of Open Access Journals (Sweden)

    Maria Margaretha Bogar

    2017-04-01

    Full Text Available Introduction: Nursing care is integral part of health care and having important role in management of patient with emergency condition. The purpose of this research was to develop nurse performance improvement model based on individual, organization and job characteristics association in Emergency Department of RSUD dr TC Hillers Maumere. Method: This was an explanative survey by cross sectional approach held on July -August 2012. Respondents in this study were 22 nurses and 44 patients were obtained by purposive sampling technique. Data were analyzed by partial least square test and signi fi cant t value > 1.64 (alpha 10%. Result: Results showed that individual characteristic had effect on nurse performance (t = 7.59, organization characteristic had effect on nurse performance (t = 2.03 and job characteristic didn’t have effect on nurse performance (t = 0.88. Nurse performance had effect on patient satisfaction (t = 6.54 but nurse satisfaction didn’t have effect on nurse performance (t = 1.31, and nurse satisfaction didn’t have effect either on patient satisfaction (t = 0.94. Discussion: This research concluded that individual characteristics which in fl uence nurse performance in nursing care were ability and skill, experience, age, sex, attitude and motivation. Organization characteristic that influence nurse performance was reward while job characteristic that include job design and feedback didn’t influence nurse performance in nursing care. Nurse performance influenced patient satisfaction but nurse satisfaction didn’t influence patient satisfaction and nurse performance.

  3. Inter-individual differences in how presentation modality affects verbal learning performance in children aged 5 to 16

    NARCIS (Netherlands)

    Meijs, Celeste; Hurks, Petra P M; Wassenberg, Renske; Feron, Frans J M; Jolles, Jelle

    2016-01-01

    This study examines inter-individual differences in how presentation modality affects verbal learning performance. Children aged 5 to 16 performed a verbal learning test within one of three presentation modalities: pictorial, auditory, or textual. The results indicated that a beneficial effect of

  4. Individual Feedback Propensities and Their Effects on Motivation, Training Success, and Performance

    National Research Council Canada - National Science Library

    Herols, David

    1997-01-01

    .... These propensities, if identified and measured, would be related to skill acquisition, performance improvement, self regulatory processes, performance maintenance, as well as a variety of affective...

  5. Speed and Lateral Inhibition of Stimulus Processing Contribute to Individual Differences in Stroop-Task Performance.

    Science.gov (United States)

    Naber, Marnix; Vedder, Anneke; Brown, Stephen B R E; Nieuwenhuis, Sander

    2016-01-01

    The Stroop task is a popular neuropsychological test that measures executive control. Strong Stroop interference is commonly interpreted in neuropsychology as a diagnostic marker of impairment in executive control, possibly reflecting executive dysfunction. However, popular models of the Stroop task indicate that several other aspects of color and word processing may also account for individual differences in the Stroop task, independent of executive control. Here we use new approaches to investigate the degree to which individual differences in Stroop interference correlate with the relative processing speed of word and color stimuli, and the lateral inhibition between visual stimuli. We conducted an electrophysiological and behavioral experiment to measure (1) how quickly an individual's brain processes words and colors presented in isolation (P3 latency), and (2) the strength of an individual's lateral inhibition between visual representations with a visual illusion. Both measures explained at least 40% of the variance in Stroop interference across individuals. As these measures were obtained in contexts not requiring any executive control, we conclude that the Stroop effect also measures an individual's pre-set way of processing visual features such as words and colors. This study highlights the important contributions of stimulus processing speed and lateral inhibition to individual differences in Stroop interference, and challenges the general view that the Stroop task primarily assesses executive control.

  6. The Use of the Performance Diagnostic Checklist-Human Services to Assess and Improve the Job Performance of Individuals with Intellectual Disabilities.

    Science.gov (United States)

    Smith, Madison; Wilder, David A

    2018-06-01

    The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to identify the variables responsible for performance problems. To date, the PDC-HS has not been examined with individuals with intellectual disabilities. In the current study, two supervisors with intellectual disabilities completed the PDC-HS to assess the productivity of two supervisees with disabilities who performed a pricing task in a thrift store. The PDC-HS suggested that performance deficits were due to a lack of training; a PDC-HS-indicated intervention was effective to increase accurate pricing. • The PDC-HS is an informant-based tool designed to identify the variables responsible for employee performance problems in human service settings. • The PDC-HS can be completed by some individuals with intellectual disabilities in a supervisory position to identify the variables responsible for problematic job performance among their supervisees. • A PDC-HS indicated intervention was demonstrated to be effective to improve the job performance of individuals with disabilities. • The PDC-HS may be a useful tool to support performance improvement and job maintenance among individuals with intellectual disabilities.

  7. Does delivery volume of family physicians predict maternal and newborn outcome?

    Energy Technology Data Exchange (ETDEWEB)

    Klein, M.C. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Univ. of British Columbia, Dept. of Family Practice, Vancouver, British Columbia (Canada); Spence, A. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Kaczorowski, J. [McMaster Univ., Depts. of Family Medicine and of Clinical Epidemiology and Biostatistics, Hamilton, Ontario (Canada); Kelly, A. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Univ. of British Columbia, Dept. of Health Care and Epidemiology, Vancouver, British Columbia (Canada); Grzybowski, S. [Univ. of British Columbia, Dept. of Family Practice, Vancouver, British Columbia (Canada)

    2002-05-01

    The number of births attended by individual family physicians who practice intrapartum care varies. We wanted to determine if the practice-volume relations that have been shown in other fields of medical practice also exist in maternity care practice by family doctors. For the period April 1997 to August 1998, we analyzed all singleton births at a major maternity teaching hospital for which the family physician was the responsible physician. Physicians were grouped into 3 categories on the basis of the number of births they attended each year: fewer than 12, 12 to 24, and 25 or more. Physicians with a low volume of deliveries (72 physicians, 549 births), those with a medium volume of deliveries (34 physicians, 871 births) and those with a high volume of deliveries (46 physicians, 3024 births) were compared in terms of maternal and newborn outcomes. The main outcome measures were maternal morbidity, 5-minute Apgar score and admission of the baby to the neonatal intensive care unit or special care unit. Secondary outcomes were obstetric procedures and consultation patterns. There was no difference among the 3 volume cohorts in terms of rates of maternal complications of delivery, 5-minute Apgar scores of less than 7 or admissions to the neonatal intensive care unit or the special care unit, either before or after adjustment for parity, pregnancy-induced hypertension, diabetes, ethnicity, lone parent status, maternal age, gestational age, newborn birth weight and newborn head circumference at birth. High-and medium-volume family physicians consulted with obstetricians less often than low-volume family physicians (adjusted odds ratio [OR] 0.586 [95% confidence interval, CI, 0.479-0.718] and 0.739 [95% Cl 0.583-0.935] respectively). High-and medium-volume family physicians transferred the delivery to an obstetrician less often than low-volume family physicians (adjusted OR 0.668 [95% CI 0.542-0.823] and 0.776 [95% Cl 0.607-0.992] respectively). Inductions were performed

  8. Does delivery volume of family physicians predict maternal and newborn outcome?

    International Nuclear Information System (INIS)

    Klein, M.C.; Spence, A.; Kaczorowski, J.; Kelly, A.; Grzybowski, S.

    2002-01-01

    The number of births attended by individual family physicians who practice intrapartum care varies. We wanted to determine if the practice-volume relations that have been shown in other fields of medical practice also exist in maternity care practice by family doctors. For the period April 1997 to August 1998, we analyzed all singleton births at a major maternity teaching hospital for which the family physician was the responsible physician. Physicians were grouped into 3 categories on the basis of the number of births they attended each year: fewer than 12, 12 to 24, and 25 or more. Physicians with a low volume of deliveries (72 physicians, 549 births), those with a medium volume of deliveries (34 physicians, 871 births) and those with a high volume of deliveries (46 physicians, 3024 births) were compared in terms of maternal and newborn outcomes. The main outcome measures were maternal morbidity, 5-minute Apgar score and admission of the baby to the neonatal intensive care unit or special care unit. Secondary outcomes were obstetric procedures and consultation patterns. There was no difference among the 3 volume cohorts in terms of rates of maternal complications of delivery, 5-minute Apgar scores of less than 7 or admissions to the neonatal intensive care unit or the special care unit, either before or after adjustment for parity, pregnancy-induced hypertension, diabetes, ethnicity, lone parent status, maternal age, gestational age, newborn birth weight and newborn head circumference at birth. High-and medium-volume family physicians consulted with obstetricians less often than low-volume family physicians (adjusted odds ratio [OR] 0.586 [95% confidence interval, CI, 0.479-0.718] and 0.739 [95% Cl 0.583-0.935] respectively). High-and medium-volume family physicians transferred the delivery to an obstetrician less often than low-volume family physicians (adjusted OR 0.668 [95% CI 0.542-0.823] and 0.776 [95% Cl 0.607-0.992] respectively). Inductions were performed

  9. An Examination of Individual Performance Using Markov Models in the Hellenic Navy’s Officer-Performance Evaluation System

    Science.gov (United States)

    2012-03-01

    similar to primary needs, but now emotions have replaced transmitted signals. In the 1940s, Maslow developed the needs-hierarchy theory. 37...is the specific design to meet new challenges and realize our potential. McShane and Von Glinow state that …according to Maslow , we are...circumstances, individuals seek their constant personal development. In addition to Abraham Maslow’s needs-hierarchy theory, a recently developed

  10. Developing a Physician׳s Professional Identity Through Medical Education.

    Science.gov (United States)

    Olive, Kenneth E; Abercrombie, Caroline L

    2017-02-01

    Professionalism represents a fundamental characteristic of physicians. Professional organizations have developed professionalism competencies for physicians and medical students. The aim of teaching medical professionalism is to ensure the development of a professional identity in medical students. Professional identity formation is a process developed through teaching principles and appropriate behavioral responses to the stresses of being a physician. Addressing lapses and critical reflection is an important part of the educational process. The "hidden curriculum" within an institution plays an important role in professional identity formation. Assessment of professionalism involves multiple mechanisms. Steps in remediating professionalism lapses include (1) initial assessment, (2) diagnosis of problems and development of an individualized learning plan, (3) instruction encompassing practice, feedback and reflection and (4) reassessment and certification of competence. No reliable outcomes data exist regarding the effectiveness of different remediation strategies. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  11. Performance and process in collective and individual memory: the role of social decision schemes and memory bias in collective memory.

    Science.gov (United States)

    Van Swol, Lyn M

    2008-04-01

    To assess performance and processes in collective and individual memory, participants watched two job candidates on video. Beforehand, half the participants were told they would be tested on their memory of the interviews, and the other half were asked to make a decision to hire one of the candidates. Afterwards, participants completed a recognition memory task in either a group or individual condition. Groups had better recognition memory than individuals. Individuals made more false positives than false negatives and groups exaggerated this. Post-hoc analysis found that groups only exaggerated the tendency towards false positives on items that reflected negatively on the job candidate. There was no significant difference between instruction conditions. When reaching consensus on the recognition task, groups tended to choose the correct answer if at least two members had the correct answer. This method of consensus is discussed as a factor in groups' superior memory performance.

  12. Why Are Some More Peer Than Others? Evidence from a Longitudinal Study of Social Networks and Individual Academic Performance

    OpenAIRE

    Lomi, Alessandro; Snijders, Tom A.B.; Steglich, Christian E.G.; Torlo, Vanina Jasmine

    2011-01-01

    Studies of peer effects in educational settings confront two main problems. The first is the presence of endogenous sorting which confounds the effects of social influence and social selection on individual attainment. The second is how to account for the local network dependencies through which peer effects influence individual behavior. We empirically address these problems using longitudinal data on academic performance, friendship, and advice seeking relations among stud...

  13. Effect of hypoxia and hyperoxia on exercise performance in healthy individuals and in patients with pulmonary hypertension: a systematic review.

    Science.gov (United States)

    Ulrich, Silvia; Schneider, Simon R; Bloch, Konrad E

    2017-12-01

    Exercise performance is determined by oxygen supply to working muscles and vital organs. In healthy individuals, exercise performance is limited in the hypoxic environment at altitude, when oxygen delivery is diminished due to the reduced alveolar and arterial oxygen partial pressures. In patients with pulmonary hypertension (PH), exercise performance is already reduced near sea level due to impairments of the pulmonary circulation and gas exchange, and, presumably, these limitations are more pronounced at altitude. In studies performed near sea level in healthy subjects, as well as in patients with PH, maximal performance during progressive ramp exercise and endurance of submaximal constant-load exercise were substantially enhanced by breathing oxygen-enriched air. Both in healthy individuals and in PH patients, these improvements were mediated by a better arterial, muscular, and cerebral oxygenation, along with a reduced sympathetic excitation, as suggested by the reduced heart rate and alveolar ventilation at submaximal isoloads, and an improved pulmonary gas exchange efficiency, especially in patients with PH. In summary, in healthy individuals and in patients with PH, alterations in the inspiratory Po 2 by exposure to hypobaric hypoxia or normobaric hyperoxia reduce or enhance exercise performance, respectively, by modifying oxygen delivery to the muscles and the brain, by effects on cardiovascular and respiratory control, and by alterations in pulmonary gas exchange. The understanding of these physiological mechanisms helps in counselling individuals planning altitude or air travel and prescribing oxygen therapy to patients with PH.

  14. Investigating pianists' individuality in the performance of five timbral nuances through patterns of articulation, touch, dynamics and pedalling

    Directory of Open Access Journals (Sweden)

    Michel eBernays

    2014-03-01

    Full Text Available Timbre is an essential expressive feature in piano performance. Concert pianists use a vast palette of timbral nuances to colour their performances at the microstructural level. Although timbre is generally envisioned in the pianistic community as an abstract concept carried through an imaged vocabulary, performers may share some common strategies of timbral expression in piano performance. Yet there may remain further leeway for idiosyncratic processes in the production of piano timbre nuances. In this study, we examined the patterns of timbral expression in performances by four expert pianists. Each pianist performed four short pieces, each with five different timbral intentions (bright, dark, dry, round, and velvety. The performances were recorded with the high-accuracy Bösendorfer CEUS system. Fine-grained performance features of dynamics, touch, articulation and pedalling were extracted. Reduced PCA performance spaces and descriptive performance portraits confirmed that pianists exhibited unique, specific profiles for different timbral intentions, derived from underlying traits of general individuality, while sharing some broad commonalities of dynamics and articulation for each timbral intention. These results confirm that pianists’ abstract notions of timbre correspond to reliable patterns of performance technique. Furthermore, these effects suggest that pianists can express individual styles while complying with specific timbral intentions.

  15. Speed and lateral inhibition of stimulus processing contribute to individual differences in Stroop-task performance

    Directory of Open Access Journals (Sweden)

    Marnix eNaber

    2016-06-01

    Full Text Available The Stroop task is a popular neuropsychological test that measures executive control. Strong Stroop interference is commonly interpreted in neuropsychology as a diagnostic marker of an impairment in executive control, possibly reflecting executive dysfunction. However, popular models of the Stroop task indicate that several other aspects of colour and word processing may also account for individual differences in the Stroop task, independent of executive control. Here we use new approaches to investigate the degree to which individual differences in Stroop interference correlate with the relative processing speed of word and colour stimuli, and the lateral inhibition between visual stimuli. We conducted an electrophysiological and behavioural experiment to measure (1 how quickly an individual’s brain processes words and colours presented in isolation (P3 latency, and (2 the strength of an individual’s lateral inhibition between visual representations with a visual illusion. Both measures explained at least 40% of the variance in Stroop interference across individuals. As these measures were obtained in contexts not requiring any executive control, we conclude that the Stroop effect also measures an individual’s pre-set way of processing visual features such as words and colours. This study highlights the important contributions of stimulus processing speed and lateral inhibition to individual differences in Stroop interference, and challenges the general view that the Stroop task primarily assesses executive control.

  16. Strong persistent growth differences govern individual performance and population dynamics in a tropical forest understorey palm

    NARCIS (Netherlands)

    Jansen, M.; Zuidema, P.A.; Anten, N.P.R.; Martínez-Ramos, M.

    2012-01-01

    1. Persistent variation in growth rate between individual plants can have strong effects on population dynamics as fast growers reach the reproductive size at an earlier age and thus potentially contribute more to population growth than slow growers. In tropical forests, such persistent growth

  17. Quantitative Approach to Collaborative Learning: Performance Prediction, Individual Assessment, and Group Composition

    Science.gov (United States)

    Cen, Ling; Ruta, Dymitr; Powell, Leigh; Hirsch, Benjamin; Ng, Jason

    2016-01-01

    The benefits of collaborative learning, although widely reported, lack the quantitative rigor and detailed insight into the dynamics of interactions within the group, while individual contributions and their impacts on group members and their collaborative work remain hidden behind joint group assessment. To bridge this gap we intend to address…

  18. The Effect of Group Composition on Individual Student Performance in an Introductory Economics Course

    Science.gov (United States)

    Moore, Robert L.

    2011-01-01

    What is the best way to allocate students to small teams in those economics courses that rely on small group work to enhance individual student learning? While experts in collaborative learning provide many suggestions, little empirical work has been done. This article begins to fill the gap. It examines whether a variety of characteristics of the…

  19. Blending Individual and Group Assessment: A Model for Measuring Student Performance

    Science.gov (United States)

    Reiser, Elana

    2017-01-01

    Two sections of a college discrete mathematics class were taught using cooperative learning techniques throughout the semester. The 33 students attending these sections were randomly assigned into groups of three. Their final examination consisted of an individual and group blended examination where students worked in their groups and discussed…

  20. Understanding the structure of skill through a detailed analysis of Individuals' performance on the Space Fortress game.

    Science.gov (United States)

    Towne, Tyler J; Boot, Walter R; Ericsson, K Anders

    2016-09-01

    In this paper we describe a novel approach to the study of individual differences in acquired skilled performance in complex laboratory tasks based on an extension of the methodology of the expert-performance approach (Ericsson & Smith, 1991) to shorter periods of training and practice. In contrast to more traditional approaches that study the average performance of groups of participants, we explored detailed behavioral changes for individual participants across their development on the Space Fortress game. We focused on dramatic individual differences in learning and skill acquisition at the individual level by analyzing the archival game data of several interesting players to uncover the specific structure of their acquired skill. Our analysis revealed that even after maximal values for game-generated subscores were reached, the most skilled participant's behaviors such as his flight path, missile firing, and mine handling continued to be refined and improved (Participant 17 from Boot et al., 2010). We contrasted this participant's behavior with the behavior of several other participants and found striking differences in the structure of their performance, which calls into question the appropriateness of averaging their data. For example, some participants engaged in different control strategies such as "world wrapping" or maintaining a finely-tuned circular flight path around the fortress (in contrast to Participant 17's angular flight path). In light of these differences, we raise fundamental questions about how skill acquisition for individual participants should be studied and described. Our data suggest that a detailed analysis of individuals' data is an essential step for generating a general theory of skill acquisition that explains improvement at the group and individual levels. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Physician Self-directed Learning and Education

    Directory of Open Access Journals (Sweden)

    Masami Tagawa

    2008-07-01

    Full Text Available Physicians are expected to be life-long learners because updated and effective patient care should be provided while medical and clinical knowledge and skills and social requirements for patient care are rapidly changing. Also, qualified clinical competence needs long periods of training and each physician has to continually learn as long as he/she works as a professional. Self-directed learning is an important factor in adult learning. Medical students' readiness for self-directed learning is not high, and should be improved by medical school and postgraduate training curricula. Garrison proposed a comprehensive model of self-directed learning, and it has dimensions of motivation (entering and task, self-monitoring (responsibility, and self-management (responsibility. To teach individual self-directed learning competencies, the following are important: (1 situate learners to experience “real” problems; (2 encourage learners to reflect on their own performance; (3 create an educational atmosphere in clinical training situations. In 2005, a 2-year mandatory residency program was implemented in Japan, and fewer medical school graduates took residency programs in medical school hospitals and advanced specialty programs provided by medical school departments. Medical school departments provide traditional, but life-long clinical training opportunities. Under the new residency program, an additional postgraduate and continuing medical training system has to be built up to maintain and confirm a physician's competencies. If physicians do clinical work using a scholarly way of thinking with critical analysis of their own competencies and improvement by reflection, they will become an excellent life-long learner.

  2. Verbal Aggressiveness Among Physicians and Trainees.

    Science.gov (United States)

    Lazarus, Jenny Lynn; Hosseini, Motahar; Kamangar, Farin; Levien, David H; Rowland, Pamela A; Kowdley, Gopal C; Cunningham, Steven C

    2016-01-01

    To better understand verbal aggressiveness among physicians and trainees, including specialty-specific differences. The Infante Verbal Aggressiveness Scale (IVAS) was administered as part of a survey to 48 medical students, 24 residents, and 257 attending physicians. The 72 trainees received the IVAS and demographic questions, whereas the attending physicians received additional questions regarding type of practice, career satisfaction, litigation, and personality type. The IVAS scores showed high reliability (Cronbach α = 0.83). Among all trainees, 56% were female with mean age 28 years, whereas among attending physicians, 63% were male with mean age 50 years. Average scores of trainees were higher than attending physicians with corresponding averages of 1.88 and 1.68, respectively. Among trainees, higher IVAS scores were significantly associated with male sex, non-US birthplace, choice of surgery, and a history of bullying. Among attending physicians, higher IVAS scores were significantly associated with male sex, younger age, self-reported low-quality of patient-physician relationships, and low enjoyment talking to patients. General surgery and general internal medicine physicians were significantly associated with higher IVAS scores than other specialties. General practitioners (surgeons and medical physicians) had higher IVAS scores than the specialists in their corresponding fields. No significant correlation was found between IVAS scores and threats of legal action against attending physicians, or most personality traits. Additional findings regarding bullying in medical school, physician-patient interactions, and having a method to deal with inappropriate behavior at work were observed. Individuals choosing general specialties display more aggressive verbal communication styles, general surgeons displaying the highest. The IVAS scoring system may identify subgroups of physicians with overly aggressive (problematic) communication skills and may provide a

  3. Physician Fee Schedule Search

    Data.gov (United States)

    U.S. Department of Health & Human Services — This website is designed to provide information on services covered by the Medicare Physician Fee Schedule (MPFS). It provides more than 10,000 physician services,...

  4. 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.

  5. Investigation into the Influence of Physician for Treatment Based on Syndrome Differentiation

    Directory of Open Access Journals (Sweden)

    Lijie Jiang

    2013-01-01

    Full Text Available Background. The characteristics of treatment based on syndrome differentiation (TBSD cause great challenges to evaluate the effectiveness of the clinical methods. Objectives. This paper aims to evaluate the influence of physician to personalized medicine in the process of TBSD. Methods. We performed a randomized, triple-blind trial involving patients of primary insomnia treated by 3 physicians individually and independently. The patients (n=30 were randomly assigned to receive treatments by the 3 physicians for every visit. However, they always received the treatment, respectively, prescribed by the physician at the first visit. The primary outcome was evaluated, respectively, by the Pittsburgh Sleep Quality Index (PSQI and the TCM symptoms measuring scale. The clinical practices of the physicians were recorded at every visit including diagnostic information, syndrome differentiation, treating principles, and prescriptions. Results. All patients in the 3 groups (30 patients showed significant improvements (>66% according to the PSQI and TCM symptoms measuring scale. Conclusion. The results indicate that although with comparable effectiveness, there exist significant differences in syndrome differentiation, the treating principles, and the prescriptions of the approaches used by the 3 physicians. This means that the physician should be considered as an important factor for individualized medicine and the related TCM clinical research.

  6. Age-related individual variability in memory performance is associated with amygdala-hippocampal circuit function and emotional pattern separation

    Science.gov (United States)

    Leal, Stephanie L.; Noche, Jessica A.; Murray, Elizabeth A.; Yassa, Michael A.

    2018-01-01

    While aging is generally associated with episodic memory decline, not all older adults exhibit memory loss. Furthermore, emotional memories are not subject to the same extent of forgetting and appear preserved in aging. We conducted high-resolution fMRI during a task involving pattern separation of emotional information in older adults with and without age-related memory impairment (characterized by performance on a word-list learning task: low performers: LP vs. high performers: HP). We found signals consistent with emotional pattern separation in hippocampal dentate (DG)/CA3 in HP but not in LP individuals, suggesting a deficit in emotional pattern separation. During false recognition, we found increased DG/CA3 activity in LP individuals, suggesting that hyperactivity may be associated with overgeneralization. We additionally observed a selective deficit in basolateral amygdala—lateral entorhinal cortex—DG/CA3 functional connectivity in LP individuals during pattern separation of negative information. During negative false recognition, LP individuals showed increased medial temporal lobe functional connectivity, consistent with overgeneralization. Overall, these results suggest a novel mechanistic account of individual differences in emotional memory alterations exhibited in aging. PMID:27723500

  7. Age-related individual variability in memory performance is associated with amygdala-hippocampal circuit function and emotional pattern separation.

    Science.gov (United States)

    Leal, Stephanie L; Noche, Jessica A; Murray, Elizabeth A; Yassa, Michael A

    2017-01-01

    While aging is generally associated with episodic memory decline, not all older adults exhibit memory loss. Furthermore, emotional memories are not subject to the same extent of forgetting and appear preserved in aging. We conducted high-resolution fMRI during a task involving pattern separation of emotional information in older adults with and without age-related memory impairment (characterized by performance on a word-list learning task: low performers: LP vs. high performers: HP). We found signals consistent with emotional pattern separation in hippocampal dentate (DG)/CA3 in HP but not in LP individuals, suggesting a deficit in emotional pattern separation. During false recognition, we found increased DG/CA3 activity in LP individuals, suggesting that hyperactivity may be associated with overgeneralization. We additionally observed a selective deficit in basolateral amygdala-lateral entorhinal cortex-DG/CA3 functional connectivity in LP individuals during pattern separation of negative information. During negative false recognition, LP individuals showed increased medial temporal lobe functional connectivity, consistent with overgeneralization. Overall, these results suggest a novel mechanistic account of individual differences in emotional memory alterations exhibited in aging. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. The effects of individual status and group performance on network ties among teammates in the National Basketball Association.

    Directory of Open Access Journals (Sweden)

    Jeremy Koster

    Full Text Available For individuals, status is derived both from their personal attributes and the groups with whom they are affiliated. Depending on the performance of their groups, the status of individuals may benefit or suffer from identifying closely with the group. When the group excels, high-status members potentially receive much of the credit and increased status. Conversely, high-status members of underperforming groups potentially suffer disproportionate declines in their status relative to the low-status group members. We therefore predict an interaction between group performance and individual status on the willingness to associate with the group and its members. We test our prediction by examining social media ties among teammates in the National Basketball Association. Specifically, we investigate the "following" ties of teammates on Twitter at the end of the 2014-2015 season. Elections to All-Star games are used to measure the status of players, and team performance is measured by recent success in the postseason playoffs. The results show that compared to high-status players on successful teams, high-status players on underperforming teams are less likely to follow their teammates. This result aligns with research on status inconsistency, suggesting that individuals deemphasize their group affiliation when it jeopardizes their individual status. An additional contribution is the advancement of the probit Social Relations Model for the analysis of binary ties in social networks.

  9. The effects of individual status and group performance on network ties among teammates in the National Basketball Association.

    Science.gov (United States)

    Koster, Jeremy; Aven, Brandy

    2018-01-01

    For individuals, status is derived both from their personal attributes and the groups with whom they are affiliated. Depending on the performance of their groups, the status of individuals may benefit or suffer from identifying closely with the group. When the group excels, high-status members potentially receive much of the credit and increased status. Conversely, high-status members of underperforming groups potentially suffer disproportionate declines in their status relative to the low-status group members. We therefore predict an interaction between group performance and individual status on the willingness to associate with the group and its members. We test our prediction by examining social media ties among teammates in the National Basketball Association. Specifically, we investigate the "following" ties of teammates on Twitter at the end of the 2014-2015 season. Elections to All-Star games are used to measure the status of players, and team performance is measured by recent success in the postseason playoffs. The results show that compared to high-status players on successful teams, high-status players on underperforming teams are less likely to follow their teammates. This result aligns with research on status inconsistency, suggesting that individuals deemphasize their group affiliation when it jeopardizes their individual status. An additional contribution is the advancement of the probit Social Relations Model for the analysis of binary ties in social networks.

  10. Ipsilesional upper limb performance in stroke individuals: relationship among outcomes of different tests used to assess hand function

    Directory of Open Access Journals (Sweden)

    Bianca Pinto Cunha

    Full Text Available Abstract Introduction: Stroke individuals have sensorimotor repercussions on their ipsilesional upper limb. Therefore, it is important to use tests that allow an adequate assessment and follow-up of such deficits. Physical and occupational therapists commonly use maximal grip strength tests to assess the functional condition of stroke individuals. However, one could ask whether a single test is able to characterize the hand function in this population. Objective: The aim of this study was to investigate the relationship among outcomes of different tests frequently used to describe the function of the hand in the ipsilesional upper limb of stroke individuals. Methods: Twenty-two stroke individuals performed four hand function tests: maximal handgrip strength (HGSMax, maximal pinch grip strength (PGSMax, Jebsen-Taylor Hand Function Test (JTHFT and Nine Hole Peg Test (9-HPT. All tests were performed with the ipsilesional hand. Pearson's correlation analyses were performed. Results: the results indicated a moderate and positive relationship between HGSMax and JTHFT (r = 0.50 and between JTHFT and 9-HPT (r = 0.55. Conclusion: We conclude that the existence of only moderate relationships between test outcomes demonstrates the need to use at least two instruments to better describe the ipsilesional hand function of stroke individuals.

  11. Employee engagement, organisational performance and individual wellbeing : Exploring the evidence, developing the theory

    NARCIS (Netherlands)

    Truss, C.; Shantz, A.; Soane, E.; Emma, C.; Alfes, K.; Delbridge, R.

    2013-01-01

    The development of mainstream human resource management (HRM) theory has long been concerned with how people management can enhance performance outcomes. It is only very recently that interest has been shown in the parallel stream of research on the link between employee engagement and performance,

  12. Modeling the Direct and Indirect Determinants of Different Types of Individual Job Performance

    Science.gov (United States)

    2008-06-01

    dimension is an element of task performance (Johnson, 2003), the middle three dimensions all tap different aspects of citizenship performance (Borman...Record your effectiveness rating for each response (from 1 to 7) on the line to the eft of the response. In addition, select which ONE response out of

  13. The effect of individual HR domains on financial performance : Evidence from Belgian small businesses

    NARCIS (Netherlands)

    Faems, D; Sels, L; De Winne, S; Maes, J

    2005-01-01

    The contribution of this study, which assesses the influence of HRM on financial performance, is fourfold. (1) We assess the relative contribution of different HR domains to organizational performance. By controlling for the overall HRM intensity in all analyses we try to meet one of the most

  14. THE INFLUENCE OF INDIVIDUAL KNOWLEDGE AND WORK TEAM DEVELOPMENT TO THE MANUFACTURING COMPANY PERFORMANCE OF IN EAST JAVA

    Directory of Open Access Journals (Sweden)

    Widjojo Suprapto

    2017-03-01

    Full Text Available Individual knowledge is the fundamental human capital to contribute to the greatness of the company.The personal capability and competence should be dispersed to other individuals within the organization toform a work team that is reliable and motivated so that each individual can easily do the workcommunication. As a result, it gives an impact on the flexibility of working people and eventually canimprove the company performance. The data are collected by questionnaires that are distributed to 90industrial practitioners, with the 86 completed data that can be further processed. The result of this studystates that the individual knowledge influences strongly on the development of the competent work team, andenhances the collaboration and communication process. The development of the work teams in the companyaffects the collaboration, communication, and effectiveness of the work teams. Finally, the cooperation andcommunication in the work place and the effectiveness of the work teams together improve the companyperformance.

  15. Physician heal thyself

    African Journals Online (AJOL)

    Compared to overweight or obese physicians, normal‑weight physicians were significantly more likely to discuss weight loss with their obese patients, according to a study among. 500 primary care physicians, undertaken by researchers at the Johns Hopkins Bloomberg School of Public Health.[4]. A recent, highly accessed ...

  16. Unravelling the performance of individual scholars: use of Canonical Biplot analysis to explore the performance of scientists by academic rank and scientific field

    OpenAIRE

    Díaz-Faes, Adrián A.; Costas Comesaña, Rodrigo; Galindo, M. Purificación; Bordons, María

    2015-01-01

    Individual research performance needs to be addressed by means of a diverse set of indicators capturing the multidimensional framework of science. In this context, Biplot methods emerge as powerful and reliable visualization tools similar to a scatterplot but capturing the multivariate covariance structures among bibliometric indicators. In this paper, we introduce the Canonical Biplot technique to explore differences in the scientific performance of Spanish CSIC researchers, o...

  17. Among Friends: The Role of Academic-Preparedness Diversity in Individual Performance within a Small-Group STEM Learning Environment

    Science.gov (United States)

    Micari, Marina; Van Winkle, Zachary; Pazos, Pilar

    2016-01-01

    In this study, we investigate the relationship between academic-preparedness diversity within small learning groups and individual academic performance in science, technology, engineering, and mathematics (STEM) university courses. We further examine whether academic-preparedness diversity impacts academically more- and less-prepared students…

  18. Why Are Some More Peer Than Others? Evidence from a Longitudinal Study of Social Networks and Individual Academic Performance.

    Science.gov (United States)

    Lomi, Alessandro; Snijders, Tom A B; Steglich, Christian E G; Torlo, Vanina Jasmine

    2011-11-01

    Studies of peer effects in educational settings confront two main problems. The first is the presence of endogenous sorting which confounds the effects of social influence and social selection on individual attainment. The second is how to account for the local network dependencies through which peer effects influence individual behavior. We empirically address these problems using longitudinal data on academic performance, friendship, and advice seeking relations among students in a full-time graduate academic program. We specify stochastic agent-based models that permit estimation of the interdependent contribution of social selection and social influence to individual performance. We report evidence of peer effects. Students tend to assimilate the average performance of their friends and of their advisors. At the same time, students attaining similar levels of academic performance are more likely to develop friendship and advice ties. Together, these results imply that processes of social influence and social selection are sub-components of a more general a co-evolutionary process linking network structure and individual behavior. We discuss possible points of contact between our findings and current research in the economics and sociology of education.

  19. The relationship between line manager behavior, perceived HRM practices and individual performance : Examining the mediating role of engagement

    NARCIS (Netherlands)

    Alfes, K.; Truss, C.; Soane, E.; Rees, C.; Gatenby, M.

    2013-01-01

    This article examines the role played by line managers in the link between HRM practices and individual performance outcomes. Drawing on social exchange theory, the authors test a mediated model linking perceived line manager behavior and perceived human resource management practices with employee

  20. A Source Activation Account of Individual Differences in Working Memory Performance

    National Research Council Canada - National Science Library

    Reder, Lynne

    1999-01-01

    ...' patterns of performance. We propose a computational model that accounts for differences in working memory capacity in terms of a quantity called source activation, which is used to maintain goal relevant information in an available state...

  1. Opening the black box: From an individual bias to portfolio performance

    OpenAIRE

    Nosic, Alen; Weber, Martin; Glaser, Markus

    2011-01-01

    We suggest an experimental design that can help opening the black box of investor behavior by documenting a channel of how biases affect portfolio performance. We study two of the most important investor biases (overreaction and overconfidence), show how they are related, and analyze their consequences for portfolio choice and resulting portfolio performance in a controlled experimental setting with 104 participants. The main innovation of our study is that we go beyond just documenting a cor...

  2. Effects of Dual-Task Management and Resistance Training on Gait Performance in Older Individuals: A Randomized Controlled Trial

    Science.gov (United States)

    Wollesen, Bettina; Mattes, Klaus; Schulz, Sören; Bischoff, Laura L.; Seydell, L.; Bell, Jeffrey W.; von Duvillard, Serge P.

    2017-01-01

    Background: Dual-task (DT) training is a well-accepted modality for fall prevention in older adults. DT training should include task-managing strategies such as task switching or task prioritization to improve gait performance under DT conditions. Methods: We conducted a randomized controlled trial to evaluate a balance and task managing training (BDT group) in gait performance compared to a single task (ST) strength and resistance training and a control group, which received no training. A total of 78 older individuals (72.0 ± 4.9 years) participated in this study. The DT group performed task managing training incorporating balance and coordination tasks while the ST group performed resistance training only. Training consisted of 12 weekly sessions, 60 min each, for 12 weeks. We assessed the effects of ST and BDT training on walking performance under ST and DT conditions in independent living elderly adults. ST and DT walking (visual verbal Stroop task) were measured utilizing a treadmill at self-selected walking speed (mean for all groups: 4.4 ± 1 km h-1). Specific gait variables, cognitive performance, and fear of falling were compared between all groups. >Results: Training improved gait performance for step length (p changes in cognitive performance. Both interventions reduced fear of falling (p management strategies into balance and strength training in our population revealed a promising modality to prevent falls in older individuals. Trial registration: German register of clinical trials DRKS00012382. PMID:29326581

  3. Job satisfaction of primary care physicians in Switzerland: an observational study.

    Science.gov (United States)

    Goetz, Katja; Jossen, Marianne; Szecsenyi, Joachim; Rosemann, Thomas; Hahn, Karolin; Hess, Sigrid

    2016-10-01

    Job satisfaction of physicians is an important issue for performance of a health care system. The aim of the study was to evaluate the job satisfaction of primary care physicians in Switzerland and to explore associations between overall job satisfaction, individual characteristics and satisfaction with aspects of work within the practice separated by gender. This cross-sectional study was based on a job satisfaction survey. Data were collected from 176 primary care physicians working in 91 primary care practices. Job satisfaction was measured with the 10-item Warr-Cook-Wall job satisfaction scale. Stepwise linear regression analysis was performed for physicians separated by gender. The response rate was 92.6%. Primary care physicians reported the highest level of satisfaction with 'freedom of working method' (mean = 6.45) and the lowest satisfaction for 'hours of work' (mean = 5.38) and 'income' (mean = 5.49). Moreover, some aspects of job satisfaction were rated higher by female physicians than male physicians. Within the stepwise regression analysis, the aspect 'opportunity to use abilities' (β = 0.644) showed the highest association to overall job satisfaction for male physicians while for female physicians it was income (β = 0.733). The presented results contribute to an understanding of factors that influence levels of satisfaction of female and male physicians. Therefore, research and intervention about job satisfaction should consider gender as well as the stereotypes that come along with these social roles. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Effect of plant-animal interactions on individual performance and population dynamics of Scorzonera hispanica

    OpenAIRE

    Červenková, Zita

    2016-01-01

    The population dynamics of plants with regard to plant-animal interactions is a remarkably complex topic. To look into how individual life stages are influenced in different directions by various animals is beyond the scope of a single paper. For each of the studies described below, I and my co-authors attempted to collect data that would cover as much of the plant life cycle as possible, focusing on interactions between plants and different animals during the flowering period and their conse...

  5. Global precedence effects account for individual differences in both face and object recognition performance

    DEFF Research Database (Denmark)

    Gerlach, Christian; Starrfelt, Randi

    2018-01-01

    examine whether global precedence effects, measured by means of non-face stimuli in Navon's paradigm, can also account for individual differences in face recognition and, if so, whether the effect is of similar magnitude for faces and objects. We find evidence that global precedence effects facilitate...... both face and object recognition, and to a similar extent. Our results suggest that both face and object recognition are characterized by a coarse-to-fine temporal dynamic, where global shape information is derived prior to local shape information, and that the efficiency of face and object recognition...

  6. A comprehensive model for diagnosing the causes of individual medical performance problems: skills, knowledge, internal, past and external factors (SKIPE).

    Science.gov (United States)

    Norfolk, Tim; Siriwardena, A Niroshan

    2013-01-01

    This discussion paper describes a new and comprehensive model for diagnosing the causes of individual medical performance problems: SKIPE (skills, knowledge, internal, past and external factors). This builds on a previous paper describing a unifying theory of clinical practice, the RDM-p model, which captures the primary skill sets required for effective medical performance (relationship, diagnostics and management), and the professionalism that needs to underpin them. The SKIPE model is currently being used, in conjunction with the RDM-p model, for the in-depth assessment and management of doctors whose performance is a cause for concern.

  7. Individual variation in working memory is associated with fear extinction performance.

    Science.gov (United States)

    Stout, Daniel M; Acheson, Dean T; Moore, Tyler M; Gur, Ruben C; Baker, Dewleen G; Geyer, Mark A; Risbrough, Victoria B

    2018-03-01

    PTSD has been associated consistently with abnormalities in fear acquisition and extinction learning and retention. Fear acquisition refers to learning to discriminate between threat and safety cues. Extinction learning reflects the formation of a new inhibitory-memory that competes with a previously learned threat-related memory. Adjudicating the competition between threat memory and the new inhibitory memory during extinction may rely, in part, on cognitive processes such as working memory (WM). Despite significant shared neural circuits and signaling pathways the relationship between WM, fear acquisition, and extinction is poorly understood. Here, we analyzed data from a large sample of healthy Marines who underwent an assessment battery including tests of fear acquisition, extinction learning, and WM (N-back). Fear potentiated startle (FPS), fear expectancy ratings, and self-reported anxiety served as the primary dependent variables. High WM ability (N = 192) was associated with greater CS + fear inhibition during the late block of extinction and greater US expectancy change during extinction learning compared to individuals with low WM ability (N = 204). WM ability was not associated with magnitude of fear conditioning/expression. Attention ability was unrelated to fear acquisition or extinction supporting specificity of WM associations with extinction. These results support the conclusion that individual differences in WM may contribute to regulating fear responses. Copyright © 2018. Published by Elsevier Ltd.

  8. Colorado family physicians' attitudes toward medical marijuana.

    Science.gov (United States)

    Kondrad, Elin; Reid, Alfred

    2013-01-01

    Over the last decade, the use of medical marijuana has expanded dramatically; it is now permitted in 16 states and the District of Columbia. Our study of family physicians in Colorado is the first to gather information about physician attitudes toward this evolving practice. We distributed an anonymous web-based electronic survey to the 1727 members of the Colorado Academy of Family Physicians' listserv. Items included individual and practice characteristics as well as experience with and attitudes toward medical marijuana. Five hundred twenty family physicians responded (30% response rate). Of these, 46% did not support physicians recommending medical marijuana; only 19% thought that physicians should recommend it. A minority thought that marijuana conferred significant benefits to physical (27%) and mental (15%) health. Most agreed that marijuana poses serious mental (64%) and physical (61%) health risks. Eighty-one percent agreed that physicians should have formal training before recommending medical marijuana, and 92% agreed that continuing medical education about medical marijuana should be available to family physicians. Despite a high prevalence of use in Colorado, most family physicians are not convinced of marijuana's health benefits and believe its use carries risks. Nearly all agreed on the need for further medical education about medical marijuana.

  9. The Ecology of Exercise: Mechanisms Underlying Individual Variation in Behavior, Activity, and Performance: An Introduction to Symposium.

    Science.gov (United States)

    Killen, Shaun S; Calsbeek, Ryan; Williams, Tony D

    2017-08-01

    Wild animals often engage in intense physical activity while performing tasks vital for their survival and reproduction associated with foraging, avoiding predators, fighting, providing parental care, and migrating. In this theme issue we consider how viewing these tasks as "exercise"-analogous to that performed by human athletes-may help provide insight into the mechanisms underlying individual variation in these types of behaviors and the importance of physical activity in an ecological context. In this article and throughout this issue, we focus on four key questions relevant to the study of behavioral ecology that may be addressed by studying wild animal behavior from the perspective of exercise physiology: (1) How hard do individual animals work in response to ecological (or evolutionary) demands?; (2) Do lab-based studies of activity provide good models for understanding activity in free-living animals and individual variation in traits?; (3) Can animals work too hard during "routine" activities?; and (4) Can paradigms of "exercise" and "training" be applied to free-living animals? Attempts to address these issues are currently being facilitated by rapid technological developments associated with physiological measurements and the remote tracking of wild animals, to provide mechanistic insights into the behavior of free-ranging animals at spatial and temporal scales that were previously impossible. We further suggest that viewing the behaviors of non-human animals in terms of the physical exercise performed will allow us to fully take advantage of these technological advances, draw from knowledge and conceptual frameworks already in use by human exercise physiologists, and identify key traits that constrain performance and generate variation in performance among individuals. It is our hope that, by highlighting mechanisms of behavior and performance, the articles in this issue will spur on further synergies between physiologists and ecologists, to take

  10. Impact of aging on neurocognitive performance in previously antiretroviral-naive HIV-infected individuals on their first suppressive regimen.

    Science.gov (United States)

    Coban, Hamza; Robertson, Kevin; Smurzynski, Marlene; Krishnan, Supriya; Wu, Kunling; Bosch, Ronald J; Collier, Ann C; Ellis, Ronald J

    2017-07-17

    Despite treatment with virologically suppressive antiretroviral therapy (ART), neurocognitive impairment may persist or develop de novo in aging HIV-infected individuals. We evaluated advancing age as a predictor of neurocognitive impairment in a large cohort of previously ART-naive individuals on long-term ART. The AIDS Clinical Trials Group Longitudinal Linked Randomized Trials was a prospective cohort study of HIV-infected individuals originally enrolled in randomized ART trials. This analysis examined neurocognitive outcomes at least 2 years after ART initiation. All participants underwent annual neurocognitive testing consisting of Trail making A and B, the wechsler adult intelligence scale-revised Digit Symbol and Hopkins Verbal Learning Tests. Uni and multivariable repeated measures regression models evaluated factors associated with neurocognitive performance. Predictors at parent study entry (ART naive) included entry demographics, smoking, injection drug use, hepatitis B surface antigen, hepatitis C virus serostatus, history of stroke, ART regimen type, pre-ART nadir CD4 cell count, and plasma viral load and as well as time-updated plasma viral load and CD4 cell count. The cohort comprised 3313 individuals with median pre-ART age of 38 years, 20% women; 36% Black, non-Hispanic; 22% Hispanic. Virologic suppression was maintained at 91% of follow-up visits. Neurocognitive performance improved with years of ART. After adjusting for the expected effects of age using norms from HIV-negative individuals, the odds of neurocognitive impairment at follow-up visits among the HIV infected increased by nearly 20% for each decade of advancing age. Despite continued virologic suppression and neurocognitive improvement in the cohort as a whole, older individuals were more likely to have neurocognitive impairment than younger individuals.

  11. The Impact of Individual Differences, Types of Model and Social Settings on Block Building Performance among Chinese Preschoolers

    Directory of Open Access Journals (Sweden)

    Mi Tian

    2018-01-01

    Full Text Available Children’s block building performances are used as indicators of other abilities in multiple domains. In the current study, we examined individual differences, types of model and social settings as influences on children’s block building performance. Chinese preschoolers (N = 180 participated in a block building activity in a natural setting, and performance was assessed with multiple measures in order to identify a range of specific skills. Using scores generated across these measures, three dependent variables were analyzed: block building skills, structural balance and structural features. An overall MANOVA showed that there were significant main effects of gender and grade level across most measures. Types of model showed no significant effect in children’s block building. There was a significant main effect of social settings on structural features, with the best performance in the 5-member group, followed by individual and then the 10-member block building. These findings suggest that boys performed better than girls in block building activity. Block building performance increased significantly from 1st to 2nd year of preschool, but not from second to third. The preschoolers created more representational constructions when presented with a model made of wooden rather than with a picture. There was partial evidence that children performed better when working with peers in a small group than when working alone or working in a large group. It is suggested that future study should examine other modalities rather than the visual one, diversify the samples and adopt a longitudinal investigation.

  12. The Impact of Individual Differences, Types of Model and Social Settings on Block Building Performance among Chinese Preschoolers.

    Science.gov (United States)

    Tian, Mi; Deng, Zhu; Meng, Zhaokun; Li, Rui; Zhang, Zhiyi; Qi, Wenhui; Wang, Rui; Yin, Tingting; Ji, Menghui

    2018-01-01

    Children's block building performances are used as indicators of other abilities in multiple domains. In the current study, we examined individual differences, types of model and social settings as influences on children's block building performance. Chinese preschoolers ( N = 180) participated in a block building activity in a natural setting, and performance was assessed with multiple measures in order to identify a range of specific skills. Using scores generated across these measures, three dependent variables were analyzed: block building skills, structural balance and structural features. An overall MANOVA showed that there were significant main effects of gender and grade level across most measures. Types of model showed no significant effect in children's block building. There was a significant main effect of social settings on structural features, with the best performance in the 5-member group, followed by individual and then the 10-member block building. These findings suggest that boys performed better than girls in block building activity. Block building performance increased significantly from 1st to 2nd year of preschool, but not from second to third. The preschoolers created more representational constructions when presented with a model made of wooden rather than with a picture. There was partial evidence that children performed better when working with peers in a small group than when working alone or working in a large group. It is suggested that future study should examine other modalities rather than the visual one, diversify the samples and adopt a longitudinal investigation.

  13. Using Mass Spectrometry to Quantify Rituximab and Perform Individualized Immunoglobulin Phenotyping in ANCA-Associated Vasculitis

    NARCIS (Netherlands)

    Mills, John R.; Cornec, Divi; Dasari, Surendra; Ladwig, Paula M.; Hummel, Amber M.; Cheu, Melissa; Murray, David L.; Willrich, Maria A.; Snyder, Melissa R.; Hoffman, Gary S.; Kallenberg, Cees G. M.; Langford, Carol A.; Merkel, Peter A.; Monach, Paul A.; Seo, Philip; Spiera, Robert F.; St Cair, E. William; Stone, John H.; Specks, Ulrich; Barnidge, David R.

    2016-01-01

    Therapeutic monoclonal immunoglobulins (mAbs) are used to treat patients with a wide range of disorders including autoimmune diseases. As pharmaceutical companies bring more fully humanized therapeutic mAb drugs to the healthcare market analytical platforms that perform therapeutic drug monitoring

  14. Visuospatial and psychomotor aptitude predicts endovascular performance of inexperienced individuals on a virtual reality simulator.

    Science.gov (United States)

    Van Herzeele, Isabelle; O'Donoghue, Kevin G L; Aggarwal, Rajesh; Vermassen, Frank; Darzi, Ara; Cheshire, Nicholas J W

    2010-04-01

    This study evaluated virtual reality (VR) simulation for endovascular training of medical students to determine whether innate perceptual, visuospatial, and psychomotor aptitude (VSA) can predict initial and plateau phase of technical endovascular skills acquisition. Twenty medical students received didactic and endovascular training on a commercially available VR simulator. Each student treated a series of 10 identical noncomplex renal artery stenoses endovascularly. The simulator recorded performance data instantly and objectively. An experienced interventionalist rated the performance at the initial and final sessions using generic (out of 40) and procedure-specific (out of 30) rating scales. VSA were tested with fine motor dexterity (FMD, Perdue Pegboard), psychomotor ability (minimally invasive virtual reality surgical trainer [MIST-VR]), image recall (Rey-Osterrieth), and organizational aptitude (map-planning). VSA performance scores were correlated with the assessment parameters of endovascular skills at commencement and completion of training. Medical students exhibited statistically significant learning curves from the initial to the plateau performance for contrast usage (medians, 28 vs 17 mL, P dexterity as well as with image recall at end of the training period. In addition to current recruitment strategies, VSA may be a useful tool for predictive validity studies.

  15. Prospective memory performance in individuals with Parkinson's disease who have mild cognitive impairment.

    Science.gov (United States)

    Costa, Alberto; Peppe, Antonella; Zabberoni, Silvia; Serafini, Francesca; Barban, Francesco; Scalici, Francesco; Caltagirone, Carlo; Carlesimo, Giovanni Augusto

    2015-09-01

    Prospective memory (PM) is the ability to keep in memory and realize future intentions. We aimed at investigating whether in Parkinson's disease (PD) PM deficits are related to mild cognitive impairment (MCI). Other aims were to investigate the cognitive abilities underlying PM performance, and the association between PM performance and measures of daily living functioning. The study included 15 PD patients with single domain MCI, 15 with multiple domain MCI, 17 PD patients without cognitive disorders (PDNC) and 25 healthy controls (HCs). All subjects were administered a PM procedure that included focal (PM cue is processed in the ongoing task) and nonfocal (PM cue is not processed in the ongoing task) conditions. PD patients were administered an extensive neuropsychological battery and scales to assess daily living abilities. PD patients with MCI (both single and multiple domains) showed lower accuracy on all PM conditions than both HC and PDNC patients. This was predicted by their scores on shifting indices. Conversely, PM accuracy of PDNC patients was comparable to HCs. Regression analyses revealed that PD patients' PM performance significantly predicted scores on daily living scales Conclusions: Results suggest that PM efficiency is not tout-court reduced in PD patients, but it specifically depends on the presence of MCI. Moreover, decreased executive functioning, but not episodic memory failure, accounts for a significant proportion of variance in PM performance. Finally, PM accuracy indices were found to be associated with measures of global daily living functioning and management of medication. (c) 2015 APA, all rights reserved).

  16. Air Pollution and Its Effects on an Individual's Health and Exercise Performance.

    Science.gov (United States)

    Singh, A. I. Clifford

    1988-01-01

    Air Pollution is a common environmental stressor affecting the training and competitive performance of athletes, commonly irritating the eyes, nose, and throat. The health and exercise effects of such primary and secondary air pollutants as carbon monoxide, sulfur dioxide, air particulates, ozone, and nitrogen dioxide are discussed. (CB)

  17. Personality Traits and Performance in Online Game-Based Learning: Collaborative versus Individual Settings

    Science.gov (United States)

    Lara, Miguel Angel

    2013-01-01

    Extant research indicates that, in face-to-face settings, cooperative learning and game-based learning strategies can be effective. However, in online settings (e.g., in distance education), there is a paucity of research in this area. This study was designed to investigate performance and attitudes of university students who played an educational…

  18. The Influence of Proactive Socialization Behaviors and Team Socialization on Individual Performance in the Team

    Science.gov (United States)

    Pennaforte, Antoine

    2016-01-01

    On the basis of the role and the social exchange theories, this research investigated the direct and indirect antecedents of three dimensions of team performance (proficiency, adaptivity, proactivity) developed through cooperative education. The theoretical model examined how proactive socialization behaviors led to team socialization and team…

  19. Individual differences and the effects of an information aid in performance of a fault diagnosis task

    NARCIS (Netherlands)

    Raaijmakers, J.G.W.; Verduyn, W.W.

    1996-01-01

    Two experiments are reported that investigated the performance of operators in a fault diagnosis task. Naval engineers working in the Ship's Control Centre (SCC) on board of frigates of the Royal Netherlands Navy were asked to solve a number of unfamiliar fault problems. In the first experiment, it

  20. Carbohydrate intake improves cognitive performance of stress-prone individuals under controllable laboratory stress

    NARCIS (Netherlands)

    Markus, C.R.; Panhuysen, G.; Jonkman, L.M.; Bachman, M.

    1999-01-01

    Cognitive performance has been found to decline after exposure to stress, particularly in stress-prone subjects. The present study investigated whether a carbohydrate-rich, protein-poor (CR/PP) diet, which may enhance cerebral serotonin function in stress-prone subjects due to increases in the

  1. Regulatory focus moderates the social performance of individuals who conceal a stigmatized identity.

    Science.gov (United States)

    Newheiser, Anna-Kaisa; Barreto, Manuela; Ellemers, Naomi; Derks, Belle; Scheepers, Daan

    2015-12-01

    People often choose to hide a stigmatized identity to avoid bias. However, hiding stigma can disrupt social interactions. We considered whether regulatory focus qualifies the social effects of hiding stigma by examining interactions in which stigmatized participants concealed a devalued identity from non-stigmatized partners. In the Prevention Focus condition, stigmatized participants were instructed to prevent a negative impression by concealing the identity; in the Promotion Focus condition, they were instructed to promote a positive impression by concealing the identity; in the Control condition, they were simply asked to conceal the identity. Both non-stigmatized partners and independent raters rated the interactions more positively in the Promotion Focus condition. Thus, promotion focus is interpersonally beneficial for individuals who conceal a devalued identity. © 2015 The British Psychological Society.

  2. Impact of high-performance work systems on individual- and branch-level performance: test of a multilevel model of intermediate linkages.

    Science.gov (United States)

    Aryee, Samuel; Walumbwa, Fred O; Seidu, Emmanuel Y M; Otaye, Lilian E

    2012-03-01

    We proposed and tested a multilevel model, underpinned by empowerment theory, that examines the processes linking high-performance work systems (HPWS) and performance outcomes at the individual and organizational levels of analyses. Data were obtained from 37 branches of 2 banking institutions in Ghana. Results of hierarchical regression analysis revealed that branch-level HPWS relates to empowerment climate. Additionally, results of hierarchical linear modeling that examined the hypothesized cross-level relationships revealed 3 salient findings. First, experienced HPWS and empowerment climate partially mediate the influence of branch-level HPWS on psychological empowerment. Second, psychological empowerment partially mediates the influence of empowerment climate and experienced HPWS on service performance. Third, service orientation moderates the psychological empowerment-service performance relationship such that the relationship is stronger for those high rather than low in service orientation. Last, ordinary least squares regression results revealed that branch-level HPWS influences branch-level market performance through cross-level and individual-level influences on service performance that emerges at the branch level as aggregated service performance.

  3. CONCEPTUAL APRROACH OF LEADERSHIP AND EMPLOYEES’ INDIVIDUAL PERFORMANCE RELATIONSHIP

    Directory of Open Access Journals (Sweden)

    Ispas Andreia

    2012-07-01

    Full Text Available There is a need for more leadership research in the hotel industry. A reason is the better understanding of the effects and influences that manager-employee relationship can have. Further, this can improve employee performance at their work and clients would be more satisfied. Due to the emergent stage of this field of research, the leadership and employee performance relationship has a lot of potential for being investigated in the context of hotel industry. There are many types of leadership styles recommended to be used in managers’ daily hotels’ activities. The most suggested is transformational leadership. Hotel industry is part of hospitality industry and is providing different services such as accommodation, food nbeverage, entertainment. This makes hotel industry very specific and the hotel products, services unique for each of client. That’s why high standards of organizational performance, a good manager-employee relationship and a high perceived employee performance by the clients are the keys for a long and sustainable business. Leadership is important in getting people to do the right things at their job. More, it helps employee to work better, to be motivated, to strive for excellence and perform beyond expectations. The first objective of this paper is to analyze the main approaches of leadership styles applied in the context of hotel industry studies. The second objective is to explore, from a theoretical point of view, the direct and indirect relationship between leadership style and employee performance based on two mediator factors: job satisfaction and organizational commitment. These two mediators are the most used in organizational researches and have a high degree of validity. The methodology applied is based on documentary study review and critic analysis of the concepts used by the literature. The results of the conceptual paper are: the construction of the conceptual model of scientific research

  4. Interference and problem size effect in multiplication fact solving: Individual differences in brain activations and arithmetic performance.

    Science.gov (United States)

    De Visscher, Alice; Vogel, Stephan E; Reishofer, Gernot; Hassler, Eva; Koschutnig, Karl; De Smedt, Bert; Grabner, Roland H

    2018-05-15

    In the development of math ability, a large variability of performance in solving simple arithmetic problems is observed and has not found a compelling explanation yet. One robust effect in simple multiplication facts is the problem size effect, indicating better performance for small problems compared to large ones. Recently, behavioral studies brought to light another effect in multiplication facts, the interference effect. That is, high interfering problems (receiving more proactive interference from previously learned problems) are more difficult to retrieve than low interfering problems (in terms of physical feature overlap, namely the digits, De Visscher and Noël, 2014). At the behavioral level, the sensitivity to the interference effect is shown to explain individual differences in the performance of solving multiplications in children as well as in adults. The aim of the present study was to investigate the individual differences in multiplication ability in relation to the neural interference effect and the neural problem size effect. To that end, we used a paradigm developed by De Visscher, Berens, et al. (2015) that contrasts the interference effect and the problem size effect in a multiplication verification task, during functional magnetic resonance imaging (fMRI) acquisition. Forty-two healthy adults, who showed high variability in an arithmetic fluency test, participated in our fMRI study. In order to control for the general reasoning level, the IQ was taken into account in the individual differences analyses. Our findings revealed a neural interference effect linked to individual differences in multiplication in the left inferior frontal gyrus, while controlling for the IQ. This interference effect in the left inferior frontal gyrus showed a negative relation with individual differences in arithmetic fluency, indicating a higher interference effect for low performers compared to high performers. This region is suggested in the literature to be

  5. The effects of individual differences, prior experience and cognitive load on the transfer of dynamic decision-making performance.

    Science.gov (United States)

    Nicholson, Brad; O'Hare, David

    2014-01-01

    Situational awareness is recognised as an important factor in the performance of individuals and teams in dynamic decision-making (DDM) environments (Salmon et al. 2014 ). The present study was designed to investigate whether the scores on the WOMBAT™ Situational Awareness and Stress Tolerance Test (Roscoe and North 1980 ) would predict the transfer of DDM performance from training under different levels of cognitive load to a novel situation. Participants practised a simulated firefighting task under either low or high conditions of cognitive load and then performed a (transfer) test in an alternative firefighting environment under an intermediate level of cognitive load. WOMBAT™ test scores were a better predictor of DDM performance than scores on the Raven Matrices. Participants with high WOMBAT™ scores performed better regardless of their training condition. Participants with recent gaming experience who practised under low cognitive load showed better practice phase performance but worse transfer performance than those who practised under high cognitive load. The relationship between task experience, situational awareness ability, cognitive load and the transfer of dynamic decision-making (DDM) performance was investigated. Results showed that the WOMBAT™ test predicted transfer of DDM performance regardless of task cognitive load. The effects of cognitive load on performance varied according to previous task-relevant experience.

  6. Evaluation of Physicians' Requests for Autopsies.

    Science.gov (United States)

    Kesler, Richard W.; And Others

    1983-01-01

    Chaplains and seminary students enrolled in the University of Virginia Medical Center's Clinical Pastoral Program were asked to judge physicians' performances while requesting autopsies by completing a confidential evaluation form. The results of the evaluations were correlated with the physicians' success in obtaining autopsies. (MLW)

  7. [Suicide in female and male physicians

    NARCIS (Netherlands)

    Lagro-Janssen, A.L.M.; Luijks, H.D.P.

    2008-01-01

    OBJECTIVE: To determine whether there are gender differences in the incidence of suicide in physicians, and whether there are differences in the methods used by male and female physicians to commit suicide. DESIGN: Systematic literature search. METHOD: A literature search was performed in the

  8. Construction of a Physician Skills Inventory

    Science.gov (United States)

    Richard, George V.; Zarconi, Joseph; Savickas, Mark L.

    2012-01-01

    The current study applied Holland's RIASEC typology to develop a "Physician Skills Inventory". We identified the transferable skills and abilities that are critical to effective performance in medicine and had 140 physicians in 25 different specialties rate the importance of those skills. Principal component analysis of their responses produced…

  9. Practical Issues in Evidence-Based Use of Performance Supplements: Supplement Interactions, Repeated Use and Individual Responses.

    Science.gov (United States)

    Burke, Louise M

    2017-03-01

    Current sports nutrition guidelines recommend that athletes only take supplements following an evidence-based analysis of their value in supporting training outcomes or competition performance in their specific event. While there is sound evidence to support the use of a few performance supplements under specific scenarios (creatine, beta-alanine, bicarbonate, caffeine, nitrate/beetroot juice and, perhaps, phosphate), there is a lack of information around several issues needed to guide the practical use of these products in competitive sport. First, there is limited knowledge around the strategy of combining the intake of several products in events in which performance benefits are seen with each product in isolation. The range in findings from studies involving combined use of different combinations of two supplements makes it difficult to derive a general conclusion, with both the limitations of individual studies and the type of sporting event to which the supplements are applied influencing the potential for additive, neutral or counteractive outcomes. The repeated use of the same supplement in sports involving two or more events within a 24-h period is of additional interest, but has received even less attention. Finally, the potential for individual athletes to respond differently, in direction and magnitude, to the use of a supplement seems real, but is hard to distinguish from normal day to day variability in performance. Strategies that can be used in research or practice to identify whether individual differences are robust include repeat trials, and the collection of data on physiological or genetic mechanisms underpinning outcomes.

  10. The effects of kinesiotape on athletic-based performance outcomes in healthy, active individuals: a literature synthesis

    Science.gov (United States)

    Drouin, Jillian L.; McAlpine, Caitlin T.; Primak, Kari A.; Kissel, Jaclyn

    2013-01-01

    Context: The effect of the application of kinesiotape to skin overlying musculature on measurable athletic-based performance outcomes in healthy individuals has not been well established. Objective: To systematically search and assess the quality of the literature on the effect of kinesiotape on athletic-based performance outcomes in healthy, active individuals. Methods: An electronic search strategy was conducted in MANTIS, Cochrane Library and EBSCO databases. Retrieved articles that met the eligibility criteria were rated for methodological quality by using an adaption of the critical appraisal criteria in Clinical Epidemiology by Sackett et al. Results: Ten articles met the inclusion criteria. Seven articles had positive results in at least one athletic-based performance measure compared to controls. Conclusion: Evidence is lacking to support the use of kinesiotape as a successful measure for improving athletic-based performance outcomes in healthy individuals. However, there is no evidence to show that kinesiotape has a negative effect on any of the performace measures. PMID:24302784

  11. Individual differences in airline captains' personalities, communication strategies, and crew performance

    Science.gov (United States)

    Orasanu, Judith

    1991-01-01

    Aircrew effectiveness in coping with emergencies has been linked to captain's personality profile. The present study analyzed cockpit communication during simulated flight to examine the relation between captains' discourse strategies, personality profiles, and crew performance. Positive Instrumental/Expressive captains and Instrumental-Negative captains used very similar communication strategies and their crews made few errors. Their talk was distinguished by high levels of planning and strategizing, gathering information, predicting/alerting, and explaining, especially during the emergency flight phase. Negative-Expressive captains talked less overall, and engaged in little problem solving talk, even during emergencies. Their crews made many errors. Findings support the theory that high crew performance results when captains use language to build shared mental models for problem situations.

  12. Systematic Assessment of Caregiving Skill Performance by Individuals with Tetraplegia and Their Caregivers

    Science.gov (United States)

    2017-12-01

    living environment, and all other tasks needed to maintain health , well-being, and productivity for PWTs.) This project addressed this gap in...of the person with tetraplegia, as well as home health aides or personal care attendants who may be hired by the person with tetraplegia to...or physically as applicable) how they would instruct or perform a task; and (3) observing their behavior (without specifically asking for a skill to

  13. Comparison of Individual Performance in Intelligence Tests WAIS III and RPM (Raven's Progressive Matrices)

    OpenAIRE

    Petrů, Vít

    2017-01-01

    This thesis deals with replacement of performative scale of Wechsler Adult Intelligence Scale (3rd revision) through Raven's Standard Progressive Matrices and Advanced Progressive Matrices. In the theoretical part introduces the concepts of intelligence, approaches to its exploration and intelligence tests. The theoretical part is also devoted to the description of the used methods and presents an overview of the research on a similar theme as this work. In the empirical part of the thesis is...

  14. How Do High-Performance Work Systems Affect Individual Outcomes: A Multilevel Perspective.

    Science.gov (United States)

    Zhang, Junwei; Akhtar, M Naseer; Bal, P Matthijs; Zhang, Yajun; Talat, Usman

    2018-01-01

    Research on high-performance work systems (HPWS) has suggested that a potential disconnection may exist between organizational-level HPWS and employee experienced HPWS. However, few studies have identified factors that are implied within such a relationship. Using a sample of 397 employees, 84 line managers, and 21 HR executives in China, we examined whether line managers' goal congruence can reduce the difference between organizational-level HPWS and employee experienced HPWS. Furthermore, this study also theorized and tested organization-based self-esteem (OBSE) as a mediator in the associations between employee experienced HPWS and job performance and job satisfaction. Using multilevel analyses, we found that line managers' goal congruence strengthened the relationship between organizational-level HPWS and employee experienced HPWS, such that the relationship was significant and positive when line managers' goal congruence was high, but a non-significant relationship when line managers' goal congruence was low. Moreover, employee experienced HPWS indirectly affected job performance and job satisfaction through the mechanism of OBSE beyond social exchange perspective.

  15. How Do High-Performance Work Systems Affect Individual Outcomes: A Multilevel Perspective

    Science.gov (United States)

    Zhang, Junwei; Akhtar, M. Naseer; Bal, P. Matthijs; Zhang, Yajun; Talat, Usman

    2018-01-01

    Research on high-performance work systems (HPWS) has suggested that a potential disconnection may exist between organizational-level HPWS and employee experienced HPWS. However, few studies have identified factors that are implied within such a relationship. Using a sample of 397 employees, 84 line managers, and 21 HR executives in China, we examined whether line managers’ goal congruence can reduce the difference between organizational-level HPWS and employee experienced HPWS. Furthermore, this study also theorized and tested organization-based self-esteem (OBSE) as a mediator in the associations between employee experienced HPWS and job performance and job satisfaction. Using multilevel analyses, we found that line managers’ goal congruence strengthened the relationship between organizational-level HPWS and employee experienced HPWS, such that the relationship was significant and positive when line managers’ goal congruence was high, but a non-significant relationship when line managers’ goal congruence was low. Moreover, employee experienced HPWS indirectly affected job performance and job satisfaction through the mechanism of OBSE beyond social exchange perspective. PMID:29743875

  16. How Do High-Performance Work Systems Affect Individual Outcomes: A Multilevel Perspective

    Directory of Open Access Journals (Sweden)

    Junwei Zhang

    2018-04-01

    Full Text Available Research on high-performance work systems (HPWS has suggested that a potential disconnection may exist between organizational-level HPWS and employee experienced HPWS. However, few studies have identified factors that are implied within such a relationship. Using a sample of 397 employees, 84 line managers, and 21 HR executives in China, we examined whether line managers’ goal congruence can reduce the difference between organizational-level HPWS and employee experienced HPWS. Furthermore, this study also theorized and tested organization-based self-esteem (OBSE as a mediator in the associations between employee experienced HPWS and job performance and job satisfaction. Using multilevel analyses, we found that line managers’ goal congruence strengthened the relationship between organizational-level HPWS and employee experienced HPWS, such that the relationship was significant and positive when line managers’ goal congruence was high, but a non-significant relationship when line managers’ goal congruence was low. Moreover, employee experienced HPWS indirectly affected job performance and job satisfaction through the mechanism of OBSE beyond social exchange perspective.

  17. Combination antiretroviral therapy improves cognitive performance and functional connectivity in treatment-naïve HIV-infected individuals.

    Science.gov (United States)

    Zhuang, Yuchuan; Qiu, Xing; Wang, Lu; Ma, Qing; Mapstone, Mark; Luque, Amneris; Weber, Miriam; Tivarus, Madalina; Miller, Eric; Arduino, Roberto C; Zhong, Jianhui; Schifitto, Giovanni

    2017-10-01

    Our study aimed to investigate the short-term effect of combination antiretroviral therapy (cART) on cognitive performance and functional and structural connectivity and their relationship to plasma levels of antiretroviral (ARV) drugs. Seventeen ARV treatment-naïve HIV-infected individuals (baseline mean CD4 cell count, 479 ± 48 cells/mm 3 ) were age matched with 17 HIV-uninfected individuals. All subjects underwent a detailed neurocognitive and functional assessment and magnetic resonance imaging. HIV-infected subjects were scanned before starting cART and 12 weeks after initiation of treatment. Uninfected subjects were assessed once at baseline. Functional connectivity (FC) was assessed within the default mode network while structural connectivity was assessed by voxel-wise analysis using tract-based spatial statistics (TBSS) and probabilistic tractography within the DMN. Tenofovir and emtricitabine blood concentration were measured at week 12 of cART. Prior to cART, HIV-infected individuals had significantly lower cognitive performance than control subjects as measured by the total Z-score from the neuropsychological tests assessing six cognitive domains (p = 0.020). After 12 weeks of cART treatment, there remained only a weak cognitive difference between HIV-infected and HIV-uninfected subjects (p = 0.057). Mean FC was lower in HIV-infected individuals compared with those uninfected (p = 0.008), but FC differences became non-significant after treatment (p = 0.197). There were no differences in DTI metrics between HIV-infected and HIV-uninfected individuals using the TBSS approach and limited evidence of decreased structural connectivity within the DMN in HIV-infected individuals. Tenofovir and emtricitabine plasma concentrations did not correlate with either cognitive performance or imaging metrics. Twelve weeks of cART improves cognitive performance and functional connectivity in ARV treatment-naïve HIV-infected individuals with relatively

  18. Pharmaceutical marketing research and the prescribing physician.

    Science.gov (United States)

    Greene, Jeremy A

    2007-05-15

    Surveillance of physicians' prescribing patterns and the accumulation and sale of these data for pharmaceutical marketing are currently the subjects of legislation in several states and action by state and national medical associations. Contrary to common perception, the growth of the health care information organization industry has not been limited to the past decade but has been building slowly over the past 50 years, beginning in the 1940s when growth in the prescription drug market fueled industry interest in understanding and influencing prescribing patterns. The development of this surveillance system was not simply imposed on the medical profession by the pharmaceutical industry but was developed through the interactions of pharmaceutical salesmen, pharmaceutical marketers, academic researchers, individual physicians, and physician organizations. Examination of the role of physicians and physician organizations in the development of prescriber profiling is directly relevant to the contemporary policy debate surrounding this issue.

  19. Performance and type testing of selected dosimeters used for individual monitoring

    International Nuclear Information System (INIS)

    Almhena, E. H. Y.

    2010-07-01

    This study describes calibration and performance testing carried out for a set of 14 electronic personal dosimeters (EPDs) and thermoluminescence dosimeters (TLDs ) at the Secondary Standard Dosimetry Laboratory of Sudan. Also the conversion coefficients from air kerma have been determined. Dosimeters tested are belonging to three manufactures representing most commonly used types in Sudan. Calibrations were carried out at three X-ray qualities: 80, 120 and 150 kV, ISO 'narrow' spectra and for ''1''3''7Cs, '' 60 Co gamma rays. The experiments were carried out using ICRU Slab phantom with dimension 30x30x15 cm. Secondary standard ionization chamber was used to measure the personal dose equivalent, Hp(10) as standard dosimetric quantity of interest. parameters tested include: The variation of response with radiation energy and angle of incident in addition to dose rate dependence. The angular dependence factors have been experimentally determined for the same qualities and for different angles (0, ±20, ±40, ±60u) + were performed in accordance to the relevant international standards. Excellent energy, angular and dose rate response was demonstrated for 662 137 Cs, 1250 60 Co beam and (118, 100,65 keV) x-ray beam qualities exception the EPD at PM1203M are slightly larger but still with the acceptable. The response of electronic dosimeters were found to in limits of acceptable performance. For the mean response of all energies is range of EPDs Type RADOS 60, Greatz ED 150, Polimaster PM1203M, TLD were (0.75 ±0.08- 1.13±0.13), (0.83±0.29 -1.06±0.07), (1.08±0.14-1.27±0.09), (0.99±0.05 - 1.14±0.13) respectively. The majority of the dosimeters tested showed good energy and angular response. (Author)

  20. Childhood conditions and current physical performance among non-institutionalized individuals aged 50+ in Israel.

    Science.gov (United States)

    Weinstein, Galit

    2016-12-01

    Adverse socioeconomic conditions in childhood have been previously linked with high risk of various health conditions. However, the association with future physical function has been less studied. Hand grip strength and chair-rising time are objective measures of physical capability indicating current and future health outcomes. The aim of this study was to test the hypothesis that perceived socio-economic status in childhood is related to current measures of physical function, among Israeli participants of the Survey of Health, Ageing and Retirement in Europe project. The study included 2300 participants aged 50 years or older (mean age 68 ± 10; 56 % women). Generalized linear regression models were used to examine the associations of childhood wealth and number of books in residence with grip strength and time to complete five rises from a chair. Logistic regression models were used to assess the relationships between the early life conditions and the ability to perform the physical tests. Adjustment was made for current income or household wealth, and for demographic, anthropometric, health, and life-style measures. Being wealthy and having a large number of books at home in childhood was associated with a stronger hand grip and a better chair-rise test performance. These associations were more robust in women compared to men, and persisted after adjustment for potential covariates. In addition, childhood wealth and number of books were associated with lower risk of being unable to perform the tests. Thus, early-life programming may contribute to physical function indicators in mid- and late-life.

  1. Simple routine tests to improve the performance of the DPRSN TLD-based individual monitoring system

    International Nuclear Information System (INIS)

    Alves, J.G.; Batel, V.I.; Silva, P.B.; Roda, A.; Santos, L.

    2002-01-01

    This paper presents some of the results of a simple quality control program developed and implemented at the thermoluminescence sector of the IMS. The European Union (EU) Directive 96/29/EURATOM has not yet been transposed to national legislation and Portuguese law concerning the monitoring of radiation workers still establishes an annual dose limit of 50 mSv. However, new legislation has recently been published with requirements on the performance of dosimetric services. Some of the results of the tests reported herein will show compliance with the above mentioned requirements

  2. Effects of Lactation Stage and Individual Performance on Milk -9, -11 Conjugated Linoleic Acids Content in Dairy Cows

    Directory of Open Access Journals (Sweden)

    T. Wang

    2013-02-01

    Full Text Available The goal of this study was to evaluate the effects of lactation stage and individual performance on milk cis-9, trans-11 conjugated linoleic acid (CLA content in dairy cows. In experiment 1, the milk cis-9, trans-11 CLA content from dairy cows in early (0.33±0.014%, middle (0.37±0.010%, and late stages (0.44±0.020% showed significant differences (p<0.05; and the individual contents of the major fatty acids, especially cis-9, trans-11 CLA in cows of the same lactation were also variable. In the second experiment design as a validation test, our results once again showed that the individual contents of cis-9, trans-11 CLA were various, and a difference of about 2-fold (0.55% vs 0.95% was observed, although the animals were offered same diet. These data demonstrated that lactation stage and individual performance have considerable effects on milk cis-9, trans-11 CLA contents.

  3. An RFID-Based Smart Nest Box: An Experimental Study of Laying Performance and Behavior of Individual Hens

    Directory of Open Access Journals (Sweden)

    Ying-Ren Chien

    2018-03-01

    Full Text Available This study designed a radio-frequency identification (RFID-based Internet of Things (IoT platform to create the core of a smart nest box. At the sensing level, we have deployed RFID-based sensors and egg detection sensors. A low-frequency RFID reader is installed in the bottom of the nest box and a foot ring RFID tag is worn on the leg of individual hens. The RFID-based sensors detect when a hen enters or exits the nest box. The egg-detection sensors are implemented with a resistance strain gauge pressure sensor, which weights the egg in the egg-collection tube. Thus, the smart nest box makes it possible to analyze the laying performance and behavior of individual hens. An evaluative experiment was performed using an enriched cage, a smart nest box, web camera, and monitoring console. The hens were allowed 14 days to become accustomed to the experimental environment before monitoring began. The proposed IoT platform makes it possible to analyze the egg yield of individual hens in real time, thereby enabling the replacement of hens with egg yield below a pre-defined level in order to meet the overall target egg yield rate. The results of this experiment demonstrate the efficacy of the proposed RFID-based smart nest box in monitoring the egg yield and laying behavior of individual hens.

  4. Effect of different types of music on exercise performance in normal individuals.

    Science.gov (United States)

    Thakur, Anuprita M; Yardi, Sujata S

    2013-01-01

    While exercising, people seem to enjoy listening to music believing that it relaxes them or helps give the necessary rhythm for exercise. But is music really beneficial? In view of different people listening to different types of music, this study was intended to assess effect of different types of music on exercise performance. 30 healthy female college students in the age group of 18 to 25 years were made to walk on the treadmill 3 times at one week interval: without music (A), with slow music (B), with fast music (C). Duration of exercise and rate of perceived exertion were recorded at the end of each session. The results showed an increase in the duration of exercise in Group B and Group C as compared to Group A and the increase was more in Group C as compared to Group B. It was observed that level of RPE was the same at the end of every exercise session. The reason for increase in exercise duration with music could be because of various factors like dissociation, arousal, motivation, etc. It can be thus suggested that exercises can be performed for longer duration with music than without music and the effect is more with fast music than with slow music. Also with music, the same level of exertion is perceived though the walking duration is considerably increased.

  5. Contributions of Sensory Coding and Attentional Control to Individual Differences in Performance in Spatial Auditory Selective Attention Tasks.

    Science.gov (United States)

    Dai, Lengshi; Shinn-Cunningham, Barbara G

    2016-01-01

    Listeners with normal hearing thresholds (NHTs) differ in their ability to steer attention to whatever sound source is important. This ability depends on top-down executive control, which modulates the sensory representation of sound in the cortex. Yet, this sensory representation also depends on the coding fidelity of the peripheral auditory system. Both of these factors may thus contribute to the individual differences in performance. We designed a selective auditory attention paradigm in which we could simultaneously measure envelope following responses (EFRs, reflecting peripheral coding), onset event-related potentials (ERPs) from the scalp (reflecting cortical responses to sound) and behavioral scores. We performed two experiments that varied stimulus conditions to alter the degree to which performance might be limited due to fine stimulus details vs. due to control of attentional focus. Consistent with past work, in both experiments we find that attention strongly modulates cortical ERPs. Importantly, in Experiment I, where coding fidelity limits the task, individual behavioral performance correlates with subcortical coding strength (derived by computing how the EFR is degraded for fully masked tones compared to partially masked tones); however, in this experiment, the effects of attention on cortical ERPs were unrelated to individual subject performance. In contrast, in Experiment II, where sensory cues for segregation are robust (and thus less of a limiting factor on task performance), inter-subject behavioral differences correlate with subcortical coding strength. In addition, after factoring out the influence of subcortical coding strength, behavioral differences are also correlated with the strength of attentional modulation of ERPs. These results support the hypothesis that behavioral abilities amongst listeners with NHTs can arise due to both subcortical coding differences and differences in attentional control, depending on stimulus characteristics

  6. Contributions of sensory coding and attentional control to individual differences in performance in spatial auditory selective attention tasks

    Directory of Open Access Journals (Sweden)

    Lengshi Dai

    2016-10-01

    Full Text Available Listeners with normal hearing thresholds differ in their ability to steer attention to whatever sound source is important. This ability depends on top-down executive control, which modulates the sensory representation of sound in cortex. Yet, this sensory representation also depends on the coding fidelity of the peripheral auditory system. Both of these factors may thus contribute to the individual differences in performance. We designed a selective auditory attention paradigm in which we could simultaneously measure envelope following responses (EFRs, reflecting peripheral coding, onset event-related potentials from the scalp (ERPs, reflecting cortical responses to sound, and behavioral scores. We performed two experiments that varied stimulus conditions to alter the degree to which performance might be limited due to fine stimulus details vs. due to control of attentional focus. Consistent with past work, in both experiments we find that attention strongly modulates cortical ERPs. Importantly, in Experiment I, where coding fidelity limits the task, individual behavioral performance correlates with subcortical coding strength (derived by computing how the EFR is degraded for fully masked tones compared to partially masked tones; however, in this experiment, the effects of attention on cortical ERPs were unrelated to individual subject performance. In contrast, in Experiment II, where sensory cues for segregation are robust (and thus less of a limiting factor on task performance, inter-subject behavioral differences correlate with subcortical coding strength. In addition, after factoring out the influence of subcortical coding strength, behavioral differences are also correlated with the strength of attentional modulation of ERPs. These results support the hypothesis that behavioral abilities amongst listeners with normal hearing thresholds can arise due to both subcortical coding differences and differences in attentional control, depending on

  7. Effects of Partial and Acute Total Sleep Deprivation on Performance across Cognitive Domains, Individuals and Circadian Phase

    Science.gov (United States)

    Lo, June C.; Groeger, John A.; Santhi, Nayantara; Arbon, Emma L.; Lazar, Alpar S.; Hasan, Sibah; von Schantz, Malcolm; Archer, Simon N.; Dijk, Derk-Jan

    2012-01-01

    Background Cognitive performance deteriorates during extended wakefulness and circadian phase misalignment, and some individuals are more affected than others. Whether performance is affected similarly across cognitive domains, or whether cognitive processes involving Executive Functions are more sensitive to sleep and circadian misalignment than Alertness and Sustained Attention, is a matter of debate. Methodology/Principal Findings We conducted a 2 × 12-day laboratory protocol to characterize the interaction of repeated partial and acute total sleep deprivation and circadian phase on performance across seven cognitive domains in 36 individuals (18 males; mean ± SD of age = 27.6±4.0 years). The sample was stratified for the rs57875989 polymorphism in PER3, which confers cognitive susceptibility to total sleep deprivation. We observed a deterioration of performance during both repeated partial and acute total sleep deprivation. Furthermore, prior partial sleep deprivation led to poorer cognitive performance in a subsequent total sleep deprivation period, but its effect was modulated by circadian phase such that it was virtually absent in the evening wake maintenance zone, and most prominent during early morning hours. A significant effect of PER3 genotype was observed for Subjective Alertness during partial sleep deprivation and on n-back tasks with a high executive load when assessed in the morning hours during total sleep deprivation after partial sleep loss. Overall, however, Subjective Alertness and Sustained Attention were more affected by both partial and total sleep deprivation than other cognitive domains and tasks including n-back tasks of Working Memory, even when implemented with a high executive load. Conclusions/Significance Sleep loss has a primary effect on Sleepiness and Sustained Attention with much smaller effects on challenging Working Memory tasks. These findings have implications for understanding how sleep debt and circadian rhythmicity

  8. Use of individual containers for prostate biopsy samples: Do we gain diagnostic performance?

    Science.gov (United States)

    Panach-Navarrete, J; García-Morata, F; Valls-González, L; Martínez-Jabaloyas, J M

    2016-05-01

    Prostate cores from transrectal biopsies are usually sent in separate vials for pathological processing. Although this is a common practice, there are controversial studies on its usefulness. We wanted to compare the rate of prostate cancer diagnosis between processing samples in 2 containers and processing them in individual containers to see if there are differences. Our secondary objective was to check the rate of diagnosis of various tumour subtypes in each of the 2 groups. A retrospective observational study was conducted of 2,601 cases of prostate biopsies. Ten cores were extracted in each biopsy. We divided the sample into 2 groups: biopsies sent in 2 containers to the department of pathology (left and right lobes) or sent in 10 (one for each cylinder), according to the different criteria used in our centre in the past. We then classified the cases according to the absence of neoplasia, insignificant tumour (involvement of just 1 cylinder, container group, and 824 were included in the 10-container group. We diagnosed a rate of 32.4% of cancers in the 2-container group and 40% in the 10-container group, a difference that was statistically significant (Pcontainer group than in the 10-container group (6.4% vs. 4.3%, respectively; P=.03). Samples with a Gleason score of 6 were diagnosed more often in the 10-container group than in the 2-container group (11.9% vs. 8.1%, respectively; P=.002). The same occurred with the Gleason score≥7 (23.8% in the 10-container group vs. 17.9% in the 2-container group; Pcontainers. Once the procedure was conducted, we also observed in our series a reduction in the diagnoses of insignificant carcinoma to the detriment of an increased diagnosis of not insignificant carcinomas. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. A rational inference approach to group and individual-level sentence comprehension performance in aphasia.

    Science.gov (United States)

    Warren, Tessa; Dickey, Michael Walsh; Liburd, Teljer L

    2017-07-01

    The rational inference, or noisy channel, account of language comprehension predicts that comprehenders are sensitive to the probabilities of different interpretations for a given sentence and adapt as these probabilities change (Gibson, Bergen & Piantadosi, 2013). This account provides an important new perspective on aphasic sentence comprehension: aphasia may increase the likelihood of sentence distortion, leading people with aphasia (PWA) to rely more on the prior probability of an interpretation and less on the form or structure of the sentence (Gibson, Sandberg, Fedorenko, Bergen & Kiran, 2015). We report the results of a sentence-picture matching experiment that tested the predictions of the rational inference account and other current models of aphasic sentence comprehension across a variety of sentence structures. Consistent with the rational inference account, PWA showed similar sensitivity to the probability of particular kinds of form distortions as age-matched controls, yet overall their interpretations relied more on prior probability and less on sentence form. As predicted by rational inference, but not by other models of sentence comprehension in aphasia, PWA's interpretations were more faithful to the form for active and passive sentences than for direct object and prepositional object sentences. However contra rational inference, there was no evidence that individual PWA's severity of syntactic or semantic impairment predicted their sensitivity to form versus the prior probability of a sentence, as cued by semantics. These findings confirm and extend previous findings that suggest the rational inference account holds promise for explaining aphasic and neurotypical comprehension, but they also raise new challenges for the account. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Behavioural strategies towards human disturbances explain individual performance in woodland caribou.

    Science.gov (United States)

    Leclerc, Martin; Dussault, Christian; St-Laurent, Martin-Hugues

    2014-09-01

    Behavioural strategies may have important fitness, ecological and evolutionary consequences. In woodland caribou, human disturbances are associated with higher predation risk. Between 2004 and 2011, we investigated if habitat selection strategies of female caribou towards disturbances influenced their calf's survival in managed boreal forest with varying intensities of human disturbances. Calf survival was 53% and 43% after 30 and 90 days following birth, respectively, and 52% of calves that died were killed by black bear. The probability that a female lose its calf to predation was not influenced by habitat composition of her annual home range, but decreased with an increase in proportion of open lichen woodland within her calving home range. At the local scale, females that did not lose their calf displayed stronger avoidance of high road density areas than females that lost their calf to predation. Further, females that lost their calf to predation and that had a low proportion of ≤5-year-old cutovers within their calving home range were mostly observed in areas where these young cutovers were locally absent. Also, females that lost their calf to predation and that had a high proportion of ≤5-year-old cutovers within their calving home range were mostly observed in areas with a high local density of ≤5-year-old cutovers. Our study demonstrates that we have to account for human-induced disturbances at both local and regional scales in order to further enhance effective caribou management plans. We demonstrate that disturbances not only impact spatial distribution of individuals, but also their reproductive success.

  11. Teachers’ perceptions of individual performance-related pay in practice : A picture of a counterproductive pay system

    OpenAIRE

    Lundström, Ulf

    2012-01-01

    This article describes and discusses Swedish upper-secondary teachers’ perceptions of the effects of individual performance-related pay (PRP) in the context of educational restructuring and governance. The empirical data were generated through semi-structured interviews of 23 teachers. Power’s distinction between programmatic and technological elements of audit is used as a frame of reference for the problematization of the pay system. The findings demonstrate a wide gap between the programma...

  12. Model Of Emergency Department Nurse Performance Improvement Based on Association of Individual Characteristic, Organization Characteristic and Job Characteristic

    OpenAIRE

    Bogar, Maria Margaretha; Nursalam, Nursalam; Dewi, Yulis Setiya

    2017-01-01

    Introduction: Nursing care is integral part of health care and having important role in management of patient with emergency condition. The purpose of this research was to develop nurse performance improvement model based on individual, organization and job characteristics association in Emergency Department of RSUD dr TC Hillers Maumere. Method: This was an explanative survey by cross sectional approach held on July -August 2012. Respondents in this study were 22 nurses and 44 patients were ...

  13. Nurse Practitioner-Physician Comanagement: A Theoretical Model to Alleviate Primary Care Strain.

    Science.gov (United States)

    Norful, Allison A; de Jacq, Krystyna; Carlino, Richard; Poghosyan, Lusine

    2018-05-01

    Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physicians and specialists. Because nurse practitioners are increasingly managing patient care as independent clinicians, our study objective was to propose a model of nurse practitioner-physician comanagement. We conducted a literature search using the following key words: comanagement; primary care; nurse practitioner OR advanced practice nurse. From 156 studies, we extracted information about nurse practitioner-physician comanagement antecedents, attributes, and consequences. A systematic review of the findings helped determine effects of nurse practitioner-physician comanagement on patient care. Then, we performed 26 interviews with nurse practitioners and physicians to obtain their perspectives on nurse practitioner-physician comanagement. Results were compiled to create our conceptual nurse practitioner-physician comanagement model. Our model of nurse practitioner-physician comanagement has 3 elements: effective communication; mutual respect and trust; and clinical alignment/shared philosophy of care. Interviews indicated that successful comanagement can alleviate individual workload, prevent burnout, improve patient care quality, and lead to increased patient access to care. Legal and organizational barriers, however, inhibit the ability of nurse practitioners to practice autonomously or with equal care management resources as primary care physicians. Future research should focus on developing instruments to measure and further assess nurse practitioner-physician comanagement in the primary care practice setting. © 2018 Annals of Family Medicine, Inc.

  14. Thinking Styles and Regret in Physicians.

    Science.gov (United States)

    Djulbegovic, Mia; Beckstead, Jason; Elqayam, Shira; Reljic, Tea; Kumar, Ambuj; Paidas, Charles; Djulbegovic, Benjamin

    2015-01-01

    Decision-making relies on both analytical and emotional thinking. Cognitive reasoning styles (e.g. maximizing and satisficing tendencies) heavily influence analytical processes, while affective processes are often dependent on regret. The relationship between regret and cognitive reasoning styles has not been well studied in physicians, and is the focus of this paper. A regret questionnaire and 6 scales measuring individual differences in cognitive styles (maximizing-satisficing tendencies; analytical vs. intuitive reasoning; need for cognition; intolerance toward ambiguity; objectivism; and cognitive reflection) were administered through a web-based survey to physicians of the University of South Florida. Bonferroni's adjustment was applied to the overall correlation analysis. The correlation analysis was also performed without Bonferroni's correction, given the strong theoretical rationale indicating the need for a separate hypothesis. We also conducted a multivariate regression analysis to identify the unique influence of predictors on regret. 165 trainees and 56 attending physicians (age range 25 to 69) participated in the survey. After bivariate analysis we found that maximizing tendency positively correlated with regret with respect to both decision difficulty (r=0.673; prational-analytical thinking (r=-0.422; p<0.001), need for cognition (r=-0.340; p<0.001), and objectivism (r=-0.309; p=0.003) and positively correlated with ambiguity intolerance (r=0.285; p=0.012). However, after conducting a multivariate regression analysis, we found that regret was positively associated with maximizing only with respect to decision difficulty (r=0.791; p<0.001), while it was negatively associated with satisficing (r=-0.257; p=0.020) and objectivism (r=-0.267; p=0.034). We found no statistically significant relationship between regret and overall accuracy on conditional inferential tasks. Regret in physicians is strongly associated with their tendency to maximize; i.e. the

  15. Thinking Styles and Regret in Physicians.

    Directory of Open Access Journals (Sweden)

    Mia Djulbegovic

    Full Text Available Decision-making relies on both analytical and emotional thinking. Cognitive reasoning styles (e.g. maximizing and satisficing tendencies heavily influence analytical processes, while affective processes are often dependent on regret. The relationship between regret and cognitive reasoning styles has not been well studied in physicians, and is the focus of this paper.A regret questionnaire and 6 scales measuring individual differences in cognitive styles (maximizing-satisficing tendencies; analytical vs. intuitive reasoning; need for cognition; intolerance toward ambiguity; objectivism; and cognitive reflection were administered through a web-based survey to physicians of the University of South Florida. Bonferroni's adjustment was applied to the overall correlation analysis. The correlation analysis was also performed without Bonferroni's correction, given the strong theoretical rationale indicating the need for a separate hypothesis. We also conducted a multivariate regression analysis to identify the unique influence of predictors on regret.165 trainees and 56 attending physicians (age range 25 to 69 participated in the survey. After bivariate analysis we found that maximizing tendency positively correlated with regret with respect to both decision difficulty (r=0.673; p<0.001 and alternate search strategy (r=0.239; p=0.002. When Bonferroni's correction was not applied, we also found a negative relationship between satisficing tendency and regret (r=-0.156; p=0.021. In trainees, but not faculty, regret negatively correlated with rational-analytical thinking (r=-0.422; p<0.001, need for cognition (r=-0.340; p<0.001, and objectivism (r=-0.309; p=0.003 and positively correlated with ambiguity intolerance (r=0.285; p=0.012. However, after conducting a multivariate regression analysis, we found that regret was positively associated with maximizing only with respect to decision difficulty (r=0.791; p<0.001, while it was negatively associated with

  16. Individualized Medicine

    Energy Technology Data Exchange (ETDEWEB)

    Mariella, R.

    2000-08-29

    The recent focus of microelectromechanical-systems (MEMS) based instrumentation has largely dealt with increasing the throughput of established processes, including drug screening/drug discovery/combinatorial chemistry, or the miniaturization of accepted bench-top instruments. The miniaturization and automation of procedures that were previously performed manually are included in these activities. We suggest that BioMEMS instrumentation will adopt an additional direction, that of providing information and capabilities to the physician that are not available, today.

  17. Relationships between in-role performance and individual values, commitment, and organizational citizenship behavior among Israeli teachers.

    Science.gov (United States)

    Cohen, Aaron; Liu, Ying

    2011-08-01

    This study examines the relationship between (1) individual values, (2) organizational and occupational commitment, and (3) organizational citizenship behavior (OCB) and in-role performance in a sample of 192 teachers employed in 10 secular Jewish schools (response rate of 64%). The results showed that individual values were related to all commitment forms examined here, but contrary to expectations, there was no clear distinction between values that represent conservation and self-transcendence and values that represent openness to change and self-enhancement in terms of their relationship either to commitment or to behavioral outcomes. Likewise, there was no clear distinction between the three dimensions of commitment (affective, continuance, and normative) or two commitment foci (organizational and occupational) in terms of their relationships to different values. Unsurprisingly, the findings showed a strong effect of commitment on OCB and in-role performance. The findings show that both individual values and commitment are concepts that can increase our understanding of employees' behavior in the workplace. We conclude by emphasizing the need for further research on the relationship between values, commitment, and performance and by suggesting some directions for such research.

  18. Physicians and euthanasia: a Canadian print-media discourse analysis of physician perspectives.

    Science.gov (United States)

    Wright, David Kenneth; Fishman, Jennifer R; Karsoho, Hadi; Sandham, Sarah; Macdonald, Mary Ellen

    2015-01-01

    Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon the medical profession itself. We conducted a discourse analysis of print media on physicians' perspectives about end-of-life care. Print media, in English and French, that appeared in Canadian newspapers from 2008 to 2012 were retrieved through a systematic database search. We analyzed the content of 285 articles either authored by a physician or directly referencing a physician's perspective. We identified 3 predominant discourses about physicians' public views toward euthanasia: 1) contentions about integrating euthanasia within the basic mission of medicine, 2) assertions about whether euthanasia can be distinguished from other end-of-life medical practices and 3) palliative care advocacy. Our data showed that although some medical professional bodies appear to be supportive in the media of a movement toward the legalization of euthanasia, individual physicians are represented as mostly opposed. Professional physician organizations and the few physicians who have engaged with the media are de facto representing physicians in public contemporary debates on medical aid in dying, in general, and euthanasia, in particular. It is vital for physicians to be aware of this public debate, how they are being portrayed within it and its potential effects on impending changes to provincial and national policies.

  19. Lung function and six-minute walk test performance in individuals with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Daniela G. Ohara

    2014-01-01

    Full Text Available Background: Sickle Cell Disease (SCD, which is characterized by a mutation in the gene encoding beta hemoglobin, causes bodily dysfunctions such as impaired pulmonary function and reduced functional capacity. Objective : To assess changes in pulmonary function and functional capacity in patients with SCD and to identify the relationships between these variables. Method: We evaluated sociodemographic, anthropometric, lung function (spirometry, respiratory (manovacuometer, peripheral muscle strength (Handgrip strength - HS and functional capacity (i.e., the six-minute walk test parameters in 21 individuals with SCD (average age of 29±6 years. Shapiro-Wilk, paired Student's, Wilcoxon, Pearson and Spearman correlation tests were used for statistical analyses, and the significance threshold was set at p<0.05. Results : A total of 47.6% of the study subjects exhibited an altered ventilation pattern, 42.8% had a restrictive ventilatory pattern (RVP and 4.8% exhibited a mixed ventilatory pattern (MVP. The observed maximal inspiratory pressure (MIP values were below the predicted values for women (64 cmH2O, and the maximum expiratory pressure (MEP values, HS values and distance walked during the 6MWT were below the predicted values for both men (103 cmH2O, 39 Kgf and 447 m, respectively and women (64 cmH2O; 27 Kgf; 405 m, respectively. Positive correlations were observed between maximum voluntary ventilation (MVV and MEP (r=0.4; p=0.046; MVV and BMI (r=0.6; p=0.003; and between HS and MIP (r=0.7; p=0.001, MEP (r=0.6; p=0.002, MVV (r=0.5; p=0.015, distance walked in the 6MWT (r=0.4; p=0.038 and BMI (r=0.6; p=0.004. Conclusions : SCD promoted changes in lung function and functional capacity, including RVPs and a reduction in the distance walked in the 6MWT when compared to the predictions. In addition, significant correlations between the variables were observed.

  20. Effects of Dual-Task Management and Resistance Training on Gait Performance in Older Individuals: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Bettina Wollesen

    2017-12-01

    Full Text Available Background: Dual-task (DT training is a well-accepted modality for fall prevention in older adults. DT training should include task-managing strategies such as task switching or task prioritization to improve gait performance under DT conditions.Methods: We conducted a randomized controlled trial to evaluate a balance and task managing training (BDT group in gait performance compared to a single task (ST strength and resistance training and a control group, which received no training. A total of 78 older individuals (72.0 ± 4.9 years participated in this study. The DT group performed task managing training incorporating balance and coordination tasks while the ST group performed resistance training only. Training consisted of 12 weekly sessions, 60 min each, for 12 weeks. We assessed the effects of ST and BDT training on walking performance under ST and DT conditions in independent living elderly adults. ST and DT walking (visual verbal Stroop task were measured utilizing a treadmill at self-selected walking speed (mean for all groups: 4.4 ± 1 km h-1. Specific gait variables, cognitive performance, and fear of falling were compared between all groups.>Results: Training improved gait performance for step length (p < 0.001 and gait-line (ST: p < 0.01; DT p < 0.05 in both training groups. The BDT training group showed greater improvements in step length (p < 0.001 and gait-line (p < 0.01 during DT walking but did not have changes in cognitive performance. Both interventions reduced fear of falling (p < 0.05.Conclusion: Implementation of task management strategies into balance and strength training in our population revealed a promising modality to prevent falls in older individuals.Trial registration: German register of clinical trials DRKS00012382.

  1. Burnout among physicians

    OpenAIRE

    Romani, Maya; Ashkar, Khalil

    2014-01-01

    Burnout is a common syndrome seen in healthcare workers, particularly physicians who are exposed to a high level of stress at work; it includes emotional exhaustion, depersonalization, and low personal accomplishment. Burnout among physicians has garnered significant attention because of the negative impact it renders on patient care and medical personnel. Physicians who had high burnout levels reportedly committed more medical errors. Stress management programs that range from relaxation to ...

  2. Effect of respiratory muscle training on exercise performance in healthy individuals: a systematic review and meta-analysis.

    Science.gov (United States)

    Illi, Sabine K; Held, Ulrike; Frank, Irène; Spengler, Christina M

    2012-08-01

    Two distinct types of specific respiratory muscle training (RMT), i.e. respiratory muscle strength (resistive/threshold) and endurance (hyperpnoea) training, have been established to improve the endurance performance of healthy individuals. We performed a systematic review and meta-analysis in order to determine the factors that affect the change in endurance performance after RMT in healthy subjects. A computerized search was performed without language restriction in MEDLINE, EMBASE and CINAHL and references of original studies and reviews were searched for further relevant studies. RMT studies with healthy individuals assessing changes in endurance exercise performance by maximal tests (constant load, time trial, intermittent incremental, conventional [non-intermittent] incremental) were screened and abstracted by two independent investigators. A multiple linear regression model was used to identify effects of subjects' fitness, type of RMT (inspiratory or combined inspiratory/expiratory muscle strength training, respiratory muscle endurance training), type of exercise test, test duration and type of sport (rowing, running, swimming, cycling) on changes in performance after RMT. In addition, a meta-analysis was performed to determine the effect of RMT on endurance performance in those studies providing the necessary data. The multiple linear regression analysis including 46 original studies revealed that less fit subjects benefit more from RMT than highly trained athletes (6.0% per 10 mL · kg⁻¹ · min⁻¹ decrease in maximal oxygen uptake, 95% confidence interval [CI] 1.8, 10.2%; p = 0.005) and that improvements do not differ significantly between inspiratory muscle strength and respiratory muscle endurance training (p = 0.208), while combined inspiratory and expiratory muscle strength training seems to be superior in improving performance, although based on only 6 studies (+12.8% compared with inspiratory muscle strength training, 95% CI 3

  3. Family physician perceptions of working with LGBTQ patients: physician training needs.

    Science.gov (United States)

    Beagan, Brenda; Fredericks, Erin; Bryson, Mary

    2015-01-01

    Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Three major themes emerged: 1) Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2) Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3) Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

  4. Family physician perceptions of working with LGBTQ patients: physician training needs

    Directory of Open Access Journals (Sweden)

    Brenda Beagan

    2015-04-01

    Full Text Available Background: Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ. Understanding physician perceptions of this area of practice may aid in developing improved education. Method: In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Results: Three major themes emerged: 1 Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2 Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3 Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Conclusions: Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

  5. Michigan's Physician Group Incentive Program offers a regional model for incremental 'fee for value' payment reform.

    Science.gov (United States)

    Share, David A; Mason, Margaret H

    2012-09-01

    Blue Cross Blue Shield of Michigan partnered with providers across the state to create an innovative, "fee for value" physician incentive program that would deliver high-quality, efficient care. The Physician Group Incentive Program rewards physician organizations-formal groups of physicians and practices that can accept incentive payments on behalf of their members-based on the number of quality and utilization measures they adopt, such as generic drug dispensing rates, and on their performance on these measures across their patient populations. Physicians also receive payments for implementing a range of patient-centered medical home capabilities, such as patient registries, and they receive higher fees for office visits for incorporating these capabilities into routine practice while also improving performance. Taken together, the incentive dollars, fee increases, and care management payments amount to a potential increase in reimbursement of 40 percent or more from Blue Cross Blue Shield of Michigan for practices designated as high-performing patient-centered medical homes. At the same time, we estimate that implementing the patient-centered medical home capabilities was associated with $155 million in lower medical costs in program year 2011 for Blue Cross Blue Shield of Michigan members. We intend to devote a higher percentage of reimbursement over time to communities of caregivers that offer high-value, system-based care, and a lower percentage of reimbursement to individual physicians on a service-specific basis.

  6. Multicriteria plan optimization in the hands of physicians: a pilot study in prostate cancer and brain tumors.

    Science.gov (United States)

    Müller, Birgit S; Shih, Helen A; Efstathiou, Jason A; Bortfeld, Thomas; Craft, David

    2017-11-06

    The purpose of this study was to demonstrate the feasibility of physician driven planning in intensity modulated radiotherapy (IMRT) with a multicriteria optimization (MCO) treatment planning system and template based plan optimization. Exploiting the full planning potential of MCO navigation, this alternative planning approach intends to improve planning efficiency and individual plan quality. Planning was retrospectively performed on 12 brain tumor and 10 post-prostatectomy prostate patients previously treated with MCO-IMRT. For each patient, physicians were provided with a template-based generated Pareto surface of optimal plans to navigate, using the beam angles from the original clinical plans. We compared physician generated plans to clinically delivered plans (created by dosimetrists) in terms of dosimetric differences, physician preferences and planning times. Plan qualities were similar, however physician generated and clinical plans differed in the prioritization of clinical goals. Physician derived prostate plans showed significantly better sparing of the high dose rectum and bladder regions (p(D1) plans indicated higher doses for targets and brainstem (p(D1) plan comparisons physicians preferred the clinical plans more often (brain: 6:3 out of 12, prostate: 2:6 out of 10) (not statistically significant). While times of physician involvement were comparable for prostate planning, the new workflow reduced the average involved time for brain cases by 30%. Planner times were reduced for all cases. Subjective benefits, such as a better understanding of planning situations, were observed by clinicians through the insight into plan optimization and experiencing dosimetric trade-offs. We introduce physician driven planning with MCO for brain and prostate tumors as a feasible planning workflow. The proposed approach standardizes the planning process by utilizing site specific templates and integrates physicians more tightly into treatment planning. Physicians

  7. Becoming a Physician

    Science.gov (United States)

    ... the Payment Process Physician Payment Resource Center Reinventing Medical Practice Managing Your Practice CPT® (Current Procedural Terminology) Medicare & Medicaid Private Payer Reform Claims Processing & Practice ...

  8. A functional neuroimaging study of sound localization: visual cortex activity predicts performance in early-blind individuals.

    Directory of Open Access Journals (Sweden)

    Frédéric Gougoux

    2005-02-01

    Full Text Available Blind individuals often demonstrate enhanced nonvisual perceptual abilities. However, the neural substrate that underlies this improved performance remains to be fully understood. An earlier behavioral study demonstrated that some early-blind people localize sounds more accurately than sighted controls using monaural cues. In order to investigate the neural basis of these behavioral differences in humans, we carried out functional imaging studies using positron emission tomography and a speaker array that permitted pseudo-free-field presentations within the scanner. During binaural sound localization, a sighted control group showed decreased cerebral blood flow in the occipital lobe, which was not seen in early-blind individuals. During monaural sound localization (one ear plugged, the subgroup of early-blind subjects who were behaviorally superior at sound localization displayed two activation foci in the occipital cortex. This effect was not seen in blind persons who did not have superior monaural sound localization abilities, nor in sighted individuals. The degree of activation of one of these foci was strongly correlated with sound localization accuracy across the entire group of blind subjects. The results show that those blind persons who perform better than sighted persons recruit occipital areas to carry out auditory localization under monaural conditions. We therefore conclude that computations carried out in the occipital cortex specifically underlie the enhanced capacity to use monaural cues. Our findings shed light not only on intermodal compensatory mechanisms, but also on individual differences in these mechanisms and on inhibitory patterns that differ between sighted individuals and those deprived of vision early in life.

  9. Tailoring hospital marketing efforts to physicians' needs.

    Science.gov (United States)

    Mackay, J M; Lamb, C W

    1988-12-01

    Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.

  10. The Relationship between the Family Physician and Psychosomatic Medicine

    Directory of Open Access Journals (Sweden)

    Farzad Goli

    2017-08-01

    Full Text Available Background: Organizing the health system around family medicine (FM has been a productive approach for developed countries. The aim of this study, which was concurrent with the Iran Health Transform Plan (HTP and the establishment of the family physician in Iran, was to discuss the sufficiency of a family physician training program for their roles and increase their competency.Methods: This descriptive study was conducted in the Psychosomatic Research Center affiliated to Isfahan University of Medical Science, Iran, with the assistance of the Iranian Institute of Higher Health (2015. An expert panel consisting of 6 individuals including specialists, trainers, and researchers in FM and psychosomatic medicine was held for this purpose. Using the World Organization of Family Doctors‎ (WONCA website for the definition of a family physician, the curriculum developed by the Ministry of Health and Medical Education was studied. Data were summarized in one table.Results: The current FM curriculum, with this content and method, does not seem to be capable of enabling physicians to perform their multidisciplinary roles. it still has a reductionist approach and disease orientation instead of a clinical reasoning method and systematic viewpoint. The psychosomatic approach is applicable at all prevention levels and in all diseases‎, since it is basically designed for this longitudinal (between all preventive levels and horizontal (bio-physical–social-spiritual intervention integration.Conclusion: Psychosomatic medicine, not as a biomedical specialty, but rather as a systems thinking model in health, had a rapid rise during previous decades. Now, its services have been integrated into all medical fields. This means that it should be adopted in the core of health care services (i.e., the family physician position before other sections. This would help the implementation of this approach in the health system, and the reduction of patients' pain and

  11. A method to assess the influence of individual player performance distribution on match outcome in team sports.

    Science.gov (United States)

    Robertson, Sam; Gupta, Ritu; McIntosh, Sam

    2016-10-01

    This study developed a method to determine whether the distribution of individual player performances can be modelled to explain match outcome in team sports, using Australian Rules football as an example. Player-recorded values (converted to a percentage of team total) in 11 commonly reported performance indicators were obtained for all regular season matches played during the 2014 Australian Football League season, with team totals also recorded. Multiple features relating to heuristically determined percentiles for each performance indicator were then extracted for each team and match, along with the outcome (win/loss). A generalised estimating equation model comprising eight key features was developed, explaining match outcome at a median accuracy of 63.9% under 10-fold cross-validation. Lower 75th, 90th and 95th percentile values for team goals and higher 25th and 50th percentile values for disposals were linked with winning. Lower 95th and higher 25th percentile values for Inside 50s and Marks, respectively, were also important contributors. These results provide evidence supporting team strategies which aim to obtain an even spread of goal scorers in Australian Rules football. The method developed in this investigation could be used to quantify the importance of individual contributions to overall team performance in team sports.

  12. Internalization Mediation towards the Relationship between Entrepreneurial Action and Individual Performance for the Next Generation of Family Companies in Surabaya

    Directory of Open Access Journals (Sweden)

    Carolina Novi Mustikarini

    2017-06-01

    Full Text Available This study  examined the effect of entrepreneurial action for the performance of the next generation using the sample of students who joined the Family Business Community. In this study, there is a high contribution given by the role of entrepreneurship education in preparing the next generation in the family business. In addition, entrepreneurship education is considered possible through the process of internalization of the leaning process that is going on. For example, it is noted that entrepreneurial action can have a significant effect on the performance of the organization. In the context of the family business and entrepreneurial education at the University of Ciputra, both variables (entrepreneurial action and individual performance are necessary to be tested and therefore, the researcher finds it possible to cary out a research that is supposed to have a contribution to the family business. This study uses a hierarchical regression analysis, to test the stages of the mediation process. The results showed that most of relationships mediate internalization Entrepreneurial Action and Individual Performance.

  13. Effects of imperfect automation and individual differences on concurrent performance of military and robotics tasks in a simulated multitasking environment.

    Science.gov (United States)

    Chen, J Y C; Terrence, P I

    2009-08-01

    This study investigated the performance and workload of the combined position of gunner and robotics operator in a simulated military multitasking environment. Specifically, the study investigated how aided target recognition (AiTR) capabilities for the gunnery task with imperfect reliability (false-alarm-prone vs. miss-prone) might affect the concurrent robotics and communication tasks. Additionally, the study examined whether performance was affected by individual differences in spatial ability and attentional control. Results showed that when the robotics task was simply monitoring the video, participants had the best performance in their gunnery and communication tasks and the lowest perceived workload, compared with the other robotics tasking conditions. There was a strong interaction between the type of AiTR unreliability and participants' perceived attentional control. Overall, for participants with higher perceived attentional control, false-alarm-prone alerts were more detrimental; for low attentional control participants, conversely, miss-prone automation was more harmful. Low spatial ability participants preferred visual cueing and high spatial ability participants favoured tactile cueing. Potential applications of the findings include personnel selection for robotics operation, robotics user interface designs and training development. The present results will provide further understanding of the interplays among automation reliability, multitasking performance and individual differences in military tasking environments. These results will also facilitate the implementation of robots in military settings and will provide useful data to military system designs.

  14. Individual versus interprofessional team performance in formulating care transition plans: A randomised study of trainees from five professional groups.

    Science.gov (United States)

    Farrell, Timothy W; Supiano, Katherine P; Wong, Bob; Luptak, Marilyn K; Luther, Brenda; Andersen, Troy C; Wilson, Rebecca; Wilby, Frances; Yang, Rumei; Pepper, Ginette A; Brunker, Cherie P

    2018-05-01

    Health professions trainees' performance in teams is rarely evaluated, but increasingly important as the healthcare delivery systems in which they will practice move towards team-based care. Effective management of care transitions is an important aspect of interprofessional teamwork. This mixed-methods study used a crossover design to randomise health professions trainees to work as individuals and as teams to formulate written care transition plans. Experienced external raters assessed the quality of the written care transition plans as well as both the quality of team process and overall team performance. Written care transition plan quality did not vary between individuals and teams (21.8 vs. 24.4, respectively, p = 0.42). The quality of team process did not correlate with the quality of the team-generated written care transition plans (r = -0.172, p = 0.659). However, there was a significant correlation between the quality of team process and overall team performance (r = 0.692, p = 0.039). Teams with highly engaged recorders, performing an internal team debrief, had higher-quality care transition plans. These results suggest that high-quality interprofessional care transition plans may require advance instruction as well as teamwork in finalising the plan.

  15. Feeling safe but appearing anxious: Differential effects of alcohol on anxiety and social performance in individuals with social anxiety disorder.

    Science.gov (United States)

    Stevens, Stephan; Cooper, Ruth; Bantin, Trisha; Hermann, Christiane; Gerlach, Alexander L

    2017-07-01

    Social anxiety disorder (SAD) and alcohol use disorders (AUD) co-occur frequently and there is preliminary evidence that alcohol might reduce social anxiety. It is, however, unclear which mechanisms contribute to the anxiety reducing effect, particularly regarding key aspects of social anxiety such as deficits in social performance. We compared self-rated and physiological measures of anxiety as well as self- and observer-rated social performance in a sample of 62 individuals with SAD and 60 nonanxious control participants during a speech task after receiving either alcohol, an alcohol-free placebo drink or orange juice. SAD patients reported more anxiety during the speech task than did control participants. Furthermore, SAD patients underestimated their performance in comparison to observer ratings. Alcohol reduced self-report anxiety only in SAD patients, while observers rated all participants as less competent when intoxicated. Although individuals with SAD experience a reduction in anxiety when drinking alcohol, simultaneous decreases in social performance might contribute to negative reactions from others and consequently increase the risk of further alcohol use to cope with these negative reactions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. The influence of age, gender and education on the performance of healthy individuals on a battery for assessing limb apraxia

    Directory of Open Access Journals (Sweden)

    Joana Mantovani-Nagaoka

    Full Text Available ABSTRACT Introduction: Apraxia is defined as a disorder of learned skilled movements, in the absence of elementary motor or sensory deficits and general cognitive impairment, such as inattention to commands, object-recognition deficits or poor oral comprehension. Limb apraxia has long been a challenge for clinical assessment and understanding and covers a wide spectrum of disorders, all involving motor cognition and the inability to perform previously learned actions. Demographic variables such as gender, age, and education can influence the performance of individuals on different neuropsychological tests. Objective: The present study aimed to evaluate the performance of healthy subjects on a limb apraxia battery and to determine the influence of gender, age, and education on the praxis skills assessed. Methods: Forty-four subjects underwent a limb apraxia battery, which was composed of numerous subtests for assessing both the semantic aspects of gestural production as well as motor performance itself. The tasks encompassed lexical-semantic aspects related to gestural production and motor activity in response to verbal commands and imitation. Results: We observed no gender effects on any of the subtests. Only the subtest involving visual recognition of transitive gestures showed a correlation between performance and age. However, we observed that education level influenced subject performance for all sub tests involving motor actions, and for most of these, moderate correlations were observed between education level and performance of the praxis tasks. Conclusion: We conclude that the education level of participants can have an important influence on the outcome of limb apraxia tests.

  17. Mental Toughness and Individual Differences in Learning, Educational and Work Performance, Psychological Well-being, and Personality: A Systematic Review.

    Science.gov (United States)

    Lin, Ying; Mutz, Julian; Clough, Peter J; Papageorgiou, Kostas A

    2017-01-01

    Mental toughness (MT) is an umbrella term that entails positive psychological resources, which are crucial across a wide range of achievement contexts and in the domain of mental health. We systematically review empirical studies that explored the associations between the concept of MT and individual differences in learning, educational and work performance, psychological well-being, personality, and other psychological attributes. Studies that explored the genetic and environmental contributions to individual differences in MT are also reviewed. The findings suggest that MT is associated with various positive psychological traits, more efficient coping strategies and positive outcomes in education and mental health. Approximately 50% of the variation in MT can be accounted for by genetic factors. Furthermore, the associations between MT and psychological traits can be explained mainly by either common genetic or non-shared environmental factors. Taken together, our findings suggest a 'mental toughness advantage' with possible implications for developing interventions to facilitate achievement in a variety of settings.

  18. Individual personality differences in goats predict their performance in visual learning and non-associative cognitive tasks.

    Science.gov (United States)

    Nawroth, Christian; Prentice, Pamela M; McElligott, Alan G

    2017-01-01

    Variation in common personality traits, such as boldness or exploration, is often associated with risk-reward trade-offs and behavioural flexibility. To date, only a few studies have examined the effects of consistent behavioural traits on both learning and cognition. We investigated whether certain personality traits ('exploration' and 'sociability') of individuals were related to cognitive performance, learning flexibility and learning style in a social ungulate species, the goat (Capra hircus). We also investigated whether a preference for feature cues rather than impaired learning abilities can explain performance variation in a visual discrimination task. We found that personality scores were consistent across time and context. Less explorative goats performed better in a non-associative cognitive task, in which subjects had to follow the trajectory of a hidden object (i.e. testing their ability for object permanence). We also found that less sociable subjects performed better compared to more sociable goats in a visual discrimination task. Good visual learning performance was associated with a preference for feature cues, indicating personality-dependent learning strategies in goats. Our results suggest that personality traits predict the outcome in visual discrimination and non-associative cognitive tasks in goats and that impaired performance in a visual discrimination tasks does not necessarily imply impaired learning capacities, but rather can be explained by a varying preference for feature cues. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. 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.

  20. Individual and contextual factors associated with community health workers' performance in Nyanza Province, Kenya: a multilevel analysis.

    Science.gov (United States)

    Kawakatsu, Yoshito; Sugishita, Tomohiko; Tsutsui, Junya; Oruenjo, Kennedy; Wakhule, Stephen; Kibosia, Kennedy; Were, Eric; Honda, Sumihisa

    2015-10-01

    Several African and South Asian countries are currently investing in new cadres of community health workers (CHWs) as a major part of strategies aimed at reaching the Millennium Development Goals. However, one review concluded that community health workers did not consistently provide services likely to have substantial effects on health and that quality was usually poor. The objective of this research was to assess the CHWs' performance in Western Kenya and describe determinants of that performance using a multilevel analysis of the two levels, individual and supervisor/community. This study conducted three surveys between August and September 2011 in Nyanza Province, Kenya. The participants of the three surveys were all 1,788 active CHWs, all their supervisors, and 2,560 randomly selected mothers who had children aged 12 to 23 months. CHW performance was generated by three indicators: reporting rate, health knowledge and household coverage. Multilevel analysis was performed to describe the determinants of that performance. The significant factors associated with the CHWs' performance were their marital status, educational level, the size of their household, their work experience, personal sanitation practice, number of supervisions received and the interaction between their supervisors' better health knowledge and the number of supervisions. A high quality of routine supervisions is one of the key interventions in sustaining a CHW's performance. In addition, decreasing the dropout rate of CHWs is important both for sustaining their performance and for avoiding the additional cost of replacing them. As for the selection criteria of new CHWs, good educational status, availability of supporters for household chores and good sanitation practices are all important in selecting CHWs who can maintain their high performance level.

  1. Individual plant examination program: Perspectives on reactor safety and plant performance. Part 6, appendices A, B, and C

    International Nuclear Information System (INIS)

    1997-12-01

    This report provides perspectives gained by reviewing 75 Individual Plant Examination (IPE) submittals pertaining to 108 nuclear power plant units. IPEs are probabilistic analyses that estimate the core damage frequency (CDF) and containment performance for accidents initiated by internal events (including internal flooding, but excluding internal fire). The U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Regulatory Research, reviewed the WE submittals with the objective of gaining perspectives in three major areas: (1) improvements made to individual plants as a result of their IPEs and the collective results of the IPE program, (2) plant-specific design and operational features and modeling assumptions that significantly affect the estimates of CDF and containment performance, and (3) strengths and weaknesses of the models and methods used in the IPEs. These perspectives are gained by assessing the core damage and containment performance results, including overall CDF, accident sequences, dominant contributions to component failure and human error, and containment failure modes. In particular, these results are assessed in relation to the design and operational characteristics of the various reactor and containment types, and by comparing the IPEs to probabilistic risk assessment characteristics. Methods, data, boundary conditions, and assumptions used in the IPEs are considered in understanding the differences and similarities observed among the various types of plants

  2. Introducing Physician Assistants to Ontario

    Directory of Open Access Journals (Sweden)

    Meredith Vanstone

    2014-02-01

    Full Text Available In 2006, the Ontario Ministry of Health and Long-Term Care (MOHLTC introduced Physician Assistants (PAs through the announcement of demonstration projects, education and training programs, and subsequent funding. PAs are directly supervised by physicians and act as physician extenders by performing acts as delegated to them by their supervising physicians. PAs were proposed as a potential solution to help improve access to health care and reduce wait times throughout the province. Prior to the 2006 Ministry announcement, there was little public discussion regarding the acceptance of the PA role or its sustainability. Opposition from nursing and other groups emerged in response to the 2006 announcement and flared again when stakeholder comments were solicited in 2012 as part of the PA application for status as regulated health professionals. As a health reform, the introduction of PAs has neither succeeded nor failed. In 2013, the majority of PA funding continues to be provided by the MOHLTC, and it is unknown whether the PA role will be sustainable when the MOHTLC withdraws salary funding and health system employers must decide whether or not to continue employing PAs at their own expense.

  3. Business plan writing for physicians.

    Science.gov (United States)

    Cohn, Kenneth H; Schwartz, Richard W

    2002-08-01

    Physicians are practicing in an era in which they are often expected to write business plans in order to acquire, develop, and implement new technology or programs. This task is yet another reminder of the importance of business principles in providing quality patient care amid allocation of increasingly scarce resources. Unfortunately, few physicians receive training during medical school, residencies, or fellowships in performing such tasks. The process of writing business plans follows an established format similar to writing a consultation, in which the risks, benefits, and alternatives to a treatment option are presented. Although administrative assistance may be available in compiling business plans, it is important for physicians to understand the rationale, process, and pitfalls of business planning. Writing a business plan will serve to focus, clarify, and justify a request for scarce resources, and thus, increase its chance of success, both in terms of funding and implementation. A well-written business plan offers a plausible, coherent story of an uncertain future. Therefore, a business plan is not merely an exercise to obtain funding but also a rationale for investment that can help physicians reestablish leadership in health care.

  4. Individual Pressure Vessel (PV) and Common Pressure Vessel (CPV) Nickel-Hydrogen Battery Performance Under LEO Cycling Conditions

    Science.gov (United States)

    Miller, Thomas B.; Lewis, Harlan L.

    2004-01-01

    LEO life cycle testing of Individual Pressure Vessel (PV) and Common Pressure Vessel (CPV) nickel-hydrogen cell packs have been sponsored by the NASA Aerospace Flight Battery Program. The cell packs have cycled under both 35% and 60% depth-of- discharge and temperature conditions of -5 C and +lO C. The packs have been on test since as early as 1992 and have generated a substantial database. This report will provide insight into performance trends as a function of the specific cell configuration and manufacturer for eight separate nickel-hydrogen battery cell packs.

  5. Team Performance and Error Management in Chinese and American Simulated Flight Crews: The Role of Cultural and Individual Differences

    Science.gov (United States)

    Davis, Donald D.; Bryant, Janet L.; Tedrow, Lara; Liu, Ying; Selgrade, Katherine A.; Downey, Heather J.

    2005-01-01

    This report describes results of a study conducted for NASA-Langley Research Center. This study is part of a program of research conducted for NASA-LARC that has focused on identifying the influence of national culture on the performance of flight crews. We first reviewed the literature devoted to models of teamwork and team performance, crew resource management, error management, and cross-cultural psychology. Davis (1999) reported the results of this review and presented a model that depicted how national culture could influence teamwork and performance in flight crews. The second study in this research program examined accident investigations of foreign airlines in the United States conducted by the National Transportation Safety Board (NTSB). The ability of cross-cultural values to explain national differences in flight outcomes was examined. Cultural values were found to covary in a predicted way with national differences, but the absence of necessary data in the NTSB reports and limitations in the research method that was used prevented a clear understanding of the causal impact of cultural values. Moreover, individual differences such as personality traits were not examined in this study. Davis and Kuang (2001) report results of this second study. The research summarized in the current report extends this previous research by directly assessing cultural and individual differences among students from the United States and China who were trained to fly in a flight simulator using desktop computer workstations. The research design used in this study allowed delineation of the impact of national origin, cultural values, personality traits, cognitive style, shared mental model, and task workload on teamwork, error management and flight outcomes. We briefly review the literature that documents the importance of teamwork and error management and its impact on flight crew performance. We next examine teamwork and crew resource management training designed to improve

  6. Box-ticking and Olympic high jumping - Physicians' perceptions and acceptance of national physician validation systems.

    Science.gov (United States)

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

    2018-05-24

    National physician validation systems aim to ensure lifelong learning through periodic appraisals of physicians' competence. Their effectiveness is determined by physicians' acceptance of and commitment to the system. This study, therefore, sought to explore physicians' perceptions and self-reported acceptance of validation across three different physician validation systems in Europe. Using a constructivist grounded-theory approach, we conducted semi-structured interviews with 32 respiratory specialists from three countries with markedly different validation systems: Germany, which has a mandatory, credit-based system oriented to continuing professional development; Denmark, with mandatory annual dialogs and ensuing, non-compulsory activities; and the UK, with a mandatory, portfolio-based revalidation system. We analyzed interview data with a view to identifying factors influencing physicians' perceptions and acceptance. Factors that influenced acceptance were the assessment's authenticity and alignment of its requirements with clinical practice, physicians' beliefs about learning, perceived autonomy, and organizational support. Users' acceptance levels determine any system's effectiveness. To support lifelong learning effectively, national physician validation systems must be carefully designed and integrated into daily practice. Involving physicians in their design may render systems more authentic and improve alignment between individual ambitions and the systems' goals, thereby promoting acceptance.

  7. Bone quality: educational tools for patients, physicians, and educators.

    Science.gov (United States)

    Shams, Junaid; Spitzer, Allison B; Kennelly, Ann M; Tosi, Laura L

    2011-08-01

    Defining bone quality remains elusive. From a patient perspective bone quality can best be defined as an individual's likelihood of sustaining a fracture. Fracture risk indicators and performance measures can help clinicians better understand individual fracture risk. Educational resources such as the Web can help clinicians and patients better understand fracture risk, communicate effectively, and make decisions concerning diagnosis and treatment. We examined four questions: What tools can be used to identify individuals at high risk for fracture? What clinical performance measures are available? What strategies can help ensure that patients at risk for fracture are identified? What are some authoritative Web sites for educating providers and patients about bone quality? Using Google, PUBMED, and trademark names, we reviewed the literature using the terms "bone quality" and "osteoporosis education." Web site legitimacy was evaluated using specific criteria. Educational Web sites were limited to English-language sites sponsored by nonprofit organizations The Fracture Risk Assessment Tool® (FRAX®) and the Fracture Risk Calculator (FRC) are reliable means of assessing fracture risk. Performance measures relating to bone health were developed by the AMA convened Physician Consortium for Performance Improvement® and are included in the Physician Quality Reporting Initiative. In addition, quality measures have been developed by the Joint Commission. Strategies for identifying individuals at risk include designating responsibility for case finding and intervention, evaluating secondary causes of osteoporosis, educating patients and providers, performing cost-effectiveness evaluation, and using information technology. An abundance of authoritative educational Web sites exists for providers and patients. Effective clinical indicators, performance measures, and educational tools to better understand and identify fracture risk are now available. The next challenge is to

  8. The C.L.E.A.R. Score: a new comprehensive assessment method for academic physicians in military medical centers.

    Science.gov (United States)

    Buller, Jerome L; Tetteh, Hassan A

    2012-07-01

    Evaluation of medical officer performance is a critical leadership role. This study offers a comprehensive evaluation system for military physicians. The Comprehensive Assessment equation (COMPASS equation), a modified Cobb-Douglas equation, was developed to evaluate academic physicians. The COMPASS equation assesses military physicians within five comprehensive dimensions: (1) Clinical (2) Leadership, (3) Educational (4) Administrative, and (5) Research productivity excellence to yield a composite "C.L.E.A.R. Score." The COMPASS equation's fidelity was tested with a cohort of military physicians within the department of Obstetrics and Gynecology in the Capital District Region and a C.L.E.A.R. score was calculated for individual physicians. Mean C.L.E.A.R score was 53.6 +/- 28.8 (range 10.1-98.5). The responsiveness of the model was tested using two hypothetical physician models: "low-performing-faculty" and "super-faculty," and calculated C.L.E.A.R. scores were 6.3 and 153.4, respectively. The C.L.E.A.R. score appears to recognize and assess the performance excellence of military physicians. Weighting measured characteristics of the COMPASS equation can be used to promote organizational priorities. Thus, leaders of military medicine can communicate institutional priorities and inculcate them through use of the COMPASS equation to reward and recognize the activities of military medical officers that are commensurate with institutional goals.

  9. Identify and Quantify the Mechanistic Sources of Sensor Performance Variation Between Individual Sensors SN1 and SN2

    Energy Technology Data Exchange (ETDEWEB)

    Diaz, Aaron A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Baldwin, David L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Cinson, Anthony D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Jones, Anthony M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Larche, Michael R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Mathews, Royce [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Mullen, Crystal A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pardini, Allan F. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Posakony, Gerald J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Prowant, Matthew S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hartman, Trenton S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Edwards, Matthew K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2014-08-06

    This Technical Letter Report satisfies the M3AR-14PN2301022 milestone, and is focused on identifying and quantifying the mechanistic sources of sensor performance variation between individual 22-element, linear phased-array sensor prototypes, SN1 and SN2. This effort constitutes an iterative evolution that supports the longer term goal of producing and demonstrating a pre-manufacturing prototype ultrasonic probe that possesses the fundamental performance characteristics necessary to enable the development of a high-temperature sodium-cooled fast reactor inspection system. The scope of the work for this portion of the PNNL effort conducted in FY14 includes performing a comparative evaluation and assessment of the performance characteristics of the SN1 and SN2 22 element PA-UT probes manufactured at PNNL. Key transducer performance parameters, such as sound field dimensions, resolution capabilities, frequency response, and bandwidth are used as a metric for the comparative evaluation and assessment of the SN1 and SN2 engineering test units.

  10. Choke or thrive? The relation between salivary cortisol and math performance depends on individual differences in working memory and math-anxiety.

    Science.gov (United States)

    Mattarella-Micke, Andrew; Mateo, Jill; Kozak, Megan N; Foster, Katherine; Beilock, Sian L

    2011-08-01

    In the current study, we explored how a person's physiological arousal relates to their performance in a challenging math situation as a function of individual differences in working memory (WM) capacity and math-anxiety. Participants completed demanding math problems before and after which salivary cortisol, an index of arousal, was measured. The performance of lower WM individuals did not depend on cortisol concentration or math-anxiety. For higher WM individuals high in math-anxiety, the higher their concentration of salivary cortisol following the math task, the worse their performance. In contrast, for higher WM individuals lower in math-anxiety, the higher their salivary cortisol concentrations, the better their performance. For individuals who have the capacity to perform at a high-level (higher WMs), whether physiological arousal will lead an individual to choke or thrive depends on math-anxiety. 2011 APA, all rights reserved

  11. General intelligence in another primate: individual differences across cognitive task performance in a New World monkey (Saguinus oedipus.

    Directory of Open Access Journals (Sweden)

    Konika Banerjee

    Full Text Available BACKGROUND: Individual differences in human cognitive abilities show consistently positive correlations across diverse domains, providing the basis for the trait of "general intelligence" (g. At present, little is known about the evolution of g, in part because most comparative studies focus on rodents or on differences across higher-level taxa. What is needed, therefore, are experiments targeting nonhuman primates, focusing on individual differences within a single species, using a broad battery of tasks. To this end, we administered a large battery of tasks, representing a broad range of cognitive domains, to a population of captive cotton-top tamarin monkeys (Saguinus oedipus. METHODOLOGY AND RESULTS: Using a Bayesian latent variable model, we show that the pattern of correlations among tasks is consistent with the existence of a general factor accounting for a small but significant proportion of the variance in each task (the lower bounds of 95% Bayesian credibility intervals for correlations between g and task performance all exceed 0.12. CONCLUSION: Individual differences in cognitive abilities within at least one other primate species can be characterized by a general intelligence factor, supporting the hypothesis that important aspects of human cognitive function most likely evolved from ancient neural substrates.

  12. The impact of health information technology and e-health on the future demand for physician services.

    Science.gov (United States)

    Weiner, Jonathan P; Yeh, Susan; Blumenthal, David

    2013-11-01

    Arguably, few factors will change the future face of the American health care workforce as widely and dramatically as health information technology (IT) and electronic health (e-health) applications. We explore how such applications designed for providers and patients will affect the future demand for physicians. We performed what we believe to be the most comprehensive review of the literature to date, including previously published systematic reviews and relevant individual studies. We estimate that if health IT were fully implemented in 30 percent of community-based physicians' offices, the demand for physicians would be reduced by about 4-9 percent. Delegation of care to nurse practitioners and physician assistants supported by health IT could reduce the future demand for physicians by 4-7 percent. Similarly, IT-supported delegation from specialist physicians to generalists could reduce the demand for specialists by 2-5 percent. The use of health IT could also help address regional shortages of physicians by potentially enabling 12 percent of care to be delivered remotely or asynchronously. These estimated impacts could more than double if comprehensive health IT systems were adopted by 70 percent of US ambulatory care delivery settings. Future predictions of physician supply adequacy should take these likely changes into account.

  13. Individual plant examination program: Perspectives on reactor safety and plant performance. Parts 2--5: Final report; Volume 2

    International Nuclear Information System (INIS)

    1997-12-01

    This report provides perspectives gained by reviewing 75 Individual Plant Examination (IPE) submittals pertaining to 108 nuclear power plant units. IPEs are probabilistic analyses that estimate the core damage frequency (CDF) and containment performance for accidents initiated by internal events. The US Nuclear Regulatory Commission (NRC) reviewed the IPE submittals with the objective of gaining perspectives in three major areas: (1) improvements made to individual plants as a result of their IPEs and the collective results of the IPE program, (2) plant-specific design and operational features and modeling assumptions that significantly affect the estimates of CDF and containment performance, and (3) strengths and weaknesses of the models and methods used in the IPEs. These perspectives are gained by assessing the core damage and containment performance results, including overall CDF, accident sequences, dominant contributions to component failure and human error, and containment failure modes. Methods, data, boundary conditions, and assumptions used in the IPEs are considered in understanding the differences and similarities observed among the various types of plants. This report is divided into three volumes containing six parts. Part 1 is a summary report of the key perspectives gained in each of the areas identified above, with a discussion of the NRC's overall conclusions and observations. Part 2 discusses key perspectives regarding the impact of the IPE Program on reactor safety. Part 3 discusses perspectives gained from the IPE results regarding CDF, containment performance, and human actions. Part 4 discusses perspectives regarding the IPE models and methods. Part 5 discusses additional IPE perspectives. Part 6 contains Appendices A, B and C which provide the references of the information from the IPEs, updated PRA results, and public comments on draft NUREG-1560 respectively

  14. Individual plant examination program: Perspectives on reactor safety and plant performance. Part 1: Final summary report; Volume 1

    International Nuclear Information System (INIS)

    1997-12-01

    This report provides perspectives gained by reviewing 75 Individual Plant Examination (IPE) submittals pertaining to 108 nuclear power plant units. IPEs are probabilistic analyses that estimate the core damage frequency (CDF) and containment performance for accidents initiated by internal events. The US Nuclear Regulatory Commission (NRC) reviewed the IPE submittals with the objective of gaining perspectives in three major areas: (1) improvements made to individual plants as a result of their IPEs and the collective results of the IPE program, (2) plant-specific design and operational features and modeling assumptions that significantly affect the estimates of CDF and containment performance, and (3) strengths and weaknesses of the models and methods used in the IPEs. These perspectives are gained by assessing the core damage and containment performance results, including overall CDF, accident sequences, dominant contributions to component failure and human error, and containment failure modes. Methods, data, boundary conditions, and assumptions used in the IPEs are considered in understanding the differences and similarities observed among the various types of plants. This report is divided into three volumes containing six parts. Part 1 is a summary report of the key perspectives gained in each of the areas identified above, with a discussion of the NRC's overall conclusions and observations. Part 2 discusses key perspectives regarding the impact of the IPE Program on reactor safety. Part 3 discusses perspectives gained from the IPE results regarding CDF, containment performance, and human actions. Part 4 discusses perspectives regarding the IPE models and methods. Part 5 discusses additional IPE perspectives. Part 6 contains Appendices A, B and C which provide the references of the information from the IPEs, updated PRA results, and public comments on draft NUREG-1560 respectively

  15. Individual plant examination program: Perspectives on reactor safety and plant performance. Parts 2--5: Final report; Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-01

    This report provides perspectives gained by reviewing 75 Individual Plant Examination (IPE) submittals pertaining to 108 nuclear power plant units. IPEs are probabilistic analyses that estimate the core damage frequency (CDF) and containment performance for accidents initiated by internal events. The US Nuclear Regulatory Commission (NRC) reviewed the IPE submittals with the objective of gaining perspectives in three major areas: (1) improvements made to individual plants as a result of their IPEs and the collective results of the IPE program, (2) plant-specific design and operational features and modeling assumptions that significantly affect the estimates of CDF and containment performance, and (3) strengths and weaknesses of the models and methods used in the IPEs. These perspectives are gained by assessing the core damage and containment performance results, including overall CDF, accident sequences, dominant contributions to component failure and human error, and containment failure modes. Methods, data, boundary conditions, and assumptions used in the IPEs are considered in understanding the differences and similarities observed among the various types of plants. This report is divided into three volumes containing six parts. Part 1 is a summary report of the key perspectives gained in each of the areas identified above, with a discussion of the NRC`s overall conclusions and observations. Part 2 discusses key perspectives regarding the impact of the IPE Program on reactor safety. Part 3 discusses perspectives gained from the IPE results regarding CDF, containment performance, and human actions. Part 4 discusses perspectives regarding the IPE models and methods. Part 5 discusses additional IPE perspectives. Part 6 contains Appendices A, B and C which provide the references of the information from the IPEs, updated PRA results, and public comments on draft NUREG-1560 respectively.

  16. Natural antioxidant ice cream acutely reduces oxidative stress and improves vascular function and physical performance in healthy individuals.

    Science.gov (United States)

    Sanguigni, Valerio; Manco, Melania; Sorge, Roberto; Gnessi, Lucio; Francomano, Davide

    2017-01-01

    The formation of reactive oxygen species (ROS) contributes to the pathogenesis and progression of several diseases. Polyphenols have been shown to be beneficial against ROS. The aim of this study was to evaluate the effects of a natural antioxidant ice cream on oxidative stress, vascular function, and physical performance. In this controlled, single-blind, crossover study, 14 healthy individuals were randomized to consume 100 g of either antioxidant ice cream containing dark cocoa powder and hazelnut and green tea extracts or milk chocolate ice cream (control ice cream). Participants were studied at baseline and 2 h after ingesting ice cream. Serum polyphenols, antioxidant status (ferric-reducing ability of plasma [FRAP]), nitric oxide (NOx) bioavailability, markers of oxidative stress (determination of reactive oxygen metabolites [d-ROMs] and hydrogen peroxide [H 2 O 2 ]), endothelium function (flow-mediated dilation [FMD] and reactive hyperemia index [RHI]), and exercise tolerance (stress test) were assessed, and the double product was measured. Serum polyphenols (P ice cream ingestion. No changes were found after control ice cream ingestion. To our knowledge, this is the first study to demonstrate that a natural ice cream rich in polyphenols acutely improved vascular function and physical performance in healthy individuals through a reduction in oxidative stress. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Combining multiple FDG-PET radiotherapy target segmentation methods to reduce the effect of variable performance of individual segmentation methods

    Energy Technology Data Exchange (ETDEWEB)

    McGurk, Ross J. [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Bowsher, James; Das, Shiva K. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Lee, John A [Molecular Imaging and Experimental Radiotherapy Unit, Universite Catholique de Louvain, 1200 Brussels (Belgium)

    2013-04-15

    Purpose: Many approaches have been proposed to segment high uptake objects in 18F-fluoro-deoxy-glucose positron emission tomography images but none provides consistent performance across the large variety of imaging situations. This study investigates the use of two methods of combining individual segmentation methods to reduce the impact of inconsistent performance of the individual methods: simple majority voting and probabilistic estimation. Methods: The National Electrical Manufacturers Association image quality phantom containing five glass spheres with diameters 13-37 mm and two irregularly shaped volumes (16 and 32 cc) formed by deforming high-density polyethylene bottles in a hot water bath were filled with 18-fluoro-deoxyglucose and iodine contrast agent. Repeated 5-min positron emission tomography (PET) images were acquired at 4:1 and 8:1 object-to-background contrasts for spherical objects and 4.5:1 and 9:1 for irregular objects. Five individual methods were used to segment each object: 40% thresholding, adaptive thresholding, k-means clustering, seeded region-growing, and a gradient based method. Volumes were co